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Physician knowledge and practices in the evaluation of coagulopathies in stroke patients

Cheryl D Bushnell1, Larry B Goldstein

  • 1Duke Center for Cerebrovascular Disease, Duke University Medical Center, Durham, NC 27710, USA. bushn002@mc.duke.edu

Stroke
|April 6, 2002
PubMed

Insights

Neurologists infrequently use specialized coagulation tests for ischemic stroke, despite guidelines. Improving knowledge application could optimize diagnostic testing for coagulopathies in stroke patients.

Area of Science:

  • Neurology
  • Hematology
  • Diagnostic Medicine

Background:

  • Coagulopathies are an uncommon cause of ischemic stroke.
  • Physician test-ordering practices for coagulopathies in ischemic stroke patients are suboptimal.
  • Understanding neurologists' perspectives on specialized coagulation testing is crucial.

Purpose of the Study:

  • To determine neurologists' views on using specialized coagulation testing for ischemic stroke.
  • To identify reasons behind current test-ordering practices for coagulopathies.
  • To explore factors influencing the decision to order specialized coagulation tests.

Main Methods:

  • A survey was distributed to 79 neurologists (faculty, residents/fellows, community practitioners).
  • The survey included multiple-choice and open-ended questions on evaluating coagulopathies.
  • Response rate was 75% (59 completed surveys).

Main Results:

  • Specialized coagulation tests rarely influenced stroke patient management (95% of respondents).
  • Factors increasing test ordering included young patient age, thrombosis history, and miscarriage history.
  • Most neurologists would order tests for young patients with no risk factors but not for those with traditional risk factors or atrial fibrillation.

Conclusions:

  • Physician-reported practices for specialized coagulation tests differ from observational data.
  • Knowledge gaps and application issues may hinder optimal diagnostic testing for coagulopathies.
  • Improving knowledge translation is key to optimizing test ordering for ischemic stroke evaluation.
Abstract

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