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IRM-DU is a prospective observational single center study conducted in an emergency department to evaluate the impact of a MRI scanner exclusively dedicated to emergency in the clinical management of patients presenting with dizziness or diplopia.
The study will compare 2 strategies : after and before availability of a MRI scanner dedicated to emergency.
The primary endpoint is the proportion of patients with a diagnosis of stroke confirmed by imaging (MRI or Computed tomography (CT)) in the group "before implementation of the emergency MRI scanner" and the group "after implementation of the emergency MRI scanner".
The hypothesis is that the availability of a MRI scanner dedicated to emergency will improve the diagnosis of stroke in patients presenting with dizziness or diplopia, and will reduce Emergency Department stay, hospital stay and hospitalisation costs.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Before dedicated MRI | |||
| After dedicated MRI |
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| Measure | Description | Time Frame |
|---|---|---|
| Diagnosis is established on the positive signs of stroke highlighted on the CT scan or brain MRI according to the examination performed | Proportion of patients with a diagnosis of stroke confirmed by cerebral radiology (MRI or scan according to examination) in the pre- and post-MRI groups. | 18 months |
| Measure | Description | Time Frame |
|---|---|---|
| Evaluate the time of care | Evaluate the time of care: time of realization of the examination of radiology (scanner or brain MRI), delay of passage in emergencies | 18 months |
| Number of CT and brain MRI requested by the emergency physician in the before / after groups |
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Inclusion Criteria:
Exclusion Criteria:
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Primary care
All patients presented in ED with dizziness or diplopia are eligible to the study protocol
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| Name | Affiliation | Role |
|---|---|---|
| Sabrina GARNIER KEPKA | Les Hôpitaux Universitaires de Strasbourg | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Les Hôpitaux Universitaires de Strasbourg | Strasbourg | 67091 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35554653 | Derived | Kepka S, Zarca K, Lersy F, Moris M, Godet J, Deur J, Stoessel M, Muller J, Le Borgne P, Baloglu S, Fleury MC, Anheim M, Bilbault P, Bierry G, Durand Zaleski I, Kremer S. MRI dedicated to the emergency department for diplopia or dizziness: a cost-effectiveness analysis. Eur Radiol. 2022 Nov;32(11):7344-7353. doi: 10.1007/s00330-022-08791-7. Epub 2022 May 13. |
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Number of CT and brain MRI requested by the emergency physician in the before / after groups |
| 18 months |
| Evaluate the usual management of vertigo and diplopia | Evaluate the usual management of vertigo and diplopia: number of CT and brain MRI requested by the emergency physician in the "before / after" groups; number of cerebral CT and MRI performed by the radiologist in the "before / after" groups | 18 months |
| Evaluate the rate of new consultations in emergencies | Evaluate the rate of new consultations in emergencies for a neurological reason in the month following the initial care in emergencies, and the rate of new hospitalizations for the same reason | 18 months |
| Rate of new emergency department visits for neurological | Rate of new emergency department visits for neurological reasons in the month following initial emergency care | the month following initial emergency care |
| Evaluate the irradiation rate | Evaluate the irradiation rate related to the initial radiological examination performed during emergency care | 18 months |
| ID | Term |
|---|---|
| D020521 | Stroke |
| D004244 | Dizziness |
| D004172 | Diplopia |
| D004630 | Emergencies |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D012678 | Sensation Disorders |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D014786 | Vision Disorders |
| D005128 | Eye Diseases |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
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