{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T06:22:30Z","timestamp":1772950950142,"version":"3.50.1"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>OPTIMISTmain (Main Optimal Post rtPA-IV Monitoring in Ischemic Stroke Trial) has shown that low-intensity monitoring is feasible and safe compared with standard monitoring in stable patients who receive thrombolysis treatment for acute ischemic stroke of mild-to-moderate neurological impairment. We aimed to estimate the economic benefits of low-intensity care compared with standard care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>A cost-minimization analysis based on OPTIMISTmain was conducted for Australia, China, Malaysia, the United Kingdom, the United States, and Vietnam. A decision tree model comprising 2 arms was developed from the trial design. State transition probabilities for each country were extracted from the trial, and cost data were sourced from the existing literature. Mean costs over the 90-day duration of follow-up were compared, and univariate and probabilistic sensitivity and scenario analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Low-intensity monitoring had the highest probability of cost saving in China (100.00%) and the United Kingdom (100.00%), followed by Australia (99.94%), the United States (95.91%), and Vietnam (86.66%), as patients in this group incurred US dollars savings of 239, 133, 647, 943, and 3 in direct costs compared with patients in the standard group, respectively. In Malaysia, however, the intervention costs slightly exceeded those for standard care (US dollars 5643 versus 5378). Countries with higher proportions of patients having intensive care unit monitoring had greater cost savings. Cost-saving thresholds of monitoring costs were 1.24, 1.30, 1.26, 1.24, 1.01, and 0.91 times the base case value in Australia, China, the United Kingdom, the United States, Vietnam, and Malaysia, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>The low-intensity monitoring protocol was cost saving in countries with high proportions of intensive care resources for postthrombolysis treatment monitoring, such as in the United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>REGISTRATION:<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT03734640. URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.anzctr.org.au\/\">https:\/\/www.anzctr.org.au\/<\/jats:ext-link>\n                      ; Unique identifier: ACTRN 12619001556134p.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.125.053506","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T10:00:15Z","timestamp":1769680815000},"page":"587-596","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Low-Intensity Monitoring for Mild-to-Moderate Acute Ischemic Stroke Is Cost Saving: Economic Evaluation for OPTIMISTmain"],"prefix":"10.1161","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2881-0473","authenticated-orcid":true,"given":"Lizheng","family":"Xu","sequence":"first","affiliation":[{"name":"The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia (L.X., M.O., E.R.A., L.B., A. Malavera, P.M.-V., X.L., Q.L., L.S., C.D., H.L., X.W., S.J., C.S.A.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7917-6858","authenticated-orcid":true,"given":"Menglu","family":"Ouyang","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia (L.X., M.O., E.R.A., L.B., A. Malavera, P.M.-V., X.L., Q.L., L.S., C.D., H.L., X.W., S.J., C.S.A.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2522-3510","authenticated-orcid":true,"given":"Emily R.","family":"Atkins","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia (L.X., M.O., E.R.A., L.B., A. Malavera, P.M.-V., X.L., Q.L., L.S., C.D., H.L., X.W., S.J., C.S.A.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6392-8613","authenticated-orcid":true,"given":"Debbie","family":"Summers","sequence":"additional","affiliation":[{"name":"Saint Luke\u2019s Hospital of Kansas City, Marion Bloch Neuroscience Institute, MO (D.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2898-7877","authenticated-orcid":true,"given":"Yi","family":"Sui","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Fourth People\u2019s Hospital of Shenyang, China Medical University (Y.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9350-6446","authenticated-orcid":true,"given":"Brenda","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Johns Hopkins Hospital Comprehensive Stroke Center, Johns Hopkins University School of Medicine, Baltimore, MD (B.J., V.C.U.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4975-9793","authenticated-orcid":true,"given":"Laurent","family":"Billot","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia (L.X., M.O., E.R.A., L.B., A. 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