VISIT STROKE: non-inferiority of telemedicine-based neurological consultation for post-acute stroke patients - protocol of a prospective observational controlled multi-center study

• Main Authors: Juliane Herm (Author), Hebun Erdur (Author), Annette Aigner (Author), Johannes Hengelbrock (Author), Anselm Angermaier (Author), Agnes Flöel (Author), Annegret Hille (Author), Claudia Gorski (Author), Stephan Kinze (Author), Ingo Schmehl (Author), Gordian J. Hubert (Author), Hanni Wiestler (Author), Timo Siepmann (Author), Martin Arndt (Author), Christoph Gumbinger (Author), Miriam Heyse (Author), Joachim E. Weber (Author), Heinrich J. Audebert (Author), for the ANNOTeM-network (Author)
• Format: Book
• Published: BMC, 2024-10-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.1186/s12913-024-11651-3; 1472-6963
• Keywords: Stroke; Telemedicine; Tele-stroke; Tele-visitation; Stroke unit; Post-acute stroke management; Public aspects of medicine; RA1-1270
• Source: BMC Health Services Research, Vol 24, Iss 1, Pp 1-5 (2024)

Abstract Background Telemedicine provides specialized medical expertise in underserved areas where neurological expertise is frequently not available on a daily basis for hospitalized stroke patients. While tele-consultations are well established in acute stroke assessment, the value of telemedicine-based ward-rounds in the subsequent in-patient stroke management is unknown. Methods Four telemedicine stroke networks in Germany, implemented in eight out of 16 federal states, participate in this prospective observational multi-center study. We plan to enroll 523 patients hospitalized due to acute (suspected or confirmed) stroke or transient ischemic attack. Each recruited patient will receive both a tele-consultation and an on-site consultation at the same day within the first three days after hospital admission. We will test non-inferiority of telemedicine-based assessments in ward-rounds in terms of quality of medical assessment and recommendations for hospitalized stroke patients. The correctness of the medical assessment and recommendation is defined as positive evaluation (binary, correct vs. in-correct) of six out of six predefined quality indicators by at least two out of three blinded independent raters. The non-inferiority margin for the difference in proportions of correct assessments is set to 5%-points. Discussion If non-inferiority of telemedicine-based ward-rounds compared to on-site ward-rounds by a neurologist were demonstrated, telemedicine-based neurological consultation for post-acute stroke patients may contribute to deliver evidence-based high-quality stroke care more easily in underserved regions. Trial registration DRKS - DRKS00028671 ( https://drks.de/search/de/trial/DRKS00028671 ; registration date 09-27-2022).