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Pre-hospital LVO detection: One size does not fit all.

Christopher G Favilla1, Michael T Mullen2, Soren Konecky3

  • 1Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA.

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Summary

New methods for detecting large vessel occlusion (LVO) in prehospital settings allow flexible threshold adjustments. This optimizes sensitivity or specificity, improving care for diverse emergency medical systems.

Keywords:
Acute ischemic strokebiomedical opticsendovascular thrombectomylarge vessel occlusionprehospital LVO detectionstroke detection

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Area of Science:

  • Biomedical Engineering
  • Emergency Medicine
  • Medical Imaging

Background:

  • Prehospital detection of large vessel occlusion (LVO) relies on techniques yielding continuous data.
  • Current methods apply a single, mathematically optimal threshold for binary LVO classification.
  • This one-size-fits-all approach may not balance false negatives and false positives effectively for all prehospital systems.

Purpose of the Study:

  • To demonstrate a flexible thresholding approach for prehospital LVO detection.
  • To show how optical blood flow imaging can be titrated for sensitivity or specificity.
  • To provide adaptable LVO detection options for diverse prehospital environments.

Main Methods:

  • Utilizing optical blood flow imaging, a novel technique for physiologic data acquisition.
  • Applying adjustable thresholds to the continuous output of optical blood flow imaging.
  • Evaluating the ability to tailor thresholds to favor sensitivity or specificity.

Main Results:

  • Optical blood flow imaging allows for straightforward titration of detection thresholds.
  • Thresholds can be adjusted to prioritize either high sensitivity or high specificity.
  • This adaptability offers tailored solutions for specific prehospital care needs.

Conclusions:

  • Flexible thresholding offers a significant advantage over single-threshold approaches for prehospital LVO detection.
  • Optical blood flow imaging provides a practical platform for implementing such adaptable detection strategies.
  • Optimizing thresholds can lead to more effective and context-appropriate LVO identification in emergency medical services.