Publication

Rationale and design for studying organisation of care for intra-arterial thrombectomy in the Netherlands: simulation modelling study

Lahr, M., Maas, W., van der Zee, D. J., Uyttenboogaart, M. & Buskens, E., 7-Jan-2020, In : BMJ Open. 10, 1, 7 p., 032754.

Research output: Contribution to journalArticleAcademicpeer-review

APA

Lahr, M., Maas, W., van der Zee, D. J., Uyttenboogaart, M., & Buskens, E. (2020). Rationale and design for studying organisation of care for intra-arterial thrombectomy in the Netherlands: simulation modelling study. BMJ Open, 10(1), [032754]. https://doi.org/10.1136/bmjopen-2019-032754

Author

Lahr, Maarten ; Maas, Willemijn ; van der Zee, D.J. ; Uyttenboogaart, Maarten ; Buskens, Erik. / Rationale and design for studying organisation of care for intra-arterial thrombectomy in the Netherlands : simulation modelling study. In: BMJ Open. 2020 ; Vol. 10, No. 1.

Harvard

Lahr, M, Maas, W, van der Zee, DJ, Uyttenboogaart, M & Buskens, E 2020, 'Rationale and design for studying organisation of care for intra-arterial thrombectomy in the Netherlands: simulation modelling study', BMJ Open, vol. 10, no. 1, 032754. https://doi.org/10.1136/bmjopen-2019-032754

Standard

Rationale and design for studying organisation of care for intra-arterial thrombectomy in the Netherlands : simulation modelling study. / Lahr, Maarten; Maas, Willemijn; van der Zee, D.J.; Uyttenboogaart, Maarten; Buskens, Erik.

In: BMJ Open, Vol. 10, No. 1, 032754, 07.01.2020.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

Lahr M, Maas W, van der Zee DJ, Uyttenboogaart M, Buskens E. Rationale and design for studying organisation of care for intra-arterial thrombectomy in the Netherlands: simulation modelling study. BMJ Open. 2020 Jan 7;10(1). 032754. https://doi.org/10.1136/bmjopen-2019-032754


BibTeX

@article{680204a99f61438383ee4881ceadd9fb,
title = "Rationale and design for studying organisation of care for intra-arterial thrombectomy in the Netherlands: simulation modelling study",
abstract = "INTRODUCTION: The introduction of intra-arterial thrombectomy (IAT) challenges acute stroke care organisations to provide fast access to acute stroke therapies. Parameters of pathway performance include distances to primary and comprehensive stroke centres (CSCs), time to treatment and availability of ambulance services. Further expansion of IAT centres may increase treatment rates yet could affect efficient use of resources and quality of care due to lower treatment volume. The aim was to study the organisation of care and patient logistics of IAT for patients with ischaemic stroke in the Netherlands.METHODS AND ANALYSES: Using a simulation modelling approach, we will quantify performance of 16 primary and CSCs offering IAT in the Netherlands. Patient data concerning both prehospital and intrahospital pathway logistics will be collected and used as input for model validation. A previously validated simulation model for intravenous thrombolysis (IVT) patients will be expanded with data of the MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) Registry and trials performed in the Collaboration for New Treatments in Acute Stroke consortium to represent patient logistics, time delays and outcomes in IAT patients. Simulation experiments aim to assess effectiveness and efficiency of alternative network topologies, that is, IAT with or without IVT at the nearest primary stroke centre (PSC) versus centralised care at a CSC. Primary outcomes are IAT treatment rates and clinical outcome according to the modified Rankin Scale. Secondary outcomes include onset-to-treatment time and resource use. Mann-Whitney U and Fisher's exact tests will be used to estimate differences for continuous and categorical variables. Model and parameter uncertainty will be tested using sensitivity analyses.ETHICS AND DISSEMINATION: This will be the first study to examine the organisation of acute stroke care for IAT delivery on a national scale using discrete event simulation. There are no ethics or safety concerns regarding the dissemination of information, which includes publication in peer-reviewed journals and (inter)national conference presentations.TRIAL REGISTRATION NUMBER: ISRCTN99503308, ISRCTN76741621, ISRCTN19922220, ISRCTN80619088, NCT03608423; Pre-results.",
keywords = "stroke, stroke medicine, epidemiology, organisation of health services, ACUTE STROKE PATIENTS, ISCHEMIC-STROKE, THROMBOLYSIS",
author = "Maarten Lahr and Willemijn Maas and {van der Zee}, D.J. and Maarten Uyttenboogaart and Erik Buskens",
note = "{\circledC} Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.",
year = "2020",
month = "1",
day = "7",
doi = "10.1136/bmjopen-2019-032754",
language = "English",
volume = "10",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "BMJ PUBLISHING GROUP",
number = "1",

}

RIS

TY - JOUR

T1 - Rationale and design for studying organisation of care for intra-arterial thrombectomy in the Netherlands

T2 - simulation modelling study

AU - Lahr, Maarten

AU - Maas, Willemijn

AU - van der Zee, D.J.

AU - Uyttenboogaart, Maarten

AU - Buskens, Erik

N1 - © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.

PY - 2020/1/7

Y1 - 2020/1/7

N2 - INTRODUCTION: The introduction of intra-arterial thrombectomy (IAT) challenges acute stroke care organisations to provide fast access to acute stroke therapies. Parameters of pathway performance include distances to primary and comprehensive stroke centres (CSCs), time to treatment and availability of ambulance services. Further expansion of IAT centres may increase treatment rates yet could affect efficient use of resources and quality of care due to lower treatment volume. The aim was to study the organisation of care and patient logistics of IAT for patients with ischaemic stroke in the Netherlands.METHODS AND ANALYSES: Using a simulation modelling approach, we will quantify performance of 16 primary and CSCs offering IAT in the Netherlands. Patient data concerning both prehospital and intrahospital pathway logistics will be collected and used as input for model validation. A previously validated simulation model for intravenous thrombolysis (IVT) patients will be expanded with data of the MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) Registry and trials performed in the Collaboration for New Treatments in Acute Stroke consortium to represent patient logistics, time delays and outcomes in IAT patients. Simulation experiments aim to assess effectiveness and efficiency of alternative network topologies, that is, IAT with or without IVT at the nearest primary stroke centre (PSC) versus centralised care at a CSC. Primary outcomes are IAT treatment rates and clinical outcome according to the modified Rankin Scale. Secondary outcomes include onset-to-treatment time and resource use. Mann-Whitney U and Fisher's exact tests will be used to estimate differences for continuous and categorical variables. Model and parameter uncertainty will be tested using sensitivity analyses.ETHICS AND DISSEMINATION: This will be the first study to examine the organisation of acute stroke care for IAT delivery on a national scale using discrete event simulation. There are no ethics or safety concerns regarding the dissemination of information, which includes publication in peer-reviewed journals and (inter)national conference presentations.TRIAL REGISTRATION NUMBER: ISRCTN99503308, ISRCTN76741621, ISRCTN19922220, ISRCTN80619088, NCT03608423; Pre-results.

AB - INTRODUCTION: The introduction of intra-arterial thrombectomy (IAT) challenges acute stroke care organisations to provide fast access to acute stroke therapies. Parameters of pathway performance include distances to primary and comprehensive stroke centres (CSCs), time to treatment and availability of ambulance services. Further expansion of IAT centres may increase treatment rates yet could affect efficient use of resources and quality of care due to lower treatment volume. The aim was to study the organisation of care and patient logistics of IAT for patients with ischaemic stroke in the Netherlands.METHODS AND ANALYSES: Using a simulation modelling approach, we will quantify performance of 16 primary and CSCs offering IAT in the Netherlands. Patient data concerning both prehospital and intrahospital pathway logistics will be collected and used as input for model validation. A previously validated simulation model for intravenous thrombolysis (IVT) patients will be expanded with data of the MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) Registry and trials performed in the Collaboration for New Treatments in Acute Stroke consortium to represent patient logistics, time delays and outcomes in IAT patients. Simulation experiments aim to assess effectiveness and efficiency of alternative network topologies, that is, IAT with or without IVT at the nearest primary stroke centre (PSC) versus centralised care at a CSC. Primary outcomes are IAT treatment rates and clinical outcome according to the modified Rankin Scale. Secondary outcomes include onset-to-treatment time and resource use. Mann-Whitney U and Fisher's exact tests will be used to estimate differences for continuous and categorical variables. Model and parameter uncertainty will be tested using sensitivity analyses.ETHICS AND DISSEMINATION: This will be the first study to examine the organisation of acute stroke care for IAT delivery on a national scale using discrete event simulation. There are no ethics or safety concerns regarding the dissemination of information, which includes publication in peer-reviewed journals and (inter)national conference presentations.TRIAL REGISTRATION NUMBER: ISRCTN99503308, ISRCTN76741621, ISRCTN19922220, ISRCTN80619088, NCT03608423; Pre-results.

KW - stroke

KW - stroke medicine

KW - epidemiology

KW - organisation of health services

KW - ACUTE STROKE PATIENTS

KW - ISCHEMIC-STROKE

KW - THROMBOLYSIS

U2 - 10.1136/bmjopen-2019-032754

DO - 10.1136/bmjopen-2019-032754

M3 - Article

C2 - 31915166

VL - 10

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 1

M1 - 032754

ER -

ID: 112112385