# Comparative Effectiveness of Imaging Strategies in Acute Ischemic Stroke Based on Patient Profiles - Resubmission - 1

> **NIH NIH R56** · FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH · 2020 · $627,915

## Abstract

Project Summary/Abstract
Stroke has a significant health impact and presents an ongoing challenge for the health of the population
and the availability of healthcare resources. Imaging plays a critical role in both diagnosis and treatment
decisions in acute ischemic stroke. However, optimal strategies regarding advanced imaging with 
angiography and perfusion using either CT (CTAP) or MR (MRAP) remain uncertain according to national guide-
lines. Consequently, inefficient imaging practices have evolved with marked increased utilization of 
advanced imaging. Wide variations in stroke imaging also exist in clinical practice, mostly defaulted to 
physician preferences and institutional factors, without a clear understanding of the benefits and risks involved in
stroke care. The main concern is that inefficient imaging leads to time-delays to treatment and potentially
worse outcomes. Although CTAP and MRAP each have unique benefits and risks in the acute stroke 
setting, the effect of this risk-benefit tradeoff on health outcomes and utilization of resources is unknown. The
problem is this lack of outcomes-based evidence results in wide variations and inefficient imaging practices
in stroke care, directly affecting utilization of resources and costs, but more importantly affecting treatment
decisions, time-delays and health outcomes. Unfortunately, no efforts to-date have been effective in moving
beyond this as the status-quo because significant knowledge gaps exist in understanding how different 
imaging strategies affect stroke outcomes given the unique risk-benefit tradeoffs of advanced imaging with 
either CTAP or MRAP in the acute stroke setting. The overall objective of this proposal is to compare the 
effectiveness of imaging strategies in acute ischemic stroke employing decision science methods to assess
the risk-benefit tradeoffs on health outcomes, utilization of resources (imaging and treatment) and costs. Our
central hypothesis is that health outcomes will be improved and healthcare resources used most efficiently
when advanced imaging (CTAP or MRAP) is selected according to specific patient profiles, defined by 
characteristics known to impact stroke outcomes such as age, clinical stroke severity and symptom onset time.
We will perform the following specific aims: (1) Update trends in stroke health outcomes, quality metrics, 
utilization of resources and costs, (2) Develop new imaging recommendations tailored to patient profiles based
on stroke outcomes, and (3) Quantify the potential impact of the new imaging recommendations on health
outcomes, utilization of resources and costs in an ideal model-based scenario compared to current real-
world practice. Our deliverables are innovative imaging recommendations tailored to patient profiles in acute
ischemic stroke with comprehensive model evaluation of the potential impact on health outcomes and 
utilization of resources, providing critical safety, feasibility and efficacy data prior to imp...

## Key facts

- **NIH application ID:** 10201377
- **Project number:** 1R56NS114275-01A1
- **Recipient organization:** FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH
- **Principal Investigator:** Pina Christine Sanelli
- **Activity code:** R56 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $627,915
- **Award type:** 1
- **Project period:** 2020-09-30 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10201377

## Citation

> US National Institutes of Health, RePORTER application 10201377, Comparative Effectiveness of Imaging Strategies in Acute Ischemic Stroke Based on Patient Profiles - Resubmission - 1 (1R56NS114275-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10201377. Licensed CC0.

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