Future of Quality and Outcomes Research in Stroke

All this blather and not one word on a strategy or planning on how to solve all the problems in stroke.
http://circoutcomes.ahajournals.org/content/8/6_suppl_3/S66.extract?etoc

1. Gregg C. Fonarow, MD,
2. Moira K. Kapral, MD, MSc and
3. Lee H. Schwamm, MD

+ Author Affiliations

1. From the Division of Cardiology, Geffen School of Medicine at UCLA, Los Angeles, CA (G.C.F.); Department of Medicine, University of Toronto, Toronto, Ontario, Canada (M.K.K.); and Department of Neurology, MGH Stroke Services, Fireman Vascular Center Massachusetts General Hospital, Harvard Medical School, Boston (L.H.S.).

1. Correspondence to Gregg C. Fonarow, MD, Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center, 10833 LeConte Ave, Room 47-123 CHS, Los Angeles, CA 90095. E-mail gfonarow@mednet.ucla.edu

Stroke is a common and costly condition that affects 15 million people worldwide each year.¹ Globally, stroke results in nearly 6 million deaths, and another 5 million people are permanently disabled by stroke each year. Stroke is the fourth leading cause of death, the second most common reason for hospitalization in older adults, and the most common cause of long-term disability in the United States.² Although there have been important advances in stroke treatment and rehabilitation over the past few decades, stroke patients, care partners, and clinicians frequently still have too little information to determine which diagnostic tests, treatments, and strategies to apply and which to avoid in specific instances. There remain critical voids in knowledge about which approaches to stroke care are likely to produce optimal clinical outcomes for the greatest number of patients. In addition, despite well-developed repositories for the assessment of neurological quality of life and other patient-reported outcomes, the field of cerebrovascular disease has been slow to incorporate these measures into care planning and shared decision-making.^3,4 Even when strong evidence exists, there are frequently gaps, variations, and disparities in how that evidence is applied in clinical practice. Challenges remain in accurately capturing and reporting quality and outcomes, including functional outcomes, that are properly risk adjusted. Quality and outcomes research in stroke is essential to bridging these substantial gaps in knowledge, better informing clinical decision making, and driving further improvements in stroke care and outcomes.