New evidence for stroke prevention: clinical applications.
Stroke is a leading cause of morbidity and mortality in most developed nations. There is a significant body of evidence supporting strategies that target primary and secondary stroke prevention. This evidence cannot be broadly applied to all patients, and each patient's situation and values must be considered with regard to shared evidence-based decision making. Several models can be used to apply evidence to individual patients, including formal clinical decision analysis, decision aids, or simpler tools such as the likelihood of being helped vs harmed. Various programmatic models of providing patient care in stroke prevention may also be useful; these include specialized clinics or disease-management programs, anticoagulation management services, and self-testing and management of anticoagulation by patients.
Straus
Sharon E
SE
Division of General Internal Medicine, Department of Medicine, University Health Network, Toronto General Hospital, 200 Elizabeth St, ENG 248, Toronto, Ontario, Canada M5G 2C4. sstraus@mtsinai.on.ca
Majumdar
Sumit R
SR
McAlister
Finlay A
FA
D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications / Q000517:prevention & control*; D003661:Decision Support Techniques; D019317:Evidence-Based Medicine; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000517:prevention & control*; D006973:Hypertension / Q000150:complications / Q000517:prevention & control*; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors