Evidence map›Paper›PMID 26284533›Full record

ArticlePloS one2015

Awareness of Stroke Risk after TIA in Swiss General Practitioners and Hospital Physicians.

Sven Streit, Philippe Baumann, Jürgen Barth, Heinrich P Mattle, Marcel Arnold, Claudio L Bassetti, Damian N Meli, Urs Fischer

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.9field-weighted citation impact, top 25% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 9 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Sven StreitInstitute of Primary Health Care BIHAM, University of Bern, Bern, Switzerland.
Philippe BaumannInstitute of Primary Health Care BIHAM, University of Bern, Bern, Switzerland.
Jürgen BarthInstitute of Complementary and Integrative Medicine, University Hospital Zurich, Zurich, Switzerland.
Heinrich P MattleDepartment of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland.
Marcel ArnoldDepartment of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland.
Claudio L BassettiDepartment of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland.
Damian N MeliInstitute of Primary Health Care BIHAM, University of Bern, Bern, Switzerland.
Urs FischerDepartment of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland.
University of Bern · CHUniversity Hospital of Bern · CHUniversity Hospital of Zurich · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTransient ischemic attacks (TIA) are stroke warning signs and emergency situations, and, if immediately investigated, doctors can intervene to prevent strokes. Nevertheless, many patients delay going to the doctor, and doctors might delay urgently needed investigations and preventative treatments. We set out to determine how much general practitioners (GPs) and hospital physicians (HPs) knew about stroke risk after TIA, and to measure their referral rates.

methodsWe used a structured questionnaire to ask GPs and HPs in the catchment area of the University Hospital of Bern to estimate a patient's risk of stroke after TIA. We also assessed their referral behavior. We then statistically analysed their reasons for deciding not to immediately refer patients.

resultsOf the 1545 physicians, 40% (614) returned the survey. Of these, 75% (457) overestimated stroke risk within 24 hours, and 40% (245) overestimated risk within 3 months after TIA. Only 9% (53) underestimated stroke risk within 24 hours and 26% (158) underestimated risk within 3 months; 78% (473) of physicians overestimated the amount that carotid endarterectomy reduces stroke risk; 93% (543) would rigorously investigate the cause of a TIA, but only 38% (229) would refer TIA patients for urgent investigations "very often". Physicians most commonly gave these reasons for not making emergency referrals: patient's advanced age; patient's preference; patient was multimorbid; and, patient needed long-term care.

conclusionsAlthough physicians overestimate stroke risk after TIA, their rate of emergency referral is modest, mainly because they tend not to refer multimorbid and elderly patients at the appropriate rate. Since old and frail patients benefit from urgent investigations and treatment after TIA as much as younger patients, future educational campaigns should focus on the importance of emergency evaluations for all TIA patients.

Indexed as

Health Knowledge, Attitudes, PracticeHospitalsEmergency Medical ServicesFemaleGeneral PractitionersHumansIschemic Attack, TransientMaleMiddle AgedReferral and ConsultationRisk AssessmentStrokeSurveys and QuestionnairesSwitzerland

Identifiers

PMID26284533
PMCPMC4540278
OpenAlexW1793167192

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.