Table 1

Patient Intervention Comparison Outcome: PICO statement

PICO aspect
PopulationCare facilities admitting patients for treatment of acute ischaemic stroke with intravenous thrombolytic therapy.
InterventionThe review will only consider studies where a door-to-needle optimisation programme was in place, wherein the goal of the programme was to reduce the time from suspected acute ischaemic stroke patient intake at a care facility until the point where they received thrombolytic therapy.
Comparison/controlInterventions, defined here as methods or programmes to reduce door-to-needle times, will be the focus of comparison.
If a study introduces different interventions to reduce door-to-needle times at different time points, the previous time point will be considered inactive control interventions.
Across studies, different methods to reduce door-to-needle times will be considered active control interventions. The common core feature to all active control interventions is a specific aim and detailed method to reduce door-to-needle time for ischaemic thrombotic stroke patients, and may include prehospital care or a component of door-to-needle time (door-to-imaging time, imaging-to-needle time, etc). Trials including only one component of the intervention will be limited to comparison among data sets for the same component (eg, door-to-imaging time data will only be compared with door-to-imaging time data from other studies). Where two or more interventions, each for a different component, are combined in a study, data will be both split into its components and compared against other complete interventions as a novel method.
OutcomeThe primary outcome measured for all compared studies is the absolute improvement of the door-to-needle measurement, in units of time (usually minutes).