Evidence map›Paper›PMID 35135062›Full record

ArticleJournal of stroke2022

Effect of the Coronavirus Disease 2019 Pandemic on the Quality of Stroke Care in Stroke Units and Alternative Wards: A National Comparative Analysis.

Dominique A Cadilhac, Joosup Kim, Geoffrey Cloud, Craig S Anderson, Emma K Tod, Sibilah J Breen, Steven Faux, Timothy Kleinig, Helen Castley, Richard I Lindley and 10 more

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of stroke, 2022. 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
0.8field-weighted citation impact, top 30% 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, 5 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
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

20 authors at 14 institutions in 1 country.

Dominique A CadilhacDepartment of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia.
Joosup KimDepartment of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia.
Geoffrey CloudDepartment of Neuroscience, Central Clinical School, Monash University, Clayton, Australia.
Craig S AndersonThe George Institute for Global Health, Sydney, Australia.
Emma K TodThe Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Australia.
Sibilah J BreenThe Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Australia.
Steven FauxDepartment of Rehabilitation Medicine, St Vincent's Hospital Sydney, Sydney, Australia.
Timothy KleinigDepartment of Neurology, Royal Adelaide Hospital, Adelaide, Australia.
Helen CastleyDepartment of Neurology, Royal Hobart Hospital, Hobart, Australia.
Richard I LindleyDepartment of Medicine, University of Sydney, Sydney, Australia.
Sandy MiddletonNursing Research Institute, Australian Catholic University, Sydney, Australia.
Bernard YanDepartment of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Australia.
Kelvin HillStroke Foundation, Melbourne, Australia.
Brett JonesDepartment of Neurology, Canberra Hospital, Canberra, Australia.
Darshan ShahDepartment of Neurology, Gold Coast Hospital and Health Service, Southport, Australia.
Katherine JaquesStroke Statewide Clinical Network, Healthcare Improvement Unit, Clinical Excellence, Queensland Health, Brisbane, Australia.
Benjamin ClissoldDepartment of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia.
Bruce CampbellThe Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Australia.
Natasha A LanninDepartment of Neuroscience, Central Clinical School, Monash University, Clayton, Australia.
AuSCR COVID-19 Reporting Consortium GroupDepartment of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia.
The University of Melbourne · AUAlfred Health · AUThe Royal Melbourne Hospital · AUAustralian Catholic University · AUCanberra Hospital · AUMater Health Services · AUMonash Health · AUNational Stroke Foundation · AUQueensland Health · AURoyal Adelaide Hospital · AURoyal Hobart Hospital · AUSt Vincent's Hospital Sydney · AUThe George Institute for Global Health · AUThe University of Sydney · AU

Funding

National Health and Medical Research Council 1154273Wellcome Trust 102055
6 · The paper itself

Abstract

background and purposeChanges to hospital systems were implemented from March 2020 in Australia in response to the coronavirus disease 2019 pandemic, including decreased resources allocated to stroke units. We investigate changes in the quality of acute care for patients with stroke or transient ischemic attack during the pandemic according to patients' treatment setting (stroke unit or alternate ward).

methodsWe conducted a retrospective cohort study of patients admitted with stroke or transient ischemic attack between January 2019 and June 2020 in the Australian Stroke Clinical Registry (AuSCR). The AuSCR monitors patients' treatment setting, provision of allied health and nursing interventions, prescription of secondary prevention medications, and discharge destination. Weekly trends in the quality of care before and during the pandemic period were assessed using interrupted time series analyses.

resultsIn total, 18,662 patients in 2019 and 8,850 patients in 2020 were included. Overall, 75% were treated in stroke units. Before the pandemic, treatment in a stroke unit was superior to alternate wards for the provision of all evidence-based therapies assessed. During the pandemic period, the proportion of patients receiving a swallow screen or assessment, being discharged to rehabilitation, and being prescribed secondary prevention medications decreased by 0.58% to 1.08% per week in patients treated in other ward settings relative to patients treated in stroke units. This change represented a 9% to 17% increase in the care gap between these treatment settings during the period of the pandemic that was evaluated (16 weeks).

conclusionsDuring the first 6 months of the pandemic, widening care disparities between stroke units and alternate wards have occurred.

Indexed as

COVID-19Quality of health careStroke

Identifiers

PMID35135062
PMCPMC8829483
OpenAlexW4210598336

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.