An interventional study of Video call assisted assessment of acute stroke in Stroke, Cerebrovascular Disorders and Brain Diseases, sponsored by University of Southern Denmark. Recruiting at 1 site in Denmark. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-30.
Sponsored by University of Southern Denmark · Not applicable, Interventional, and Diagnostic
This study aims to investigate whether a live stream video between the on-call neurologist and the emergency medical technicians can increase feasibility and performance of symptom-based prehospital stroke scales.
Treatment of stroke with either thrombolysis or thrombectomy is highly time-dependent (administration within 4.5 hours and 24 hours from symptom onset, respectively), and morbidity and mortality increase with time from symptom onset to treatment. Hence, prehospital evaluation and transport must be as accurate and rapid as possible in order to minimise time to treatment.
Different triage and transport paradigms for patients with suspected stroke are being investigated and multiple stroke scales have been coined in order to examine patients suspected of stroke in a prehospital setting. However, performance and feasibility vary greatly in different validation studies suggesting that those outcomes are greatly dependent on other factors i.e. acceptance amongst stakeholders, implementation process, patient segment etc. Some recent studies have shown promising results using video solutions between emergency medical services (EMS) personnel and on-call neurologist in examining patients suspected of stroke in the prehospital phase. The investigators will perform this trial to examine whether a video call assisted assessment of patients suspected of stroke in a prehospital setting can increase feasibility and performance of symptom-based prehospital stroke scales.
Exclusion Criteria:
If the patient is eligible for study inclusion, eight symptoms from the study protocol are evaluated and registered in the Prehospital Patient Journal (PPJ) on the amPHITM Prehospital Health Care Record (Amphi Systems, Hasserisvej 125, 9000 Aalborg, Denmark), on a tablet mounted in each EMT vehicle. If the vehicle is in the control arm the patient is triaged by the on-call neurologist based on a standard telephone call
If the patient is eligible for study inclusion, the last symptoms from the study protocol are evaluated and registered in the Prehospital Patient Journal (PPJ) on the amPHITM Prehospital Health Care Record (Amphi Systems, Hasserisvej 125, 9000 Aalborg, Denmark), on a tablet mounted in each EMT vehicle. Afterwards the EMS personnel will contact the on-call neurologist and if the vehicle is in the intervention arm a live video stream is initiated. The on-call neurologist then examines the patient via the video-call and triage the patient.
Diagnostic Test: Video call assisted assessment of acute stroke
If the patient is eligible for study inclusion, eight symptoms from the study protocol are evaluated and registered in the Prehospital Patient Journal (PPJ) on the amPHITM Prehospital Health Care Record (Amphi Systems, Hasserisvej 125, 9000 Aalborg, Denmark), on a tablet mounted in each EMT vehicle. Afterwards, the EMS personnel will contact the on-call neurologist and if the vehicle is in the intervention arm a live video stream is initiated. The on-call neurologist then examines the patient via via the video-call and triages the patient.
Acute ischemic stroke (AIS) or transient ischemic attack (TIA) diagnosis at discharge
AIS or TIA as diagnosis. (binary outcome)
Time frame: At discharge, assessed within one week from symptom onset
Number of patients with acute ischemic stroke (AIS) with LVO on neuroimaging
AIS with LVO on neuroimaging (computer tomography (CT), CT angiography, magnetic resonance imaging (MRi), MR angiography or catheter-based angiography). LVO is defined as a occlusion or sub-occlusion of the intracranial internal carotid artery, middle cerebral artery M1 or M2, basilar artery. Sign of dense cerebral artery on CT is also considered LVO positive. (binary outcome).
Time frame: Within 48 hours of admission
Number of patients with Other large vessel AIS
Neuroimaging (computer tomography (CT), CT angiography, magnetic resonance imaging (MRi), MR angiography or catheter-based angiography) with AIS with occlusion or sub-occlusion of either anterior cerebral artery A1 or A2, posterior cortical artery P1 or intracranial vertebral artery (binary outcome).
Time frame: at admission
Number of patients with verified acute ischemic stroke (AIS) on neuroimaging
Neuroimaging (computer tomography (CT), CT angiography, magnetic resonance imaging (MRi), MR angiography or catheter-based angiography) with AIS
Time frame: Within 48 hours of admission
Number of patients with Haemorrhagic stroke
Neuroimaging (computer tomography (CT), CT angiography, magnetic resonance imaging (MRi), MR angiography or catheter-based angiography) with intra cranial haemorrhage (ICH) (binary outcome)
Time frame: at admission
Duration of examination on video-call
Duration of examination on video-call measured in minutes (continuous outcome)
Time frame: up to 120 minutes prior to admission (prehospital phase)
Number of patients which have mimic mistaken for stroke
Mimic mistaken for stroke evaluated as discrepancy between stroke as tentative diagnoses at primary contact from EMS and final diagnosis at discharge
Time frame: Through study completion, approximately 2 months
Prehospital time on scene
Time on scene from arrival EMS to departure EMS measured in minutes (continuous outcome)
Time frame: up to 120 minutes prior to admission (prehospital phase)
Type of department patient is admitted to after consultation with the neurologist
Where was the patient sent after telephone/video consultation with the on-call neurologist.
Time frame: At admission
Door-in-door-out (DIDO) time
DIDO times for patients subsequently sent to comprehensive stroke unit for thrombectomy treatment.
Time frame: at admission
Door-to-needle (DNT) time
DNT times for patients receiving thrombolysis
Time frame: at admission
Door-to-Groin-Puncture (DTGP) time
DTGP times for patients receiving treatment with thrombectomy
Time frame: within 24 hours of admission
Onset-to-Groin-Puncture (OTP) time
OTP for patients receiving treatment with thrombectomy
Time frame: within 24 hours of admission
90 days modified Ranking Scale (mRS)
Modified Rankin Scale score in stroke patients as evaluated through a structured telephone-based interview performed by a central assessor who is blinded to group assignment
Time frame: 90 days post admission date
Plan to share: No
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University of Southern Denmark