MEDIC ONE STROKE SCALE

随着中风疗法的出现，如果在中风发病后及早给予，效果可能会更好。这项以患者为导向的研究职业发展奖提案涉及设计、实施和验证院前卒中量表，即医生一级卒中量表(MOSS)，David Tirschwell博士担任首席研究员。Tirschwell博士是一名神经学家，在华盛顿大学攻读流行病学硕士学位，并计划成为一名中风临床研究员和流行病学家。他将通过研究围绕临床测量工具的创建和验证的问题来进一步开展他的研究培训。Tirschwell博士一直在与西雅图神经病学和流行病学系以及西雅图医疗一号(消防部门)的成员合作，研究华盛顿州西雅图中风患者的院前护理。我们的假设是，这种持续的合作可以为院前环境产生一种快速、可靠、易于使用的中风评估工具，这将有助于准确地识别和有效地运送急性中风患者。另一个假设是，使用同样的工具，可以提供中风严重程度的有用的早期测量。将创建两个版本的MOSS，对每个版本的患者进行队列评估，Tirschwell博士将在为期3个月的随访中检查患者，以确定结果。第一个版本(预测)将记录历史和临床变量以及评估和运输时间。较短的第二版(验证)，只包含最具预测性的变量，将与诊断和分诊算法相关联，以最大限度地减少最紧急中风病例的运输时间。MOSS的易用性、可靠性和预测价值将在第二个队列中得到验证，并与格拉斯哥昏迷分级和NIHSS提取的医疗记录进行比较。第一组和第二组的诊断准确性、转运时间、接受tPA治疗的缺血性中风患者的比例和结果将进行比较。随着中风治疗研究进入院前环境，MOSS将作为一种标准化的评估工具，允许早期准确的中风诊断和严重程度分层。

As stroke therapies emerge, they will likely work better if given earlier after stroke onset. This Patient-oriented Research Career Development Award proposal involves the design, implementation and validation of a prehospital stroke scale, the Medic One Stroke Scale (MOSS), with Dr. David Tirschwell as the principal investigator. Dr. Tirschwell is a neurologist completing a Master's degree in epidemiology at the University of Washington and plans a career as a stroke clinical researcher and epidemiologist. He will further his research training through study of issues surrounding the creation and validation of clinical measurement tools. Dr. Tirschwell has been studying the prehospital care of stroke patients in Seattle, Washington in collaboration with members of the Departments of Neurology and Epidemiology and Seattle Medic One (fire department). The hypothesis is that this continued collaboration can produce a rapid, reliable, easy to use stroke evaluation tool for the prehospital setting that will facilitate accurate identification and efficient transport times for acute stroke patients. A further hypothesis is that with this same tool, one can provide a useful early measure of stroke severity. Two versions of the MOSS will be created, a cohort of patients evaluated with each, and Dr. Tirschwell will examine the patients at a 3-month follow-up visit to determine outcomes. The first version (prediction) will record historical and clinical variables and evaluation and transport times. The shorter second version (validation), incorporating only the most predictive variables, will be associated with diagnosis and triage algorithms to minimize transport time for the most urgent stroke cases. The ease of use, reliability and predictive value of the MOSS will be validated in the second cohort and compared with the Glasgow Coma Scale and medical record abstracted NIHSS. Diagnostic accuracy, transport times, proportion of ischemic stroke patients receiving tPA and outcomes will be compared between the first and second cohorts. As stroke therapeutic research moves into the prehospital setting, the MOSS will serve as a standardized evaluation tool allowing early and accurate stroke diagnosis and severity stratification.