Testing of alternative what-if? scenarios#

This section describes experiments using the pathway simulation. Key components of each hospital’s pathway may be changed, and the effect on thrombolysis use and clinical benefit estimated. Scenarios tested are:

  1. Base: Uses the hospitals’ recorded pathway statistics in SSNAP (same as validation notebook).

  2. Speed: Sets 95% of patients having a scan within 4 hours of arrival, and all patients have 15 minutes arrival to scan and 15 minutes scan to needle.

  3. Onset-known: Sets the proportion of patients with a known onset time of stroke to the national upper quartile if currently less than the national upper quartile (leave any greater than the upper national quartile at their current level).

  4. Benchmark: The benchmark thrombolysis rate takes the likelihood to give thrombolysis for patients scanned within 4 hours of onset from the majority vote of the 30 hospitals with the highest predicted thrombolysis use in a standard 10k cohort set of patients. These are from Random Forests models.

  5. Combinations of the above.

This section contains the following notebooks:

  • Stroke pathway simulation - generation of results from alternative scenarios: Generate results for alternative scenarios (no analysis)

  • Analysis of alternative pathway scenarios: Numerical and graphical analysis of results from the scenario modelling.

  • Modelling the same patient population attending all hospitals: Predicting the thrombolysis rate at each hospital if the same patient population (based on the national average patient characteristics) attend each hospital.

  • How much of the inter-hospital variation in thrombolysis use do in-hospital processes explain: Investigates the correlation (explained variance) between hospital model process parameters and the variation in use of thrombolysis between hospitals.