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Factors that influence variation in clinical decision-making about thrombolysis in the treatment of acute ischaemic stroke: results of a discrete choice experiment |
Thomson R G, De Brún A, Flynn D, Ternent L, Price C I, Rodgers H, Ford G A, Rudd M, Lancsar E, Simpson S & Teah J |
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Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Thomson R G, De Brún A, Flynn D, Ternent L, Price C I, Rodgers H, Ford G A, Rudd M, Lancsar E, Simpson S & Teah J. Factors that influence variation in clinical decision-making about thrombolysis in the treatment of acute ischaemic stroke: results of a discrete choice experiment. Health Services and Delivery Research 2017; 5(4) Authors' objectives To identify the factors which contribute to variation in, and influence, clinicians' decision-making about treating ischaemic stroke patients with intravenous thrombolysis.
Intravenous thrombolysis for patients with acute ischaemic stroke is underused (only 80% of eligible patients receive it) and there is variation in its use across the UK. Previously, variation might have been explained by structural differences; however, continuing variation may reflect differences in clinical decision-making regarding the eligibility of patients for treatment. This variation in decision-making could lead to the underuse, or result in inappropriate use, of thrombolysis. Authors' conclusions There was considerable heterogeneity among respondents in thrombolysis decision-making, indicating that clinicians differ in their thresholds for treatment across a number of patient-related factors. Respondents were significantly more likely to treat 85-year-old patients than patients aged 68 years and this probably reflects acceptance of data from Third International Stroke Trial that report benefit for patients aged > 80 years. That respondents were more likely to offer thrombolysis to patients with severe stroke than to patients with mild stroke may indicate uncertainty/concern about the risk/benefit balance in treatment of minor stroke. Findings will be disseminated via peer-review publication and presentation at national/international conferences, and will be linked to training/continuing professional development (CPD) programmes. Indexing Status Subject indexing assigned by CRD MeSH Clinical Decision-Making; Humans; Stroke; Thrombolytic Therapy Language Published English Country of organisation England English summary An English language summary is available. Address for correspondence HS&DR Programme, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, University of Southampton, Alpha House, Enterprise Road, Southampton, SO16 7NS, UK Tel: +44 23 8059 4304
Email: hsdrinfo@southampton.ac.uk AccessionNumber 32017000142 Date abstract record published 07/02/2017 |
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