title: Transient ischameic attack/stroke electronic decision support: a 14-month safety audit.
abstract: BACKGROUND
  To assess the safety of a Transient Ischameic Attack (TIA)/Stroke Electronic Decision Support (EDS) tool in the primary care setting intended to aid general practitioners in the timely management of transient ischemic attacks (TIAs).
  
  
  METHODS
  A 14-month safety audit reviewing all patients managed with the help of the TIA/Stroke EDS tool. Major morbidity and mortality were assessed by screening patients for subsequent hospital admissions and investigating potential links to EDS use.
  
  
  RESULTS
  Seventy-nine patients were managed with the aid of the TIA/Stroke EDS. EDS use resulted in 8 appropriate immediate hospital admissions because of patients being at high risk of stroke. Three patients had delayed admission, but care was fully guideline based and patients had no adverse outcome. Eleven admissions were unrelated to EDS use. Two deaths occurred; these did not result from inappropriate EDS advice.
  
  
  CONCLUSIONS
  Results suggest that TIA/Stroke EDS use is not associated with major morbidity or mortality. Larger studies are needed to draw more definite conclusions regarding the utility of this TIA/Stroke EDS in preventing strokes.
authors.affiliation: Department of Neurology, Royal Preston Hospital, Sharoe Green Lane, Preston, Lancashire, UK.
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Lavin
authors.affiliation: Department of Neurology, MidCentral Health, Palmerston North, New Zealand; Dean's Department, University of Otago, Wellington at Palmerston North, New Zealand. Electronic address: anna.ranta@otago.ac.nz.
authors.forename: Annemarei
authors.initials: A
authors.lastname: Ranta
mesh_terms: D000369:Aged, 80 and over; D057189:Checklist; D020000:Decision Support Systems, Clinical; D003661:Decision Support Techniques; D019033:Delivery of Health Care, Integrated; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D008297:Male; D008485:Medical Audit; D010343:Patient Admission; D061214:Patient Safety; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011237:Predictive Value of Tests; D011320:Primary Health Care; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000628:therapy*; D013813:Therapy, Computer-Assisted; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome
keywords: Stroke; Transient Ischameic Attack (TIA); computer-assisted; decision making; decision support techniques; delivery of health care; electronic decision support (EDS); integrated