Beyond conventional stroke guidelines - Setting priorities

Research output: Contribution to journalArticle

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.

Details

Authors
  • Bo Norrving
  • Per Wester
  • Katharina Stibrant Sunnerhagen
  • Andreas Terent
  • Anna Sohlberg
  • Fredrik Berggren
  • Per-Olov Wester
  • Kjell Asplund
Organisations
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Neurology

Keywords

  • health priorities, cost analysis, needs assessment, guidelines, practice, stroke services
Original languageEnglish
Pages (from-to)2185-2190
Journal Stroke: a journal of cerebral circulation
Volume38
Issue number7
Publication statusPublished - 2007
Publication categoryResearch
Peer-reviewedYes