Does the Primary Imaging Modality-Computed Tomography or Magnetic Resonance Imaging-Influence Stroke Physicians' Certainty on Whether or Not to Give Thrombolysis to Randomized Acute Stroke Patients?

Research output: Contribution to journalJournal articleResearchpeer-review

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Does the Primary Imaging Modality-Computed Tomography or Magnetic Resonance Imaging-Influence Stroke Physicians' Certainty on Whether or Not to Give Thrombolysis to Randomized Acute Stroke Patients? / Hansen, Christine Krarup; Christensen, Anders; Rodgers, Helen; Havsteen, Inger; Kruuse, Christina; Christensen, Hanne.

In: Journal of Stroke & Cerebrovascular Diseases, Vol. 27, No. 4, 04.2018, p. 926-935.

Research output: Contribution to journalJournal articleResearchpeer-review

Harvard

Hansen, CK, Christensen, A, Rodgers, H, Havsteen, I, Kruuse, C & Christensen, H 2018, 'Does the Primary Imaging Modality-Computed Tomography or Magnetic Resonance Imaging-Influence Stroke Physicians' Certainty on Whether or Not to Give Thrombolysis to Randomized Acute Stroke Patients?', Journal of Stroke & Cerebrovascular Diseases, vol. 27, no. 4, pp. 926-935. https://doi.org/10.1016/j.jstrokecerebrovasdis.2017.10.035

APA

Hansen, C. K., Christensen, A., Rodgers, H., Havsteen, I., Kruuse, C., & Christensen, H. (2018). Does the Primary Imaging Modality-Computed Tomography or Magnetic Resonance Imaging-Influence Stroke Physicians' Certainty on Whether or Not to Give Thrombolysis to Randomized Acute Stroke Patients? Journal of Stroke & Cerebrovascular Diseases, 27(4), 926-935. https://doi.org/10.1016/j.jstrokecerebrovasdis.2017.10.035

Vancouver

Hansen CK, Christensen A, Rodgers H, Havsteen I, Kruuse C, Christensen H. Does the Primary Imaging Modality-Computed Tomography or Magnetic Resonance Imaging-Influence Stroke Physicians' Certainty on Whether or Not to Give Thrombolysis to Randomized Acute Stroke Patients? Journal of Stroke & Cerebrovascular Diseases. 2018 Apr;27(4):926-935. https://doi.org/10.1016/j.jstrokecerebrovasdis.2017.10.035

Author

Hansen, Christine Krarup ; Christensen, Anders ; Rodgers, Helen ; Havsteen, Inger ; Kruuse, Christina ; Christensen, Hanne. / Does the Primary Imaging Modality-Computed Tomography or Magnetic Resonance Imaging-Influence Stroke Physicians' Certainty on Whether or Not to Give Thrombolysis to Randomized Acute Stroke Patients?. In: Journal of Stroke & Cerebrovascular Diseases. 2018 ; Vol. 27, No. 4. pp. 926-935.

Bibtex

@article{66005e4a2f4d40a392f2fc3d701bad68,
title = "Does the Primary Imaging Modality-Computed Tomography or Magnetic Resonance Imaging-Influence Stroke Physicians' Certainty on Whether or Not to Give Thrombolysis to Randomized Acute Stroke Patients?",
abstract = "BACKGROUND: Door-to-needle time of 20 minutes to stroke patients with intravenous tissue plasminogen activator (iv-tPA) is feasible when computed tomography (CT) is used as first-line of brain imaging. Magnetic resonance imaging (MRI)-based assessment is more time-consuming but superior in detecting acute ischemia. The certainty with which stroke physicians prescribe or refrain from giving iv-tPA treatment to CT- versus MRI-examined patients has not previously been studied. The aim of the present study was to determine the effect of a primary imaging strategy of CT or MRI on clinicians' certainty to prescribe or refrain from giving iv-tPA to patients with suspected acute stroke.METHOD: Consecutive patients with suspected stroke were quasi-randomized to either CT- or MRI-based assessment before potential iv-tPA treatment. The influence of (1) the clinical findings and (2) the image findings, and (3) the certainty with which the stroke physician prescribed or refrained from giving iv-tPA treatment were assessed with visual analog scales (VAS). Predictors of treatment certainty were identified with a random-effect model.RESULTS: Four-hundred forty-four consecutive patients were quasi-randomized. MRI influenced the final treatment decision more than CT (P = .002). Compared with CT-examined patients (mean VAS score 8.6, SD ±1.6) stroke physicians were significantly more certain when prescribing or refraining from giving iv-tPA to MRI-examined patients (mean VAS score 9.0, SD ±1.2) (P = .014). No differences in modified Rankin scale or mortality were detected at 3 months in CT- versus MRI-examined iv-tPA-treated patients.CONCLUSIONS: Stroke physicians were significantly more certain when prescribing iv-tPA to MRI-examined stroke patients, and MRI influences the final treatment decision significantly more compared with CT, although no difference in mortality and functional outcome at 3 months was detected between CT- and MRI-examined patients treated with iv-tPA.",
author = "Hansen, {Christine Krarup} and Anders Christensen and Helen Rodgers and Inger Havsteen and Christina Kruuse and Hanne Christensen",
note = "Copyright {\circledC} 2018 National Stroke Association. All rights reserved.",
year = "2018",
month = "4",
doi = "10.1016/j.jstrokecerebrovasdis.2017.10.035",
language = "English",
volume = "27",
pages = "926--935",
journal = "Journal of Stroke & Cerebrovascular Diseases",
issn = "1052-3057",
publisher = "W.B.Saunders Co.",
number = "4",

}

RIS

TY - JOUR

T1 - Does the Primary Imaging Modality-Computed Tomography or Magnetic Resonance Imaging-Influence Stroke Physicians' Certainty on Whether or Not to Give Thrombolysis to Randomized Acute Stroke Patients?

AU - Hansen, Christine Krarup

AU - Christensen, Anders

AU - Rodgers, Helen

AU - Havsteen, Inger

AU - Kruuse, Christina

AU - Christensen, Hanne

N1 - Copyright © 2018 National Stroke Association. All rights reserved.

PY - 2018/4

Y1 - 2018/4

N2 - BACKGROUND: Door-to-needle time of 20 minutes to stroke patients with intravenous tissue plasminogen activator (iv-tPA) is feasible when computed tomography (CT) is used as first-line of brain imaging. Magnetic resonance imaging (MRI)-based assessment is more time-consuming but superior in detecting acute ischemia. The certainty with which stroke physicians prescribe or refrain from giving iv-tPA treatment to CT- versus MRI-examined patients has not previously been studied. The aim of the present study was to determine the effect of a primary imaging strategy of CT or MRI on clinicians' certainty to prescribe or refrain from giving iv-tPA to patients with suspected acute stroke.METHOD: Consecutive patients with suspected stroke were quasi-randomized to either CT- or MRI-based assessment before potential iv-tPA treatment. The influence of (1) the clinical findings and (2) the image findings, and (3) the certainty with which the stroke physician prescribed or refrained from giving iv-tPA treatment were assessed with visual analog scales (VAS). Predictors of treatment certainty were identified with a random-effect model.RESULTS: Four-hundred forty-four consecutive patients were quasi-randomized. MRI influenced the final treatment decision more than CT (P = .002). Compared with CT-examined patients (mean VAS score 8.6, SD ±1.6) stroke physicians were significantly more certain when prescribing or refraining from giving iv-tPA to MRI-examined patients (mean VAS score 9.0, SD ±1.2) (P = .014). No differences in modified Rankin scale or mortality were detected at 3 months in CT- versus MRI-examined iv-tPA-treated patients.CONCLUSIONS: Stroke physicians were significantly more certain when prescribing iv-tPA to MRI-examined stroke patients, and MRI influences the final treatment decision significantly more compared with CT, although no difference in mortality and functional outcome at 3 months was detected between CT- and MRI-examined patients treated with iv-tPA.

AB - BACKGROUND: Door-to-needle time of 20 minutes to stroke patients with intravenous tissue plasminogen activator (iv-tPA) is feasible when computed tomography (CT) is used as first-line of brain imaging. Magnetic resonance imaging (MRI)-based assessment is more time-consuming but superior in detecting acute ischemia. The certainty with which stroke physicians prescribe or refrain from giving iv-tPA treatment to CT- versus MRI-examined patients has not previously been studied. The aim of the present study was to determine the effect of a primary imaging strategy of CT or MRI on clinicians' certainty to prescribe or refrain from giving iv-tPA to patients with suspected acute stroke.METHOD: Consecutive patients with suspected stroke were quasi-randomized to either CT- or MRI-based assessment before potential iv-tPA treatment. The influence of (1) the clinical findings and (2) the image findings, and (3) the certainty with which the stroke physician prescribed or refrained from giving iv-tPA treatment were assessed with visual analog scales (VAS). Predictors of treatment certainty were identified with a random-effect model.RESULTS: Four-hundred forty-four consecutive patients were quasi-randomized. MRI influenced the final treatment decision more than CT (P = .002). Compared with CT-examined patients (mean VAS score 8.6, SD ±1.6) stroke physicians were significantly more certain when prescribing or refraining from giving iv-tPA to MRI-examined patients (mean VAS score 9.0, SD ±1.2) (P = .014). No differences in modified Rankin scale or mortality were detected at 3 months in CT- versus MRI-examined iv-tPA-treated patients.CONCLUSIONS: Stroke physicians were significantly more certain when prescribing iv-tPA to MRI-examined stroke patients, and MRI influences the final treatment decision significantly more compared with CT, although no difference in mortality and functional outcome at 3 months was detected between CT- and MRI-examined patients treated with iv-tPA.

U2 - 10.1016/j.jstrokecerebrovasdis.2017.10.035

DO - 10.1016/j.jstrokecerebrovasdis.2017.10.035

M3 - Journal article

VL - 27

SP - 926

EP - 935

JO - Journal of Stroke & Cerebrovascular Diseases

JF - Journal of Stroke & Cerebrovascular Diseases

SN - 1052-3057

IS - 4

ER -

ID: 193273352