Discrepancies between current and ideal endovascular stroke treatment practice in Europe and North America: Results from UNMASK EVT, a multidisciplinary survey.

Ospel, Johanna M; Kashani, Nima; Turjman, Francis; Fischer, Urs; Baxter, Blaise; Rabinstein, Alejandro; Coutts, Sheilagh; Menon, Bijoy K; Almekhlafi, Mohammed; Hill, Michael D; Saposnik, Gustavo; Goyal, Mayank (2020). Discrepancies between current and ideal endovascular stroke treatment practice in Europe and North America: Results from UNMASK EVT, a multidisciplinary survey. Interventional neuroradiology, 26(4), pp. 420-424. Sage Publications 10.1177/1591019920908131

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BACKGROUND

Since 2015, endovascular therapy has been established as a standard of care for acute stroke. This has caused major challenges regarding the organization of systems of care, which have to meet the increasing demand for thrombectomies. This study aims to evaluate how endovascular therapy decisions made by European and North American physicians under their current local resources differ from those made under assumed ideal conditions.

METHODS

In an international, multidisciplinary survey, physicians involved in acute stroke care were asked to give their treatment decisions to 10 out of 22 randomly assigned stroke case-scenarios. Participants stated (a) their treatment approach under assumed ideal conditions (without any external limitations) and (b) the treatment they would pursue under their current local resources. Resources gaps (ideal minus current endovascular therapy rates) were calculated for different countries/states/provinces and correlated to economic and healthcare key metrics (gross domestic product-per-capita, public or private health insurance coverage, etc.).

RESULTS

A total of 607 physicians, among them 218 from North America and 136 from 25 European countries, responded to the survey. Resources gaps in the majority of North American states/provinces and European countries were small (<5%). The highest gaps were observed among few European countries, namely Poland (30%) and the United Kingdom (33%). The magnitude of the resources gap did not correlate to national economic or healthcare metrics.

DISCUSSION AND CONCLUSION

In the majority of North American states/provinces and European countries covered in this study, the discrepancy between endovascular therapy decisions under current local resources and assumed ideal conditions seems to be small, even in countries with a limited economic status and healthcare infrastructure.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Fischer, Urs

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1591-0199

Publisher:

Sage Publications

Language:

English

Submitter:

Chantal Kottler

Date Deposited:

07 Jul 2020 16:05

Last Modified:

16 Aug 2020 01:33

Publisher DOI:

10.1177/1591019920908131

PubMed ID:

32077353

Uncontrolled Keywords:

Endovascular therapy ischemic stroke stroke systems of care thrombectomy

BORIS DOI:

10.7892/boris.145019

URI:

https://boris.unibe.ch/id/eprint/145019

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