All the more reason to have a Great stroke association
Everyone must be incompetent, we should ask for their performance evaluations
http://onlinelibrary.wiley.com/doi/10.1111/j.1747-4949.2012.00973.x/abstract?deniedAccessCustomisedMessage=&userIsAuthenticated=false
Stroke survivors experience complex combinations of impairments,
activity limitations, and participation restrictions. The essential
components of stroke rehabilitation remain elusive. Determining efficacy
in randomized controlled trials (RCTs) is challenging; there is no
commonly agreed primary outcome measure for rehabilitation trials.
Clinical guidelines depend on proof of efficacy in RCTs and
meta-analyses. However, diverse trial aims, differing methods,
inconsistent data collection, and use of multiple assessment tools
hinder comparability across trials. Consistent data collection in acute
stroke trials has facilitated meta-analyses to inform trial design and
clinical practice. With few exceptions, inconsistent data collection has
hindered similar progress in stroke rehabilitation research. There is
an urgent need for the routine collection of a core dataset of common
variables in rehabilitation trials. The European Stroke Organisation
Outcomes Working Group, the National Institutes of Neurological
Disorders and Stroke Common Data Elements project, and the Collaborative
Stroke Audit and Research project have called for consistency in data
collection in stroke trials. Standardizing data collection can decrease
study start up times, facilitate data sharing, and inform clinical
guidelines. Although achieving consensus on which outcome measures to
use in stroke rehabilitation trials is a considerable task, perhaps a
feasible starting point is to achieve consistency in the collection of
data on demography, stroke severity, and stroke onset to inclusion
times. Longer term goals could include the development of a consensus
process to establish the core dataset. This should be endorsed by
researchers, funders, and journal editors in order to facilitate
sustainable change.
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