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BEnefits of Stroke Treatment delivered using a Mobile Stroke Unit compared to standard management by emergency medical services: the BEST-MSU Study
Investigator (PI): Grotta, James
Performing Organization (PO): (Current): Memorial Hermann, Clinical Innovation and Research Institute / (713) 222-2273
(Past): Memorial Hermann Hospital-Texas Medical Center / (713) 704-4000
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2016
Final Year: 2022
Record Source/Award ID: PCORI/IHS-1511-33024
Funding: Total Award Amount: $7,997,773
Award Type: Contract
Award Information: PCORI: More information and project results (when completed)
Abstract: Stroke caused by a blocked artery in the brain is a common cause of significant disability. In the last 20 years, there has been great progress in finding effective stroke treatments. Stroke patients can now enjoy much better outcomes if they are treated with medications and catheters which open the blocked artery. One consistent and critically important finding in all studies is that this treatment works best if given very soon after stroke onset. A major problem, however, and the one that will be addressed by this project, is that treatment is necessarily delayed because evaluation and testing is first required in the emergency department to make the appropriate diagnosis and organize the treatment. This project seeks to speed treatment by moving the emergency department to the patient by placing a brain scanner and physician in an ambulance and treating the patient on-scene. Preliminary data suggests this Mobile Stroke Unit (MSU) approach is safe, speeds treatment, and may improve outcomes. Before this approach is widely adopted, however, we need to understand how much benefit will occur, measuring outcomes that are important to patients such as quality of life, dependency, and need for further medical care. This project will obtain this information in patients with strokes who call 911 and are treated in 3 representative US cities--Houston, Texas; Denver/Aurora, Colorado; and Memphis, Tennessee. We will compare outcomes on weeks when a MSU is deployed to those when a MSU is not deployed and patients receive standard management by the cities' emergency medical services (EMS). We will follow patients and their caregivers for a full year after their stroke, with interviews and evaluations every 3 months. If this study is positive, it would provide evidence to support embedding such Mobile Stroke Units in ambulance fleets throughout the country, thereby helping reduce the disabling effects of stroke for thousands of patients each year. We will engage MSU manufacturers and EMS providers to help us conduct the study, including how best to design MSUs and how best to reorganize EMS services to accommodate them. We will engage patients to help us understand their perception of this innovation and assess their outcomes. Patients will help us assign relative value to their quality of life after the stroke and identify outcomes that are important to this calculation.
MeSH Terms:
  • Ambulances
  • Catheterization
  • Colorado
  • Emergency Medical Services /*methods
  • Emergency Medicine /*methods
  • Humans
  • * Mobile Health Units
  • Outcome Assessment, Health Care
  • Quality of Life
  • Stroke /*therapy
  • Tennessee
  • Texas
Country: United States || United States
State: Texas || Texas
Zip Code: 77030 / 77030
UI: 20164084
CTgovId: NCT02190500
Project Status: Ongoing
Record History: ('2018: Project extended to 2022',) ('2020: PO changed',)