Abstract
Background: Enrollment into hyperacute stroke trials may be constrained since candidates are usually not identified until they arrive in the emergency department. Pre-hospital identification may increase and speed study enrollment. Methods: Midway through the Multi-Arm Optimization of Stroke Thrombolysis (MOST) trial, our mobile stroke unit research personnel monitored EMS radio for potential stroke patients en route to our study hospital. Time of onset, symptoms, and expected arrival time were relayed to the MOST research team, who met the patient upon ED arrival. Expected site enrollment was 1 patient per month. Results: The rate of trial enrollment before intervention (10/2019 - 11/2021) was 0.8 patients per month compared to 2.4 after intervention (12/2021 - 07/2023), 2.43, 95% CI: 1.48-4.10, p<0.01 - see figure. In addition, there was a 17.5-minute reduction in ED arrival to trial randomization (88 vs. 70.5 minutes). Conclusion: Pre-hospital screening tripled the rate of trial recruitment and can help overcome challenges when enrolling participants in hyperacute clinical trials.
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