{"id":"https://openalex.org/W2009526873","doi":"https://doi.org/10.1148/radiol.2283021557","title":"Stroke: Effect of Implementing an Evaluation and Treatment Protocol Compliant with NINDS Recommendations","display_name":"Stroke: Effect of Implementing an Evaluation and Treatment Protocol Compliant with NINDS Recommendations","publication_year":2003,"publication_date":"2003-09-01","ids":{"openalex":"https://openalex.org/W2009526873","doi":"https://doi.org/10.1148/radiol.2283021557","mag":"2009526873","pmid":"https://pubmed.ncbi.nlm.nih.gov/12954888"},"language":"en","primary_location":{"id":"doi:10.1148/radiol.2283021557","doi":"https://doi.org/10.1148/radiol.2283021557","is_oa":false,"landing_page_url":"https://doi.org/10.1148/radiol.2283021557","pdf_url":null,"source":{"id":"https://openalex.org/S50280174","display_name":"Radiology","issn_l":"0033-8419","issn":["0033-8419","1527-1315"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315931","host_organization_name":"Radiological Society of North America","host_organization_lineage":["https://openalex.org/P4310315931"],"host_organization_lineage_names":["Radiological Society of North America"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Radiology","raw_type":"journal-article"},"volume":null,"type":"review","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5026034059","display_name":"James E. Stahl","orcid":"https://orcid.org/0000-0001-9739-0583","observed_orcids":["https://orcid.org/0000-0001-9739-0583"]},"institutions":[{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]},{"id":"https://openalex.org/I4210087915","display_name":"Massachusetts General Hospital","ror":"https://ror.org/002pd6e78","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210087915","https://openalex.org/I48633490"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"James E. Stahl","raw_affiliation_strings":["Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Zero Emerson Bldg, Suite 2H, Boston, MA 02114, USA. james@mgh-ita.org","Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Zero Emerson Bldg, Suite 2H, Boston, MA 02114, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Zero Emerson Bldg, Suite 2H, Boston, MA 02114, USA. james@mgh-ita.org","institution_ids":["https://openalex.org/I136199984","https://openalex.org/I4210087915"]},{"raw_affiliation_string":"Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Zero Emerson Bldg, Suite 2H, Boston, MA 02114, USA","institution_ids":["https://openalex.org/I136199984","https://openalex.org/I4210087915"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5004980235","display_name":"Karen L. Furie","orcid":"https://orcid.org/0000-0003-0065-3784","observed_orcids":["https://orcid.org/0000-0003-0065-3784"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Karen L. Furie","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":null,"display_name":"Suzanne Gleason","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Suzanne Gleason","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"last","author":{"id":"https://openalex.org/A5108497798","display_name":"G. Scott Gazelle","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"G. Scott Gazelle","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.5066,"has_fulltext":false,"cited_by_count":63,"citation_normalized_percentile":{"value":0.42592593,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":88,"max":99},"biblio":{"volume":"228","issue":"3","first_page":"659","last_page":"668"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10227","display_name":"Acute Ischemic Stroke Management","score":0.9970999956130981,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Clinical Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10227","display_name":"Acute Ischemic Stroke Management","score":0.9970999956130981,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Clinical Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10804","display_name":"Health Systems, Economic Evaluations, Quality of Life","score":0.00139999995008111,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T11095","display_name":"Emergency and Acute Care Studies","score":0.0010000000474974513,"subfield":{"id":"https://openalex.org/subfields/2711","display_name":"Emergency Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/acute-ischemic-stroke","display_name":"acute ischemic stroke","score":0.9919999837875366},{"id":"https://openalex.org/keywords/cost-effectiveness","display_name":"cost-effectiveness","score":0.8080000281333923},{"id":"https://openalex.org/keywords/tissue-plasminogen-activator","display_name":"tissue plasminogen activator","score":0.9660000205039978},{"id":"https://openalex.org/keywords/thrombolysis","display_name":"thrombolysis","score":0.6110000014305115},{"id":"https://openalex.org/keywords/computed-tomography","display_name":"computed tomography","score":0.5540000200271606},{"id":"https://openalex.org/keywords/quality-adjusted-life-years","display_name":"quality-adjusted life years","score":0.8029999732971191},{"id":"https://openalex.org/keywords/treatment-window","display_name":"therapeutic time window","score":0.5230000019073486},{"id":"https://openalex.org/keywords/emergency-department-care","display_name":"emergency department care","score":0.5910000205039978},{"id":"https://openalex.org/keywords/discrete-event-simulation","display_name":"discrete event simulation","score":0.7260000109672546},{"id":"https://openalex.org/keywords/health-care-resource-allocation","display_name":"healthcare resource allocation","score":0.4230000078678131}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.959519624710083},{"id":"https://openalex.org/C2780645631","wikidata":"https://www.wikidata.org/wiki/Q671554","display_name":"Stroke (engine)","level":2,"score":0.6372880935668945},{"id":"https://openalex.org/C2776572282","wikidata":"https://www.wikidata.org/wiki/Q416351","display_name":"Tissue plasminogen activator","level":2,"score":0.5886884927749634},{"id":"https://openalex.org/C2779581417","wikidata":"https://www.wikidata.org/wiki/Q1931577","display_name":"Thrombolysis","level":3,"score":0.5304346084594727},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.4815409779548645},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.1473463773727417},{"id":"https://openalex.org/C78519656","wikidata":"https://www.wikidata.org/wiki/Q101333","display_name":"Mechanical engineering","level":1,"score":0.0},{"id":"https://openalex.org/C127413603","wikidata":"https://www.wikidata.org/wiki/Q11023","display_name":"Engineering","level":0,"score":0.0},{"id":"https://openalex.org/C500558357","wikidata":"https://www.wikidata.org/wiki/Q12152","display_name":"Myocardial infarction","level":2,"score":0.0}],"mesh":[{"descriptor_ui":"D002985","descriptor_name":"Clinical Protocols","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D003362","descriptor_name":"Cost-Benefit Analysis","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D004630","descriptor_name":"Emergencies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008962","descriptor_name":"Models, Theoretical","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D009316","descriptor_name":"National Institutes of Health (U.S.)","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D010959","descriptor_name":"Tissue Plasminogen Activator","qualifier_ui":"Q000008","qualifier_name":"administration & dosage","is_major_topic":false},{"descriptor_ui":"D013997","descriptor_name":"Time Factors","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014057","descriptor_name":"Tomography, X-Ray Computed","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014481","descriptor_name":"United States","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D016896","descriptor_name":"Treatment Outcome","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D020521","descriptor_name":"Stroke","qualifier_ui":"Q000191","qualifier_name":"economics","is_major_topic":false},{"descriptor_ui":"D020521","descriptor_name":"Stroke","qualifier_ui":"Q000628","qualifier_name":"therapy","is_major_topic":true}],"locations_count":2,"locations":[{"id":"doi:10.1148/radiol.2283021557","doi":"https://doi.org/10.1148/radiol.2283021557","is_oa":false,"landing_page_url":"https://doi.org/10.1148/radiol.2283021557","pdf_url":null,"source":{"id":"https://openalex.org/S50280174","display_name":"Radiology","issn_l":"0033-8419","issn":["0033-8419","1527-1315"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315931","host_organization_name":"Radiological Society of North America","host_organization_lineage":["https://openalex.org/P4310315931"],"host_organization_lineage_names":["Radiological Society of North America"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Radiology","raw_type":"journal-article"},{"id":"pmid:12954888","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/12954888","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Radiology","raw_type":"Journal Article"}],"best_oa_location":null,"sustainable_development_goals":[{"score":0.98580002784729,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":74,"referenced_works":["https://openalex.org/W9086055","https://openalex.org/W165933147","https://openalex.org/W400980888","https://openalex.org/W1512398135","https://openalex.org/W1564168759","https://openalex.org/W1568370682","https://openalex.org/W1577560346","https://openalex.org/W1877283940","https://openalex.org/W1966175035","https://openalex.org/W1973229741","https://openalex.org/W1976533027","https://openalex.org/W1978584465","https://openalex.org/W1978866428","https://openalex.org/W1979099938","https://openalex.org/W1983567452","https://openalex.org/W1986757453","https://openalex.org/W1994790018","https://openalex.org/W1999986053","https://openalex.org/W2003537300","https://openalex.org/W2007836752","https://openalex.org/W2021132816","https://openalex.org/W2023798019","https://openalex.org/W2025070800","https://openalex.org/W2027123157","https://openalex.org/W2028306051","https://openalex.org/W2030591885","https://openalex.org/W2039392119","https://openalex.org/W2045438043","https://openalex.org/W2046373516","https://openalex.org/W2046830455","https://openalex.org/W2047003730","https://openalex.org/W2049612542","https://openalex.org/W2050735040","https://openalex.org/W2052703205","https://openalex.org/W2053389966","https://openalex.org/W2066157763","https://openalex.org/W2070772868","https://openalex.org/W2072583074","https://openalex.org/W2078969020","https://openalex.org/W2090823406","https://openalex.org/W2096853976","https://openalex.org/W2098032054","https://openalex.org/W2099242380","https://openalex.org/W2099706007","https://openalex.org/W2106720948","https://openalex.org/W2109639282","https://openalex.org/W2112053016","https://openalex.org/W2114140850","https://openalex.org/W2123041586","https://openalex.org/W2131829789","https://openalex.org/W2133640401","https://openalex.org/W2136876490","https://openalex.org/W2140481308","https://openalex.org/W2140961401","https://openalex.org/W2146114745","https://openalex.org/W2153144068","https://openalex.org/W2160041557","https://openalex.org/W2160411267","https://openalex.org/W2161648295","https://openalex.org/W2169742106","https://openalex.org/W2179508744","https://openalex.org/W2189726121","https://openalex.org/W2244796790","https://openalex.org/W2292308933","https://openalex.org/W2312970899","https://openalex.org/W2333466480","https://openalex.org/W2333504742","https://openalex.org/W2346381464","https://openalex.org/W2478734695","https://openalex.org/W2760905760","https://openalex.org/W4211016789","https://openalex.org/W4240994847","https://openalex.org/W4244041297","https://openalex.org/W4252102346"],"related_works":["https://openalex.org/W1983567452","https://openalex.org/W1986757453","https://openalex.org/W2792131068","https://openalex.org/W1971890855","https://openalex.org/W2109490919","https://openalex.org/W4213325930","https://openalex.org/W1976745255","https://openalex.org/W4361264984","https://openalex.org/W1992853904","https://openalex.org/W2170776713"],"abstract_inverted_index":{"PURPOSE:":[0],"To":[1],"evaluate--relative":[2],"to":[3,67,134,208,217,236,244,254,259,267,277,279,295],"routine":[4],"clinical":[5],"practice--the":[6],"potential":[7],"cost-effectiveness":[8],"of":[9,17,26,33,44,47,55,72,93,114,122,151,159,179,191,203,215,231,241,249],"implementing":[10],"a":[11,86,100,163],"strategy":[12,88,102,170,199],"compliant":[13],"with":[14,29,132],"National":[15],"Institute":[16],"Neurological":[18],"Disorders":[19],"and":[20,31,78,98,120,136,147,157,210],"Stroke":[21],"(NINDS)":[22],"recommendations":[23,284],"for":[24,142,183,213],"care":[25,49],"patients":[27,160,205,243],"presenting":[28],"signs":[30],"symptoms":[32],"acute":[34],"ischemic":[35],"stroke.":[36],"MATERIALS":[37],"AND":[38],"METHODS:":[39],"A":[40,62],"discrete-event":[41],"simulation":[42],"model":[43],"the":[45,91,96,184,201,229,239,247,257,262,275,290],"process":[46,69],"stroke":[48,265,293],"from":[50,206,234,252,264,292],"symptom":[51],"onset":[52,266,294],"through":[53],"administration":[54,121],"tissue":[56],"plasminogen":[57],"activator":[58],"(tPA)":[59],"was":[60,65],"constructed.":[61],"literature":[63,97],"review":[64],"performed":[66,141],"determine":[68],"times,":[70],"performance":[71],"computed":[73],"tomography":[74],"(CT),":[75],"health":[76],"outcomes,":[77],"cost":[79,135,190],"estimates.":[80],"The":[81,168,197],"following":[82],"were":[83,130,140,153],"compared:":[84],"(a)":[85],"\"base-case\"":[87],"determined":[89],"on":[90],"basis":[92],"findings":[94],"in":[95,108,172],"(b)":[99],"NINDS-compliant":[101,169,198],"(ie,":[103],"evaluation":[104],"by":[105,271],"emergency":[106,268,296],"physician":[107],"less":[109],"than":[110],"10":[111],"minutes,":[112,119],"interpretation":[113],"CT":[115,232],"scans":[116],"within":[117,124,162],"45":[118],"tPA":[123],"1":[125],"hour":[126],"after":[127],"presentation).":[128],"Strategies":[129],"compared":[131],"regard":[133],"effectiveness.":[137],"Sensitivity":[138],"analyses":[139],"all":[143],"relevant":[144],"cost,":[145],"timing,":[146],"resource":[148],"parameters.":[149],"Outcomes":[150],"concern":[152],"quality-adjusted":[154,175],"life":[155,176],"years":[156,177],"number":[158,230,248],"treated":[161],"3-hour":[164],"therapeutic":[165],"window.":[166],"RESULTS:":[167],"resulted":[171],"an":[173,188],"average":[174],"value":[178],"3.64,":[180],"versus":[181],"3.63":[182],"base":[185],"case,":[186],"at":[187],"approximate":[189],"434":[192],"US":[193,219],"dollars":[194,220],"per":[195,221],"patient.":[196,222],"increased":[200],"proportion":[202,240,258,276],"treatable":[204,242],"1.4%":[207],"3.7%":[209],"remained":[211],"cost-effective":[212],"expenditures":[214],"up":[216,278],"450":[218],"Assuming":[223],"base-case":[224],"parameters":[225],"are":[226],"used,":[227],"increasing":[228],"scanners":[233],"two":[235],"eight":[237,255],"raised":[238,256,274],"1.5%.":[245],"Increasing":[246],"available":[250],"neurologists":[251],"four":[253],"1.44%.":[260],"Reducing":[261],"time":[263,291],"department":[269,297],"arrival":[270,298],"30":[272],"minutes":[273],"7.7%.":[280],"CONCLUSION:":[281],"Applying":[282],"NINDS":[283],"is":[285],"potentially":[286],"cost-effective,":[287],"although":[288],"reducing":[289],"may":[299],"be":[300],"even":[301],"more":[302],"so.":[303]},"counts_by_year":[{"year":2025,"cited_by_count":1},{"year":2024,"cited_by_count":1},{"year":2022,"cited_by_count":4},{"year":2021,"cited_by_count":2},{"year":2020,"cited_by_count":1},{"year":2017,"cited_by_count":3},{"year":2016,"cited_by_count":3},{"year":2015,"cited_by_count":5},{"year":2014,"cited_by_count":9},{"year":2013,"cited_by_count":6},{"year":2012,"cited_by_count":5}],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2016-06-24T00:00:00"}