Trial reportBMC health services research2008
A cluster randomized trial to assess the impact of clinical pathways for patients with stroke: rationale and design of the Clinical Pathways for Effective and Appropriate Care Study [NCT00673491].
Trial report in BMC health services research, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00673491 (Diffusion of Clinical Pathways for the Implementation of Effective and Appropriate Care), which is not on this map. Cited by 10 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Diffusion of Clinical Pathways for the Implementation of Effective and Appropriate Care
Who cites it
10 citing papers in PubMed.
- Impact of a care pathway for COPD on adherence to guidelines and hospital readmission: a cluster randomized trial.International journal of chronic obstructive pulmonary disease · 2016Trial
- A cluster randomized trial to assess the effect of clinical pathways for patients with stroke: results of the clinical pathways for effective and appropriate care study.BMC medicine · 2012Trial
- The impact of care pathways for patients with proximal femur fracture: rationale and design of a cluster-randomized controlled trial.BMC health services research · 2012Trial
- Trial
- Interventions for the uptake of evidence-based recommendations in acute stroke settings.The Cochrane database of systematic reviews · 2023Review
- Adherence to standardized assessments through a complexity-based model for categorizing rehabilitation©: design and implementation in an acute hospital.BMC medical informatics and decision making · 2018Article
- Effect of a 72 Hour Stroke Care Bundle on Early Outcomes after Acute Stroke: A Non Randomised Controlled Study.PloS one · 2016Article
- Main barriers to effective implementation of stroke care pathways in France: a qualitative study.BMC health services research · 2014Article
- The European quality of care pathways (EQCP) study on the impact of care pathways on interprofessional teamwork in an acute hospital setting: study protocol: for a cluster randomised controlled trial and evaluation of implementation processes.Implementation science : IS · 2012Article
- Randomized clinical trials in stroke research.Journal of investigative medicine : the official publication of the American Federation for Clinical Research · 2010Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with stroke should have access to a continuum of care from organized stroke units in the acute phase, to appropriate rehabilitation and secondary prevention measures. Moreover to improve the outcomes for acute stroke patients from an organizational perspective, the use of multidisciplinary teams and the delivery of continuous stroke education both to the professionals and to the public, and the implementation of evidence-based stroke care are recommended. Clinical pathways are complex interventions that can be used for this purpose. However in stroke care the use of clinical pathways remains questionable because little prospective controlled data has demonstrated their effectiveness. The purpose of this study is to determine whether clinical pathways could improve the quality of the care provided to the patients affected by stroke in hospital and through the continuum of the care.
methodsTwo-arm, cluster-randomized trial with hospitals and rehabilitation long-term care facilities as randomization units. 14 units will be randomized either to arm 1 (clinical pathway) or to arm 2 (no intervention, usual care). The sample will include 238 in each group, this gives a power of 80%, at 5% significance level. The primary outcome measure is 30-days mortality. The impact of the clinical pathways along the continuum of care will also be analyzed by comparing the length of hospital stay, the hospital re-admissions rates, the institutionalization rates after hospital discharge, the patients' dependency levels, and complication rates. The quality of the care provided to the patients will be assessed by monitoring the use of diagnostic and therapeutic procedures during hospital stay and rehabilitation, and by the use of key quality indicators at discharge. The implementation of organized care will be also evaluated.
conclusionThe management of patients affected by stroke involves the expertise of several professionals, which can result in poor coordination or inefficiencies in patient treatment, and clinical pathways can significantly improve the outcomes of these patients. It is proposed that this study will test a new hypothesis and provide evidence of how clinical pathways can work.
trial registrationClinicalTrials.gov ID [NCT00673491].
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