Stroke metrics, safety, and outcomes of telemedicine-administered thrombolytics for acute ischemic stroke: A meta-analysis

Table 1 Prespecified eligibility criteria

Participants	Interventions	Comparison	Outcomes	Study types
Age > 18 years; acute stroke patients receiving intravenous thrombolytics	Intervention group: Telemedicine (audio and video) evaluation by neurology specialist	Control group: In-person evaluation by neurology specialist	Primary outcome: Door-to-needle time. Secondary outcomes: sICH; mortality; mRS ≤ 2; only studies evaluating one or more of these outcomes	RCT; observational cohort study

sICH: Symptomatic intracranial hemorrhage; RCT: Randomized controlled trial.

Table 2 Characteristics of included studies, mean ± SD/median (25^th-75^th percentiles)

Ref.	Country	Telemedicine	In-person	DTN, in minutes	sICH	Mortality	Favorable short-term outcome
Loggini et al[6], 2024	United States	n = 142	n = 97	TM: 55 (43-73); IP: 42 (35-54)	TM: 3; IP: 3	TM: 8; IP: 9	TM: 98; IP: 60
Ho et al[23], 2024	Canada	n = 55	n = 247	TM: 35.5 ± 12.7; IP: 34 ± 15.9	TM: 0; IP: 4	TM: 7; IP: 40	-
Riegler et al[25], 2023	Germany	n = 50	n = 42	TM: 65 (43-78); IP: 37 (25-51)	TM: 10; IP: 10	TM: 15; IP: 8	TM: 4; IP: 15
Lin et al[22], 2022	Taiwan	n = 25	n = 153	TM: 62 (53-78); IP: 51 (41-65)	TM: 1; IP: 5	TM: 4; IP: 14	TM: 15; IP: 91
Zhang et al[20], 2020	China	n = 235	n = 588	TM: 62 ± 12; IP: 47 ± 8	-	-	-
Sobhani et al[27], 2021	United States	n = 55	n = 77	TM: 56.8; IP: 41.5	-	-	TM: 29/44; IP: 27/57
Asaithambi et al[24], 2017	United States	n = 52	n = 65	TM: 54 (41-72); IP: 43 (35-55)	TM: 0; IP: 1	TM: 2; IP: 1	-
Nardetto et al[21], 2016	Italy	n = 25	n = 106	TM: 73 (98-121); IP: 95 (82-125)	TM: 2; IP: 3	-	TM: 12; IP: -
Raulot et al[19], 2015	France	n = 27	n = 70	TM: 86 (63-94); IP: 55 (45-64)	TM: 1; IP: 5	-	TM: 8; IP: 22
Chowdhury et al[17], 2012	United Kingdom	n = 45	n = 52	TM: 61; IP: 33	TM: 2; IP: 4	-	TM: 19 IP: 19
Zaidi et al[26], 2011	United States	n = 83	n = 59	TM: 89.9 ± 36.3; IP: 67.8 ± 26.1	TM: 1; IP: 3	TM: 18; IP: 26	TM: 22; IP: 35

TM: Telemedicine; IP: In-person; DTN: Door-to-needle; sICH: Symptomatic intracranial hemorrhage.