Abstract Number ‐ 109: Mechanical Thrombectomy Hands‐on Skill Workshop for MT2020+ in the Caribbean
Notice bibliographique
Résumé
Introduction While mechanical thrombectomy (MT) is proven to be lifesaving and disability‐sparing, there remains disparities in access in low‐ to middle‐income countries (LTMICs), including the Caribbean. We hypothesized that team‐oriented MT workshops would improve MT skills and change practice patterns for MT services in this region. Methods We designed a 22‐hour MT workshop which was conducted as two identical events: in English (Jamaica, January 2022), and in Spanish (Dominican Republic, May 2022). The workshops included neurointerventional teams (practicing neurointerventionalists, neuroIR nurses and technicians), focused on patient selection, acutetreatment and post‐MT care of patients with stroke due to large vessel occlusion. MT skills, procedure duration and potential harmful techniques were recorded before and after by independent evaluators utilizing flow models under fluoroscopy. Overall course evaluation was performed. Press conferences were included to raise stroke awareness and emphasize the importance of early stroke presentation. Results Twenty‐two physicians and their teams from eight countries across the Caribbean completed the didactic and hands‐on training. Eighteen groups completed both pre‐ and post‐MT hands‐on testing and were included in the final analysis. Pre‐ and post‐course hands‐on assessment showed that the course effectively reduced the total time to complete a simulated MT procedure from 36.5 to 21.1 min (Figure 1; p< 1.0×10‐7). All groups showed an improvement in measures of good MT techniques, which resulted in a 39% improvement in complete reperfusion (8/18 groups achieved a TICI 3 score on pre‐course vs. 15/18 groups on post‐course). There was a significant reduction in total potentially dangerous maneuvers by 82% (p< 0.002), with 12/18 groups performing an average 2 dangerous maneuvers on pre‐course simulation vs. only 4/18 groups performing an average 1 dangerous maneuver after completing the course. Participants also demonstrated increased knowledge of stroke treatment and stroke system of care. Utilizing a basic stroke knowledge questionnaire, we found 28% respondents did not have a baseline passing grade vs 100% passed after the workshop. The average post‐workshop knowledge score was 80%. Universally the workshop was rated as very satisfactory and likely to change practice in 93% of the Dominican Republic participants and 75% among Jamaican participants. Conclusions A team‐based approach to MT training is novel, effective in reducing time to reperfusion and harmful techniques, and improves competencies. Team members independently demonstrated advanced stroke learning post‐training. To our knowledge, this is the first workshop of its kind; it is feasible, practice‐changing and creates a pathway for increasing access to MT in LTMICs.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,002 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,015 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».