2022
No short-term mortality from benzodiazepine use post-acute ischemic stroke after accounting for bias
Moura L, Yan Z, Donahue M, Smith L, Schwamm L, Hsu J, Newhouse J, Haneuse S, Blacker D, Hernandez-Diaz S. No short-term mortality from benzodiazepine use post-acute ischemic stroke after accounting for bias. Journal Of Clinical Epidemiology 2022, 154: 136-145. PMID: 36572369, PMCID: PMC10033385, DOI: 10.1016/j.jclinepi.2022.12.013.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeRisk differenceIschemic strokeBenzodiazepine useShort-term mortalityImmortal time biasElectronic health recordsAIS admissionsBenzodiazepine initiationStroke RegistryPoststroke mortalityTreatment initiationMortality riskPatientsFurther adjustmentMortalityBenzodiazepinesOlder adultsTime biasHealth recordsImmortal timeStrokeRiskDaysContraindicationsComparative Effectiveness and Safety of Seizure Prophylaxis Among Adults After Acute Ischemic Stroke
Moura L, Donahue M, Yan Z, Smith L, Hsu J, Newhouse J, Schwamm L, Haneuse S, Hernandez-Diaz S, Blacker D. Comparative Effectiveness and Safety of Seizure Prophylaxis Among Adults After Acute Ischemic Stroke. Stroke 2022, 54: 527-536. PMID: 36544249, PMCID: PMC9870933, DOI: 10.1161/strokeaha.122.039946.Peer-Reviewed Original ResearchConceptsSeizure prophylaxisRisk differenceAntiseizure drugsEarly seizure prophylaxisSevere AIS patientsAcute ischemic strokePrespecified subgroup analysisHealth care factorsInverse probability weightsElectronic health recordsAIS admissionsPoststroke mortalityStroke RegistryIschemic strokeAIS patientsStroke settingsCare factorsSubgroup analysisProphylaxisMortality riskHigh riskPatientsComparative effectivenessExcess deathsTrial data
2021
Antithrombotic Therapy for Stroke Prevention in Patients With Ischemic Stroke With Aspirin Treatment Failure
Lusk J, Xu H, Peterson E, Bhatt D, Fonarow G, Smith E, Matsouaka R, Schwamm L, Xian Y. Antithrombotic Therapy for Stroke Prevention in Patients With Ischemic Stroke With Aspirin Treatment Failure. Stroke 2021, 52: e777-e781. PMID: 34702067, PMCID: PMC8608737, DOI: 10.1161/strokeaha.121.034622.Peer-Reviewed Original ResearchConceptsAspirin treatment failureDual antiplatelet therapyIschemic strokeAspirin monotherapyClopidogrel monotherapyAntiplatelet therapyAntithrombotic therapyTreatment failureAntithrombotic treatment patternsAspirin/dipyridamoleGuidelines-Stroke registryIschemic stroke survivorsAcute ischemic strokeHalf of patientsAmerican Heart AssociationComplex clinical scenariosNonvitamin KOral anticoagulantsStroke preventionStroke RegistryOlder patientsPreventive therapyTreatment patternsHeart AssociationStroke survivors
2020
Disease Burden Following Non-Cardioembolic Minor Ischemic Stroke or High-Risk TIA: A GWTG-Stroke Study
Kaufman B, Shah S, Hellkamp A, Lytle B, Fonarow G, Schwamm L, Lesén E, Hedberg J, Tank A, Fita E, Bhalla N, Atreja N, Bettger J. Disease Burden Following Non-Cardioembolic Minor Ischemic Stroke or High-Risk TIA: A GWTG-Stroke Study. Journal Of Stroke And Cerebrovascular Diseases 2020, 29: 105399. PMID: 33254370, DOI: 10.1016/j.jstrokecerebrovasdis.2020.105399.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCost-Benefit AnalysisFee-for-Service PlansFemaleFunctional StatusHealth Care CostsHealth Services Needs and DemandHealth Services ResearchHospital CostsHumansIschemic Attack, TransientMaleMedicarePatient DischargeRegistriesRisk AssessmentRisk FactorsSeverity of Illness IndexStrokeTime FactorsTreatment OutcomeUnited StatesConceptsHigh-risk transient ischemic attackTransient ischemic attackMinor ischemic strokeIschemic strokeHigh-risk TIA patientsLimited real-world dataMedicare paymentsBurden of illnessClinical trial populationsMean Medicare paymentsImportant unmet needMedicare spendingIschemic attackTIA patientsAntiplatelet therapyIndex hospitalizationStroke RegistryComposite outcomeCumulative incidenceClinical outcomesTherapeutic optionsTrial populationFunctional statusDisease burdenPatient outcomesCryptogenic stroke: Contemporary trends, treatments, and outcomes in the United States.
Prabhakaran S, Messé S, Kleindorfer D, Smith E, Fonarow G, Xu H, Zhao X, Lytle B, Cigarroa J, Schwamm L. Cryptogenic stroke: Contemporary trends, treatments, and outcomes in the United States. Neurology Clinical Practice 2020, 10: 396-405. PMID: 33299667, PMCID: PMC7717635, DOI: 10.1212/cpj.0000000000000736.Peer-Reviewed Original ResearchCryptogenic strokeIschemic strokeStroke etiologyDischarge outcomesHospital treatmentHospital characteristicsMultivariable logistic regressionGWTG-StrokeStroke RegistryNationwide registryMultivariable analysisPatientsLower mortalityHigh mortalityNationwide dataLogistic regressionSubtypesStrokeNational InstituteScale scaleOutcomesTreatmentRegistryHospitalEtiology
2018
Evidence-Based Performance Measures and Outcomes in Patients With Acute Ischemic Stroke
Wang Y, Li Z, Zhao X, Liu L, Wang C, Wang C, Peterson E, Schwamm L, Fonarow G, Smith S, Bettger J, Wang D, Li H, Xian Y, Wang Y. Evidence-Based Performance Measures and Outcomes in Patients With Acute Ischemic Stroke. Circulation Cardiovascular Quality And Outcomes 2018, 11: e001968. PMID: 30557048, DOI: 10.1161/circoutcomes.115.001968.Peer-Reviewed Original ResearchMeSH KeywordsAgedBrain IschemiaChinaClinical CompetenceDisability EvaluationEvidence-Based MedicineFemaleFibrinolytic AgentsGuideline AdherenceHumansMaleMiddle AgedOutcome and Process Assessment, Health CarePractice Guidelines as TopicPractice Patterns, Physicians'Prospective StudiesQuality ImprovementQuality Indicators, Health CareRecovery of FunctionRegistriesRisk FactorsSmoking CessationStrokeStroke RehabilitationThrombolytic TherapyTime FactorsTime-to-TreatmentTreatment OutcomeConceptsAcute ischemic strokeIschemic strokeOptimal complianceStroke careChina National Stroke RegistryEvidence-based performance measuresMultivariable Cox modelNational Stroke RegistryFavorable functional outcomeProspective cohort studyEvidence-based guidelinesRoutine clinical practiceCause of deathIntravenous tPAStroke recurrenceStroke RegistryCohort studyNationwide registryClinical outcomesFunctional outcomeCare measuresImproved outcomesHospital measuresCox modelClinical practiceInternational Comparison of Patient Characteristics and Quality of Care for Ischemic Stroke: Analysis of the China National Stroke Registry and the American Heart Association Get With The Guidelines––Stroke Program
Wangqin R, Laskowitz D, Wang Y, Li Z, Wang Y, Liu L, Liang L, Matsouaka R, Saver J, Fonarow G, Bhatt D, Smith E, Schwamm L, Bettger J, Hernandez A, Peterson E, Xian Y. International Comparison of Patient Characteristics and Quality of Care for Ischemic Stroke: Analysis of the China National Stroke Registry and the American Heart Association Get With The Guidelines––Stroke Program. Journal Of The American Heart Association 2018, 7: e010623. PMID: 30371291, PMCID: PMC6474951, DOI: 10.1161/jaha.118.010623.Peer-Reviewed Original ResearchConceptsChina National Stroke RegistryNational Stroke RegistryAcute ischemic strokeStroke RegistryIschemic strokeChinese patientsDeep venous thrombosis prophylaxisHealth Stroke ScaleVenous thrombosis prophylaxisAcute stroke careAdministration of thrombolyticsEvidence-based guidelinesAmerican Heart AssociationQuality of careBackground AdherenceDischarge antithromboticsThrombosis prophylaxisCessation counselingStroke ProgramStroke ScaleClinical characteristicsHospital arrivalNeedle timePatient characteristicsSecondary preventionEffect of a Multifaceted Quality Improvement Intervention on Hospital Personnel Adherence to Performance Measures in Patients With Acute Ischemic Stroke in China: A Randomized Clinical Trial
Wang Y, Li Z, Zhao X, Wang C, Wang X, Wang D, Liang L, Liu L, Wang C, Li H, Shen H, Bettger J, Pan Y, Jiang Y, Yang X, Zhang C, Han X, Meng X, Yang X, Kang H, Yuan W, Fonarow G, Peterson E, Schwamm L, Xian Y, Wang Y. Effect of a Multifaceted Quality Improvement Intervention on Hospital Personnel Adherence to Performance Measures in Patients With Acute Ischemic Stroke in China: A Randomized Clinical Trial. JAMA 2018, 320: 245-254. PMID: 29959443, DOI: 10.1001/jama.2018.8802.Peer-Reviewed Original ResearchConceptsMultifaceted quality improvement interventionAcute ischemic strokeQuality improvement interventionsEvidence-based performance measuresIschemic strokeImprovement interventionsControl groupUsual careClinical trialsIntervention groupEvidence-based stroke careCluster-randomized clinical trialClinical vascular eventsCo-primary outcomesLong-term outcomesHospital mortalityStroke RegistryVascular eventsSecondary outcomesPrimary outcomeStroke careCare protocolsClinical pathwayMAIN OUTCOMEPatients
2016
Substantial Progress Yet Significant Opportunity for Improvement in Stroke Care in China
Li Z, Wang C, Zhao X, Liu L, Wang C, Li H, Shen H, Liang L, Bettger J, Yang Q, Wang D, Wang A, Pan Y, Jiang Y, Yang X, Zhang C, Fonarow G, Schwamm L, Hu B, Peterson E, Xian Y, Wang Y, Wang Y. Substantial Progress Yet Significant Opportunity for Improvement in Stroke Care in China. Stroke 2016, 47: 2843-2849. PMID: 27758941, DOI: 10.1161/strokeaha.116.014143.Peer-Reviewed Original ResearchConceptsChina National Stroke RegistryIntravenous thrombolytic therapyNational Stroke RegistryQuality Improvement ProgramHigher composite scoresStroke RegistryDysphagia screeningStroke careThrombolytic therapyAtrial fibrillationSmoking cessationLeading causeStroke educationMultivariate analysisStudy periodAdherenceComposite scoreHospitalPhase 2Phase 1CareRegression modelsOddsOverall qualitySignificant improvementAcute management of stroke patients taking non–vitamin K antagonist oral anticoagulants Addressing Real-world Anticoagulant Management Issues in Stroke (ARAMIS) Registry: Design and rationale
Xian Y, Hernandez A, Harding T, Fonarow G, Bhatt D, Suter R, Khan Y, Schwamm L, Peterson E. Acute management of stroke patients taking non–vitamin K antagonist oral anticoagulants Addressing Real-world Anticoagulant Management Issues in Stroke (ARAMIS) Registry: Design and rationale. American Heart Journal 2016, 182: 28-35. PMID: 27914497, DOI: 10.1016/j.ahj.2016.07.023.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, OralAdultAnticoagulantsAntithrombinsAtrial FibrillationCohort StudiesDabigatranEmergency TreatmentFemaleHumansMaleMedication Therapy ManagementOutcome and Process Assessment, Health CarePyrazolesPyridinesPyridonesQuality ImprovementRegistriesRivaroxabanStrokeThiazolesUnited StatesWarfarinConceptsAcute ischemic strokeAnticoagulation-related intracerebral hemorrhageIntracerebral hemorrhageIschemic strokeStroke patientsOral anticoagulantsAcute ischemic stroke patientsCurrent treatment patternsLongitudinal medication useMulticenter cohort studyAcute stroke patientsIschemic stroke patientsReal-world clinical decisionsChronic anticoagulation therapyPatient-reported outcomesCritical unmet needChronic anticoagulationGuidelines-StrokeStroke prophylaxisAnticoagulation therapyIndex hospitalizationStroke RegistryCohort studyAcute managementMedication use
2015
National stroke registries for monitoring and improving the quality of hospital care: A systematic review
Cadilhac D, Kim J, Lannin N, Kapral M, Schwamm L, Dennis M, Norrving B, Meretoja A. National stroke registries for monitoring and improving the quality of hospital care: A systematic review. International Journal Of Stroke 2015, 11: 28-40. PMID: 26763018, DOI: 10.1177/1747493015607523.Peer-Reviewed Original ResearchConceptsStroke careNational strokePatient outcomesNational Stroke RegistryAcute stroke careEvidence-based careHospital-based strokeStroke RegistryNational registryHospital careInitial keyword searchRegistrySystematic reviewPatient consentData linkagePotential papersSystematic searchMost registriesCareStrokeOutcomesBetter awarenessRoutine monitoringCurrent useBetter access
2013
Impact of macroeconomic status on prehospital management, in-hospital care and functional outcome of acute stroke in China
Ji R, Wang D, Liu G, Shen H, Wang Y, Li H, Schwamm L, Wang Y. Impact of macroeconomic status on prehospital management, in-hospital care and functional outcome of acute stroke in China. Journal Of Clinical Practice 2013, 10: 701-712. DOI: 10.2217/cpr.13.68.Peer-Reviewed Original ResearchPrehospital managementFunctional outcomeChina National Stroke RegistryModified Rankin Scale scoreOpportunity-based scoreNational Stroke RegistryRankin Scale scoreGood functional outcomeGeneralized estimation equationsStroke RegistryIschemic strokeHospital careScale scoreHospital qualityStrokeComposite measureCareOutcomesScoresCharacteristics and Outcomes Among Patients Transferred to a Regional Comprehensive Stroke Center for Tertiary Care
Ali S, Singhal A, Viswanathan A, Rost N, Schwamm L. Characteristics and Outcomes Among Patients Transferred to a Regional Comprehensive Stroke Center for Tertiary Care. Stroke 2013, 44: 3148-3153. PMID: 24021682, DOI: 10.1161/strokeaha.113.002493.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeIntravenous tissue plasminogen activatorInitial National InstitutesComprehensive stroke centerHospital mortalityIschemic strokeTissue plasminogen activatorStroke centersStroke careDoor patientsHealth Stroke Scale scoreMedian initial National InstitutesAcute ischemic stroke carePlasminogen activatorLonger hospital lengthStroke care centerHealth Stroke ScaleStroke Scale scoreCoronary artery diseaseIschemic stroke careAcute care hospitalsNational InstituteHospital lengthSevere strokeStroke RegistryInsurance Status and Outcome after Intracerebral Hemorrhage: Findings from Get With The Guidelines-Stroke
James M, Grau-Sepulveda M, Olson D, Smith E, Hernandez A, Peterson E, Schwamm L, Bhatt D, Fonarow G. Insurance Status and Outcome after Intracerebral Hemorrhage: Findings from Get With The Guidelines-Stroke. Journal Of Stroke And Cerebrovascular Diseases 2013, 23: 283-292. PMID: 23537567, DOI: 10.1016/j.jstrokecerebrovasdis.2013.02.016.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCerebral HemorrhageChi-Square DistributionFemaleGuideline AdherenceHealth Services AccessibilityHealthcare DisparitiesHumansInsurance CoverageInsurance, HealthLogistic ModelsMaleMedicaidMedically UninsuredMedicareMiddle AgedMultivariate AnalysisOdds RatioPatient DischargePractice Guidelines as TopicPractice Patterns, Physicians'Private SectorQuality of Health CareRegistriesRetrospective StudiesRisk FactorsTreatment OutcomeUnited StatesConceptsInsurance statusIntracerebral hemorrhageCare measuresOdds ratioND groupHospital mortality rateProspective stroke registryPrivate insurance groupHigher mortality riskHigher odds ratioEvidence-based qualityInsurance groupsHospital-specific variablesGuidelines-StrokeHospital outcomesStroke RegistryDischarge destinationIndependent ambulationComorbid conditionsStroke databaseAdjusted analysisICH patientsFunctional statusCare indicatorsMedicare patients
2012
Data quality in the American Heart Association Get With The Guidelines-Stroke (GWTG-Stroke): Results from a National Data Validation Audit
Xian Y, Fonarow G, Reeves M, Webb L, Blevins J, Demyanenko V, Zhao X, Olson D, Hernandez A, Peterson E, Schwamm L, Smith E. Data quality in the American Heart Association Get With The Guidelines-Stroke (GWTG-Stroke): Results from a National Data Validation Audit. American Heart Journal 2012, 163: 392-398.e1. PMID: 22424009, DOI: 10.1016/j.ahj.2011.12.012.Peer-Reviewed Original ResearchConceptsMedical recordsDeep venous thrombosis prophylaxisPrimary stroke center certificationGWTG-Stroke hospitalsHospital academic statusStroke center certificationVenous thrombosis prophylaxisNational Stroke RegistryAmerican Heart AssociationQuality Improvement ProgramIntraclass correlationIschemic stroke volumeGuidelines-StrokeGWTG-StrokeStroke RegistryThrombosis prophylaxisNeedle timeSerum creatinineSymptom onsetHeart AssociationCenter certificationStroke volumeRegistry dataRegistry participationCategorical variables
2010
Patient-Level and Hospital-Level Determinants of the Quality of Acute Stroke Care
Reeves M, Gargano J, Maier K, Broderick J, Frankel M, LaBresh K, Moomaw C, Schwamm L. Patient-Level and Hospital-Level Determinants of the Quality of Acute Stroke Care. Stroke 2010, 41: 2924-2931. PMID: 20966407, DOI: 10.1161/strokeaha.110.598664.Peer-Reviewed Original ResearchConceptsHospital-level determinantsAcute stroke careQuality of careStroke RegistryStroke carePatient levelPaul Coverdell National Acute Stroke RegistryNational Acute Stroke RegistryAcute Stroke RegistryHospital-level factorsPatient-level factorsHospital-level variablesPatient-level variablesComposite scoreMultilevel linear regression analysesMean composite scoreTIA admissionsHospital factorsIschemic strokeStatus documentationRegistry dataLinear regression analysisHospitalNeurologist involvementSmall hospitals
2009
Frequency and Determinants of Lipid Testing in Ischemic Stroke and Transient Ischemic Attack
Smith E, Pan W, Olson D, Reeves M, Ovbiagele B, Peterson E, Fonarow G, Schwamm L. Frequency and Determinants of Lipid Testing in Ischemic Stroke and Transient Ischemic Attack. Stroke 2009, 41: 232-238. PMID: 20035071, DOI: 10.1161/strokeaha.109.567693.Peer-Reviewed Original ResearchConceptsTransient ischemic attackIschemic attackLDL measurementIschemic strokeLipid testingLarger quality improvement programmesLow-density lipoprotein testingTransient ischemic attack admissionsAdditional calendar yearConsecutive ischemic strokeGuidelines-Stroke hospitalsNationwide stroke registryLipid-lowering therapyHistory of strokeQuality Improvement ProgramLogistic regression modelsStroke RegistryHospitalized patientsLipoprotein testingAtrial fibrillationLDL levelsClinical managementHospital characteristicsNational guidelinesPatients
2008
Stroke Center Designation Can be Achieved by Small Hospitals
Smith E, Dreyer P, Prvu-Bettger J, Abdullah A, Palmeri G, Goyette L, McElligott C, Schwamm L. Stroke Center Designation Can be Achieved by Small Hospitals. Critical Pathways In Cardiology A Journal Of Evidence-Based Medicine 2008, 7: 173-177. PMID: 18791405, DOI: 10.1097/hpc.0b013e318184e2bc.Peer-Reviewed Original ResearchConceptsAcute stroke teamSmall hospitalsStroke teamMassachusetts hospitalsStroke center designationTeaching hospital statusAcute ischemic strokeAcute stroke carePrimary stroke centerMassachusetts DepartmentPublic healthStroke RegistryIschemic strokeStroke centersStroke careStroke servicesCenter designationCare pathwayHospital characteristicsHospital statusTelemedicine consultationsHospitalTomography scanningLarge hospitalsBed size
2006
The Paul Coverdell National Acute Stroke Registry Initial Results from Four Prototypes
Reeves M, Broderick J, Frankel M, LaBresh K, Schwamm L, Moomaw C, Weiss P, Katzan I, Arora S, Heinrich J, Hickenbottom S, Karp H, Malarcher A, Mensah G, Reeves M. The Paul Coverdell National Acute Stroke Registry Initial Results from Four Prototypes. American Journal Of Preventive Medicine 2006, 31: s202-s209. PMID: 17178304, DOI: 10.1016/j.amepre.2006.08.007.Peer-Reviewed Original ResearchConceptsRecombinant tissue plasminogen activatorTissue plasminogen activatorStroke admissionsPaul Coverdell National Acute Stroke RegistryNational Acute Stroke RegistryPlasminogen activatorAcute stroke admissionsAcute Stroke RegistrySmoking cessation counselingPercent of patientsTransient ischemic attackAcute stroke careAcute stroke patientsPercent of admissionsHours of onsetIschemic stroke admissionsHealthcare system levelQuality improvement interventionsYears of ageAntithrombotic treatmentIschemic attackLipid testingStroke RegistryEligible subjectsIschemic strokeDesigning a Sustainable National Registry for Stroke Quality Improvement
Schwamm L, Reeves M, Frankel M. Designing a Sustainable National Registry for Stroke Quality Improvement. American Journal Of Preventive Medicine 2006, 31: s251-s257. PMID: 17178314, DOI: 10.1016/j.amepre.2006.08.013.Peer-Reviewed Original ResearchConceptsStroke careResource-constrained healthcare environmentsQI programStroke quality improvementNational Stroke RegistryAcute ischemic strokeHospital-based careRate of adherenceConsensus-based guidelinesTargeted quality improvement effortsQuality Improvement OrganizationPublic health departmentsFederal health agenciesQuality improvement effortsStroke RegistryIschemic strokeHealth payersNational registryHealth departmentsHealthcare providersPatient careElectronic data captureQI initiativesHealth agenciesCare