Prehospital unassisted assessment of stroke severity using telemedicine: a feasibility study

Stroke. 2013 Oct;44(10):2907-9. doi: 10.1161/STROKEAHA.113.002079. Epub 2013 Aug 6.

Abstract

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.

Keywords: acute; diagnostic methods; stroke; stroke management; telemedicine.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Ambulances / standards
  • Humans
  • Internet / instrumentation*
  • Male
  • Middle Aged
  • Severity of Illness Index*
  • Software*
  • Stroke / diagnosis*
  • Stroke / physiopathology*
  • Telemedicine* / instrumentation
  • Telemedicine* / methods