治疗急性中风的远程医疗网络:对全球覆盖范围、差距和机遇的分析。

IF 6.3 2区 医学 Q1 CLINICAL NEUROLOGY International Journal of Stroke Pub Date : 2024-10-26 DOI:10.1177/17474930241298450
Christine Tunkl, Ayush Agarwal, Emily Ramage, Faddi Saleh Velez, Tamer Roushdy, Teresa Ullberg, Linxin Li, Leonardo Augusto Carbonera, Abdul Hanif Khan Yusof Khan, Bogdan Ciopleias, Zhe Kang Law, Aristeidis H Katsanos, Mirjam R Heldner, Maria Khan, Sarah Shali Matuja, Matias J Alet, Javier Lagos-Servellon, Jatinder S Minhas, Susanna Zuurbier, Maria Giulia Mosconi, Radhika Lotlikar, Ahmed Elkady, Stefan T Gerner, Shirsho Shreyan, Alexandra Krauss, Christoph Gumbinger, Padma Mv Srivastava, Pawel Kiper, Robin Ohannessian, Anne Berberich, Gisele Sampaio Silva, Anna Ranta
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引用次数: 0

摘要

背景:目的:我们旨在绘制全球远程卒中地图并描述现有网络的特征:方法:我们采用了四层方法来全面识别远程卒中网络,主要涉及国家卒中专家、卒中协会和国际卒中权威机构。然后,我们向所有已确定网络的领导者发放了一份精心设计的调查问卷,以评估这些网络的结构、流程和结果:结果:我们确定了分布在 67 个国家的 254 个远程卒中网络。高收入国家(HICs)集中了 175 个网络(69%)。58个国家(30%)没有发现远程卒中服务。在已确定的网络中,有 88 个(34%)完成了调查,其中 61 个(71%)位于高收入国家。网络设置的差异很大,有 17 个(22%)网络拥有 20 多家附属医院,使用专门设计的高度专业化技术,每年提供数千次会诊;也有 11 个(13%)网络使用普通视频会议设备,每年提供少于 120 次会诊。有 64 个(75%)网络采用了实时视频和图像传输技术,62 个(74%)网络进行了质量监控。过去三年中建立的大多数网络都位于中低收入国家(LMICs):这项关于远程卒中网络的全球综合调查发现,在网络覆盖、设置和技术使用方面存在很大差异。大多数服务在高收入国家,很少有服务在低收入国家,尽管这些地区新网络的出现标志着全球远程卒中医疗的关键时刻。不同网络的质量监测方法差异很大,许多网络没有报告关键的绩效指标,这突出表明迫切需要标准化的、适合资源的质量保证措施,以适应不同的环境。
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Telemedicine networks for acute stroke: an analysis of global coverage, gaps and opportunities.

Background: Despite the proven efficacy of telestroke in improving clinical outcomes by providing access to specialized expertise and allowing rapid expert hyperacute stroke management and decision-making, detailed operational evidence is scarce, especially for less developed or lower - income regions.

Aim: We aimed to map the global telestroke landscape and characterize existing networks.

Methods: We employed a four-tiered approach to comprehensively identify telestroke networks, primarily involving engagement with national stroke experts, stroke societies, and international stroke authorities. A carefully designed questionnaire was then distributed to the leaders of all identified networks to assess these networks' structures, processes, and outcomes.

Results: We identified 254 telestroke networks distributed across 67 countries. High-income countries (HICs) concentrated 175 (69%) of the networks. No evidence of telestroke services was found in 58 (30%) countries. From the identified networks, 88 (34%) completed the survey, being 61 (71%) located in HICs. Network set-up was highly heterogenous, ranging from 17 (22%) networks with more than twenty affiliated hospitals, providing thousands of annual consultations using purpose-built highly specialized technology, to 11 (13%) networks with fewer than 120 consultations annually using generic videoconferencing equipment. Real-time video and image transfer was employed in 64 (75%) networks, while 62 (74%) conducting quality monitoring. Most networks established in the last three years were located in low- and middle-income countries (LMICs).

Conclusions: This comprehensive global survey of telestroke networks found significant variation in network coverage, set-up, and technology use. Most services are in HICs, and few services are in LMICs, although an emerging trend of new networks in these regions marks a pivotal moment in global telestroke care. The wide variation in quality monitoring practices across networks, with many failing to report key performance metrics, underscores the urgent need for standardized, resource-appropriate quality assurance measures that can be adapted to diverse settings.

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来源期刊
International Journal of Stroke
International Journal of Stroke 医学-外周血管病
CiteScore
13.90
自引率
6.00%
发文量
132
审稿时长
6-12 weeks
期刊介绍: The International Journal of Stroke is a welcome addition to the international stroke journal landscape in that it concentrates on the clinical aspects of stroke with basic science contributions in areas of clinical interest. Reviews of current topics are broadly based to encompass not only recent advances of global interest but also those which may be more important in certain regions and the journal regularly features items of news interest from all parts of the world. To facilitate the international nature of the journal, our Associate Editors from Europe, Asia, North America and South America coordinate segments of the journal.
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