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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
neuroscience
The CLOQS trial protocol: A cluster-randomized trial evaluating a simple, low-cost intervention to reduce treatment times in acute stroke
International Journal of Stroke, Volume 9, No. 4, Year 2014
Notification
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Description
Rationale: In acute stroke, time is brain: faster tissue plasminogen activator treatment improves patient outcomes. Published guidelines for door-to-scanner time are <25 minutes, and for door-to-needle time <60 minutes. These benchmarks are rarely met. Paradoxically, the earlier a stroke patient arrives to hospital, the longer treatment takes. There is an urgent need to shift focus away from the 4·5 hour time window, towards treatment times <60 minutes. Aims: The objective of the Countdown Lights to Optimize Quality in acute Stroke (CLOQS) trial is to determine whether a simple, low-cost organizational behavior intervention, a large, red stopwatch timer attached to the stretcher upon arrival, will decrease door-to-scanner and door-to-needle treatment times for tissue plasminogen activator-treated patients. Design: A multicenter, time-clustered randomized control trial. The stopwatch timers will be used in Emergency Departments for all acute stroke patients across the University of Toronto Stroke Program. The order of intervention (ON) and control (OFF) blocks will be randomly assigned in a 1:1 ratio over an 18 month period. Blocks will be weighted in a 2:1 ratio of ON/OFF using a permuted block design (ON blocks last two weeks; OFF blocks last one week). Study Outcomes: The primary end-point is percentage of patients achieving best-practice guidelines (door-to-needle treatment time <60 minutes). Secondary end-points are median time intervals for 1) door-to-scanner and 2) door-to-needle times during ON versus OFF blocks. Tertiary end-points are in-hospital mortality and time series analysis to determine change in treatment times from prior to study onset through study completion. © 2013 World Stroke Organization.
Authors & Co-Authors
Swartz, Richard H.
Canada, Toronto
Sunnybrook Health Sciences Centre
Silver, Frank L.
Canada, Toronto
Toronto Western Hospital University of Toronto
Saposnik, Gustavo
Canada, Toronto
University of Toronto
Gladstone ScD, David J.
Canada, Toronto
Sunnybrook Health Sciences Centre
Zwarenstein, Merrick F.
Canada, Toronto
Sunnybrook Health Sciences Centre
Jaigobin, Cheryl S.
Unknown Affiliation
Selchen, Daniel H.
Unknown Affiliation
Casaubon, Leanne K.
Unknown Affiliation
del Campo, Martin
Unknown Affiliation
Statistics
Citations: 2
Authors: 9
Affiliations: 4
Identifiers
Doi:
10.1111/ijs.12066
ISSN:
17474930
Research Areas
Health System And Policy
Noncommunicable Diseases
Study Design
Randomised Control Trial