ArticleStroke2013
Disparities in evaluation at certified primary stroke centers: reasons for geographic and racial differences in stroke.
Article in Stroke, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- Diffusion-weighted imaging and diagnosis of transient ischemic attack.Annals of neurology · 2014Pooled it
- Blood RNA Signatures Enable Accurate Discrimination of Stroke Subtype and Onset Time at Hospital Admission.Research square · 2026Article
- Rural Emergency Medical Services Perspectives on Improving Acute Stroke Care: A Qualitative Study.Prehospital emergency care · 2025Article
- Provision of Stroke Care Services by Community Disadvantage Status in the US, 2009-2022.JAMA network open · 2024Article
- Socioeconomic disparities in the association of age at first live birth with incident stroke among Chinese parous women: A prospective cohort study.Journal of global health · 2024Article
- Variation in US acute ischemic stroke treatment by hospital regions: limited endovascular access despite evidence.Journal of neurointerventional surgery · 2024Article
- Structural Inequities for Historically Underserved Communities in the Adoption of Stroke Certification in the United States.JAMA neurology · 2022Article
- The relationship between stroke system organization and disparities in access to stroke center care in California.Journal of the American College of Emergency Physicians open · 2022Article
- Rural-Urban Differences in Diagnosed Cervical Artery Dissection in New York State.Cerebrovascular diseases (Basel, Switzerland) · 2022Article
- Rural-urban differences in stroke risk.Preventive medicine · 2021Article
- Article
- Strategies for improving outcomes in the acute management of ischemic stroke in rural emergency departments: a quality improvement initiative in the Stroke Belt.Open access emergency medicine : OAEM · 2018Article
- Access disparities to Magnet hospitals for ischemic stroke patients.Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2017Review
- A low-cost, tablet-based option for prehospital neurologic assessment: The iTREAT Study.Neurology · 2016Article
- Article
- Article
- Mobile Telestroke During Ambulance Transport Is Feasible in a Rural EMS Setting: The iTREAT Study.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2016Article
- Sex Disparities in Access to Acute Stroke Care: Can Telemedicine Mitigate this Effect?Journal of health disparities research and practice · 2016Article
- Racial Disparities in Intravenous Recombinant Tissue Plasminogen Activator Use Persist at Primary Stroke Centers.Journal of the American Heart Association · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
background and purposeEvaluation at primary stroke centers (PSCs) has the potential to improve outcomes for patients with stroke. We looked for differences in evaluation at Joint Commission certified PSCs by race, education, income, and geography (urban versus nonurban; Southeastern Stroke Belt versus non-Stroke Belt).
methodsCommunity-dwelling, black and white participants from the national Reasons for Geographic And Racial Differences in Stroke (REGARDS) prospective population-based cohort were enrolled between January 2003 and October 2007. Participants were contacted at 6-month intervals for suspected stroke events. For suspected stroke events, it was determined whether the evaluating hospital was a certified PSC.
resultsOf 1000 suspected strokes, 204 (20.4%) strokes were evaluated at a PSC. A smaller proportion of women than men (17.8% versus 23.0%; P=0.04), those with a previous stroke (15.1% versus 21.6%; P=0.04), those living in the Stroke Belt (14.7% versus 27.3%; P<0.001), and those in a nonurban area (9.1% versus 23.1%; P<0.001) were evaluated at a PSC. There were no differences by race, education, or income. In multivariable analysis, subjects were less likely to be evaluated at a PSC if they lived in a nonurban area (odds ratio, 0.39; 95% confidence interval, 0.22-0.67) or lived in the Stroke Belt (odds ratio, 0.54; 95% confidence interval, 0.38-0.77) or had a previous stroke (odds ratio, 0.46; 95% confidence interval, 0.27-0.78).
conclusionsDisparities in evaluation by PSCs are predominately related to geographic factors but not to race, education, or low income. Despite an increased burden of cerebrovascular disease in the Stroke Belt, subjects there were less likely to be evaluated at certified hospitals.
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Registered trials
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