title: Substantial Progress Yet Significant Opportunity for Improvement in Stroke Care in China.
abstract: Stroke is a leading cause of death in China. Yet the adherence to guideline-recommended ischemic stroke performance metrics in the past decade has been previously shown to be suboptimal. Since then, several nationwide stroke quality management initiatives have been conducted in China. We sought to determine whether adherence had improved since then.
  
  
  
  Data were obtained from the 2 phases of China National Stroke Registries, which included 131 hospitals (12 173 patients with acute ischemic stroke) in China National Stroke Registries phase 1 from 2007 to 2008 versus 219 hospitals (19 604 patients) in China National Stroke Registries phase 2 from 2012 to 2013. Multiple regression models were developed to evaluate the difference in adherence to performance measure between the 2 study periods.
  
  
  
  The overall quality of care has improved over time, as reflected by the higher composite score of 0.76 in 2012 to 2013 versus 0.63 in 2007 to 2008. Nine of 13 individual performance metrics improved. However, there were no significant improvements in the rates of intravenous thrombolytic therapy and anticoagulation for atrial fibrillation. After multivariate analysis, there remained a significant 1.17-fold (95% confidence interval, 1.14-1.21) increase in the odds of delivering evidence-based performance metrics in the more recent time periods versus older data. The performance metrics with the most significantly increased odds included stroke education, dysphagia screening, smoking cessation, and antithrombotics at discharge.
  
  
  
  Adherence to stroke performance metrics has increased over time, but significant opportunities remain for further improvement. Continuous stroke quality improvement program should be developed as a national priority in China.
authors.affiliation: From the Division of Vascular Neurology, Department of Neurology (Z.L., X.Z., C.Z., Yongjun Wang), Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology (Z.L., Chunjuan Wang, H.L., A.W., Y.P., Y.J., X.Y., Yilong Wang), Neurointensive Care Unit, Department of Neurology (L.L.), and Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology (Chunxue Wang), Beijing TianTan Hospital, Capital Medical University, China; China National Clinical Research Center for Neurological Diseases, Beijing (Yilong Wang, Yongjun Wang); Center of Stroke, Beijing Institute for Brain Disorders, China (Z.L., X.Z.); Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (Chunjuan Wang); Department of Statistics and Operations Research, University of North Carolina at Chapel Hill (H.S.); Duke Clinical Research Institute (J.B., E.D.P., Y.X.) and Duke University School of Nursing (J.B., Q.Y.), Duke University, Durham, NC; INI Stroke Network, OSF Healthcare System, University of Illinois College of Medicine, Peoria (D.W.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center (G.C.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (L.H.S.); and Department of Quantitative Health Sciences, Cleveland Clinic, OH (B.H.).
authors.forename: Zixiao
authors.initials: Z
authors.lastname: Li
authors.affiliation: From the Division of Vascular Neurology, Department of Neurology (Z.L., X.Z., C.Z., Yongjun Wang), Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology (Z.L., Chunjuan Wang, H.L., A.W., Y.P., Y.J., X.Y., Yilong Wang), Neurointensive Care Unit, Department of Neurology (L.L.), and Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology (Chunxue Wang), Beijing TianTan Hospital, Capital Medical University, China; China National Clinical Research Center for Neurological Diseases, Beijing (Yilong Wang, Yongjun Wang); Center of Stroke, Beijing Institute for Brain Disorders, China (Z.L., X.Z.); Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (Chunjuan Wang); Department of Statistics and Operations Research, University of North Carolina at Chapel Hill (H.S.); Duke Clinical Research Institute (J.B., E.D.P., Y.X.) and Duke University School of Nursing (J.B., Q.Y.), Duke University, Durham, NC; INI Stroke Network, OSF Healthcare System, University of Illinois College of Medicine, Peoria (D.W.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center (G.C.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (L.H.S.); and Department of Quantitative Health Sciences, Cleveland Clinic, OH (B.H.).
authors.forename: Chunjuan
authors.initials: C
authors.lastname: Wang
authors.affiliation: From the Division of Vascular Neurology, Department of Neurology (Z.L., X.Z., C.Z., Yongjun Wang), Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology (Z.L., Chunjuan Wang, H.L., A.W., Y.P., Y.J., X.Y., Yilong Wang), Neurointensive Care Unit, Department of Neurology (L.L.), and Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology (Chunxue Wang), Beijing TianTan Hospital, Capital Medical University, China; China National Clinical Research Center for Neurological Diseases, Beijing (Yilong Wang, Yongjun Wang); Center of Stroke, Beijing Institute for Brain Disorders, China (Z.L., X.Z.); Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (Chunjuan Wang); Department of Statistics and Operations Research, University of North Carolina at Chapel Hill (H.S.); Duke Clinical Research Institute (J.B., E.D.P., Y.X.) and Duke University School of Nursing (J.B., Q.Y.), Duke University, Durham, NC; INI Stroke Network, OSF Healthcare System, University of Illinois College of Medicine, Peoria (D.W.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center (G.C.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (L.H.S.); and Department of Quantitative Health Sciences, Cleveland Clinic, OH (B.H.).
authors.forename: Xingquan
authors.initials: X
authors.lastname: Zhao
authors.affiliation: From the Division of Vascular Neurology, Department of Neurology (Z.L., X.Z., C.Z., Yongjun Wang), Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology (Z.L., Chunjuan Wang, H.L., A.W., Y.P., Y.J., X.Y., Yilong Wang), Neurointensive Care Unit, Department of Neurology (L.L.), and Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology (Chunxue Wang), Beijing TianTan Hospital, Capital Medical University, China; China National Clinical Research Center for Neurological Diseases, Beijing (Yilong Wang, Yongjun Wang); Center of Stroke, Beijing Institute for Brain Disorders, China (Z.L., X.Z.); Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (Chunjuan Wang); Department of Statistics and Operations Research, University of North Carolina at Chapel Hill (H.S.); Duke Clinical Research Institute (J.B., E.D.P., Y.X.) and Duke University School of Nursing (J.B., Q.Y.), Duke University, Durham, NC; INI Stroke Network, OSF Healthcare System, University of Illinois College of Medicine, Peoria (D.W.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center (G.C.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (L.H.S.); and Department of Quantitative Health Sciences, Cleveland Clinic, OH (B.H.).
authors.forename: Liping
authors.initials: L
authors.lastname: Liu
authors.affiliation: From the Division of Vascular Neurology, Department of Neurology (Z.L., X.Z., C.Z., Yongjun Wang), Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology (Z.L., Chunjuan Wang, H.L., A.W., Y.P., Y.J., X.Y., Yilong Wang), Neurointensive Care Unit, Department of Neurology (L.L.), and Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology (Chunxue Wang), Beijing TianTan Hospital, Capital Medical University, China; China National Clinical Research Center for Neurological Diseases, Beijing (Yilong Wang, Yongjun Wang); Center of Stroke, Beijing Institute for Brain Disorders, China (Z.L., X.Z.); Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (Chunjuan Wang); Department of Statistics and Operations Research, University of North Carolina at Chapel Hill (H.S.); Duke Clinical Research Institute (J.B., E.D.P., Y.X.) and Duke University School of Nursing (J.B., Q.Y.), Duke University, Durham, NC; INI Stroke Network, OSF Healthcare System, University of Illinois College of Medicine, Peoria (D.W.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center (G.C.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (L.H.S.); and Department of Quantitative Health Sciences, Cleveland Clinic, OH (B.H.).
authors.forename: Chunxue
authors.initials: C
authors.lastname: Wang
authors.affiliation: From the Division of Vascular Neurology, Department of Neurology (Z.L., X.Z., C.Z., Yongjun Wang), Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology (Z.L., Chunjuan Wang, H.L., A.W., Y.P., Y.J., X.Y., Yilong Wang), Neurointensive Care Unit, Department of Neurology (L.L.), and Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology (Chunxue Wang), Beijing TianTan Hospital, Capital Medical University, China; China National Clinical Research Center for Neurological Diseases, Beijing (Yilong Wang, Yongjun Wang); Center of Stroke, Beijing Institute for Brain Disorders, China (Z.L., X.Z.); Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (Chunjuan Wang); Department of Statistics and Operations Research, University of North Carolina at Chapel Hill (H.S.); Duke Clinical Research Institute (J.B., E.D.P., Y.X.) and Duke University School of Nursing (J.B., Q.Y.), Duke University, Durham, NC; INI Stroke Network, OSF Healthcare System, University of Illinois College of Medicine, Peoria (D.W.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center (G.C.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (L.H.S.); and Department of Quantitative Health Sciences, Cleveland Clinic, OH (B.H.).
authors.forename: Hao
authors.initials: H
authors.lastname: Li
authors.affiliation: From the Division of Vascular Neurology, Department of Neurology (Z.L., X.Z., C.Z., Yongjun Wang), Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology (Z.L., Chunjuan Wang, H.L., A.W., Y.P., Y.J., X.Y., Yilong Wang), Neurointensive Care Unit, Department of Neurology (L.L.), and Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology (Chunxue Wang), Beijing TianTan Hospital, Capital Medical University, China; China National Clinical Research Center for Neurological Diseases, Beijing (Yilong Wang, Yongjun Wang); Center of Stroke, Beijing Institute for Brain Disorders, China (Z.L., X.Z.); Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (Chunjuan Wang); Department of Statistics and Operations Research, University of North Carolina at Chapel Hill (H.S.); Duke Clinical Research Institute (J.B., E.D.P., Y.X.) and Duke University School of Nursing (J.B., Q.Y.), Duke University, Durham, NC; INI Stroke Network, OSF Healthcare System, University of Illinois College of Medicine, Peoria (D.W.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center (G.C.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (L.H.S.); and Department of Quantitative Health Sciences, Cleveland Clinic, OH (B.H.).
authors.forename: Haipeng
authors.initials: H
authors.lastname: Shen
authors.affiliation: From the Division of Vascular Neurology, Department of Neurology (Z.L., X.Z., C.Z., Yongjun Wang), Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology (Z.L., Chunjuan Wang, H.L., A.W., Y.P., Y.J., X.Y., Yilong Wang), Neurointensive Care Unit, Department of Neurology (L.L.), and Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology (Chunxue Wang), Beijing TianTan Hospital, Capital Medical University, China; China National Clinical Research Center for Neurological Diseases, Beijing (Yilong Wang, Yongjun Wang); Center of Stroke, Beijing Institute for Brain Disorders, China (Z.L., X.Z.); Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (Chunjuan Wang); Department of Statistics and Operations Research, University of North Carolina at Chapel Hill (H.S.); Duke Clinical Research Institute (J.B., E.D.P., Y.X.) and Duke University School of Nursing (J.B., Q.Y.), Duke University, Durham, NC; INI Stroke Network, OSF Healthcare System, University of Illinois College of Medicine, Peoria (D.W.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center (G.C.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (L.H.S.); and Department of Quantitative Health Sciences, Cleveland Clinic, OH (B.H.).
authors.forename: Li
authors.initials: L
authors.lastname: Liang
authors.affiliation: From the Division of Vascular Neurology, Department of Neurology (Z.L., X.Z., C.Z., Yongjun Wang), Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology (Z.L., Chunjuan Wang, H.L., A.W., Y.P., Y.J., X.Y., Yilong Wang), Neurointensive Care Unit, Department of Neurology (L.L.), and Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology (Chunxue Wang), Beijing TianTan Hospital, Capital Medical University, China; China National Clinical Research Center for Neurological Diseases, Beijing (Yilong Wang, Yongjun Wang); Center of Stroke, Beijing Institute for Brain Disorders, China (Z.L., X.Z.); Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (Chunjuan Wang); Department of Statistics and Operations Research, University of North Carolina at Chapel Hill (H.S.); Duke Clinical Research Institute (J.B., E.D.P., Y.X.) and Duke University School of Nursing (J.B., Q.Y.), Duke University, Durham, NC; INI Stroke Network, OSF Healthcare System, University of Illinois College of Medicine, Peoria (D.W.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center (G.C.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (L.H.S.); and Department of Quantitative Health Sciences, Cleveland Clinic, OH (B.H.).
authors.forename: Janet
authors.initials: J
authors.lastname: Bettger
authors.affiliation: From the Division of Vascular Neurology, Department of Neurology (Z.L., X.Z., C.Z., Yongjun Wang), Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology (Z.L., Chunjuan Wang, H.L., A.W., Y.P., Y.J., X.Y., Yilong Wang), Neurointensive Care Unit, Department of Neurology (L.L.), and Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology (Chunxue Wang), Beijing TianTan Hospital, Capital Medical University, China; China National Clinical Research Center for Neurological Diseases, Beijing (Yilong Wang, Yongjun Wang); Center of Stroke, Beijing Institute for Brain Disorders, China (Z.L., X.Z.); Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (Chunjuan Wang); Department of Statistics and Operations Research, University of North Carolina at Chapel Hill (H.S.); Duke Clinical Research Institute (J.B., E.D.P., Y.X.) and Duke University School of Nursing (J.B., Q.Y.), Duke University, Durham, NC; INI Stroke Network, OSF Healthcare System, University of Illinois College of Medicine, Peoria (D.W.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center (G.C.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (L.H.S.); and Department of Quantitative Health Sciences, Cleveland Clinic, OH (B.H.).
authors.forename: Qing
authors.initials: Q
authors.lastname: Yang
authors.affiliation: From the Division of Vascular Neurology, Department of Neurology (Z.L., X.Z., C.Z., Yongjun Wang), Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology (Z.L., Chunjuan Wang, H.L., A.W., Y.P., Y.J., X.Y., Yilong Wang), Neurointensive Care Unit, Department of Neurology (L.L.), and Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology (Chunxue Wang), Beijing TianTan Hospital, Capital Medical University, China; China National Clinical Research Center for Neurological Diseases, Beijing (Yilong Wang, Yongjun Wang); Center of Stroke, Beijing Institute for Brain Disorders, China (Z.L., X.Z.); Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (Chunjuan Wang); Department of Statistics and Operations Research, University of North Carolina at Chapel Hill (H.S.); Duke Clinical Research Institute (J.B., E.D.P., Y.X.) and Duke University School of Nursing (J.B., Q.Y.), Duke University, Durham, NC; INI Stroke Network, OSF Healthcare System, University of Illinois College of Medicine, Peoria (D.W.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center (G.C.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (L.H.S.); and Department of Quantitative Health Sciences, Cleveland Clinic, OH (B.H.).
authors.forename: David
authors.initials: D
authors.lastname: Wang
authors.affiliation: From the Division of Vascular Neurology, Department of Neurology (Z.L., X.Z., C.Z., Yongjun Wang), Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology (Z.L., Chunjuan Wang, H.L., A.W., Y.P., Y.J., X.Y., Yilong Wang), Neurointensive Care Unit, Department of Neurology (L.L.), and Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology (Chunxue Wang), Beijing TianTan Hospital, Capital Medical University, China; China National Clinical Research Center for Neurological Diseases, Beijing (Yilong Wang, Yongjun Wang); Center of Stroke, Beijing Institute for Brain Disorders, China (Z.L., X.Z.); Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (Chunjuan Wang); Department of Statistics and Operations Research, University of North Carolina at Chapel Hill (H.S.); Duke Clinical Research Institute (J.B., E.D.P., Y.X.) and Duke University School of Nursing (J.B., Q.Y.), Duke University, Durham, NC; INI Stroke Network, OSF Healthcare System, University of Illinois College of Medicine, Peoria (D.W.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center (G.C.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (L.H.S.); and Department of Quantitative Health Sciences, Cleveland Clinic, OH (B.H.).
authors.forename: Anxin
authors.initials: A
authors.lastname: Wang
authors.affiliation: From the Division of Vascular Neurology, Department of Neurology (Z.L., X.Z., C.Z., Yongjun Wang), Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology (Z.L., Chunjuan Wang, H.L., A.W., Y.P., Y.J., X.Y., Yilong Wang), Neurointensive Care Unit, Department of Neurology (L.L.), and Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology (Chunxue Wang), Beijing TianTan Hospital, Capital Medical University, China; China National Clinical Research Center for Neurological Diseases, Beijing (Yilong Wang, Yongjun Wang); Center of Stroke, Beijing Institute for Brain Disorders, China (Z.L., X.Z.); Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (Chunjuan Wang); Department of Statistics and Operations Research, University of North Carolina at Chapel Hill (H.S.); Duke Clinical Research Institute (J.B., E.D.P., Y.X.) and Duke University School of Nursing (J.B., Q.Y.), Duke University, Durham, NC; INI Stroke Network, OSF Healthcare System, University of Illinois College of Medicine, Peoria (D.W.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center (G.C.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (L.H.S.); and Department of Quantitative Health Sciences, Cleveland Clinic, OH (B.H.).
authors.forename: Yuesong
authors.initials: Y
authors.lastname: Pan
authors.affiliation: From the Division of Vascular Neurology, Department of Neurology (Z.L., X.Z., C.Z., Yongjun Wang), Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology (Z.L., Chunjuan Wang, H.L., A.W., Y.P., Y.J., X.Y., Yilong Wang), Neurointensive Care Unit, Department of Neurology (L.L.), and Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology (Chunxue Wang), Beijing TianTan Hospital, Capital Medical University, China; China National Clinical Research Center for Neurological Diseases, Beijing (Yilong Wang, Yongjun Wang); Center of Stroke, Beijing Institute for Brain Disorders, China (Z.L., X.Z.); Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (Chunjuan Wang); Department of Statistics and Operations Research, University of North Carolina at Chapel Hill (H.S.); Duke Clinical Research Institute (J.B., E.D.P., Y.X.) and Duke University School of Nursing (J.B., Q.Y.), Duke University, Durham, NC; INI Stroke Network, OSF Healthcare System, University of Illinois College of Medicine, Peoria (D.W.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center (G.C.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (L.H.S.); and Department of Quantitative Health Sciences, Cleveland Clinic, OH (B.H.).
authors.forename: Yong
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: From the Division of Vascular Neurology, Department of Neurology (Z.L., X.Z., C.Z., Yongjun Wang), Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology (Z.L., Chunjuan Wang, H.L., A.W., Y.P., Y.J., X.Y., Yilong Wang), Neurointensive Care Unit, Department of Neurology (L.L.), and Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology (Chunxue Wang), Beijing TianTan Hospital, Capital Medical University, China; China National Clinical Research Center for Neurological Diseases, Beijing (Yilong Wang, Yongjun Wang); Center of Stroke, Beijing Institute for Brain Disorders, China (Z.L., X.Z.); Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (Chunjuan Wang); Department of Statistics and Operations Research, University of North Carolina at Chapel Hill (H.S.); Duke Clinical Research Institute (J.B., E.D.P., Y.X.) and Duke University School of Nursing (J.B., Q.Y.), Duke University, Durham, NC; INI Stroke Network, OSF Healthcare System, University of Illinois College of Medicine, Peoria (D.W.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center (G.C.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (L.H.S.); and Department of Quantitative Health Sciences, Cleveland Clinic, OH (B.H.).
authors.forename: Xiaomeng
authors.initials: X
authors.lastname: Yang
authors.affiliation: From the Division of Vascular Neurology, Department of Neurology (Z.L., X.Z., C.Z., Yongjun Wang), Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology (Z.L., Chunjuan Wang, H.L., A.W., Y.P., Y.J., X.Y., Yilong Wang), Neurointensive Care Unit, Department of Neurology (L.L.), and Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology (Chunxue Wang), Beijing TianTan Hospital, Capital Medical University, China; China National Clinical Research Center for Neurological Diseases, Beijing (Yilong Wang, Yongjun Wang); Center of Stroke, Beijing Institute for Brain Disorders, China (Z.L., X.Z.); Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (Chunjuan Wang); Department of Statistics and Operations Research, University of North Carolina at Chapel Hill (H.S.); Duke Clinical Research Institute (J.B., E.D.P., Y.X.) and Duke University School of Nursing (J.B., Q.Y.), Duke University, Durham, NC; INI Stroke Network, OSF Healthcare System, University of Illinois College of Medicine, Peoria (D.W.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center (G.C.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (L.H.S.); and Department of Quantitative Health Sciences, Cleveland Clinic, OH (B.H.).
authors.forename: Changqing
authors.initials: C
authors.lastname: Zhang
authors.affiliation: From the Division of Vascular Neurology, Department of Neurology (Z.L., X.Z., C.Z., Yongjun Wang), Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology (Z.L., Chunjuan Wang, H.L., A.W., Y.P., Y.J., X.Y., Yilong Wang), Neurointensive Care Unit, Department of Neurology (L.L.), and Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology (Chunxue Wang), Beijing TianTan Hospital, Capital Medical University, China; China National Clinical Research Center for Neurological Diseases, Beijing (Yilong Wang, Yongjun Wang); Center of Stroke, Beijing Institute for Brain Disorders, China (Z.L., X.Z.); Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (Chunjuan Wang); Department of Statistics and Operations Research, University of North Carolina at Chapel Hill (H.S.); Duke Clinical Research Institute (J.B., E.D.P., Y.X.) and Duke University School of Nursing (J.B., Q.Y.), Duke University, Durham, NC; INI Stroke Network, OSF Healthcare System, University of Illinois College of Medicine, Peoria (D.W.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center (G.C.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (L.H.S.); and Department of Quantitative Health Sciences, Cleveland Clinic, OH (B.H.).
authors.forename: Gregg C
authors.initials: GC
authors.lastname: Fonarow
authors.affiliation: From the Division of Vascular Neurology, Department of Neurology (Z.L., X.Z., C.Z., Yongjun Wang), Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology (Z.L., Chunjuan Wang, H.L., A.W., Y.P., Y.J., X.Y., Yilong Wang), Neurointensive Care Unit, Department of Neurology (L.L.), and Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology (Chunxue Wang), Beijing TianTan Hospital, Capital Medical University, China; China National Clinical Research Center for Neurological Diseases, Beijing (Yilong Wang, Yongjun Wang); Center of Stroke, Beijing Institute for Brain Disorders, China (Z.L., X.Z.); Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (Chunjuan Wang); Department of Statistics and Operations Research, University of North Carolina at Chapel Hill (H.S.); Duke Clinical Research Institute (J.B., E.D.P., Y.X.) and Duke University School of Nursing (J.B., Q.Y.), Duke University, Durham, NC; INI Stroke Network, OSF Healthcare System, University of Illinois College of Medicine, Peoria (D.W.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center (G.C.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (L.H.S.); and Department of Quantitative Health Sciences, Cleveland Clinic, OH (B.H.).
authors.forename: Lee H
authors.initials: LH
authors.lastname: Schwamm
authors.affiliation: From the Division of Vascular Neurology, Department of Neurology (Z.L., X.Z., C.Z., Yongjun Wang), Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology (Z.L., Chunjuan Wang, H.L., A.W., Y.P., Y.J., X.Y., Yilong Wang), Neurointensive Care Unit, Department of Neurology (L.L.), and Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology (Chunxue Wang), Beijing TianTan Hospital, Capital Medical University, China; China National Clinical Research Center for Neurological Diseases, Beijing (Yilong Wang, Yongjun Wang); Center of Stroke, Beijing Institute for Brain Disorders, China (Z.L., X.Z.); Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (Chunjuan Wang); Department of Statistics and Operations Research, University of North Carolina at Chapel Hill (H.S.); Duke Clinical Research Institute (J.B., E.D.P., Y.X.) and Duke University School of Nursing (J.B., Q.Y.), Duke University, Durham, NC; INI Stroke Network, OSF Healthcare System, University of Illinois College of Medicine, Peoria (D.W.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center (G.C.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (L.H.S.); and Department of Quantitative Health Sciences, Cleveland Clinic, OH (B.H.).
authors.forename: Bo
authors.initials: B
authors.lastname: Hu
authors.affiliation: From the Division of Vascular Neurology, Department of Neurology (Z.L., X.Z., C.Z., Yongjun Wang), Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology (Z.L., Chunjuan Wang, H.L., A.W., Y.P., Y.J., X.Y., Yilong Wang), Neurointensive Care Unit, Department of Neurology (L.L.), and Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology (Chunxue Wang), Beijing TianTan Hospital, Capital Medical University, China; China National Clinical Research Center for Neurological Diseases, Beijing (Yilong Wang, Yongjun Wang); Center of Stroke, Beijing Institute for Brain Disorders, China (Z.L., X.Z.); Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (Chunjuan Wang); Department of Statistics and Operations Research, University of North Carolina at Chapel Hill (H.S.); Duke Clinical Research Institute (J.B., E.D.P., Y.X.) and Duke University School of Nursing (J.B., Q.Y.), Duke University, Durham, NC; INI Stroke Network, OSF Healthcare System, University of Illinois College of Medicine, Peoria (D.W.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center (G.C.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (L.H.S.); and Department of Quantitative Health Sciences, Cleveland Clinic, OH (B.H.).
authors.forename: Eric D
authors.initials: ED
authors.lastname: Peterson
authors.affiliation: From the Division of Vascular Neurology, Department of Neurology (Z.L., X.Z., C.Z., Yongjun Wang), Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology (Z.L., Chunjuan Wang, H.L., A.W., Y.P., Y.J., X.Y., Yilong Wang), Neurointensive Care Unit, Department of Neurology (L.L.), and Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology (Chunxue Wang), Beijing TianTan Hospital, Capital Medical University, China; China National Clinical Research Center for Neurological Diseases, Beijing (Yilong Wang, Yongjun Wang); Center of Stroke, Beijing Institute for Brain Disorders, China (Z.L., X.Z.); Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (Chunjuan Wang); Department of Statistics and Operations Research, University of North Carolina at Chapel Hill (H.S.); Duke Clinical Research Institute (J.B., E.D.P., Y.X.) and Duke University School of Nursing (J.B., Q.Y.), Duke University, Durham, NC; INI Stroke Network, OSF Healthcare System, University of Illinois College of Medicine, Peoria (D.W.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center (G.C.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (L.H.S.); and Department of Quantitative Health Sciences, Cleveland Clinic, OH (B.H.).
authors.forename: Ying
authors.initials: Y
authors.lastname: Xian
authors.affiliation: From the Division of Vascular Neurology, Department of Neurology (Z.L., X.Z., C.Z., Yongjun Wang), Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology (Z.L., Chunjuan Wang, H.L., A.W., Y.P., Y.J., X.Y., Yilong Wang), Neurointensive Care Unit, Department of Neurology (L.L.), and Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology (Chunxue Wang), Beijing TianTan Hospital, Capital Medical University, China; China National Clinical Research Center for Neurological Diseases, Beijing (Yilong Wang, Yongjun Wang); Center of Stroke, Beijing Institute for Brain Disorders, China (Z.L., X.Z.); Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (Chunjuan Wang); Department of Statistics and Operations Research, University of North Carolina at Chapel Hill (H.S.); Duke Clinical Research Institute (J.B., E.D.P., Y.X.) and Duke University School of Nursing (J.B., Q.Y.), Duke University, Durham, NC; INI Stroke Network, OSF Healthcare System, University of Illinois College of Medicine, Peoria (D.W.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center (G.C.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (L.H.S.); and Department of Quantitative Health Sciences, Cleveland Clinic, OH (B.H.). yongjunwang1962@gmail.com yilong528@gmail.com.
authors.forename: Yilong
authors.initials: Y
authors.lastname: Wang
authors.affiliation: From the Division of Vascular Neurology, Department of Neurology (Z.L., X.Z., C.Z., Yongjun Wang), Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology (Z.L., Chunjuan Wang, H.L., A.W., Y.P., Y.J., X.Y., Yilong Wang), Neurointensive Care Unit, Department of Neurology (L.L.), and Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology (Chunxue Wang), Beijing TianTan Hospital, Capital Medical University, China; China National Clinical Research Center for Neurological Diseases, Beijing (Yilong Wang, Yongjun Wang); Center of Stroke, Beijing Institute for Brain Disorders, China (Z.L., X.Z.); Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (Chunjuan Wang); Department of Statistics and Operations Research, University of North Carolina at Chapel Hill (H.S.); Duke Clinical Research Institute (J.B., E.D.P., Y.X.) and Duke University School of Nursing (J.B., Q.Y.), Duke University, Durham, NC; INI Stroke Network, OSF Healthcare System, University of Illinois College of Medicine, Peoria (D.W.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center (G.C.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (L.H.S.); and Department of Quantitative Health Sciences, Cleveland Clinic, OH (B.H.). yongjunwang1962@gmail.com yilong528@gmail.com.
authors.forename: Yongjun
authors.initials: Y
authors.lastname: Wang
mesh_terms: D000368:Aged; D002681:China; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D012042:Registries / Q000706:statistics & numerical data*; D020521:Stroke / Q000628:therapy*
keywords: China; hospitals; quality improvement; registries; stroke