UI Health Care researchers are developing a mobile app to help paramedics determine the best place to take a stroke patient for treatment—a decision that can have profound implications for stroke patients’ survival and long-term quality of life.  

Using a computer simulation to test the app’s ability to improve outcomes for stroke patients, the researchers have demonstrated promising results, which they presented at the European Stroke Conference in May.

“We applied our algorithm in an in-silico study across the entire continental U.S., simulating 115 million stroke events over 10 years,” explains Santiago Ortega-Gutiérrez, MD, UI clinical professor of neurology. “Compared to the American Heart Association guidelines for routing stroke patients, our algorithm improved neurological outcomes by a factor of four—which would equate to nearly 12,000 Americans benefiting from faster, more precise triage. When we focused solely on rural America, that benefit tripled.”

The new simulation-based findings will need to be replicated in a real-world clinical setting, but the results suggest this tool has exceptional potential to transform stroke outcomes. The UI team hopes to have a prototype of the app within the next two years.

“Our vision is that a personalized, data-driven destination recommendation app can be used by paramedics throughout Iowa and the country to improve stroke outcomes."

Why it matters

The adage in stroke care is that ‘time is brain,” meaning the faster a patient gets the most appropriate care, the better the outcome—including a higher likelihood of survival without long-term disability.

Paramedics are often the first providers to treat a patient who has had a stroke. They make the complicated decision of where to take the patient to ensure they get the right care as fast as possible.

Taking a stroke patient to the nearest hospital gets that individual treated faster—but it also sometimes means delaying other, potentially more effective, treatments.

The app will allow paramedics to enter a patient’s symptoms and determine how far they are from nearby hospitals and stroke centers. The app will then quickly predict the patient’s outcome if that individual were to get clot-busting drugs in one site versus surgery in another.

The MAP-STROKE project—launched three years ago by a multidisciplinary team led by Ortega-Gutiérrez, Nicholas Mohr, MD, UI professor of emergency medicine, and Grant Brown, PhD, an associate professor of biostatistics in the UI College of Public Health —aims to make evidence-based destination recommendations to paramedics via the mobile app.

“Our vision is that a personalized, data-driven destination recommendation app can be used by paramedics throughout Iowa and the country to improve stroke outcomes,” Mohr says.  

The MAP-STROKE project is one example of the innovative work being done by UI Health Care researchers to advance emergency medical care and improve outcomes for patients. For more on this work, read the most recent issue of the Medicine Iowa magazine.