Maybe these 17 diagnosis possibilities to find out which one is the best? Or maybe the Qualcomm Xprize for the tricorder?
These people are only thinking of what is currently capable rather than what the best solution is and figure out a way to get there. They are stuck in the past just like your doctor who hasn't read a single research article since medical school. You don't want these people anywhere near you.
http://stroke.ahajournals.org/content/early/2017/01/18/STROKEAHA.116.015321
Abstract
Background and Purpose—There
is uncertainty regarding the best way for patients outside of
endovascular-capable or Comprehensive Stroke Centers (CSC) to access
endovascular treatment for acute ischemic stroke. The role of the
nonendovascular-capable Primary Stroke Centers (PSC) that can offer
thrombolysis with alteplase but not endovascular treatment is unclear. A
key question is whether average benefit is greater with early
thrombolysis at the closest PSC before transportation to the CSC (Drip
‘n Ship) or with PSC bypass and direct transport to the CSC
(Mothership). Ideal transportation options were mapped based on the
location of their endovascular-capable CSCs and nonendovascular-capable
PSCs.
Methods—Probability
models for endovascular treatment were developed from the ESCAPE
trial’s (Endovascular Treatment for Small Core and Anterior Circulation
Proximal Occlusion With Emphasis on Minimizing CT to Recanalization
Times) decay curves and for alteplase treatment were extracted from the
Get With The Guidelines decay curve. The time on-scene,
needle-to-door-out time at the PSC, door-to-needle time at the CSC, and
door-to-reperfusion time were assumed constant at 25, 20, 30, and 115
minutes, respectively. Emergency medical services transportation times
were calculated using Google’s Distance Matrix Application Programming
Interface interfaced with MATLAB’s Mapping Toolbox to create map
visualizations.
Results—Maps
were generated for multiple onset-to-first medical response times and
door-to-needle times at the PSCs of 30, 60, and 90. These figures
demonstrate the transportation option that yields the better modeled
outcome in specific regions. The probability of good outcome is shown.
Conclusions—Drip
‘n Ship demonstrates that a PSC that is in close proximity to a CSC
remains significant only when the PSC is able to achieve a
door-to-needle time of ≤30 minutes when the CSC is also efficient. (DTN<30 minutes is pathetic, it should be negative, figure out a way to get there.)
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