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What’s the best way to diagnose a stroke? MedStar Washington has an idea

By WTOP Staff

The moment a person is rushed with stroke-like symptoms to MedStar Washington Hospital Center, a chain-reaction process starts. The goal: To move the patient toward getting the clot-busting drug tPA as quickly as possible, preferably within 60 minutes.

But it’s one of the stops along the way in that process — magnetic resonance imaging, or the MRI — which has mixed reviews in the stroke community but also helped recently earn the hospital The Joint Commission designation as a Certified Comprehensive Stroke Center.

Most hospitals use CT scans as their default first-line test to diagnose stroke, said Dr. Amie Hsia, medical director of the Stroke Center at the hospital center. They are faster to perform, but provide less information than an MRI, Hsia said. The hospital has used MRIs as the default standard of care for suspected strokes for the last couple of years, Hsia said.

“We’re able to get more detailed information about what is really going on,” Hsia said. The sharper image helps providers determine who’s really suffering a stroke, where it’s occurring in the brain and how severe it is.

“But the push in the stroke community is to make sure we’re treating patients with tPA as quickly as possible,” Hsia said. “So some argue we don’t need to have a much detailed information.” Among the additional support for CT scans, much of the debate in stroke imaging has centered around access-related limitations of MRI. As well, some studies have found certain strokes can be better detected by CT scans.

While multiple hospitals in the area are designated by the Joint Commission as primary stroke centers, MedStar is the only hospital in Greater Washington and one of just 74 hospitals around the country with the comprehensive designation. To achieve the recognition, MedStar Washington Hospital Center underwent an on-site review in May when Joint Commission surveyors reviewed compliance with all comprehensive stroke center standards and requirements.

It serves as a stamp of approval from the Joint Commission that the hospital can handle some of the most complex stroke cases, Hsia said.

A representative from the Joint Commission said only hospitals which use MRI imaging for stroke diagnosis can be designated “Comprehensive Stroke Centers.” That is because these centers handle the most complex stroke cases and scientific literature shows MRI’s provide the most accurate imaging of the brain.

Johns Hopkins University Hospital also has the Comprehensive Stroke Center designation. In May, Johns Hopkins published a study in the journal Stroke supporting the use of the MRI, saying it developed a technique that can predict with 95 percent accuracy which stroke victims will benefit from clot-busters and which will suffer potentially dangerous side effects.

Don’t Settle for Student Loans to Pay for Online Education

By WTOP Staff
Online college programs are becoming a more popular choice for prospective students, with one study finding that more than 6 million students enrolled in at least one online course in fall 2015. The popularity of these courses can be attributed in part to their flexibility with working adults' schedules, students' ability to progress more quickly through online programs and, oftentimes, cheaper tuition. [See 10 low-cost online bachelor's programs for out-of-state students.]Online degrees can be beneficial to many college students, but some studies have shown online learners complete their programs at lower rates than students at traditional brick-and-mortar campuses. Individuals with student loans but no degree comprise two-thirds of defaulted borrowers. Though these numbers are not encouraging, just like for traditional programs, there are ways to reduce how much you'll need to borrow for an online program to ensure you won't become one of these statistics. Don't just settle on borrowing student loans to cover the whole cost of your program and living expenses. Instead, start thinking about how to cut costs and cover your balance in different ways, such as the following. -- Grants and scholarships: Even though you are taking an online course, you can still apply and receive grants and scholarships. But your first step should be to complete the Free Application for Federal Student Aid, commonly referred to as the FAFSA, which will allow you to receive a Pell Grant if your expected family contribution is low enough. The EFC criteria and award amounts are adjusted annually, but the 2017-2018 academic year awards range from $606 to $5,920, which could significantly lower the amount you borrow annually. Your next step is to apply for scholarships. You can start by checking online scholarship search engines, such as the Salt Scholarship Search, College Board's BigFuture and Peterson's. But don't forget to take advantage of local organizations and your school's financial aid office. Both may offer scholarships that you can't find with a national scholarship search. [Review these 10 sites to kick off your scholarship search.]For instance, organizations like the Elks Club, Knights of Columbus or the Rotary Club typically offer scholarships annually to local students. Just because you're going to school online doesn't mean you're ineligible. Visit your local library for scholarship listings, and ask around town. You might be surprised how many local organizations offer scholarships. While these scholarships typically aren't large, every little bit counts. Each dollar you receive in a scholarship is a dollar you don't have to borrow and pay interest on. -- Work-study: Another option for online students may be work-study awards. Not all students enrolled in online programs are eligible, but students at some schools -- including, for example, SUNY Empire State College and Liberty University -- are. Work-study awards are not given upfront like scholarships and grants. In most cases, they are an offer to earn up to the awarded amount if you secure an eligible work-study job. While there is a misconception that all work-study jobs must be on campus, students can work for off-campus, nonprofit or public employers as long as the work is in the public's interest. You may be able to work for a for-profit employer if the job is relevant to your course of study. No matter who the outside employer is, it will need to have an established agreement with your college for you to receive work-study funds. Remember, to be eligible for federal financial aid, you must be enrolled and pursuing a degree or certificate. If you're not working toward a credential, Pell Grants and work-study won't be option, but you may still be able to take advantage of private scholarships -- just be sure to read the eligibility criteria carefully. [Explore what to know about financial aid in online programs.]-- Pay as you go: One of the great benefits to enrolling online is the flexible schedule, which can allow you to complete your college coursework around your responsibilities. But prospective students often overlook using their part- or full-time job earnings as an option for paying for college. Almost 80 percent of college students in 2015 worked at least part time while attending classes, according to the National Center for Education Statistics. By budgeting and thinking strategically about your college costs, you can likely reduce your dependence on student loans by paying a portion out of pocket. Many -- but not all -- online programs are less expensive than traditional programs and often have shorter payment periods. Six, eight or 10 weeks are common course durations. Because of the frequency of payments in an online setting, you may be well-placed to pay as you go and possibly avoid borrowing altogether. Attending college online and avoiding student loans may be challenging, but if you are willing to put in the effort, you can limit the amount you need to borrow. More from U.S. News Q&A: Understanding Student Loan Discharge Eligibility Student Loan Refinancing Isn't Right for All Borrowers
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