BACKGROUND AND PURPOSE: Priorities in the care of stroke patients are often intuitive. An open and translucent priority-setting procedure would benefit patients, professionals, and decision-makers. Prioritization is an innovative part of the new Swedish national stroke guidelines. METHODS: Working groups identified diagnostic procedures, interventions and therapies in stroke care, assessed each one according to severity (needs), effect of action, level of scientific evidence and cost-effectiveness. The items were then ranked into priority groups from 1 (highest) to 10 (lowest). Procedures lacking evidence for routine clinical use were also identified (and entered a do-not-do list), as well as procedures in research and development. Resource allocations resulting from the priority-setting process were identified. RESULTS: Of 102 core procedures identified, 50 were assigned to high-priority groups (1-3), 29 to moderate priority groups (4-7) and 23 to low priority groups (8-10). Almost a quarter were graded 8 to 10, indicating that they may not necessarily be applied if resources are scarce. Twenty-eight procedures were assigned to the do-not-do list and 16 to the research and development list. CONCLUSIONS: In stroke services, it is possible to identify not only diagnostic procedures and interventions with high priority, but also a considerable number of items used today that have low priority or should not be used at all. Strict adherence to the guidelines would result in a substantial reallocation of resources from low-priority to high-priority areas.
BACKGROUND AND PURPOSE: Priorities in the care of strokepatients are often intuitive. An open and translucent priority-setting procedure would benefit patients, professionals, and decision-makers. Prioritization is an innovative part of the new Swedish national stroke guidelines. METHODS: Working groups identified diagnostic procedures, interventions and therapies in stroke care, assessed each one according to severity (needs), effect of action, level of scientific evidence and cost-effectiveness. The items were then ranked into priority groups from 1 (highest) to 10 (lowest). Procedures lacking evidence for routine clinical use were also identified (and entered a do-not-do list), as well as procedures in research and development. Resource allocations resulting from the priority-setting process were identified. RESULTS: Of 102 core procedures identified, 50 were assigned to high-priority groups (1-3), 29 to moderate priority groups (4-7) and 23 to low priority groups (8-10). Almost a quarter were graded 8 to 10, indicating that they may not necessarily be applied if resources are scarce. Twenty-eight procedures were assigned to the do-not-do list and 16 to the research and development list. CONCLUSIONS: In stroke services, it is possible to identify not only diagnostic procedures and interventions with high priority, but also a considerable number of items used today that have low priority or should not be used at all. Strict adherence to the guidelines would result in a substantial reallocation of resources from low-priority to high-priority areas.
Authors: Vladimir Hachinski; Geoffrey A Donnan; Philip B Gorelick; Werner Hacke; Steven C Cramer; Markku Kaste; Marc Fisher; Michael Brainin; Alastair M Buchan; Eng H Lo; Brett E Skolnick; Karen L Furie; Graeme J Hankey; Miia Kivipelto; John Morris; Peter M Rothwell; Ralph L Sacco; Sidney C Smith; Yulun Wang; Alan Bryer; Gary A Ford; Costantino Iadecola; Sheila C O Martins; Jeff Saver; Veronika Skvortsova; Mark Bayley; Martin M Bednar; Pamela Duncan; Lori Enney; Seth Finklestein; Theresa A Jones; Lalit Kalra; Jeff Kleim; Ralph Nitkin; Robert Teasell; Cornelius Weiller; Bhupat Desai; Mark P Goldberg; Wolf-Dieter Heiss; Osmo Saarelma; Lee H Schwamm; Yukito Shinohara; Bhargava Trivedi; Nils Wahlgren; Lawrence K Wong; Antoine Hakim; Bo Norrving; Stephen Prudhomme; Natan M Bornstein; Stephen M Davis; Larry B Goldstein; Didier Leys; Jaakko Tuomilehto Journal: Stroke Date: 2010-06 Impact factor: 7.914
Authors: Vladimir Hachinski; Geoffrey A Donnan; Philip B Gorelick; Werner Hacke; Steven C Cramer; Markku Kaste; Marc Fisher; Michael Brainin; Alastair M Buchan; Eng H Lo; Brett E Skolnick; Karen L Furie; Graeme J Hankey; Miia Kivipelto; John Morris; Peter M Rothwell; Ralph L Sacco; Sidney C Smith; Yulun Wang; Alan Bryer; Gary A Ford; Costantino Iadecola; Sheila C O Martins; Jeff Saver; Veronika Skvortsova; Mark Bayley; Martin M Bednar; Pamela Duncan; Lori Enney; Seth Finklestein; Theresa A Jones; Lalit Kalra; Jeff Kleim; Ralph Nitkin; Robert Teasell; Cornelius Weiller; Bhupat Desai; Mark P Goldberg; Wolf-Dieter Heiss; Osmo Saarelma; Lee H Schwamm; Yukito Shinohara; Bhargava Trivedi; Nils Wahlgren; Lawrence K Wong; Antoine Hakim; Bo Norrving; Stephen Prudhomme; Natan M Bornstein; Stephen M Davis; Larry B Goldstein; Didier Leys; Jaakko Tuomilehto Journal: Cerebrovasc Dis Date: 2010-05-24 Impact factor: 2.762
Authors: Vladimir Hachinski; Geoffrey A Donnan; Philip B Gorelick; Werner Hacke; Steven C Cramer; Markku Kaste; Marc Fisher; Michael Brainin; Alastair M Buchan; Eng H Lo; Brett E Skolnick; Karen L Furie; Graeme J Hankey; Miia Kivipelto; John Morris; Peter M Rothwell; Ralph L Sacco; Sidney C Smith; Yulun Wang; Alan Bryer; Gary A Ford; Costantino Iadecola; Sheila C O Martins; Jeff Saver; Veronika Skvortsova; Mark Bayley; Martin M Bednar; Pamela Duncan; Lori Enney; Seth Finklestein; Theresa A Jones; Lalit Kalra; Jeff Kleim; Ralph Nitkin; Robert Teasell; Cornelius Weiller; Bhupat Desai; Mark P Goldberg; Wolf-Dieter Heiss; Osmo Saarelma; Lee H Schwamm; Yukito Shinohara; Bhargava Trivedi; Nils Wahlgren; Lawrence K Wong; Antoine Hakim; Bo Norrving; Stephen Prudhomme; Natan M Bornstein; Stephen M Davis; Larry B Goldstein; Didier Leys; Jaakko Tuomilehto Journal: Int J Stroke Date: 2010-08 Impact factor: 5.266
Authors: Susanne Palmcrantz; Malin Tistad; Ann Catrine Eldh; Lotta Widén Holmqvist; Anna Ehrenberg; Göran Tomson; Christina B Olsson; Lars Wallin Journal: BMC Health Serv Res Date: 2015-11-23 Impact factor: 2.655