AI Decision Support for Stroke Treatment(NOT RECOVERY!)

 

This is the whole problem in stroke enumerated in one word; 'care' and 'treatment'; NOT RECOVERY! 

Our non-existent stroke leadership should be demanding RECOVERY NOT 'CARE'!

My god, anyone in the business world would be fired immediately for managing or caring about something rather than delivering RESULTS. And this is why this is a complete fucking failure! This does nothing to guarantee recovery for survivors!

If your stroke medical 'professional'/hospital is touting 'care' it means they are a failure because they are delivering 'care'; NOT RECOVERY! I would never go to a failed hospital! Anytime I see the word 'care' associated with a stroke hospital; I immediately think fucking failure!

YOU have to get involved and change this failure mindset of 'care' to 100% RECOVERY! Survivors want RECOVERY, NOT 'CARE'!

I see nothing here that states going for 100% recovery! You need to create EXACT PROTOCOLS FOR THAT!

ASK SURVIVORS WHAT THEY WANT, THEY'LL NEVER RESPOND 'CARE' OR 'TREATMENT'! This tyranny of low expectations has to be completely rooted out of any stroke conversation! I wouldn't go there because of such incompetency as not having 100% recovery protocols!

RECOVERY IS THE ONLY GOAL IN STROKE!

GET THERE!

AI Decision Support for Stroke Treatment

And finally then, remaining in The Lancet, this study taking a look at artificial intelligence imaging decision support for acute stroke treatment in England. We've talked about many times that endovascular thrombectomy is the standard of care(NOT RECOVERY!) with patients who have large vessel occlusion stroke. What these folks wanted to see was, can artificial intelligence imaging software used to support the identification of this particular subset of strokes and the selection of patients who would then go on for thrombectomy, is that helpful?

They were looking at data from stroke units in England's National Health Service and all patients 16 years of age and older who were admitted to the hospital with a primary diagnosis of stroke were collected. That endovascular thrombectomy rates and inter-hospital transfer times, and this is a really important fact, for all 107 National Health Service hospitals admitting patients with acute stroke in England were included in this from January 2019 through December 2023. They had patient-level data available for 71,000+ patients with ischemic stroke during this time period.

And what they showed was that before they implemented the AI-driven software to help with this identification of these patients, their endovascular thrombectomy rate was 2.3% in evaluation sites and the post-implementation rate was 4.6%. For the non-evaluation sites among these hospitals, the pre-implementation rate was 1.6% and it improved to a post-implementation rate of 2.6%. Lots more folks who were eligible to have endovascular thrombectomy were able to undergo this as a result of using this AI imaging software.

I just have to note that I was chagrined by these numbers that still they were only having just less than 5% of these folks who were eligible having this intervention. Here in the U.S. actually, when we take a look at folks who have a stroke that would be eligible for this intervention, we're still only looking at less than 10% of them getting it. Gosh, I hope AI can help.

Rick: So Elizabeth, the percentage of individuals that actually present with large vessel occlusion is actually relatively small. Secondly is you have to present with a certain time window and that's why this particular study is important. In the U.K., there were 107 hospitals that admit people with strokes. There's only 20 that are considered to be primary stroke and only 6 that are comprehensive that actually offer thrombectomy. So you need to identify those individuals quickly and correctly, then get them transferred to a center. And the use of AI decreased the time from when the patient came to the hospital to when they got transferred out by an hour. And that's the great value of AI, particularly when you have a hub-and-spoke way for treating strokes as they do in the United Kingdom.

Elizabeth: And I would also say it sure looks like there's plenty of room for improvement and I hope that AI is able to inform that.

Rick: Yep, and so I would say it's not just unique to the United Kingdom, but we have a hub-and-spoke way of treating strokes here in the United States as well, where there are comprehensive stroke centers that we need to get people to quickly when they present to an outlying hospital, so they can have the best therapy as quickly as possible.