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Padgham M, Boeing G, Cooley D, Tierney N, Sumner M, Phan TG, Beare R. An Introduction to Software Tools, Data, and Services for Geospatial Analysis of Stroke Services. Front Neurol 2019; 10:743. [PMID: 31440197 PMCID: PMC6693386 DOI: 10.3389/fneur.2019.00743] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 06/25/2019] [Indexed: 12/01/2022] Open
Abstract
Background: There is interest in the use geospatial data for development of acute stroke services given the importance of timely access to acute reperfusion therapy. This paper aims to introduce clinicians and citizen scientists to the possibilities offered by open source softwares (R and Python) for analyzing geospatial data. It is hoped that this introduction will stimulate interest in the field as well as generate ideas for improving stroke services. Method: Instructions on installation of libraries for R and Python, source codes and links to census data are provided in a notebook format to enhance experience with running the software. The code illustrates different aspects of using geospatial analysis: (1) creation of choropleth (thematic) map which depicts estimate of stroke cases per post codes; (2) use of map to help define service regions for rehabilitation after stroke. Results: Choropleth map showing estimate of stroke per post codes and service boundary map for rehabilitation after stroke. Conclusions The examples in this article illustrate the use of a range of components that underpin geospatial analysis. By providing an accessible introduction to these areas, clinicians and researchers can create code to answer clinically relevant questions on topics such as service delivery and service demand.
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Affiliation(s)
| | - Geoff Boeing
- School of Public Policy and Urban Affairs, Northeastern University, Boston, MA, United States
| | | | - Nicholas Tierney
- Department of Econometrics and Business Statistics, Monash University, Melbourne, VIC, Australia
| | - Michael Sumner
- Australian Antarctic Division, Department of the Environment and Energy, Kingston, TAS, Australia
| | - Thanh G Phan
- Clinical Trials Imaging and Informatics Division of Stroke and Aging Research Group, Monash University, Melbourne, VIC, Australia.,Stroke Unit, Monash Medical Centre, Melbourne, VIC, Australia
| | - Richard Beare
- Department of Medicine, Monash University, Melbourne, VIC, Australia.,Developmental Imaging, Murdoch Children's Research Institute, Melbourne, VIC, Australia
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Phan TG, Beare R, Srikanth V, Ma H. Googling Service Boundaries for Endovascular Clot Retrieval (ECR) Hub Hospitals in Metropolitan Sydney. Front Neurol 2019; 10:708. [PMID: 31333564 PMCID: PMC6614527 DOI: 10.3389/fneur.2019.00708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 06/17/2019] [Indexed: 11/13/2022] Open
Abstract
Background and Purpose: Endovascular clot retrieval (ECR) has revolutionized acute stroke therapy but is expensive to run and staff with accredited interventional neuroradiologists 24/7; consequently, it is only feasible for each metropolitan city to have a minimum number of hubs that is adequate to service the population. This method is applied to search the minimum number of hospitals to be designated as ECR hubs in Sydney as well as the population at risk of stroke reachable within 30 min. Methods: Traveling time from the centroids of each suburbs to five ECR capable hubs [Royal Prince Alfred/RPA, Prince of Wales/POW, Royal North Shore/RNS, Liverpool/LH and Westmead/WH]. This step was performed using ggmap package in R to interface with Google Map application program interface (API). Next, we calculate the percentage of suburbs within each catchment in which traveling time to the ECR hub is <30 min. This step was performed for all possible combination of ECR hubs. The maps are available at https://gntem3.shinyapps.io/ambsydney/. The population at risk of stroke was estimated using stroke incident studies in Melbourne and Adelaide. Results: The best 3-hospital combinations are LPH/WH/RNS (82.3, 45.7, and 79.7% of suburbs reachable within 30 min or 187 of 226 suburbs) follow by RPA/LPH/RNS (100.0, 80.9, and 73.1% of suburbs) and LPH/POW/RNS (83.3, 90.7, and 76.6% of suburbs). The best 4-hospital model is LPH/WH/POW/RNS (84.2%, 91.1%, 90.7%, 77.8%). In the 5-hospital model, ECR is available for 191 suburbs within 30 min: LPH (83%), RPA (100%), WH (90.2%), RNS (72.7%), POW (88.9%). Based on 3-hospital model and 15% of patient eligible for ECR, the expected number of cases to be handled by each hospital is 465. This number drops down to 374 if a 4-hospital model is preferred. Conclusions: The simulation studies supported a minimum of 4 ECR hubs servicing Sydney. This model provides data on number of suburbs and population at risk of stroke that can reach these hubs within 30 min.
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Affiliation(s)
- Thanh G Phan
- Department of Neurology, Monash Health, Melbourne, VIC, Australia.,Clinical Trials, Imaging and Infomatics (CTI), Division of Stroke and Aging Research Group, Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
| | - Richard Beare
- Clinical Trials, Imaging and Infomatics (CTI), Division of Stroke and Aging Research Group, Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia.,Department of Medicine, Frankston Hospital, Peninsula Health, Melbourne, VIC, Australia.,Central Clinical School, Monash University, Melbourne, VIC, Australia.,Developmental Imaging, Murdoch Children Research Institute, Melbourne, VIC, Australia
| | - Velandai Srikanth
- Department of Neurology, Monash Health, Melbourne, VIC, Australia.,Clinical Trials, Imaging and Infomatics (CTI), Division of Stroke and Aging Research Group, Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia.,Department of Medicine, Frankston Hospital, Peninsula Health, Melbourne, VIC, Australia.,Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Henry Ma
- Department of Neurology, Monash Health, Melbourne, VIC, Australia.,Clinical Trials, Imaging and Infomatics (CTI), Division of Stroke and Aging Research Group, Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
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