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Beyond conventional stroke guidelines - Setting priorities

Norrving, Bo LU ; Wester, Per; Sunnerhagen, Katharina Stibrant; Terent, Andreas; Sohlberg, Anna; Berggren, Fredrik; Wester, Per-Olov and Asplund, Kjell (2007) In Stroke: a journal of cerebral circulation 38(7). p.2185-2190
Abstract
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.... (More)
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. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
health priorities, cost analysis, needs assessment, guidelines, practice, stroke services
in
Stroke: a journal of cerebral circulation
volume
38
issue
7
pages
2185 - 2190
publisher
American Heart Association
external identifiers
  • wos:000247513300047
  • scopus:34347346078
ISSN
1524-4628
DOI
10.1161/STROKEAHA.106.481457
language
English
LU publication?
yes
id
58f9a767-878c-46e9-9f13-a43b27680f12 (old id 647953)
alternative location
http://stroke.ahajournals.org/cgi/content/short/38/7/2185
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17540970&dopt=Abstract
date added to LUP
2007-12-14 11:10:50
date last changed
2017-01-01 05:03:10
@article{58f9a767-878c-46e9-9f13-a43b27680f12,
  abstract     = {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.},
  author       = {Norrving, Bo and Wester, Per and Sunnerhagen, Katharina Stibrant and Terent, Andreas and Sohlberg, Anna and Berggren, Fredrik and Wester, Per-Olov and Asplund, Kjell},
  issn         = {1524-4628},
  keyword      = {health priorities,cost analysis,needs assessment,guidelines,practice,stroke services},
  language     = {eng},
  number       = {7},
  pages        = {2185--2190},
  publisher    = {American Heart Association},
  series       = { Stroke: a journal of cerebral circulation},
  title        = {Beyond conventional stroke guidelines - Setting priorities},
  url          = {http://dx.doi.org/10.1161/STROKEAHA.106.481457},
  volume       = {38},
  year         = {2007},
}