At the heart of the Lone Star Stroke Consortium’s mission is research that will improve the lives of all Texans affected by stroke and cerebrovascular disease. LSS has established a state-wide network for patient-centered stroke research and therapeutic trials within Texas. The network links academic health institutions with proven expertise in stroke research to community stroke centers.
Projects Under Way
LESTER is a database that captures preliminary, clinical, treatment, and long term outcomes data on all stroke patients treated via the telestroke network of the Lone Star Stroke Consortium. The goal of the database is to understand the patterns, mechanisms, and impact of regional stroke care in the context of expanding the telestroke network in the state of Texas. We seek to understand how stroke care is delivered and how outcomes are achieved with the use of telemedicine.
V-STOP helps stroke patients self-manage their risk factors to prevent a second stroke using Video-Teleconference (VT) delivery of self-management education and stroke prevention services.
Can MRI Identify Cardioembolic Stroke? This project is the first in a planned series of studies to develop and validate a brain imaging biomarker of cardioembolic stroke toward the long term goal of identifying a high risk group that may preferentially benefit from long term cardiac monitoring or anticoagulation in the absence of proven cardioembolic source.
EnRICH (Efficient Resource Utilization for Patients with Intracerebral Hemorrhage)
Are 90-day outcomes for spontaneous ICH patients with same risk subset associated with level of care? What is the comparative effectiveness for management of spontaneous ICH patients at a higher level of care? The Lone Star Stroke Consortium, with its network of hub and spoke hospitals, provides a unique opportunity to answers these questions. The first logical step towards developing evidence based recommendations is to study the regional patterns of care for ICH patients. Regional data are imperative to obtain detailed and granular information on in-patient and long term outcomes like resource utilization and functional and quality of life for ICH patients treated both at CSCs and non-certified community hospitals. These data are also necessary to study various transfer related decision parameters.
IAT-TiMeS (Intra-arterial Transfer Time Metric Study) aims to describe the current landscape of IAT transfer times at Texas CSCs to identify barriers/delays in the transfer process (phase 1). We will determine which hospitals have the longest and shortest transfer times and share the data with each of the LSS hospitals. Our objective is for each hospital to learn from each other and evaluate best practices associated with shorter transfer times that could be implemented throughout the network.
WISHES (Women’s Imaging of Stroke Hemodynamics Study) will attempt to determine candidate sex differences in cerebrovascular and hemodynamic predictors of stroke outcome for hypothesis generation from a retrospective database and prospectively test the hypothesis that sex differences in cerebrovascular and hemodynamic factors predict sex differences in stroke outcome.
START To determine the time-to-treatment interval for initiating NOACs for acute ischemic stroke patients with non-valvular A-Fib which has the lowest associated risk for adverse events in the context of anticoagulation therapy through an adaptive randomized clinical trial
FY2023 New Projects
ASSIST-TNK: To assess the barriers and facilitators faced by medical institutions in the transition from Alteplase to Tenecteplase as the standard therapy for acute ischemic stroke patients. This will be established through a series of quantitative and qualitative surveys.
Telecteplase vs Alteplase: To compare the therapeutic profile of Tenecteplase and Alteplase in the context of efficacy, door to needle time, hospice care cost, post discharge favorable and unfavorable outcomes in ischemic stroke patients through an adaptive randomized clinical trial
VAST2 VAST (eVAluation of post Stroke Telehealth Services in Texas) Using a series of virtual focus group sessions, VAST 2 evaluates perceptions, barriers, and facilitators of post-acute telehealth services among stroke survivors, their families, health care providers and health organizations since the beginning of the COVID pandemic.
In this qualitative study, the Lone Star Stroke study team will utilize a semi-structured interview format.
CT First vs MRI First To understand whether MRI can be used as an initial screening tool with comparable precision to CT in diagnosing hemorrhagic strokes.
In this study, many variables will be considered such as the accuracy, clinical history, index of suspicion and the time saved in diagnosis to initiation of treatment for better patient outcomes. This will be established through a randomized clinical trial.
