Development and implementation of a rapid, accurate, and cost-effective protocol for national stroke prevention screening.
BACKGROUND
Three medical conditions--cervical carotid artery disease, atrial fibrillation, and hypertension--cause the majority of strokes. Discovering these silent, immediate causes of stroke through screening, so they can be treated before stroke occurs, can potentially prevent strokes on an epidemiologic scale.


METHODS
A rapid, accurate, and cost-effective stroke prevention screening (SPS) protocol was developed.


RESULTS
The SPS protocol was used to screen 6,073 seniors residing in the central valley of California, at Madigan Army Medical Center, at New York University, and by the American Vascular Association at 68 leading institutions. The screening was estimated to have prevented 30 strokes and to have saved the health care system >$2 million.


CONCLUSIONS
Implementation of a national SPS for seniors can discover the silent, immediate causes of strokes so they can be managed before stroke occurs and can potentially prevent the majority of strokes that we are currently not preventing.
Lavenson
George S
GS
Department of Vascular Surgery, Kaweah Delta District Hospital, 609 Acequia, Suite C, Visalia, CA 93291, USA. glavenson@aol.com
Pantera
Richard L
RL
Garza
Rosa M
RM
Neff
Tracey
T
Rothwell
Sue D
SD
Cisneros
Jane
J
D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging; D002985:Clinical Protocols; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D004562:Electrocardiography / Q000191:economics / Q000379:methods; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000458:organization & administration*; D008875:Middle Aged; D009313:National Health Programs / Q000458:organization & administration*; D016730:Program Development; D015397:Program Evaluation; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*; D018608:Ultrasonography, Doppler / Q000191:economics / Q000379:methods; D014481:United States