Publications by authors named "R L Grimley"
Objective: This study sought to determine the use and perceived value of a user-centered electronic medical record (EMR) enhancement for stroke care and understand if its value was in alignment with its intended design. The EMR enhancement was introduced into Queensland public hospitals in Australia and included a summary page for enhanced interprofessional collaboration and data collection forms for efficient data extraction.
Methods: A mixed methods design was adopted and data collected from four hospital sites.
Background: Stroke affects long-term physical and cognitive function; many survivors report unmet health needs, such as pain or depression. A hospital-led follow-up service designed to address ongoing health problems may avoid unplanned readmissions and improve quality of life.
Methods: This paper outlines the protocol for a registry-based, randomised controlled trial with allocation concealment of participants and outcome assessors.
Tenecteplase versus alteplase for thrombolysis in patients selected by use of perfusion imaging within 4·5 h of onset of ischaemic stroke (TASTE): a multicentre, randomised, controlled, phase 3 non-inferiority trial.
Lancet Neurol
August 2024
Article Synopsis
- The study compared the effectiveness of intravenous tenecteplase and alteplase in treating ischaemic stroke patients identified as having salvageable brain tissue using perfusion imaging, focusing on whether tenecteplase is at least as effective (non-inferior) to alteplase in terms of patient outcomes after 3 months.
- Conducted across 35 hospitals in eight countries, the trial enrolled 680 patients aged 18 and older, who were randomly assigned to receive either tenecteplase or alteplase, with the primary outcome being the rate of patients without disability measured through the modified Rankin Scale.
- The trial was halted early due to positive results
Article Synopsis
- The health system is evolving towards Learning Health System (LHS) models that effectively integrate digital tools, engage stakeholders, and enhance patient-centered care by providing performance feedback against best practices.* -
- The LHS framework consists of four quadrants: gathering evidence from the community, incorporating research findings, utilizing data for practice, and generating implementation evidence, all aimed at continuous system improvement.* -
- The Australian Stroke program illustrates a successful national LHS implementation that has improved stroke care since 2007, serving as a model for applying evidence-based practices to other healthcare conditions.*
Article Synopsis
- The study investigated whether intravenous tranexamic acid can reduce haematoma growth in patients experiencing an acute intracerebral hemorrhage when administered within 2 hours of onset, compared to a placebo.
- Conducted as a double-blind, randomized phase 2 trial across multiple countries, the research included 201 eligible participants who were assigned to receive either tranexamic acid or saline as a placebo.
- The primary outcome measured was haematoma growth assessed through CT scans at 24 hours, alongside safety endpoints including mortality and thromboembolic events at specified intervals.