WHAT FUCKING BULLSHIT! Survivors want RECOVERY AND RESULTS not 'access'. The fucking tyranny of low expectations assuming that survivors want 'access' needs to stop. Talk to survivors sometime! I'd fire all of you for not understanding what survivors want!
I expect every single stroke leader wants to tell me exactly where I'm wrong. Here's my email address; oc1dean@gmail.com; tell me where I'm wrong, I'll publish it all! Are you fucking scared to contact me?
The MAPSTROKE project: a Computational Strategy to Improve Access to Acute Stroke Care
Abstract
Background:
Global
access to acute stroke treatment is variable worldwide, with notable
gaps in low and middle-income countries (LMIC), especially in rural
areas. Ensuring a standardized method for pinpointing the existing
regional coverage and proposing potential sites for new stroke centers
is essential to change this scenario.
Aims:
To
create and apply computational strategies (CS) to determine optimal
locations for new Acute Stroke Centers (ASCs), with a pilot application
in nine Latin-American regions/countries.
Methods:
Hospitals
treating Acute Ischemic Stroke (AIS) with intravenous thrombolysis
(IVT) and meeting the minimum infrastructure requirements per structured
protocols were categorized as ASCs. Hospitals with emergency
departments, non-contrast CT scanners, and 24/7 laboratories were
identified as Potential Acute Stroke Centers (PASCs). Hospital
geolocation data were collected and mapped using the OpenStreetMap®
dataset. A 45-minute drive radius was considered the ideal coverage area
for each hospital based on the drive speeds from the OpenRouteService®
database. Population data, including demographic density, was obtained
from the Kontur Population® datasets. The proposed CS assessed the
population covered by ASCs and proposed new ASCs or artificial points
(APs) settled in densely populated areas to achieve a target population
coverage (TPC) of 95%.
Results:
The
observed coverage in the region presented significant disparities,
ranging from 0% in the Bahamas to 73.92% in Trinidad and Tobago. No
country/region reached the 95% TPC using only its current ASCs or PASCs,
leading to the proposal of APs. For example, in Rio Grande do Sul,
Brazil, the introduction of 132 new centers was suggested. Furthermore,
It was observed that most ASCs were in major urban hubs or university
hospitals, leaving rural areas largely underserved.
Conclusions:
The
MAPSTROKE project has the potential to provide a systematic approach to
identify areas with limited access to stroke centers and propose
solutions for increasing access to AIS treatment.
Data Access Statement:
Data used for this publication are available from the authors upon reasonable request.
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