Abstract TP504: Development of a Smart-phone App for Fast and Accurate Pediatric NIHSS Administration

Abstract

Background: The NIH stroke scale (NIHSS) is a standardized scale for evaluation of severity in stroke patient, and is utilized in adults with acute stroke to select patients for urgent intervention. A modified NIHSS has been validated for use in children (PedNIHSS). As pediatric stroke is rare, the PedNIHSS is not used frequently, and physicians are less familiar with the administration. Hence, this scale is used inconsistently, scoring can be less accurate, and important information is lost. We developed a smart-phone app for facilitated administration and recording of PedNIHSS in pediatrics. Methods: The PedNIHSS-App was built using the cross-platform software-developed environment Xamarin. Throughout development] validation and testing was performed with neurology colleagues. Feedbacks were collected from six pediatric neurologists for optimization. A web-based testing version was available during development. Results: Administration of the NIHSS stroke scale involves scoring 11 items of neurologic function. Administration of the PedNIHSS in children requires specific age-appropriate modification for testing and scoring. In the newly-developed PedNIHSSApp each item appears on a single page with clear explanations for administration and immediate scoring. Cartoons have been developed for visual instruction. Anonymously-recorded scoring -with no concerns for violation of confidentiality and/or dissemination of protected medical information- can be saved with a time stamp or sent via password-protected email. Conclusion: The user friendly, easy-to-use PedNIHSS App will facilitate accurate acquisition of PedNIHSS in children with acute stroke, particularly in situations when time is critical and standardized tools can support decision-making. Additionally, the easy to use PedNIHSS App will support increased data acquisition and therefore facilitate future outcome studies in pediatric stroke.