Table 2. Re-configuration decentralized model: results simulation experiments.

	tPA rate (95% CI)	OTT min (95% CI)	tPA 0–1.5 hr (95% CI)	tPA 1.5–3.0 hr (95% CI)	tPA 3.0–4.5 hr (95% CI)	mRS 0–1‡
Scenario
0. Current practice	14.4% (13.7% –15.1%)	134 (63–235)	14.3% (12.6% –16.3%)	70.5% (68.1% –72.8%)	15.2% (13.4% –17.1%)	14.7%
Pre-hospital phase
1. Symptom onset to call for help	16.1% (15.4% –16.8%)	128 (50–238)	21.0% (19.0% –23.0%)	64.7% (62.3% –67.0%)	14.4% (12.7% –16.2%)	17.5%
2. First responder	15.3% (14.6% –16.0%)	130 (63–235)	15.5% (13.8% –17.4%)	71.8% (69.5% –74.0%)	12.7% (11.1% –14.5%)	15.9%
3. EMS transport	17.2% (16.4% –17.9%)	134 (67–235)	13.2% (11.7% –14.9%)	73.0% (70.9% –75.1%)	13.8% (12.2% –15.5%)	17.5%
4. High priority transport by EMS	14.6% (13.9% –15.3%)	133 (64–240)	14.8% (13.1% –16.7%)	70.1% (67.7% –72.4%)	15.1% (13.4% –17.1%)	15.0%
5. Combining all pre-hospital scenarios	20.8% (20.0% –21.6%)	127 (44–241)	20.8% (19.1% –22.6%)	66.2% (64.2% –68.2%)	13.0% (11.6% –14.5%)	22.7%
In-hospital phase
6. Neurological examination	14.9% (14.2% –15.6%)	130 (63–235)	17.1% (15.3% –19.1%)	69.9% (67.6% –72.2%)	13.0% (11.4% –14.8%)	15.7%
7. Neuroimaging examination	15.2% (14.5% –15.9%)	127 (56–232)	20.0% (18.1% –22.1%)	66.9% (64.5% –69.2%)	13.1% (11.5% –14.9%)	16.4%
8. Combing both in-hospital scenarios	15.4% (14.8% –16.2%)	124 (55–230)	22.8% (20.8% –25.0%)	65.5% (63.1% –67.9%)	11.7% (10.2% –13.4%)	17.2%
9. Combining all scenarios	22.3% (21.5% –23.1%)	117 (32–236)	28.4% (26.8% –30.3%)	61.2% (59.2% –63.2%)	10.4% (9.3% –11.8%)	26.1%

tPA indicates tissue plasminogen activator; CI, confidence interval; OTT, onset-treatment-time; mRS, modified rankin scale; EMS, emergency medical services.

‡Indicates the proportion of patients with good outcome (mRS 0–1) ascribed to treatment with thrombolysis. The number needed to treat to achieve one patient with mRS 0–1 at 90 days for OTT 0–90 = 4.5, OTT 91–180 = 9.0, OTT 181–270 = 14.1 [21].