Stroke Transport Route Calculation Using Infarct Growth Models
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Solution Overview
Problem
Emergency medical services (EMS) face challenges in determining the optimal transport strategy for stroke patients due to uncertainty in stroke type, leading to ambiguous decision-making between Drip and Ship and Mothership transport strategies.
Innovation Solution
A method and system that calculate and display preferred transport routes by generating simulated infarct core growth models for stroke patients along different paths to various stroke centers, using probabilistic models based on patient-specific and environmental parameters to determine the most effective transport route.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Loss of time
If a Primary Stroke Center (PSC) is closer to the patient pickup location than a Comprehensive Stroke Center (CSC), then transport time to the nearest stroke center is reduced, but the optimal treatment strategy becomes ambiguous due to uncertainty in stroke type
Solution Approach 1:
The system performs preliminary actions by pre-calculating and storing infarct core growth models for various stroke types and transport scenarios before the actual transport decision is needed. These pre-computed models include probability distributions of infarct core volumes at different time points, which enable rapid decision-making without requiring real-time complex calculations during the emergency transport situation.
Solution Approach 2:
The system introduces an intermediary probabilistic model that mediates between the uncertainty of stroke type diagnosis and the need for timely transport decisions. This intermediary layer provides probability distributions of infarct core growth for different stroke types, allowing EMS personnel to make informed decisions about Drip and Ship versus Mothership strategies without needing certain stroke type identification.
2Reliability
If EMS transports patients directly to a Comprehensive Stroke Center (CSC), then EVT-capable treatment is ensured for large vessel occlusions, but transport time increases when a closer Primary Stroke Center is available
Solution Approach 1:
The system changes the decision parameter from binary choice (PSC only or CSC only) to a probabilistic framework that incorporates infarct core growth rates and stroke type probabilities. By varying parameters such as infarct core volume distributions, collateral blood flow estimates, and transport times, the system determines optimal transport strategies that balance treatment availability with time efficiency for each specific patient scenario.
3Measurement precision
If field-testing capabilities are used to determine stroke type, then treatment strategy can be optimized, but the ability to ascertain stroke type with certainty remains insufficient for ambiguous cases
Solution Approach 1:
The system creates a probabilistic copy of the diagnostic uncertainty by modeling infarct core growth distributions for different stroke types rather than attempting to directly measure stroke type with certainty. This probabilistic copying allows the system to work with the inherent uncertainty in field-testing results and make optimal transport decisions based on probability distributions rather than requiring certain diagnostic identification.
Data Source
AI summary
A method of calculating a set of desired transport routes for a stroke patient comprises selecting a set of destination points, comprising a first stroke center and a second stroke center, generating a set of infarct core growth models for stroke patients along at least a first path from a starting point to the first stroke center followed by an optional trip to the second stroke center, and a second path from the starting point to the second stroke center, varying a set of parameters of the stroke patients, calculating a model of patient outcomes from each origin point, and designating whether the first path or the second path is preferable based on the probabilistic model. A system for displaying a desired transport route for a stroke patient and a method of calculating a preferred location for a mobile treatment unit in a geographic region are also described.