Related Experiment Video
Updated: Aug 26, 2026
Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
Validation of a method to establish practice-based stroke and TIA registers
Bruce Willoughby1, Richard Thomson, Rakesh Chopra
1Public Health, Northumberland Care Trust, Loansdean, Morpeth, Northumberland NE61 2DL, UK. bruce.willoughby@northumberlandcaretrust.nhs.uk
Insights
Establishing stroke and transient ischaemic attack (TIA) registers is crucial. A pragmatic method, involving fewer patient notes, proved nearly as effective as an extensive review, suggesting its utility for practices with limited coding resources.
Area of Science:
- Neurology
- Public Health
- Health Informatics
Background:
- Establishing accurate stroke and transient ischaemic attack (TIA) registers is challenging for practices with limited diagnostic coding capabilities.
- Existing methods for register creation can be resource-intensive, requiring extensive review of patient records.
Purpose of the Study:
- To compare the effectiveness and efficiency of two distinct methods for establishing stroke and TIA practice-based registers.
- To identify a more resource-efficient approach suitable for primary care settings with limited diagnostic coding.
Main Methods:
- Two arms were compared: an 'extensive arm' involving a detailed notes review of patients with antiplatelet/anticoagulant use, ischemic heart disease (IHD), or diabetes.
- A 'pragmatic arm' involved a similar notes review but supplemented by direct patient questioning during IHD or diabetic clinics, focusing on stroke/TIA history.
- The pragmatic arm required reviewing only 3% of practice notes compared to 11% in the extensive arm.
Main Results:
- The pragmatic arm, despite reviewing significantly fewer patient notes (3% vs. 11%), achieved a yield comparable to the extensive arm.
- This indicates a high degree of efficiency in identifying relevant cases for stroke and TIA registers using the pragmatic approach.
Conclusions:
- The pragmatic method for establishing stroke and TIA registers is a viable and efficient alternative for practices with limited diagnostic coding.
- This approach offers a practical solution for improving data collection and register accuracy in primary care settings.
Abstract:
This study compares two methods to establish stroke and transient ischaemic attack (TIA) practice-based registers, which are of particular relevance to practices with limited diagnostic coding. Both arms involved a notes review of all patients taking antiplatelets or anticoagulants, and, either a further notes review of all patients with ischaemic heart disease (IHD) or diabetes (extensive arm), or asking about a history of stroke or TIA during IHD or diabetic clinics (pragmatic arm). The extensive arm involved searching 11% of the practice notes, whereas the pragmatic arm only involved 3% and had almost as high a yield. This study suggests that the pragmatic method could be used to help build practice-based stroke and TIA registers.
Related Concept Videos
01:26Transient Ischemic Attack l: Introduction
01:23Atherosclerosis IV: Nursing Management