title: A prototype worldwide survey of diagnostic and treatment modalities for stroke.
abstract: Stroke is a global health problem. However, very little is known about stroke care in low- to middle-income countries. Obtaining country-specific information could enable us to develop targeted programs to improve stroke care. We surveyed neurologists from 12 countries (Chile, Georgia, Nigeria, Qatar, India, Lithuania, Kazakhstan, Indonesia, Denmark, Brazil, Belgium, and Bangladesh) using a web-based survey tool. Data were analyzed both for individual countries and by income classification (low income, lower middle income, upper middle income, and high income). Six percent (n = 200) of 3123 targeted physicians completed the survey. There was a significant correlation between income classification and access and affordability of head computed tomography scan (ρ = .215, P = .002), transthoracic echocardiogram (ρ = .181, P = .012), extracranial carotid Doppler ultrasound (ρ = .312, P ≤ .000), cardiac telemetry (ρ = .353, P ≤ .000), and stroke treatments such as intravenous thrombolysis (ρ = .276, P ≤ .001), and carotid endarterectomy (ρ = .214, P ≤ .004); stroke quality measures such as venous thromboembolism prophylaxis during hospital stay (ρ = .163, P ≤ .022), discharge from hospital on antithrombotic therapy (ρ = .266, P ≤ .000), consideration for acute thrombolytic therapy (ρ = .358, P ≤ .000), and antithrombotic therapy prescribed by end of hospital day 2 (ρ = .334, P ≤ .000). However, there was no significant correlation between income classification and the access and affordability of antiplatelet agents, vitamin K antagonists and statins, anticoagulation for atrial fibrillation/flutter, statin medication, stroke education, and assessment for rehabilitation. Our study shows that it is possible to get an overview of stroke treatment measures in different countries by conducting an internet-based survey. The generalizability of the findings may be limited by the low survey response rate.
authors.affiliation: Departments of Neurological Surgery and Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas. Electronic address: Venkatesh.aiyagari@utsouthwestern.edu.
authors.forename: Venkatesh
authors.initials: V
authors.lastname: Aiyagari
authors.affiliation: Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Dilip K
authors.initials: DK
authors.lastname: Pandey
authors.affiliation: Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Fernando D
authors.initials: FD
authors.lastname: Testai
authors.affiliation: Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Rebbeca A
authors.initials: RA
authors.lastname: Grysiewicz
authors.affiliation: Department of Neurology, Sarajishvili Institute of Neurology and Neurosurgery, Tbilisi, Georgia.
authors.forename: Alexander
authors.initials: A
authors.lastname: Tsiskaridze
authors.affiliation: Department of Neurology, Universidad de Valparaíso, Valparaíso, Chile.
authors.forename: Claudio
authors.initials: C
authors.lastname: Sacks
authors.affiliation: Department of Internal Medicine/Neurology, Aruna Ogun MSHosp, Ikorodu, Nigeria.
authors.forename: Yomi
authors.initials: Y
authors.lastname: Ogun
authors.affiliation: Neurology Unit, Department of Medicine University of Benin, Benin City, Nigeria.
authors.forename: Olubunmi A
authors.initials: OA
authors.lastname: Ogunrin
authors.affiliation: Department of Neurology, Weill Cornell Medical College in Qatar and Hamad Medical Corporation, Doha, Qatar.
authors.forename: Basim M
authors.initials: BM
authors.lastname: Uthman
authors.affiliation: Heart and Stroke Foundation, Ottawa, Ontario, Canada.
authors.forename: Patrice
authors.initials: P
authors.lastname: Lindsay
authors.affiliation: Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine & Mercy Health Hausenstein Neurosciences, Grand Rapids, Michigan.
authors.forename: Philip B
authors.initials: PB
authors.lastname: Gorelick
mesh_terms: D002545:Brain Ischemia / Q000175:diagnosis* / Q000517:prevention & control / Q000628:therapy*; D016894:Endarterectomy, Carotid; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D019538:Health Care Surveys; D006801:Humans; D020521:Stroke / Q000175:diagnosis* / Q000517:prevention & control / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: Stroke; acute treatment of stroke; clinical protocols; health care surveys; stroke prevention