Benefits of Stroke Treatment Delivered Using a Mobile Stroke Unit Compared to Standard Management by Emergency Medical Services (BEST-MSU Study), United States, 2014-2022 (ICPSR 39547)
The standard care of hospital or emergency department patients experiencing an acute ischemic stroke includes intravenously administered tissue plasminogen activator (tPA). Mobile stroke units (MSUs) are ambulances equipped with staff and a computed tomographic scanner that can allow for tPA to be administered more quickly. This comparative effectiveness trial examined clinical outcomes in stroke patients who received either an earlier diagnosis and treatment using an MSU or standard triage and transport by Emergency Medical Services (EMS). The sample included multicenter cohorts with randomized deployment weeks and blinded assessment of both trial entry and clinical outcomes.
Integrated Health Services to Reduce Opioid Use While Managing Chronic Pain (INSPIRE Trial), North Carolina and Tennessee, 2019-2023 (ICPSR 39271)
INtegrated Services for Pain: Interventions to Reduce Pain Effectively (INSPIRE) was a pragmatic randomized trial conducted from 2019 to 2023 with adults receiving chronic opioid therapy (COT) of at least 20 morphine milligram equivalents (MME) daily for chronic noncancer pain (CNCP). Participants were recruited from primary care and specialty pain clinics at three academic health centers in North Carolina and Tennessee. The study compared the effectiveness of the two behavioral interventions, 1) shared decision making (SDM) versus 2) motivational interviewing plus cognitive behavioral therapy for chronic pain (MI+CBT), on change in opioid dose, physical function, and pain interference. INSPIRE combined data from electronic health records (EHR) on opioid dose from baseline to 18 months and comorbidities with participant survey data at baseline, 6, and 12 months on the following topics:
- physical function,
- pain interference,
- pain intensity,
- anxiety,
- depression,
- pain severity,
- discontinuation of opioids,
- intent to reduce opioids,
- opioid use relative to baseline,
- adverse events,
- demographics,
- health insurance coverage,
- health literacy,
- patient-centered communication, and
- types of pain treatment used.
The collection includes three analysis datasets:
- Adverse Events Dataset - one record per subject per adverse event
- Opioid Prescriptions Dataset (post-processed opioid prescriptions used to derive the study's primary outcome) - one record per subject per opioid prescription
- Outcomes Dataset (contains all of the study's demographics, primary, secondary, exploratory, and subgroup analysis variables) - one record per subject per timepoint