2023
Most Promising Approaches to Improve Stroke Outcomes: The Stroke Treatment Academic Industry Roundtable XII Workshop
Wechsler L, Adeoye O, Alemseged F, Bahr-Hosseini M, Deljkich E, Favilla C, Fisher M, Grotta J, Hill M, Kamel H, Khatri P, Lyden P, Mirza M, Nguyen T, Samaniego E, Schwamm L, Selim M, Silva G, Yavagal D, Yenari M, Zachrison K, Boltze J, Yaghi S, Roundtable O. Most Promising Approaches to Improve Stroke Outcomes: The Stroke Treatment Academic Industry Roundtable XII Workshop. Stroke 2023, 54: 3202-3213. PMID: 37886850, DOI: 10.1161/strokeaha.123.044279.Peer-Reviewed Original ResearchRationale and design of the GOLDEN BRIDGE II: a cluster-randomised multifaceted intervention trial of an artificial intelligence-based cerebrovascular disease clinical decision support system to improve stroke outcomes and care quality in China
Li Z, Zhang X, Ding L, Jing J, Gu H, Jiang Y, Meng X, Du C, Wang C, Wang M, Xu M, Zhang Y, Hu M, Li H, Gong X, Dong K, Zhao X, Wang Y, Liu L, Xian Y, Peterson E, Fonarow G, Schwamm L, Wang Y. Rationale and design of the GOLDEN BRIDGE II: a cluster-randomised multifaceted intervention trial of an artificial intelligence-based cerebrovascular disease clinical decision support system to improve stroke outcomes and care quality in China. Stroke And Vascular Neurology 2023, svn-2023-002411. PMID: 37699726, DOI: 10.1136/svn-2023-002411.Peer-Reviewed Original ResearchClinical decision support systemVascular eventsIntervention trialsIntervention groupControl groupGuideline-based treatment recommendationsCare qualityNew vascular eventsStroke care qualityAcute ischemic strokeComposite vascular eventsII trialUsual careIschemic strokeStroke etiologyStroke onsetStroke outcomePrimary outcomeTreat principleClinical outcomesStroke careCerebrovascular diseaseEligible participantsTreatment recommendationsIntervention studies
2021
Associations of Medicaid Expansion With Access to Care, Severity, and Outcomes for Acute Ischemic Stroke
McGee B, Seagraves K, Smith E, Xian Y, Zhang S, Alhanti B, Matsouaka R, Reeves M, Schwamm L, Fonarow G. Associations of Medicaid Expansion With Access to Care, Severity, and Outcomes for Acute Ischemic Stroke. Circulation Cardiovascular Quality And Outcomes 2021, 14: e007940. PMID: 34587752, DOI: 10.1161/circoutcomes.121.007940.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeLow-income cohortSkilled nursing facilitiesIschemic strokeMedicaid expansionStroke admissionsNonexpansion statesNursing facilitiesLow-income US populationHigh stroke burdenPrimary stroke preventionOdds of dischargeIschemic stroke admissionsExpansion statesSeverity of presentationLevel of disabilityReceipt of rehabilitationHealth insurance statusHealth insurance coverageHospital mortalityUninsured hospitalizationsStroke preventionDischarge dispositionStroke burdenStroke outcomeReperfusion Treatment and Stroke Outcomes in Hospitals With Telestroke Capacity
Wilcock A, Schwamm L, Zubizarreta J, Zachrison K, Uscher-Pines L, Richard J, Mehrotra A. Reperfusion Treatment and Stroke Outcomes in Hospitals With Telestroke Capacity. JAMA Neurology 2021, 78: 527-535. PMID: 33646272, PMCID: PMC7922240, DOI: 10.1001/jamaneurol.2021.0023.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeReperfusion treatmentIschemic strokeShort-term acute carePatients 85 yearsLow-volume hospitalsYear of admissionHospital emergency departmentTraditional Medicare beneficiariesClinical characteristicsCritical access hospitalsStroke outcomeAcute careControl hospitalsEmergency departmentMean ageFunctional statusPrimary diagnosisStroke expertiseHospital characteristicsMAIN OUTCOMEMedicare beneficiariesPatientsHospitalCare patterns
2020
Acute ischemic stroke: improving access to intravenous tissue plasminogen activator
Turner A, Schwamm L, Etherton M. Acute ischemic stroke: improving access to intravenous tissue plasminogen activator. Expert Review Of Cardiovascular Therapy 2020, 18: 277-287. PMID: 32323590, DOI: 10.1080/14779072.2020.1759422.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeIschemic stroke patientsIschemic strokeStroke patientsTreatment windowAcute ischemic stroke patientsIntravenous tissue plasminogen activatorTreatment ratesUnknown symptom onsetAcute stroke careTissue plasminogen activatorQuality improvement initiativesHealth care resourcesUnited States FoodStroke outcomeSymptom onsetStroke careStroke specialistsStroke systemsTelestroke networkDrug AdministrationAlteplasePatientsPlasminogen activatorStates Food
2017
Regional Variation in 30-Day Ischemic Stroke Outcomes for Medicare Beneficiaries Treated in Get With The Guidelines–Stroke Hospitals
Thompson M, Zhao X, Bekelis K, Gottlieb D, Fonarow G, Schulte P, Xian Y, Lytle B, Schwamm L, Smith E, Reeves M. Regional Variation in 30-Day Ischemic Stroke Outcomes for Medicare Beneficiaries Treated in Get With The Guidelines–Stroke Hospitals. Circulation Cardiovascular Quality And Outcomes 2017, 10: e003604. PMID: 28798017, DOI: 10.1161/circoutcomes.117.003604.Peer-Reviewed Original ResearchMeSH KeywordsAdministrative Claims, HealthcareAgedBrain IschemiaDatabases, FactualFee-for-Service PlansFemaleGuideline AdherenceHealth ResourcesHealthcare DisparitiesHospitalsHumansInsurance BenefitsMaleMedicarePatient ReadmissionPractice Guidelines as TopicProcess Assessment, Health CareQuality Indicators, Health CareRegistriesRisk FactorsStrokeTime FactorsTreatment OutcomeUnited StatesConceptsReadmission ratesHospital characteristicsHRR levelHealthcare resourcesGuidelines-Stroke hospitalsGuidelines-Stroke registryHealthcare resource dataIschemic stroke outcomeThirty-day mortalityIschemic stroke mortalityHospital referral region levelStroke outcomeHospital factorsPatient characteristicsStroke mortalityCare measuresMedicare beneficiariesMedicare feeMortalityDartmouth AtlasPatientsRegional variationHealth careOutcomesReadmissionThe American Heart Association’s Get With the Guidelines (GWTG)-Stroke development and impact on stroke care
Ormseth CH, Sheth KN, Saver JL, Fonarow GC, Schwamm LH. The American Heart Association’s Get With the Guidelines (GWTG)-Stroke development and impact on stroke care. Stroke And Vascular Neurology 2017, 2: 94. PMID: 28959497, PMCID: PMC5600018, DOI: 10.1136/svn-2017-000092.Peer-Reviewed Original ResearchConceptsStroke care deliveryAmerican Heart AssociationHeart AssociationCare deliveryEvidence-based careContinuous quality improvement initiativesQuality improvement initiativesInpatient outcomesStroke ProgramPatient characteristicsStroke outcomeStroke careStroke developmentVoluntary registryPatient outcomesHospital adherenceImprovement initiativesOutcomesCareGuidelinesAssociationGWTGDeliveryRegistryHealthcare Resource Availability, Quality of Care, and Acute Ischemic Stroke Outcomes
O'Brien E, Wu J, Zhao X, Schulte P, Fonarow G, Hernandez A, Schwamm L, Peterson E, Bhatt D, Smith E. Healthcare Resource Availability, Quality of Care, and Acute Ischemic Stroke Outcomes. Journal Of The American Heart Association 2017, 6: e003813. PMID: 28159820, PMCID: PMC5523738, DOI: 10.1161/jaha.116.003813.Peer-Reviewed Original ResearchConceptsHealthcare resource availabilityHospital referral regionsQuality of careReferral regionsHealthcare resourcesAcute ischemic stroke outcomesAcute ischemic stroke treatmentGuidelines-Stroke hospitalsIschemic stroke outcomeIschemic stroke patientsIschemic stroke treatmentMultivariable logistic regressionLength of stayHospital-based resourcesGuidelines-StrokeHospital mortalityHospital outcomesStroke outcomeStroke careStroke treatmentStroke patientsCare resourcesHealth care dataHospital qualityStroke quality
2016
Treatment With Tissue Plasminogen Activator in the Golden Hour and the Shape of the 4.5-Hour Time-Benefit Curve in the National United States Get With The Guidelines-Stroke Population
Kim J, Fonarow G, Smith E, Reeves M, Navalkele D, Grotta J, Grau-Sepulveda M, Hernandez A, Peterson E, Schwamm L, Saver J. Treatment With Tissue Plasminogen Activator in the Golden Hour and the Shape of the 4.5-Hour Time-Benefit Curve in the National United States Get With The Guidelines-Stroke Population. Circulation 2016, 135: 128-139. PMID: 27815374, DOI: 10.1161/circulationaha.116.023336.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeTissue plasminogen activatorIschemic strokeHospital mortalityIndependent ambulationPlasminogen activatorTissue plasminogen activator-treated patientsIntravenous tissue plasminogen activatorTissue plasminogen activator treatmentIschemic stroke outcomeHours of onsetOdds of dischargePlasminogen activator treatmentMinutes of onsetNational United StatesHemorrhagic complicationsStroke outcomeMedian onsetThrombolytic therapyStroke systemsBetter outcomesPatientsActivator treatmentGolden hourTreatment time
2015
An International Standard Set of Patient-Centered Outcome Measures After Stroke
Salinas J, Sprinkhuizen S, Ackerson T, Bernhardt J, Davie C, George M, Gething S, Kelly A, Lindsay P, Liu L, Martins S, Morgan L, Norrving B, Ribbers G, Silver F, Smith E, Williams L, Schwamm L. An International Standard Set of Patient-Centered Outcome Measures After Stroke. Stroke 2015, 47: 180-186. PMID: 26604251, PMCID: PMC4689178, DOI: 10.1161/strokeaha.115.010898.Peer-Reviewed Original ResearchConceptsPatient-reported outcomesOutcome measuresInternational standard setTransient ischemic attackHealth-related qualityCare-related factorsStroke Outcome MeasureSystemic risk factorsDifferent care settingsPreferred outcome measureRisk-adjustment variablesValue-based health careInternational expert panelIschemic attackAcute complicationsIschemic strokePatient demographicsStroke outcomeStroke RegisterIntracerebral hemorrhageStroke careStroke managementRisk factorsStroke typeCare settingsRacial/Ethnic and Sex Differences in Emergency Medical Services Transport Among Hospitalized US Stroke Patients: Analysis of the National Get With The Guidelines–Stroke Registry
Mochari-Greenberger H, Xian Y, Hellkamp A, Schulte P, Bhatt D, Fonarow G, Saver J, Reeves M, Schwamm L, Smith E. Racial/Ethnic and Sex Differences in Emergency Medical Services Transport Among Hospitalized US Stroke Patients: Analysis of the National Get With The Guidelines–Stroke Registry. Journal Of The American Heart Association 2015, 4: e002099. PMID: 26268882, PMCID: PMC4599467, DOI: 10.1161/jaha.115.002099.Peer-Reviewed Original ResearchMeSH KeywordsAgedAsianBlack or African AmericanChi-Square DistributionEmergency Medical ServicesFemaleHealth Knowledge, Attitudes, PracticeHispanic or LatinoHospitalizationHumansLogistic ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioPatient Acceptance of Health CareRegistriesSex FactorsStrokeTransportation of PatientsUnited StatesWhite PeopleConceptsEmergency medical servicesStroke patientsStroke symptomsEMS useRace/ethnicityHospitalized acute stroke patientsEmergency medical services transportWhite womenGuidelines-Stroke registryAcute stroke patientsMultivariable logistic regressionLevel of consciousnessSex differencesGuidelines-StrokeNational GetIschemic strokeStroke outcomePatient characteristicsPotential confoundersMedical historyEMS transportSex disparitiesPatientsHispanic menLogistic regressionPerception Versus Actual Performance in Timely Tissue Plasminogen Activation Administration in the Management of Acute Ischemic Stroke
Lin C, Cox M, Olson D, Britz G, Constable M, Fonarow G, Schwamm L, Peterson E, Shah B. Perception Versus Actual Performance in Timely Tissue Plasminogen Activation Administration in the Management of Acute Ischemic Stroke. Journal Of The American Heart Association 2015, 4: e001298. PMID: 26201547, PMCID: PMC4608060, DOI: 10.1161/jaha.114.001298.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAttitude of Health PersonnelBrain IschemiaDelivery of Health CareDrug Administration ScheduleFemaleFibrinolytic AgentsGuideline AdherenceHealth Care SurveysHealth Knowledge, Attitudes, PracticeHumansMaleMiddle AgedPerceptionPractice Guidelines as TopicPractice Patterns, Physicians'Quality ImprovementQuality Indicators, Health CareRegistriesStrokeThrombolytic TherapyTime FactorsTime-to-TreatmentTissue Plasminogen ActivatorTreatment OutcomeUnited StatesConceptsTissue plasminogen activatorIntravenous tissue plasminogen activatorAcute ischemic strokeAcute stroke careMinutes of arrivalLow annual volumeEligible patientsGuidelines hospitalsTPA administrationIschemic strokeStroke outcomeStroke careThrombolytic therapySmall percentageUS hospitalsDifferent hospitalsHospitalPatientsPlasminogen activatorTelephone surveyOne-thirdAdministrationMinutesAnnual volumePercentage
2013
Comparison of Ischemic Stroke Outcomes and Patient and Hospital Characteristics by Race/Ethnicity and Socioeconomic Status
Hanchate A, Schwamm L, Huang W, Hylek E. Comparison of Ischemic Stroke Outcomes and Patient and Hospital Characteristics by Race/Ethnicity and Socioeconomic Status. Stroke 2013, 44: 469-476. PMID: 23306327, PMCID: PMC3595403, DOI: 10.1161/strokeaha.112.669341.Peer-Reviewed Original ResearchConceptsRace/ethnicityAcute ischemic strokeInpatient mortalityRisk-adjusted ratesIschemic strokeSocioeconomic statusBlack patientsArea patientsNonfederal acute care hospitalsRisk-adjusted inpatient mortalityIschemic stroke outcomeInpatient mortality rateIschemic stroke admissionsCrude inpatient mortality rateLength of stayPatient's zip codeAcute care hospitalsLonger lengthStroke admissionsStroke outcomeStroke severityCare hospitalDischarge outcomesWhite patientsMechanical ventilation
2011
Stroke Quality Metrics
Parker C, Schwamm L, Fonarow G, Smith E, Reeves M. Stroke Quality Metrics. Stroke 2011, 43: 155-162. PMID: 21980213, DOI: 10.1161/strokeaha.111.635011.Peer-Reviewed Original ResearchConceptsPatient-centered outcomesQuality of carePublic reportingStroke metricsAcute hospital settingHigh-quality studiesPositive associationQuality improvement activitiesStroke outcomeStroke unitEmbase databasesEligible studiesPatient outcomesHospital settingEligibility criteriaSystematic reviewReported associationsHospital certificationProvider reimbursementOutcomesAssociationLimited associationCareQuality improvementCompliance
2010
Combining Acute Diffusion-Weighted Imaging and Mean Transmit Time Lesion Volumes With National Institutes of Health Stroke Scale Score Improves the Prediction of Acute Stroke Outcome
Yoo A, Barak E, Copen W, Kamalian S, Gharai L, Pervez M, Schwamm L, González R, Schaefer P. Combining Acute Diffusion-Weighted Imaging and Mean Transmit Time Lesion Volumes With National Institutes of Health Stroke Scale Score Improves the Prediction of Acute Stroke Outcome. Stroke 2010, 41: 1728-1735. PMID: 20595665, DOI: 10.1161/strokeaha.110.582874.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBrainBrain IschemiaDiffusion Magnetic Resonance ImagingFemaleHumansImage Processing, Computer-AssistedMaleMiddle AgedNational Institutes of Health (U.S.)Predictive Value of TestsPrognosisROC CurveSeverity of Illness IndexStatistics, NonparametricStrokeTime FactorsTreatment OutcomeUnited StatesConceptsAcute diffusion-weighted imagingDiffusion-weighted imagingAcute ischemic strokeNIHSS scorePoor outcomeLesion volumeIschemic strokeRankin ScaleBetter outcomesHealth Stroke Scale scoreAcute stroke outcomeDWI lesion volumeBaseline NIHSS scoreHealth Stroke ScaleStroke Scale scoreLower NIHSS scoreModified Rankin ScaleNational InstituteQuantitative diffusion-weighted imagingMTT volumesStroke ScaleStroke outcomeSymptom onsetClinical outcomesPrognostic yieldMeasure for Measure: New Insights Offered and Challenges Encountered in the Efforts to Improve Acute Stroke Care: Comment on “Processes of Care Associated With Acute Stroke Outcomes”
Schwamm L. Measure for Measure: New Insights Offered and Challenges Encountered in the Efforts to Improve Acute Stroke Care: Comment on “Processes of Care Associated With Acute Stroke Outcomes”. JAMA Internal Medicine 2010, 170: 810-812. PMID: 20458089, DOI: 10.1001/archinternmed.2010.93.Peer-Reviewed Original Research
2006
Risk factors for stroke after acute coronary syndromes in the Orbofiban in Patients with Unstable Coronary Syndromes–Thrombolysis In Myocardial Infarction (OPUS-TIMI) 16 study
Smith E, Cannon C, Murphy S, Feske S, Schwamm L. Risk factors for stroke after acute coronary syndromes in the Orbofiban in Patients with Unstable Coronary Syndromes–Thrombolysis In Myocardial Infarction (OPUS-TIMI) 16 study. American Heart Journal 2006, 151: 338-344. PMID: 16442896, DOI: 10.1016/j.ahj.2005.03.031.Peer-Reviewed Original ResearchConceptsTransient ischemic attackAcute coronary syndromeHistory of hypertensionPrior ischemic strokeIschemic strokeCerebrovascular eventsIntracranial hemorrhageRisk factorsCoronary syndromeHistory of TIAUnstable Coronary Syndromes-ThrombolysisHemorrhagic cerebrovascular eventsPlacebo-controlled trialCoronary artery diseaseLong-term patientsSignificant excess riskIschemic attackStroke outcomeArtery diseaseCoronary angiographyOverall incidenceCerebrovascular diseaseExcess riskHeart ratePatients