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DOI: 10.1148/radiol.2283021557
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Stroke: Effect of Implementing an Evaluation and Treatment Protocol Compliant with NINDS Recommendations1

James E. Stahl, MD, CM, MPH, Karen L. Furie, MD, Suzanne Gleason, PhD and G. Scott Gazelle, MD, MPH, PhD

1 From the Institute for Technology Assessment (J.E.S.) and Departments of Radiology (J.E.S., G.S.G.), Medicine (J.E.S.), and Neurology (K.L.F.), Massachusetts General Hospital, Harvard Medical School, Zero Emerson Bldg, Suite 2H, Boston, MA 02114; and Department of Economics, Trinity College, Hartford, Conn (S.G.). Received November 25, 2002; revision requested February 4, 2003; revision received March 31; accepted April 10. Supported in part by the U.S. Department of the Army with DAMD 17-99-2-9001. Address correspondence to J.E.S. (e-mail: james@mgh-ita.org).



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  		Figure 1. Flowchart shows timing of events in current practice and in proposed NINDS recommendation-compliant strategy. * = start of in-hospital evaluation and management, ED = emergency department, EMS = emergency medical services, EP = emergency medicine physician.

 


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  		Figure 2. Flowchart shows stroke evaluation and management model. CAT Scan = CT scanning, N = no, Y = yes.

 


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  		Figure 3. Graph shows average QALYs (for 10,000 patients presenting with stroke symptoms) versus number of patients competing for CT per day.

 


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  		Figure 4. Graph shows time from emergency arrival to treatment for patients with stroke versus number of patients competing for CT per day.

 




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