In response to Mobile Stroke Units - Cost-Effective or Just an Expensive Hype?

  • D. A. CadilhacEmail author
  • S. S. Rajan
  • J. Kim
Cardiovascular Disease and Stroke (S. Prabhakaran, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Cardiovascular Disease and Stroke

Dear Editor,

In their review, Walter et al. highlight an important point about the economic evidence to support the use of mobile stroke units. While it has been demonstrated that mobile stroke units (MSU) improve the provision of acute therapies, the evidence for cost-effectiveness is not as strong [1].

Two major limitations of the cost-effectiveness analyses of mobile stroke units (MSUs) conducted to date were discussed [2, 3]. The first reflected that the estimated health benefits were not based on prospectively collected data from participants treated in the respective MSU. Rather, the health benefits were estimated by applying expected benefits of additional treatment and time to treatment based on the findings of published literature. Secondly, these studies did not include the additional benefits of avoiding secondary transfers that often occur after patients are determined to be eligible for procedures, such as clot retrieval or surgical intervention for intracerebral...


Compliance with Ethical Standards

Conflict of Interest

Cadilhac DA, Rajan SS and Kim J declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


  1. 1.
    Walter S, Grunwald IQ, Helwig SA, Ragoschke-Schumm A, Kettner M, Fousse M, et al. Mobile stroke units - cost-effective or just an expensive hype? Curr Atheroscler Rep. 2018;20(10):49.CrossRefGoogle Scholar
  2. 2.
    Dietrich M, Walter S, Ragoschke-Schumm A, Helwig S, Levine S, Balucani C, et al. Is prehospital treatment of acute stroke too expensive an economic evaluation based on the first trial. Cerebrovasc Dis. 2014;38(6):457–63.CrossRefGoogle Scholar
  3. 3.
    Gyrd-Hansen D, Olsen KR, Bollweg K, Kronborg C, Ebinger M, Audebert HJ. Cost-effectiveness estimate of prehospital thrombolysis. Neurology. 2015;84(11):1090–7.CrossRefGoogle Scholar
  4. 4.
    Yamal J-M, Rajan SS, Parker SA, Jacob AP, Gonzalez MO, Gonzales NR, et al. Benefits of stroke treatment delivered using a mobile stroke unit trial. Int J Stroke. 2017;13(3):321–7.CrossRefGoogle Scholar
  5. 5.
    Zhao H, Coote S, Pesavento L, et al. Prehospital idarucizumab prior to intravenous thrombolysis in a mobile stroke unit. Int J Stroke. 2018:1747493018790081.Google Scholar
  6. 6.
    Audebert H, Fassbender K, Hussain MS, Ebinger M, Turc G, Uchino K, et al. The PRE-hospital Stroke Treatment Organization. Int J Stroke. 2017;12(9):932–40.CrossRefGoogle Scholar
  7. 7.
    Cadilhac DA, Lannin NA, Anderson CS, Levi CR, Faux S, Price C, et al. Protocol and pilot data for establishing the Australian Stroke Clinical Registry. Int J Stroke. 2010;5(3):217–26.CrossRefGoogle Scholar
  8. 8.
    Shuaib A, Amlani S, Kalashyan H, Morrison L, Khan K, Jickling G, et al. Mobile stroke unit triage of patients with a suspected stroke: a novel solution to reducing suspected stroke admissions in busy emergency departments. BMJ Innovations. 2018;4(2):54–9.CrossRefGoogle Scholar

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Stroke and Ageing Research, School of Clinical Sciences at Monash HealthMonash UniversityMelbourneAustralia
  2. 2.Stroke DivisionFlorey Institute of Neuroscience and Mental HealthParkvilleAustralia
  3. 3.Department of Management, Policy and Community Health, School of Public HealthUniversity of Texas Health Science Center at HoustonHoustonUSA

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