title: PreSSUB II: The prehospital stroke study at the Universitair Ziekenhuis Brussel II.
abstract: BACKGROUND
  Stroke is a time-critical medical emergency requiring specialized treatment. Prehospital delay contributes significantly to delayed or missed treatment opportunities. In-ambulance telemedicine can bring stroke expertise to the prehospital arena and facilitate this complex diagnostic and therapeutic process.
  
  
  OBJECTIVE
  This study evaluates the efficacy, safety, feasibility, reliability and cost-effectiveness of in-ambulance telemedicine for patients with suspicion of acute stroke. We hypothesize that this approach will reduce the delay to in-hospital treatment by streamlining the diagnostic process and that prehospital stroke care will be improved by expert stroke support via telemedicine during the ambulance transportation.
  
  
  METHODS
  PreSSUB II is an interventional, prospective, randomized, open-blinded, end-point, single-center trial comparing standard emergency care by the Paramedic Intervention Team of the Universitair Ziekenhuis Brussel (control) with standard emergency care complemented with in-ambulance teleconsultation service by stroke experts (PreSSUB).
  
  
  RESULTS
  The primary efficacy endpoint is the call-to-brain imaging time. Secondary endpoints for the efficacy analysis include the prevalence of medical events diagnosed and corrected during in-ambulance teleconsultation, the proportion of patients with ischemic stroke receiving recanalization therapy, the assessment of disability, functional status, quality of life and overall well-being. Mortality at 90 days after stroke is the primary safety endpoint. Secondary safety analysis will involve the registration of any adverse event. Other analyses include assessment of feasibility and reliability and a health economic evaluation.
authors.affiliation: Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, Belgium; Interuniversity Center for Health Economics Research (I-CHER), Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, Belgium.
authors.forename: Alexis Valenzuela
authors.initials: AV
authors.lastname: Espinoza
authors.affiliation: Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, Belgium; Department of Neurology, Universitair Ziekenhuis Brussel, Belgium.
authors.forename: Robbert-Jan
authors.initials: RJ
authors.lastname: Van Hooff
authors.affiliation: Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, Belgium; Department of Neurology, Universitair Ziekenhuis Brussel, Belgium.
authors.forename: Ann
authors.initials: A
authors.lastname: De Smedt
authors.affiliation: Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, Belgium; Department of Neurosurgery, Universitair Ziekenhuis Brussel, Belgium.
authors.forename: Maarten
authors.initials: M
authors.lastname: Moens
authors.affiliation: Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, Belgium; Department of Neurology, Universitair Ziekenhuis Brussel, Belgium; Department of Neurology, Universitair Ziekenhuis Antwerpen, Wilrijkstraat 10, 2650 Edegem, Belgium.
authors.forename: Laetitia
authors.initials: L
authors.lastname: Yperzeele
authors.affiliation: Department of Radiology, Universitair Ziekenhuis Brussel, Belgium.
authors.forename: Koenraad
authors.initials: K
authors.lastname: Nieboer
authors.affiliation: Department of Emergency Medicine, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium and Research Group on Emergency and Disaster Medicine (ReGEDiM), Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium.
authors.forename: Ives
authors.initials: I
authors.lastname: Hubloue
authors.affiliation: Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, Belgium; Department of Neurology, Universitair Ziekenhuis Brussel, Belgium; Department of Neurology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, Netherlands.
authors.forename: Jacques
authors.initials: J
authors.lastname: De Keyser
authors.affiliation: Research Group Clinical Pharmacology and Clinical Pharmacy (KFAR), Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels, Belgium.
authors.forename: Alain
authors.initials: A
authors.lastname: Dupont
authors.affiliation: Public Health, Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels, Belgium.
authors.forename: Liesbet
authors.initials: L
authors.lastname: De Wit
authors.affiliation: Interuniversity Center for Health Economics Research (I-CHER), Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, Belgium; Public Health, Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels, Belgium.
authors.forename: Koen
authors.initials: K
authors.lastname: Putman
authors.affiliation: Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, Belgium; Department of Neurology, Universitair Ziekenhuis Brussel, Belgium.
authors.forename: Raf
authors.initials: R
authors.lastname: Brouns
keywords: Emergency medicine; prehospital; stroke; telemedicine