New Device Could Detect In Hospital Strokes Faster
Steven Messe, MD, discusses an innovation in stroke detection: a wristband that could alert hospital professionals for earlier intervention.
https://www.webmd.com/stroke/video/steven-messe
— TRANSCRIPT —
JOHN WHYTE
A person has a stroke nearly every 40 seconds in the United States. Despite recent advances in treatment, there are still significant challenges after suffering a stroke. That’s why diagnosis is so important. We tend to think about strokes occurring in the community. But strokes can also occur in the hospital setting. And when they do, they often go undetected for over 4 hours.
My guest today has the device to change that, using a special wristband. It received FDA breakthrough designation last year and was also named one of Time magazine’s 200 Best Inventions of 2022. Joining me is Dr. Steven Messe. He’s a Professor of Neurology at the Hospital the University of Pennsylvania, as well as Associate Director of the Vascular Neurology Fellowship. Steve, it’s nice to see you.
STEVEN MESSE
Thanks, Dr. Whyte. Appreciate the opportunity to speak with you today.
JOHN WHYTE
Well, I have to start off because a lot of viewers are probably thinking strokes occur in the hospital? What’s going on here? Because you’re not talking about people who came in with stroke. Is that correct?
STEVEN MESSE
Absolutely correct. So about 10% overall of all the strokes that are occurring are happening under our noses in the hospital. And the issue is that people come in with diseases or are undergoing procedures that we know are high risk for stroke. And so they definitely can occur while we are taking care of these patients. And in particular, procedures of the heart, cardiovascular procedures, and the aorta, which is the main artery leaving the heart, you can have debris or a clot that can go up into the head and cause a stroke. So it definitely happens all the time.
JOHN WHYTE
ut Steve, people are in a hospital setting, where there’s a lot of monitoring and a lot of oversight. So it still seems a bit surprising, doesn’t it, that your data shows it can take over 4 hours in the current environment if someone has a stroke in the hospital to actually be detected? Is that right?
STEVEN MESSE
That is. Yeah, that’s absolutely correct. And there are a number of challenges. Patients are in bed or bedbound, oftentimes sedated, coming out of anesthesia. And when you have a stroke, it’s not like a heart attack, where you have a lot of pain and maybe will wake up and say, I’m in pain. When you have a stroke, pain is not usually involved. But you may not be able to speak. You may not be able to move.
So the patients can’t necessarily tell the staff they’re having trouble. And as we all know, the nurses and doctors are working very hard in the hospital. But they can’t be in the room all the time. And so oftentimes things will go undetected for hours. And with stroke, as you mentioned, we have treatments that are amazing, but time is the most critical factor to getting a good outcome, even to be eligible for treatment. If you’re too late, you may not be eligible to be treated.
JOHN WHYTE
And that’s where diagnosis comes into play. We always talk about recognizing the signs and symptoms, which sometimes can be confusing, and then quick diagnosis. But when we think about the diagnosis, we often think about fancy imaging, right? We’re going to do a CT scan. We’re going to do an MRI, PET scan, and all these other type of scans. But your device involves a wristband. So tell us how you thought about that and how it works.
STEVEN MESSE
Yeah. So we recognized that this was a problem, that we weren’t catching the strokes fast enough. And we wanted to really work on that. And one of the hallmarks of stroke, one of the cardinal signs of stroke is weakness on one side of the body. And so we knew that’s what we wanted to tackle as sort of a low-hanging fruit for stroke detection. And accelerometers are ubiquitous and really sort of basic technology now, things that can measure movements very easily. We wear them on our smartwatches and our Fitbits. And we knew, again, that asymmetric movement is a hallmark of stroke. So we put accelerometers on our patients’ wrists, patients who had a stroke and patients who didn’t have a stroke so that we could develop an algorithm that can differentiate between the two and detect when somebody has that weakness that’s indicative of stroke, to alert the staff to come check the patient and identify that stroke faster. So this has been going on for– something we’ve been working on for years now. And it took a long time to get the algorithm to work as we need it to because we can’t have it alerting the nurses all the time.
JOHN WHYTE
Sure.
STEVEN MESSE
You don’t want to have a lot of false alarms. But we also want to catch these strokes quickly.
JOHN WHYTE
Is it looking for subtle changes? Because let’s be fair.
https://www.webmd.com/stroke/video/steven-messe