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Prehospital unassisted assessment of stroke severity using telemedicine: a feasibility study
Robbert-Jan Van Hooff1, Melissa Cambron, Rita Van Dyck
1From the Department of Neurology (R.-J.V.H., M.C., R.V.D., A.D.S., J.D.K., R.B.), Department of Neurosurgery (M.M.), and Department of Emergency Medicine (I.H.), Universitair Ziekenhuis Brussel, Brussels, Belgium; Center for Neurosciences (R.-J.V.H., M.C., A.D.S., M.M., A.V.E., A.C., J.D.K., R.B.), and Research Group on Emergency and Disaster Medicine Brussels (I.H.), Vrije Universiteit Brussel (VUB), Brussels, Belgium; Flanders District of Creativity, Leuven, Belgium (R.V.d.C.); and Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands (J.D.K.).
Background And Purpose:
We evaluated the feasibility and the reliability of remote stroke severity quantification in the prehospital setting using the Unassisted TeleStroke Scale (UTSS) via a telestroke ambulance system and a fourth-generation mobile network.
Methods:
The technical feasibility and the reliability of the UTSS were studied in healthy volunteers mimicking 41 stroke syndromes during ambulance transportation.
Results:
Except for 1 issue, high-quality telestroke assessment was feasible in all scenarios. The mean examination time for the UTSS was 3.1 minutes (SD, 0.4). The UTSS showed excellent intrarater and interrater variability (ρ=0.98 and 0.97; P<0.001), as well as excellent internal consistency and rater agreement. Adequate concurrent validity can be derived from the strong correlation between the UTSS and the National Institutes of Health Stroke Scale (ρ=0.90; P<0.001).
Conclusions:
Remote assessment of stroke severity in fast-moving ambulances using a system dedicated to prehospital telemedicine, 4G technology, and the UTSS is feasible and reliable.