Long-term clinical trials are usually only halted when early findings aren’t promising enough for researchers to plow ahead, but a four-year, 400-patient telemedicine study was stopped just over half-way through because of its nearly perfect success rate, according to researchers at the University of California, San Diego Medical Center.

The aborted study focused on Stroke Doc, a program developed by UCSD, Qualcomm Inc. and Carmel Valley-based BF Technologies that improved the diagnostic accuracy of stroke patients from 82 percent by telephone to greater than 98 percent via internet, said Dr. Brett C. Meyer, co-director of the UCSD Medical Center Stroke Center.

After the results of 222 patient cases, the 16 percent drop in error rate convinced doctors that further trials weren’t necessary.

The program is designed to work from any internet connection and lets the doctor see the patient through a mobile camera at the patient’s bedside. Stroke specialists made quicker and more informed decisions when evaluating stroke patients across distant sites via internet than they did through traditional telephone consultations, according to study published Aug. 2 in the online issue of the journal The Lancet Neurology.

BF Technologies makes the program’s audio/visual equipment, and San Diego-based Qualcomm developed the broadband wireless technology used to transmit information through a laptop when there’s no wired connection.

Stroke Doc is the latest success in the emerging field of telemedicine, a merger of the life science and wireless communications fields which connects doctors and patients through the internet. Collaboration between the fields, two of the region’s leading industries, could lead to lower health care costs and improved quality of care for outpatients, researchers said.

Strokes kill more than 150,000 Americans annually, according to the American Heart Association. Timely treatment reduces the risk of death or permanent brain damage, improving patient health and saving money that would otherwise be spent on rehabilitation.

“When a person suffers a stroke, time is of the essence,” Meyer said.

Meyer said most strokes are caused by blood clots in the brain that can be broken up by a clot-busting drug called tPA. But, he said, tPA is dangerous in some instances, and if wrongly given can cause brain hemorrhage or death. Relatively few doctors have the experience to make the correct decision, but Stroke Doc gives a distant stroke expert the detailed information needed to decide whether tPA should be given, Meyer said.

The technology, which allows patients, their families and attending doctors to communicate directly with the stroke expert, could lead to some immediate changes in how stroke patients in rural areas, where stroke experts aren’t physically on hand, are evaluated and treated, Meyer said.

The UC San Diego researchers say that the next step is a study to evaluate the long-term health outcomes of patients. Other partners in the study included Calit2, a research program of the UC system, and the Jacobs School of Engineering at UCSD.


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