The prevalence of obesity in Hungary ranks among the highest in the European Union, representing a significant healthcare burden. In modern medicine, stroke remains one of the major cardiovascular cost drivers, with obesity being a key modifiable risk factor. To estimate annual stroke-related healthcare cost savings achievable through population-level reduction in body mass index (BMI) in Hungary, based on five international risk models. A cross-sectional study of 2,442 adults was conducted between June and August 2022 via the nationwide “Bringing Screening to You” program. Post-stratification weighting by sex and age was applied to align with the 2022 national census. Population-attributable fraction (PAF) analysis incorporated five published BMI–stroke models (HUNT, CHARLS-male cohort, Physicians’ Health Study, meta-analysis, INTERSTROKE) and was applied to the €1.016 billion national stroke cost for 2022. Uncertainty was assessed using a 10,000-iteration Monte Carlo simulation. Weighted overweight and obesity prevalence was 72.5
BACKGROUND AND PURPOSE:Brain magnetic resonance imaging (MRI) is an essential component for outpatient neurological evaluation, though access to timely imaging at the point of care is not feasible for most outpatient neurology practices. Portable ultra-low-field MRI systems offer a potential solution, but studies describing their clinical performance in routine outpatient neurology practice remain limited. This study evaluated clinical concordance and patient experience of portable MRI (pMRI) compared to standard-of-care MRI (sMRI) in independent neurology practices. METHODS:In this prospective, multicenter study, adults presenting to outpatient neurology clinics and requiring clinically indicated brain MRI completed imaging with both pMRI (0.064 T) and sMRI (91% 3 T, 9% 1.5 T) in the neurology clinic. All examinations were independently reviewed by board-certified neuroradiologists in a blinded, randomized fashion without access to clinical history. The primary endpoint was patient-level concordance between modalities for the presence or absence of abnormal findings. Discordant cases underwent post hoc unblinded paired review with clinical history to assess clinical significance. Secondary endpoints included patient-reported experience, assessed using a structured questionnaire evaluating noise, comfort, claustrophobia, anxiety, and overall experience on 10-point Likert scales, as well as modality preference. RESULTS:Among 125 participants imaged for common outpatient indications, including headache (40%), cognitive impairment or dementia (16%), multiple sclerosis follow-up (16%), and tumor surveillance (16%), portable and sMRI demonstrated 92% concordance on blinded review. Following clinically informed post hoc review, concordance increased to 98%. pMRI was rated more favorably across all patient experience domains (p < 0.001), and participants preferred pMRI (61%) over sMRI (14%) by a 4:1 ratio. CONCLUSIONS:In outpatient neurology practices, pMRI images demonstrated high clinical concordance with sMRI for identifying the presence or absence of structural brain abnormalities and were strongly preferred by patients. These findings support the use of pMRI as a practical point-of-care imaging tool for neurology patients, enabling timely access to structural neuroimaging during the clinical encounter.
