Review criteria for hospital utilization for patients with cerebrovascular disease

Dj, Lanska

doi:10.1212/wnl.44.8.1531

Cited by 12 publications

(1 citation statement)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Guidelines from the Stroke Council of the American Heart Association state: 'Hospitalization is often justified to expedite evaluation and lessen the possibility of stroke' [2]. The Task Force on Hospital Utilization for Stroke of the American Academy of Neurology recommended hospital admission for all patients with onset of TIA within the previous 48 h [3]. Both organizations acknowledge that these guidelines are not based on reliable clinical data.…”

Section: Introductionmentioning

confidence: 99%

Practice Variability in Management of Transient Ischemic Attacks

Johnston¹,

Smith²

1999

Eur Neurol

View full text Add to dashboard Cite

To define practice patterns in the management of transient ischemic attacks (TIAs), we surveyed practicing neurologists attending an educational conference in San Francisco, evaluating management decisions in 2 TIA case vignettes. In a vignette describing a hemispheric TIA 1 day prior with ipsilateral bruit, 53% chose admission, 47% elected an outpatient work-up, 28% treated with intravenous heparin and 70% chose aspirin, reflecting the disagreement about medical management of carotid stenosis in the literature. There was more agreement in the second case, a posterior circulation TIA 1 day prior with atrial fibrillation, in which 84% chose hospital admission, 74% chose intravenous heparin and 90% treated with some form of anticoagulation. There are areas of important practice variability in the management of TIAs. Further research is justified to guide patient care decisions in TIA patients.

show abstract

Section: Introductionmentioning

confidence: 99%

Practice Variability in Management of Transient Ischemic Attacks

Johnston¹,

Smith²

1999

Eur Neurol

View full text Add to dashboard Cite

show abstract

Evidence-Based Medicine, Critical Pathways, Practice Guidelines, and Managed Care

Ringel¹

1996

Arch Neurol

View full text Add to dashboard Cite

Because managed care plans are exerting enormous pressure to reduce the cost of medical care, neurologists need to enhance their skills at identifying appropriate, high-quality, and cost-effective care for patients with neurological disorders. A variety of health services research methods are available that foster evidence-based decisions and de-emphasize intuition in decision making. Despite imperfect data and a lack of familiarity with some of these methods, we have found them useful in developing guidelines and pathways for the prevention and management of stroke. Neurologists should become more familiar with the pragmatic benefits, limitations, and obstacles that hinder acceptance and implementation of these approaches. If we wish to continue to influence the medical decision process, we must focus on the provision of quality neurological care and not on the managed care plan.

show abstract