{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:28:19Z","timestamp":1793384899365,"version":"4.5.0"},"reference-count":19,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Telemedicine and e-Health"],"published-print":{"date-parts":[[2023,12]]},"abstract":"\n Introduction:<\/jats:title>\n \n Telestroke is an effective strategy to increase appropriate stroke treatments among patients in resource-limited environments. Despite the well-documented benefits of telestroke, there is limited literature regarding its utilization. The purposes of this study are: (1) determine the percentage of potential stroke patients who generate a telestroke consult in rural critical access hospitals (CAHs) and (2) validate an electronic medical record (EMR)-derived report as a stroke screen.<\/jats:italic>\n <\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n This retrospective chart review analyzed patients presenting between September 1, 2020 and February 1, 2021 to three CAHs. Visits with triage complaints suggesting acute ischemic stroke (AIS)\/transient ischemic attack (TIA) were pooled for analysis using an EMR-derived report. Patients with confirmed AIS\/TIA at discharge over this period were used to validate the EMR tool.<\/jats:italic>\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The EMR report pooled 252 possible AIS\/TIA visits out of 12,685 emergency department visits for analysis. It had a specificity of 98.78% and sensitivity of 58.06%. Of the 252 visits, 12.7% met telestroke criteria and 38.89% received telestroke evaluation. Among these, a definite diagnosis of AIS\/TIA was made in 92.86%. Of the remaining population who met criteria but didn't undergo consultation, 61.11% were diagnosed with AIS\/TIA at discharge.<\/jats:italic>\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n \n This study provides novel characterization of stroke presentations and telestroke in rural CAHs. The EMR-derived report is a reasonable tool to concentrate potential AIS\/TIA cases for review and resource allocation but is not sensitive enough to detect stroke as a stand-alone tool. The majority (56%) of eligible patients did not undergo telestroke consultation. Future studies are critical to further understand reasons contributing to this.<\/jats:italic>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1089\/tmj.2022.0408","type":"journal-article","created":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T14:55:51Z","timestamp":1684508151000},"page":"1828-1833","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Analysis of Telestroke Usage in Rural Critical Access Emergency Departments"],"prefix":"10.1177","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3187-729X","authenticated-orcid":false,"given":"Priya","family":"Arumuganathan","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, School of Medicine, West Virginia University, Morgantown, West Virginia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia K.","family":"Adcock","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine, West Virginia University, Morgantown, West Virginia, USA."},{"name":"Department of Neurology, Mayo Clinic, Phoenix, Arizona, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristal","family":"Espinosa","sequence":"additional","affiliation":[{"name":"Department of Pediatric Emergency Medicine, West Virginia University, Morgantown, West Virginia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Findley","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, School of Medicine, West Virginia University, Morgantown, West Virginia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,12,8]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1201534"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000152"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2017.0006"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.4103\/0028-3886.190243"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2018.0336"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2019.0087"},{"key":"e_1_3_4_8_2","unstructured":"Zaborowska L. Sensitivity and Specificity Calculator. Omni Calculator; July 29 2022. Available from: https:\/\/www.omnicalculator.com\/statistics\/sensitivity-and-specificity [Last accessed: June20 2022]."},{"key":"e_1_3_4_9_2","unstructured":"WV Department of Health and Human Resources Health Statistics Center. (2018). West Virginia Behavioral Risk Factor Surveillance System Report 2016."},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2021.106171"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.689191"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0266462310000139"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2017.0252"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-020-09873-6"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.57.11.2006"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.017089"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.029318"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000003814"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.010613"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000000673"}],"container-title":["Telemedicine and e-Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/tmj.2022.0408","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/tmj.2022.0408","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/tmj.2022.0408","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T22:33:09Z","timestamp":1777588389000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/tmj.2022.0408"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12]]},"references-count":19,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1089\/tmj.2022.0408"],"URL":"https:\/\/doi.org\/10.1089\/tmj.2022.0408","relation":{},"ISSN":["1530-5627","1556-3669"],"issn-type":[{"value":"1530-5627","type":"print"},{"value":"1556-3669","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12]]}}}