Trial reportJournal of the American Heart Association2020
Cluster-Randomized Trial of Thrombolysis Implementation Support in Metropolitan and Regional Australian Stroke Centers: Lessons for Individual and Systems Behavior Change.
Trial report in Journal of the American Heart Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 4 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, 4 syntheses or guidelines pooled it.
- Audit and feedback: effects on professional practice.The Cochrane database of systematic reviews · 2025Pooled it
- Exploring the content and delivery of feedback facilitation co-interventions: a systematic review.Implementation science : IS · 2024Pooled it
- Identifying behaviour change techniques in 287 randomized controlled trials of audit and feedback interventions targeting practice change among healthcare professionals.Implementation science : IS · 2023Pooled it
- The effectiveness of quality improvement collaboratives in improving stroke care and the facilitators and barriers to their implementation: a systematic review.Implementation science : IS · 2021Pooled it
- Effectiveness of a Quality Improvement Intervention on Reperfusion Treatment for Patients With Acute Ischemic Stroke: A Stepped-Wedge Cluster Randomized Clinical Trial.JAMA network open · 2023Trial
- Process evaluation of an implementation trial to improve the triage, treatment and transfer of stroke patients in emergency departments (TImplementation science : IS · 2020Trial
- Thrombolysis implementation intervention and clinical outcome: a secondary analysis of a cluster randomized trial.BMC cardiovascular disorders · 2020Trial
- Cluster-Randomized Trial of Thrombolysis Implementation Support in Metropolitan and Regional Australian Stroke Centers: Lessons for Individual and Systems Behavior Change.Journal of the American Heart Association · 2020Trial
- Door-to-needle time for thrombolysis: a secondary analysis of the TIPS cluster randomised controlled trial.BMJ open · 2019Trial
- Can a multicomponent multidisciplinary implementation package change physicians' and nurses' perceptions and practices regarding thrombolysis for acute ischemic stroke? An exploratory analysis of a cluster-randomized trial.Implementation science : IS · 2019Trial
- Finding the right dose: a scoping review examining facilitation as an implementation strategy for evidence-based stroke care.Implementation science : IS · 2025Article
- Quantifying Hospital Opportunities to Increase Ischemic Stroke Thrombolysis.Journal of the American Heart Association · 2025Article
- Longitudinal exploration of the delivery of care following a successful antenatal practice change intervention.Frontiers in medicine · 2025Article
- From 'strong recommendation' to practice: A pre-test post-test study examining adherence to stroke guidelines for fever, hyperglycaemia, and swallowing (FeSS) management post-stroke.International journal of nursing studies advances · 2024Article
- Sustainability, spread, and scale in trials using audit and feedback: a theory-informed, secondary analysis of a systematic review.Implementation science : IS · 2023Article
- Interventions for the uptake of evidence-based recommendations in acute stroke settings.The Cochrane database of systematic reviews · 2023Review
- Association of the Stroke Ready Community-Based Participatory Research Intervention With Incidence of Acute Stroke Thrombolysis in Flint, Michigan.JAMA network open · 2023Article
- Review
- Trends in guideline implementation: an updated scoping review.Implementation science : IS · 2022Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background Intravenous thrombolytic therapy (IVT) with tissue plasminogen activator for acute ischemic stroke is underutilized in many parts of the world. Randomized trials to test the effectiveness of thrombolysis implementation strategies are limited. Methods and Results This study aimed to test the effectiveness of a multicomponent, multidisciplinary tissue plasminogen activator implementation package in increasing the proportion of thrombolyzed cases while maintaining accepted benchmarks for low rates of intracranial hemorrhage and high rates of functional outcomes at 3 months. A cluster randomized controlled trial of 20 hospitals in the early stages of thrombolysis implementation across 3 Australian states was undertaken. Monitoring of IVT rates during the baseline period allowed hospitals (the unit of randomization) to be grouped into 3 baseline IVT strata-very low rates (0% to ≤4.0%); low rates (>4.0% to ≤10.0%); and moderate rates (>10.0%). Hospitals were randomized to an implementation package (experimental group) or usual care (control group) using a 1:1 ratio. The 16-month intervention was based on behavioral theory and analysis of the steps, roles, and barriers to rapid assessment for thrombolysis eligibility and involved comprehensive strategies addressing individual and system-level change. The primary outcome was the difference in tissue plasminogen activator proportions between the 2 groups postintervention. The absolute difference in postintervention IVT rates between intervention and control hospitals adjusted for baseline IVT rate and stratum was not significant (primary outcome rate difference=1.1% (95% CI -1.5% to 3.7%;
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.