Transient ischameic attack/stroke electronic decision support: a 14-month safety audit

J Stroke Cerebrovasc Dis. 2014 Feb;23(2):267-70. doi: 10.1016/j.jstrokecerebrovasdis.2013.02.022. Epub 2013 Apr 11.

Abstract

Background: To assess the safety of a Transient Ischameic Attack (TIA)/Stroke Electronic Decision Support (EDS) tool in the primary care setting intended to aid general practitioners in the timely management of transient ischemic attacks (TIAs).

Methods: A 14-month safety audit reviewing all patients managed with the help of the TIA/Stroke EDS tool. Major morbidity and mortality were assessed by screening patients for subsequent hospital admissions and investigating potential links to EDS use.

Results: Seventy-nine patients were managed with the aid of the TIA/Stroke EDS. EDS use resulted in 8 appropriate immediate hospital admissions because of patients being at high risk of stroke. Three patients had delayed admission, but care was fully guideline based and patients had no adverse outcome. Eleven admissions were unrelated to EDS use. Two deaths occurred; these did not result from inappropriate EDS advice.

Conclusions: Results suggest that TIA/Stroke EDS use is not associated with major morbidity or mortality. Larger studies are needed to draw more definite conclusions regarding the utility of this TIA/Stroke EDS in preventing strokes.

Keywords: Stroke; Transient Ischameic Attack (TIA); computer-assisted; decision making; decision support techniques; delivery of health care; electronic decision support (EDS); integrated.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged, 80 and over
  • Checklist
  • Decision Support Systems, Clinical*
  • Decision Support Techniques*
  • Delivery of Health Care, Integrated
  • Female
  • Guideline Adherence
  • Humans
  • Ischemic Attack, Transient / diagnosis
  • Ischemic Attack, Transient / mortality
  • Ischemic Attack, Transient / therapy*
  • Male
  • Medical Audit
  • Patient Admission
  • Patient Safety
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians'
  • Predictive Value of Tests
  • Primary Health Care
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Stroke / diagnosis
  • Stroke / therapy*
  • Therapy, Computer-Assisted*
  • Time Factors
  • Time-to-Treatment
  • Treatment Outcome