This means we could get away from needing neurologists and no longer have misdiagnoses. Both excellent outcomes if we could get stroke leadership to drive these results.
http://www.nihr.ac.uk/news/chipping-away-at-stroke/5509
Stroke is the fourth single leading cause of death in the UK, with
more than 100,000 strokes occurring each year. That is around one stroke
every five minutes, according to recently published statistics by the Stroke Association. Stroke can also leave people severely disabled.
Even though stroke has become a common condition worldwide - every
two seconds, someone in the world will have a stroke - it can still be
difficult to diagnose.
A biosensor, called SMARTchip, has been designed to detect whether a
person has had a stroke or not. The development of the SMARTchip has
been led by Professor Nicholas Dale from Warwick University. The
clinical trial aspect of the study has been led by Professor
Chris Imray at University Hospitals Coventry and Warwickshire NHS Trust.
Professor Christine Roffe, NIHR Clinical Research Network (CRN)
Stroke Specialty Lead for West Midlands, explains: “The biosensor is
trying to identify an increase in the level of purines in the blood, as
it is believed to be an indicator of a stroke.”
Professor Roffe, who has been part of the research team to assess its
effectiveness, said: “One third of all stroke patients are mimics. For
example, some patients present to hospital with stroke symptoms, but are
in fact suffering from migraine.
“The
SMARTchip has the potential to speed up diagnosis and reduce doubt, by
supporting our clinical diagnostic skills and other tests. It is vital
to act fast. Any indecision can increase the time it takes to assess the
best course of action.
“However, it can even be hard for a stroke physician to decide
whether a patient has had a stroke or mimic, especially in young people.
If there is ever indecision you treat them as if they have had a
stroke, as you don’t want to wait or treat them for mimic, which could
potentially ruin someone’s life.
“Although if people suffering from a mimic are treated as though they
have had a stroke that creates major capacity issues for hospitals.”
Professor Roffe, stroke medicine lead at University Hospitals of
North Midlands NHS Trust, added: “The stress of making these decisions
is all worth it when you see patients walk out the next day.”
In 2013, the project received a £471,000 grant from the NIHR Invention for Innovation Programme.
Professor Roffe first met Professor Dale at the CRN Stroke meeting.
She said: “Nick attended the meeting to present his research idea and
receive feedback from stroke research experts. It seemed to be a
worthwhile study and as I’m the lead in West Midlands, I agreed to
support Nick with the grant proposal, for which I became a co-applicant.
I also set up the clinical protocol for the study.”
The SMARTchip started out life as a SMARTcap, which was a vial with a
biosensor inside. This was further developed into the smaller
SMARTchip. Professor Roffe said: “It just requires a pinprick of blood
to be put on the biosensor, which is then put into a machine to measure
the levels of purines - this has been a much more reliable tool for
reading the blood sample. As it only requires a small blood sample it
reduces the chance of haemolysis, which is the rupturing of red blood
cells releasing their contents into surrounding fluid, which can
increase the level of purines.”
The support provided by the CRN was important to this study, as Dr
Roffe explains: “You can’t run a study like this without the
infrastructure and research nurses support the Network provides. This
enabled us to deliver the study over three different sites across
England.
“The research nurses were key, as they identified appropriate patients and recruited them straight away.”
Norman Phillips, who suffered a stroke in 2003, has been involved
with the study from the very beginning and even attended the NIHR
funding meeting.
Norman, 68 from Coventry, said: “I’ve helped with several studies
over the past few years. With the SMARTchip study I read through the
protocols from a public perspective to make sure it made sense and
thought about its impact on real people.
“Research documents often contain scientific language, which the
public don’t need to see, so I suggest language that people will
understand.
“Also from my experience I have questions and thoughts about the study that the researchers may not have thought of.”
Professor Roffe said: “Norman certainly keeps us on our toes and reminds us all why we are here, which gives us a real drive.”
The trial is in the last phase of recruitment, which will end in
March 2017. The data will then be analysed and a report produced for the
NIHR Invention for Innovation committee.
Professor Roffe added: “The next stage will be undertake further
research to see how and where it could be used clinically for stroke.
The hope is that they would be rolled out in ambulances to speed up
diagnosis. Also to find out what other conditions the biosensor could
identify.”
An article was recently published in The Observer about the SMARTchip study.
University Hospitals Coventry and Warwickshire NHS Trust is also the study sponsor.
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