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Automating Ischemic Stroke Subtype Classification Using Machine Learning and Natural Language Processing
This study sought to use natural language processing of electronic health records (EHR) combined with machine learning methods to automate IS subtyping. Methods: Among IS patients from an observational registry with TOAST subtyping adjudicated by board-certified vascular neurologists, we analyzed unstructured text-based EHR data including neurology progress notes and neuroradiology reports using natural language processing.
Source: Journal of Stroke and Cerebrovascular Diseases - May 14, 2019 Category: Neurology Authors: Ravi Garg, Elissa Oh, Andrew Naidech, Konrad Kording, Shyam Prabhakaran Source Type: research

More Research Is Needed on Lifestyle Behaviors That Influence Progression of Parkinson's Disease
This article highlights some of these challenges in the design of lifestyle studies in PD, and suggests a more coordinated international effort is required, including ongoing longitudinal observational studies. In combination with pharmaceutical treatments, healthy lifestyle behaviors may slow the progression of PD, empower patients, and reduce disease burden. For optimal care of people with PD, it is important to close this gap in current knowledge and discover whether such associations exist. Introduction Parkinson's disease (PD) is an age-related complex progressive neurodegenerative disorder, with key p...
Source: Frontiers in Neurology - April 29, 2019 Category: Neurology Source Type: research

Ischemic Stroke in Young Adults: Profile of SARAH Hospital Brasília From 2008 to 2012
Conclusions: Etiological diagnosis of stroke in the young is challenging for clinicians. Hence, a more effective classification scheme, better investigative mechanisms, and correct determination of causal associations in ischemic stroke are needed. Thrombophilia screening should be performed in the presence of relevant clinical signs and/or family history.
Source: The Neurologist - March 1, 2017 Category: Neurology Tags: Original Article Source Type: research

Door-to-Imaging Time for Acute Stroke Patients Is Adversely Affected by Emergency Department Crowding Clinical Sciences
Conclusions—ED crowding is associated with reduced odds of meeting DIT goals for acute stroke. In addition to improving stroke-specific processes of care, efforts to reduce ED overcrowding should be considered central to optimizing the timeliness of acute stroke care.
Source: Stroke - December 22, 2016 Category: Neurology Authors: Martin A. Reznek, Evangelia Murray, Marguerite N. Youngren, Natassia T. Durham, Sean S. Michael Tags: Quality and Outcomes, Cerebrovascular Disease/Stroke Original Contributions Source Type: research

Palliative Care Consultation Did Not Reduce Length of Stay in a Comprehensive Stroke Center (P1.212)
Conclusion: Palliative care consultation for patients with ischemic or hemorrhagic strokes was not associated with decreased hospital costs or LoS. This is in contrast to previously reported studies. We will further analyze the effect of early palliative care on a larger sample size to validate the findings. We also propose that a standardized palliative care trigger tool be implemented for early PC consultation in patients with debilitating stroke, advanced age, and multiple comorbid conditions.Disclosure: Dr. Tversky has nothing to disclose. Dr. Cheng has nothing to disclose. Dr. Mahmud has nothing to disclose. Dr. Schlo...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Tversky, S., Cheng, D., Mahmud, S., Schloss, E., Wright, P. Tags: Re-admission and Stroke Outcomes Source Type: research

An EHR Template and Housestaff Incentive Program to Improve the Frequency of NIHSS Documentation for Code Stroke (P6.047)
Conclusions: At an academic center with housestaff-led Code Stroke teams, the proportion of Code Stroke activations with a documented NIHSS was higher after implementing an EHR note template and housestaff financial incentive.Disclosure: Dr. Jia has nothing to disclose. Dr. Brown has nothing to disclose. Dr. Hessler has nothing to disclose. Dr. Deleon has nothing to disclose. Dr. Parsons has nothing to disclose. Dr. Ching has nothing to disclose. Dr. Smith has received personal compensation for activities with Stryker Neurovascular and Covidien as a consultant. Dr. Josephson has received personal compensation in an editori...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Jia, X., Brown, E., Hessler, C., Deleon, J., Parsons, T., Ching, K., Smith, W., Josephson, S., Kim, A. Tags: Prehospital Stroke Care and Uses of NIHSS Source Type: research

Clinical and In-hospital Process Variables Are Associated With Hospital Length-of-Stay in Acute Ischemic Stroke Patients (P6.246)
CONCLUSIONS: For mild ischemic stroke patients, time to physical therapy evaluation (an in-hospital care process) was associated with LOS and likelihood of return to ED, whereas clinical factors (including mRS, NIHSS score, infarct location) were not. This suggests coordination of inpatient care processes, in addition to assessing and treating co-morbidities, could impact hospital LOS and, perhaps, long-term outcome.Disclosure: Dr. Kim has nothing to disclose. Dr. Conley has nothing to disclose. Dr. Kalanithi has nothing to disclose. Dr. Tai has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Kim, S., Conley, J., Kalanithi, L., Tai, W. Tags: Cerebrovascular Disease and Interventional Neurology: Thrombolysis Complications Source Type: research

Point-of-Care Cluster Randomized Trial in Stroke Secondary Prevention Using Electronic Health Records Clinical Sciences
Conclusions— Large pragmatic intervention studies may be implemented at low cost by using electronic health records. The intervention used in this trial was not found to be effective, and further research is needed to develop more effective intervention strategies. Clinical Trial Registration— URL: http://www.controlled-trials.com. Current Controlled Trials identifier: ISRCTN35701810.
Source: Stroke - June 23, 2014 Category: Neurology Authors: Dregan, A., van Staa, T. P., McDermott, L., McCann, G., Ashworth, M., Charlton, J., Wolfe, C. D. A., Rudd, A., Yardley, L., Gulliford, M. C., Meredith, Kerry, Murray, Mant, Robson, Haywood, Pursani Tags: Other Stroke Treatment - Medical Clinical Sciences Source Type: research

Comment: Does L-thyroxine prevent or cause stroke in hypothyroidism?
The association between overt hypothyroidism and atherosclerotic risk factors, especially hypertension and dyslipidemia, is clear. To date, only a few small and methodologically flawed epidemiologic studies have investigated the relationship between hypothyroidism and stroke, precluding definitive conclusions. In the current issue of Neurology®, Karch and Thomas1 present a large well-designed case-control study investigating this relationship. They compared 34,907 patients with autoimmune thyroiditis on treatment with l-thyroxine and 149,632 matched individuals without autoimmune thyroiditis from a UK primary care elec...
Source: Neurology - May 5, 2014 Category: Neurology Authors: Squizzato, A., Gerdes, V. E. A. Tags: All Cerebrovascular disease/Stroke ARTICLE Source Type: research

Outcome Assessment of Acute Ischemic Stroke Patients after Treatment with IV tPA in a Rural Health System (P02.026)
CONCLUSIONS: Patients administered IV tPA for acute ischemic stroke in a rural hospital setting experienced 90-day outcomes similar to those of historical controls. Further attempts to reduce the number of in-hospital complications and reduce time to administration may result in improved patient outcomes.Supported by: Joan Curran Memorial Summer Fellowship in Neurosciences through Gundersen Lutheran Medical Foundation.Disclosure: Dr. Milsap has nothing to disclose. Dr Aldred has received personal compensation for activities with Teva, Ipsen, and Allergan as a speaker and from Teva and Abbot as an advisor. Dr. Aldred has re...
Source: Neurology - February 14, 2013 Category: Neurology Authors: Milsap, A., Aldred, J., Skaar, J. Tags: P02 Cerebrovascular Disease II Source Type: research

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