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Applying Neuroeconomic Principles to Stroke Care: Bridging Evidence to Practice
Gustavo Saposnik1,2,3, Yongchai Nilanont4,5, S Claiborne Johnston6,7
1Stroke Outcomes and Decision Neuroscience research unit, Li Ka Shing Knowledge Institute, Unity Health Toronto, Canada (G.S.).
Abstract:
Over the past 10 years, stroke care has seen remarkable technological and pharmacological breakthroughs-ranging from advanced thrombectomy devices and streamlined thrombolytic therapies like tenecteplase to artificial intelligence-powered imaging and rehabilitation tools. Yet adoptions remain uneven due to fragmented systems, low adherence, and inconsistent implementation. To overcome these barriers, neuroeconomics-a multifaceted integration of neuroscience, behavioral economics, psychology, and clinical medicine-sharpens decision-making under uncertainty and drives sustained behavior change. Behavioral economics offers a toolkit of low-cost, scalable interventions-nudges, default options, framing effects, commitment devices, incentives, gamification, and social-norm feedback-that can be woven into every phase of stroke management. Embedding preselected treatment orders in electronic health records, default-scheduling follow-up appointments, and delivering tailored digital reminders have all boosted adherence to medications, rehabilitation exercises, and preventive measures. Financial rewards and community-based feedback loops have improved both clinicians' prescribing habits and patient self-management. Early pilot programs demonstrate that even small tweaks in workflow or choice architecture can yield outsized improvements in timely reperfusion, secondary prevention uptake, and long-term outcomes. By embedding evidence-based interventions directly into care decisions, the integration of neuroeconomic principles helps bridge the gap between scientific innovation and its transformative impact on patient outcomes.
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