National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (2)
- Arthritis (1)
- Behavioral Health (1)
- Blood Clots (2)
- Blood Thinners (2)
- Cancer: Breast Cancer (1)
- Cardiovascular Conditions (14)
- Chronic Conditions (1)
- Community-Acquired Infections (1)
- Depression (1)
- Diabetes (1)
- Diagnostic Safety and Quality (1)
- Education: Patient and Caregiver (1)
- Elderly (3)
- Evidence-Based Practice (1)
- Family Health and History (1)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Utilization (1)
- Heart Disease and Health (9)
- Hospitalization (1)
- Hospital Readmissions (2)
- Human Immunodeficiency Virus (HIV) (2)
- Imaging (1)
- Maternal Care (1)
- Medication (5)
- Medication: Safety (2)
- Mortality (2)
- Orthopedics (1)
- Outcomes (2)
- Patient-Centered Outcomes Research (2)
- Pregnancy (1)
- Primary Care (1)
- Quality Improvement (1)
- Racial and Ethnic Minorities (10)
- Research Methodologies (1)
- (-) Risk (27)
- Sepsis (2)
- Shared Decision Making (3)
- Sleep Problems (1)
- Social Determinants of Health (1)
- (-) Stroke (27)
- Surgery (2)
- Women (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 27 Research Studies DisplayedMallela DP, Canner JK, Zarkowsky DS
Association between race and perioperative outcomes after carotid endarterectomy for asymptomatic carotid artery stenosis in NSQIP.
This study investigated the association of race on carotid endarterectomy (CEA) outcomes. Perioperative outcomes (at 30 days) were compared for Black vs. White patients adjusting for age/sex, comorbidities and disease characteristics. Out of 16,764 patients from the ACS-NSQIP targeted vascular database (2011-2019), 95.2% were White and 4.8% were Black. Black patients were slightly younger and more frequently (79.5% vs 74.0%) had high-grade carotid artery stenosis compared to White patients. Comorbidities including hypertension, diabetes, kidney disease, congestive heart failure, and coronary artery disease were all more prevalent among Black patients. Crude perioperative stroke and stroke/death were higher for Black patients, but myocardial infarction leading to death were similar. After adjusting for baseline differences between groups, the risk of perioperative stroke and stroke/death remained significantly higher for Black patients than White patients.
AHRQ-funded; HS024547.
Citation: Mallela DP, Canner JK, Zarkowsky DS .
Association between race and perioperative outcomes after carotid endarterectomy for asymptomatic carotid artery stenosis in NSQIP.
J Am Coll Surg 2022 Jan;234(1):65-73. doi: 10.1097/xcs.0000000000000016..
Keywords: Racial and Ethnic Minorities, Surgery, Cardiovascular Conditions, Stroke, Risk, Adverse Events
Boehme AK, Oka M, Cohen B
Readmission rates in stroke patients with and without infections: incidence and risk factors.
Investigators examined whether an infection acquired during the initial stroke admission contributed to increased risk of readmission and infection during readmission. Their a retrospective cohort study incorporated all adult ischemic stroke patients 2006-2016 from three New York City hospitals. They found that, among stroke patients, healthcare-associated infections and infections present on admission were predictors of readmission within 60 days and infection during readmission.
AHRQ-funded; HS024915.
Citation: Boehme AK, Oka M, Cohen B .
Readmission rates in stroke patients with and without infections: incidence and risk factors.
J Stroke Cerebrovasc Dis 2022 Jan;31(1):106172. doi: 10.1016/j.jstrokecerebrovasdis.2021.106172..
Keywords: Stroke, Cardiovascular Conditions, Hospital Readmissions, Risk, Healthcare-Associated Infections (HAIs)
Papaleontiou M, Levine DA, Reyes-Gastelum D
Thyroid hormone therapy and incident stroke.
This study’s objective was to determine the relationship between thyroid hormone treatment intensity and incidence of atrial fibrillation (AFIB) and stroke. This retrospective cohort study used data from the Veterans Health Administration between 2004 and 2017, with a median follow-up of 59 months. Total study population was comprised of 733,208 thyroid hormone users aged ≥18 years with at least 2 thyroid stimulating hormone (TSH) measurements between thyroid hormone initiation and incident event (atrial fibrillation or stroke) or study conclusion. Overall, 71,333 (11.08%) developed incident atrial fibrillation and 41,931 (6.32%) stroke. Higher incidence of stroke was associated with low thyroid-stimulation hormone (TSH) or high free thyroxine (T4) levels compared to patients with normal TSH or T4 levels. Risk of developing AFIB and stroke was cumulative over time for patients with exogenous hyperthyroidism or hypothyroidism.
AHRQ-funded; HS024512.
Citation: Papaleontiou M, Levine DA, Reyes-Gastelum D .
Thyroid hormone therapy and incident stroke.
J Clin Endocrinol Metab 2021 Sep 27;106(10):e3890-e900. doi: 10.1210/clinem/dgab444..
Keywords: Medication, Medication: Safety, Risk, Stroke
Sico JJ, Kundu S, So-Armah K
Depression as a risk factor for incident ischemic stroke among HIV-positive veterans in the veterans aging cohort study.
Background HIV infection and depression are each associated with increased ischemic stroke risk. Whether depression is a risk factor for stroke within the HIV population is unknown. In this study the investigators examined depression as a risk factor for incident ischemic stroke among HIV-positive veterans in the veterans aging cohort study. The investigators concluded that depression is associated with an increased risk of stroke among HIV-positive people after adjusting for sociodemographic characteristics, traditional cerebrovascular risk factors, and HIV-specific factors.
AHRQ-funded; HS023464.
Citation: Sico JJ, Kundu S, So-Armah K .
Depression as a risk factor for incident ischemic stroke among HIV-positive veterans in the veterans aging cohort study.
J Am Heart Assoc 2021 Jul 6;10(13):e017637. doi: 10.1161/jaha.119.017637..
Keywords: Depression, Behavioral Health, Risk, Human Immunodeficiency Virus (HIV), Stroke, Cardiovascular Conditions
O'Halloran JA, Sahrmann J, Butler AM
Brief report: integrase strand transfer inhibitors are associated with lower risk of incident cardiovascular disease in people living with HIV.
AHRQ-funded; HS019455.
Citation: O'Halloran JA, Sahrmann J, Butler AM .
Brief report: integrase strand transfer inhibitors are associated with lower risk of incident cardiovascular disease in people living with HIV.
J Acquir Immune Defic Syndr 2020 Aug 1;84(4):396-99. doi: 10.1097/qai.0000000000002357..
Keywords: Human Immunodeficiency Virus (HIV), Cardiovascular Conditions, Medication, Stroke, Heart Disease and Health, Risk
Mentias A, Shantha G, Adeola O
Role of diabetes and insulin use in the risk of stroke and acute myocardial infarction in patients with atrial fibrillation: a Medicare analysis.
This study examined the role of diabetes and insulin use in the risk of stroke and acute myocardial infarction (AMI) in patients with atrial fibrillation (AF). A cohort of Medicare beneficiaries newly diagnoses with AF from 2011 to 2013 were identified. The cohort was divided into those with diabetes requiring insulin (6.7%), those with diabetes not requiring insulin (31.3%) and non-diabetics (62%). Diabetics requiring insulin were at the greatest risk of stroke and AMI, and diabetics not requiring insulin were at slightly lower risk, but non-diabetics had the lowest risk.
AHRQ-funded; HS023104.
Citation: Mentias A, Shantha G, Adeola O .
Role of diabetes and insulin use in the risk of stroke and acute myocardial infarction in patients with atrial fibrillation: a Medicare analysis.
Am Heart J 2019 Aug;214:158-66. doi: 10.1016/j.ahj.2019.05.003..
Keywords: Diabetes, Stroke, Heart Disease and Health, Cardiovascular Conditions, Risk, Chronic Conditions, Elderly
Kempker JA, Panwar B, Judd SE
Plasma 25-hydroxyvitamin d and the longitudinal risk of sepsis in the REGARDS cohort..
In this paper, researchers studied low baseline plasma 25-hydroxyvitamin D (25(OH)D) and its association with long-term risk of sepsis. Data from the Reasons for Geographic and Racial Differences in Stroke study was used. Findings reveals that, among community-dwelling US adults, low plasma 25(OH)D measured at a time of relative health was independently associated with increased risk of sepsis.
AHRQ-funded; HS025240.
Citation: Kempker JA, Panwar B, Judd SE .
Plasma 25-hydroxyvitamin d and the longitudinal risk of sepsis in the REGARDS cohort..
Clin Infect Dis 2019 May 17;68(11):1926-31. doi: 10.1093/cid/ciy794..
Keywords: Community-Acquired Infections, Racial and Ethnic Minorities, Risk, Sepsis, Stroke
Mahalingam M, Moore Jx, Donnelly JP
Frailty syndrome and risk of sepsis in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort.
This study examined the association between frailty (weakness, exhaustion, and low physical activity) and the risk of sepsis in stroke patients. Data from the cohort study Reasons for Geographic and Racial Differences in Stroke (REGARDS) was used. There was an associated increase in sepsis hospitalizations and 30-day case fatalities from sepsis in stroke patients with more frailty indicators.
AHRQ-funded; HS013852.
Citation: Mahalingam M, Moore Jx, Donnelly JP .
Frailty syndrome and risk of sepsis in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort.
J Intensive Care Med 2019 Apr;34(4):292-300. doi: 10.1177/0885066617715251..
Keywords: Elderly, Racial and Ethnic Minorities, Risk, Sepsis, Stroke
O'Brien EC, Holmes DN, Thomas L
Incremental prognostic value of renal function for stroke prediction in atrial fibrillation.
This study investigated whether renal function predicted stroke in patients diagnosed with atrial fibrillation (AF). Data from the Outcomes Registry for Better Informed Treatment (ORBIT-AF) was used. Investigators concluded that renal dysfunction was not independently associated with embolic risk in either treated or untreated patients.
AHRQ-funded; HS021092.
Citation: O'Brien EC, Holmes DN, Thomas L .
Incremental prognostic value of renal function for stroke prediction in atrial fibrillation.
Int J Cardiol 2019 Jan 1;274:152-57. doi: 10.1016/j.ijcard.2018.07.113..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Risk, Stroke
Borre ED, Goode A, Raitz G
Predicting thromboembolic and bleeding event risk in patients with non-valvular atrial fibrillation: a systematic review.
This systematic review compared the strength of tools to predict stroke and bleeding risk in patients with atrial fibrillation (AF) taking blood thinners. Sixty-one studies were found to predict thromboembolic risk and 38 to predict bleeding risk.
AHRQ-funded; 290201500004I.
Citation: Borre ED, Goode A, Raitz G .
Predicting thromboembolic and bleeding event risk in patients with non-valvular atrial fibrillation: a systematic review.
Thromb Haemost 2018 Dec;118(12):2171-87. doi: 10.1055/s-0038-1675400..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Stroke, Blood Clots, Blood Thinners, Medication, Adverse Drug Events (ADE), Adverse Events, Risk, Patient-Centered Outcomes Research, Evidence-Based Practice
Desai RJ, Wyss R, Jin Y
Extension of disease risk score-based confounding adjustments for multiple outcomes of interest: an empirical evaluation.
Use of disease risk score (DRS)-based confounding adjustment when estimating treatment effects on multiple outcomes is not well studied. In this empirical cohort study, the investigators compared dabigatran initiators and warfarin initiators with respect to risks of ischemic stroke and major bleeding in 12 sequential monitoring periods (90 days each), using data from the Truven Marketscan database (Truven Health Analytics, Ann Arbor, Michigan).
AHRQ-funded; HS022193.
Citation: Desai RJ, Wyss R, Jin Y .
Extension of disease risk score-based confounding adjustments for multiple outcomes of interest: an empirical evaluation.
Am J Epidemiol 2018 Nov;187(11):2439-48. doi: 10.1093/aje/kwy130.
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Keywords: Blood Thinners, Cardiovascular Conditions, Medication, Outcomes, Research Methodologies, Risk, Stroke
Sterling MR, Durant RW, Bryan J
N-terminal pro-B-type natriuretic peptide and microsize myocardial infarction risk in the reasons for geographic and racial differences in stroke study.
Researchers compared the association of N-terminal pro B-type peptide (NT-proBNP) with risk of incident typical myocardial infarction (MI) and microsize MI in the REasons for Geographic and Racial Differences in Stroke Study. Over a median of 5 years of follow-up, there were 315 typical MI, 139 microsize MI, and 195 incident fatal coronary heart disease (CHD). NT-proBNP was independently and strongly associated with all CHD endpoints, with significantly greater risk observed for incident microsize MI.
AHRQ-funded; HS000066.
Citation: Sterling MR, Durant RW, Bryan J .
N-terminal pro-B-type natriuretic peptide and microsize myocardial infarction risk in the reasons for geographic and racial differences in stroke study.
BMC Cardiovasc Disord 2018 Apr 16;18(1):66. doi: 10.1186/s12872-018-0806-4.
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Keywords: Heart Disease and Health, Racial and Ethnic Minorities, Risk, Stroke
Mefford MT, Rosenson RS, Cushman M
PCSK9 variants, low-density lipoprotein cholesterol, and neurocognitive impairment: Reasons for Geographic and Racial Differences in Stroke Study(REGARDS).
Researchers examined if there was an association between low lifelong exposure to PCSK9 levels and lower levels of low-density lipoprotein cholesterol with neurocognitive function in blacks. Data was analyzed from subjects in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. The mean sample age was 64, with 62% women but a low prevalence of neurocognitive impairments at any level (6.3% by CERAD battery, and 15.4% by SIS definitions). No association with found.
AHRQ-funded; HS013852.
Citation: Mefford MT, Rosenson RS, Cushman M .
PCSK9 variants, low-density lipoprotein cholesterol, and neurocognitive impairment: Reasons for Geographic and Racial Differences in Stroke Study(REGARDS).
Circulation 2018 Mar 20;137(12):1260-69. doi: 10.1161/circulationaha.117.029785..
Keywords: Heart Disease and Health, Racial and Ethnic Minorities, Risk, Stroke
Sanders BD, Davis MG, Holley SL
Pregnancy-associated stroke.
This article reviews assessment and treatment of pregnant and postpartum women experiencing stroke. There are 2 main types of stroke, ischemic and hemorrhagic that present similar symptoms but have very different pathophysiology and treatment. This article provides guidance for subsequent maternity and primary care for front-line perinatal care providers.
AHRQ-funded; HS024733.
Citation: Sanders BD, Davis MG, Holley SL .
Pregnancy-associated stroke.
J Midwifery Womens Health 2018 Jan;63(1):23-32. doi: 10.1111/jmwh.12720..
Keywords: Cardiovascular Conditions, Maternal Care, Pregnancy, Primary Care, Risk, Stroke, Women
Cramer JD, Patel UA, Maas MB
Is neck dissection associated with an increased risk of postoperative stroke?
The researchers investigated whether neck dissection is an independent risk factor for postoperative stroke. They found that the rate of postoperative stroke was greater with neck dissection than without it and concluded that stroke is a rare but highly morbid complication after head and neck surgery. Compared with other head and neck surgery, neck dissection in patients at risk for carotid artery stenosis is associated with an increased risk of postoperative stroke.
AHRQ-funded; HS023011.
Citation: Cramer JD, Patel UA, Maas MB .
Is neck dissection associated with an increased risk of postoperative stroke?
Otolaryngol Head Neck Surg 2017 Aug;157(2):226-32. doi: 10.1177/0194599817698414.
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Keywords: Orthopedics, Quality Improvement, Risk, Stroke, Surgery
Nakagawa K, Ahn HJ, Taira DA
Ethnic comparison of 30-day potentially preventable readmissions after stroke in Hawaii.
The authors sought to compare potentially preventable readmissions (PPR) among a multiethnic population in Hawaii. They concluded that the Chinese ethnicity may have a higher risk of 30-day PPR after stroke compared to whites. Other associated factors include mental illness, Medicaid, and Hawaii county.
AHRQ-funded; HS019990.
Citation: Nakagawa K, Ahn HJ, Taira DA .
Ethnic comparison of 30-day potentially preventable readmissions after stroke in Hawaii.
Stroke 2016 Oct;47(10):2611-7. doi: 10.1161/strokeaha.116.013669.
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Keywords: Stroke, Racial and Ethnic Minorities, Hospital Readmissions, Hospitalization, Risk
Kabra R, Girotra S, Vaughan Sarrazin M
Refining stroke prediction in atrial fibrillation patients by addition of African-American ethnicity to CHA2DS2-VASc score.
The authors hypothesized that the addition of African-American ethnicity to the CHA2DS2-VASc score might improve stroke prediction in patients with atrial fibrillation (AF). They found that, in patients over age 65 with newly diagnosed AF, the addition of ethnicity to CHA2DS2-VASc score significantly improved stroke prediction.
AHRQ-funded; HS023104.
Citation: Kabra R, Girotra S, Vaughan Sarrazin M .
Refining stroke prediction in atrial fibrillation patients by addition of African-American ethnicity to CHA2DS2-VASc score.
J Am Coll Cardiol 2016 Aug 2;68(5):461-70. doi: 10.1016/j.jacc.2016.05.044.
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Keywords: Stroke, Heart Disease and Health, Racial and Ethnic Minorities, Risk, Cardiovascular Conditions
Karp DN, Wolff CS, Wiebe DJ
Reassessing the stroke belt: using small area spatial statistics to identify clusters of high stroke mortality in the United States.
The researchers identified clusters of high stroke mortality and adjacent areas of low stroke mortality for US counties and evaluated for regional differences in county-level risk factors. They found that clusters of high stroke mortality exist beyond the 8-state stroke belt, and variation exists within the stroke belt. They recommended reconsideration of the stroke belt definition and suggested increased attention to local determinants of health underlying small area regional variability to inform targeted healthcare interventions.
AHRQ-funded; HS018362.
Citation: Karp DN, Wolff CS, Wiebe DJ .
Reassessing the stroke belt: using small area spatial statistics to identify clusters of high stroke mortality in the United States.
Stroke 2016 Jul;47(7):1939-42. doi: 10.1161/strokeaha.116.012997.
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Keywords: Mortality, Risk, Stroke, Social Determinants of Health
Du XL, Zhang Y, Hardy D
Associations between hematopoietic growth factors and risks of venous thromboembolism, stroke, ischemic heart disease and myelodysplastic syndrome: findings from a large population-based cohort of women with breast cancer.
The researchers sought to determine the risk of venous thromboembolism (VTE), stroke, ischemic heart disease, and myelodysplastic syndrome (MDS) in association with the receipt of colony-stimulating factors (CSFs) and/or erythropoiesis-stimulating agents (ESAs) in women with breast cancer. They found that receipts of CSFs and ESAs were significantly associated with an increased risk of VTE in women with breast cancer.
AHRQ-funded; HS018956.
Citation: Du XL, Zhang Y, Hardy D .
Associations between hematopoietic growth factors and risks of venous thromboembolism, stroke, ischemic heart disease and myelodysplastic syndrome: findings from a large population-based cohort of women with breast cancer.
Cancer Causes Control 2016 May;27(5):695-707. doi: 10.1007/s10552-016-0742-5.
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Keywords: Blood Clots, Cancer: Breast Cancer, Cardiovascular Conditions, Risk, Stroke
Kerber KA, Meurer WJ, Brown DL
Stroke risk stratification in acute dizziness presentations: a prospective imaging-based study.
The researchers estimated the ability of bedside information to risk stratify stroke in acute dizziness presentations. They found that in acute dizziness presentations, the combination of ABCD(2) score, general neurologic examination, and a specialized ocular motor examination has the capacity to risk-stratify acute stroke on MRI.
AHRQ-funded; HS018334; HS017690; HS022258.
Citation: Kerber KA, Meurer WJ, Brown DL .
Stroke risk stratification in acute dizziness presentations: a prospective imaging-based study.
Neurology 2015 Nov 24;85(21):1869-78. doi: 10.1212/wnl.0000000000002141..
Keywords: Stroke, Risk, Healthcare Utilization, Shared Decision Making
Kabra R, Cram P, Girotra S
Effect of race on outcomes (stroke and death) in patients >65 years with atrial fibrillation.
The researchers sought to determine whether there are any racial differences in the outcomes of death and stroke in patients with newly diagnosed AF in patients >65 years. They found that the risks of death and stroke are higher in blacks and Hispanics compared with whites. The increased risk was eliminated or significantly reduced after adjusting for preexisting co-morbidities.
AHRQ-funded; HS021992.
Citation: Kabra R, Cram P, Girotra S .
Effect of race on outcomes (stroke and death) in patients >65 years with atrial fibrillation.
Am J Cardiol 2015 Jul 15;116(2):230-5. doi: 10.1016/j.amjcard.2015.04.012..
Keywords: Elderly, Heart Disease and Health, Cardiovascular Conditions, Racial and Ethnic Minorities, Stroke, Mortality, Risk
Solomon DH, Reed GW, Kremer JM
Disease activity in rheumatoid arthritis and the risk of cardiovascular events.
The researchers studied whether time-averaged disease activity in rheumatoid arthritis (RA) correlates with cardiovascular (CV) events. They found that reduced time-averaged disease activity in RA is associated with fewer CV events.
AHRQ-funded; HS018517.
Citation: Solomon DH, Reed GW, Kremer JM .
Disease activity in rheumatoid arthritis and the risk of cardiovascular events.
Arthritis Rheumatol 2015 Jun;67(6):1449-55. doi: 10.1002/art.39098.
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Keywords: Cardiovascular Conditions, Heart Disease and Health, Arthritis, Risk, Stroke
Friedant AJ, Gouse BM, Boehme AK
A simple prediction score for developing a hospital-acquired infection after acute ischemic stroke.
The authors sought to develop a simple scoring system for any hospital-acquired infection (HAI). Ranging from 0 to 7, the overall infection score consists of age 70 years or more, history of diabetes, and National Institutes of Health Stroke Scale score. Patients with an infection score of 4 or more were at 5 times greater odds of developing an infection. They concluded that, if validated in other populations, this score could assist providers in predicting infections after ischemic stroke.
AHRQ-funded; HS013852.
Citation: Friedant AJ, Gouse BM, Boehme AK .
A simple prediction score for developing a hospital-acquired infection after acute ischemic stroke.
J Stroke Cerebrovasc Dis 2015 Mar;24(3):680-6. doi: 10.1016/j.jstrokecerebrovasdis.2014.11.014.
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Keywords: Shared Decision Making, Healthcare-Associated Infections (HAIs), Patient-Centered Outcomes Research, Risk, Stroke
Aycock DM, Kirkendoll KD, Coleman KC
Family history of stroke among African Americans and its association with risk factors, knowledge, perceptions, and exercise.
The authors compared modifiable risk factors, knowledge of stroke risk factors, perceived threat of stroke, perceived control of stroke, and exercise behaviors and intentions in African Americans with a family history of stroke (FHS) and those without a FHS. They found that family history of stroke was common among those studied; however, this fact did not translate into better understanding of stroke or better exercise behaviors and intentions. They recommended that more be done to identify African Americans with a FHS, especially those with multiple risk factors, in order to educate them about the significance of FHS while promoting lifestyle change and self-management.
AHRQ-funded; HS013852.
Citation: Aycock DM, Kirkendoll KD, Coleman KC .
Family history of stroke among African Americans and its association with risk factors, knowledge, perceptions, and exercise.
J Cardiovasc Nurs 2015 Mar-Apr;30(2):E1-6. doi: 10.1097/jcn.0000000000000125.
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Keywords: Education: Patient and Caregiver, Family Health and History, Racial and Ethnic Minorities, Risk, Stroke
Boehme AK, Rawal PV, Lyerly MJ
Investigating the utility of previously developed prediction scores in acute ischemic stroke patients in the stroke belt.
The researchers compared several scoring systems among patients receiving systemic and endovascular treatments. They concluded that their study demonstrated that although highly predictive of outcome in the original study design treatment groups, prediction scores may not generalize to all patient samples, highlighting the importance of validating prediction scores in diverse samples.
AHRQ-funded; HS013852.
Citation: Boehme AK, Rawal PV, Lyerly MJ .
Investigating the utility of previously developed prediction scores in acute ischemic stroke patients in the stroke belt.
J Stroke Cerebrovasc Dis 2014 Sep;23(8):2001-6. doi: 10.1016/j.jstrokecerebrovasdis.2014.02.003.
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Keywords: Shared Decision Making, Diagnostic Safety and Quality, Risk, Stroke