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International Standard Set of Patient-Centered Outcome Measures After Stroke

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机构: [1]Int Consortium Hlth Outcomes Measurement, Cambridge, MA USA; [2]Harvard Univ, Massachusetts Gen Hosp, Sch Med, Dept Neurol, Boston, MA USA; [3]Liberty Hosp, Amer Heart Assoc, Amer Stroke Assoc, Liberty, MO USA; [4]Florey Inst Neurosci & Mental Hlth, Melbourne, Vic, Australia; [5]Royal Free London NHS Fdn Trust, UCLPartners Acad Hlth Sci Network, London, England; [6]US Ctr Dis Control & Prevent, Div Heart Dis & Stroke Prevent, Atlanta, GA USA; [7]Aneurin Bevan Univ Hlth Board, Newport, Gwent, Wales; [8]Univ Rochester, Med Ctr, Rochester, NY 14627 USA; [9]World Stroke Org, Heart & Stroke Fdn Canada, Ottawa, ON, Canada; [10]Capital Med Univ, Beijing Tiantan Hosp, Beijing, Peoples R China; [11]Hosp Moinhos de Vento, Brazilian Stroke Soc, Natl Stroke Registry, Porto Alegre, RS, Brazil; [12]AHA, ASA, Dallas, TX USA; [13]Lund Univ, Dept Clin Sci Neurol, Lund, Sweden; [14]Swedish Stroke Register Riksstroke, Umea, Sweden; [15]Erasmus Univ MC, Rijndam Rehabil Ctr, Rotterdam, Netherlands; [16]Univ Toronto, Ontario Stroke Registry, Toronto, ON, Canada; [17]Univ Calgary, Hotchkiss Brain Inst, Calgary, AB, Canada; [18]Univ Calgary, Dept Clin Neurosci, Calgary, AB, Canada; [19]Indiana Univ, Sch Med, VA HSR&D Stroke QUERI, Indianapolis, IN USA; [20]AHA ASA Get Guidelines Stroke Registry, Dallas, TX USA; [21]Paul Coverdell Natl Acute Stroke Registry, Atlanta, GA USA; [22]Stroke Joint Commiss, Atlanta, GA USA; [23]Primary & Comprehens Stroke Ctr Certificat Progra, Atlanta, GA USA; [24]Massachusetts Gen Hosp, Dept Neurol, 55 Fruit St, Boston, MA 02114 USA
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关键词: outcome outcome and process assessment patient-centered outcomes research quality improvement stroke stroke care

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Background and Purpose Value-based health care aims to bring together patients and health systems to maximize the ratio of quality over cost. To enable assessment of healthcare value in stroke management, an international standard set of patient-centered stroke outcome measures was defined for use in a variety of healthcare settings. Methods A modified Delphi process was implemented with an international expert panel representing patients, advocates, and clinical specialists in stroke outcomes, stroke registers, global health, epidemiology, and rehabilitation to reach consensus on the preferred outcome measures, included populations, and baseline risk adjustment variables. Results Patients presenting to a hospital with ischemic stroke or intracerebral hemorrhage were selected as the target population for these recommendations, with the inclusion of transient ischemic attacks optional. Outcome categories recommended for assessment were survival and disease control, acute complications, and patient-reported outcomes. Patient-reported outcomes proposed for assessment at 90 days were pain, mood, feeding, selfcare, mobility, communication, cognitive functioning, social participation, ability to return to usual activities, and health-related quality of life, with mobility, feeding, selfcare, and communication also collected at discharge. One instrument was able to collect most patient-reported subdomains (9/16, 56%). Minimum data collection for risk adjustment included patient demographics, premorbid functioning, stroke type and severity, vascular and systemic risk factors, and specific treatment/care-related factors. Conclusions A consensus stroke measure Standard Set was developed as a simple, pragmatic method to increase the value of stroke care. The set should be validated in practice when used for monitoring and comparisons across different care settings.

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出版当年[2015]版:
大类 | 2 区 医学
小类 | 2 区 临床神经病学 2 区 外周血管病
最新[2023]版:
大类 | 1 区 医学
小类 | 1 区 临床神经病学 1 区 外周血管病
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出版当年[2014]版:
Q1 CLINICAL NEUROLOGY Q1 PERIPHERAL VASCULAR DISEASE
最新[2023]版:
Q1 CLINICAL NEUROLOGY Q1 PERIPHERAL VASCULAR DISEASE

影响因子: 最新[2023版] 最新五年平均 出版当年[2014版] 出版当年五年平均 出版前一年[2013版] 出版后一年[2015版]

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第一作者机构: [1]Int Consortium Hlth Outcomes Measurement, Cambridge, MA USA; [2]Harvard Univ, Massachusetts Gen Hosp, Sch Med, Dept Neurol, Boston, MA USA;
通讯作者:
通讯机构: [2]Harvard Univ, Massachusetts Gen Hosp, Sch Med, Dept Neurol, Boston, MA USA; [20]AHA ASA Get Guidelines Stroke Registry, Dallas, TX USA; [21]Paul Coverdell Natl Acute Stroke Registry, Atlanta, GA USA; [22]Stroke Joint Commiss, Atlanta, GA USA; [23]Primary & Comprehens Stroke Ctr Certificat Progra, Atlanta, GA USA; [24]Massachusetts Gen Hosp, Dept Neurol, 55 Fruit St, Boston, MA 02114 USA
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