2024
Real-world analysis of two ischaemic stroke and TIA systolic blood pressure goals on 12-month mortality and recurrent vascular events
Sico J, Hu X, Myers L, Levine D, Bravata D, Arling G. Real-world analysis of two ischaemic stroke and TIA systolic blood pressure goals on 12-month mortality and recurrent vascular events. Stroke And Vascular Neurology 2024, 9: svn-2023-002759. PMID: 38191185, DOI: 10.1136/svn-2023-002759.Peer-Reviewed Original ResearchTransient ischemic attackSystolic blood pressureVeterans Administration Medical CenterStroke/transient ischemic attackIntensive SBP goalRecurrent vascular eventsCardiovascular eventsVascular eventsSBP goalSBP groupRecurrent stroke/transient ischemic attackMultivariable Cox proportional hazards regressionGoal systolic blood pressureIndex emergency department visitStroke/TIA patientsSystolic blood pressure goalAverage systolic blood pressureLower systolic blood pressureCox proportional hazards regressionBlood pressure goalsRecurrent cerebrovascular eventsRetrospective cohort studyEmergency department visitsProportional hazards regressionSignificant higher risk
2020
Assessment of the Protocol-Guided Rapid Evaluation of Veterans Experiencing New Transient Neurological Symptoms (PREVENT) Program for Improving Quality of Care for Transient Ischemic Attack
Bravata DM, Myers LJ, Perkins AJ, Zhang Y, Miech EJ, Rattray NA, Penney LS, Levine D, Sico JJ, Cheng EM, Damush TM. Assessment of the Protocol-Guided Rapid Evaluation of Veterans Experiencing New Transient Neurological Symptoms (PREVENT) Program for Improving Quality of Care for Transient Ischemic Attack. JAMA Network Open 2020, 3: e2015920. PMID: 32897372, PMCID: PMC7489850, DOI: 10.1001/jamanetworkopen.2020.15920.Peer-Reviewed Original ResearchConceptsTransient ischemic attackQuality of careIschemic attackElectronic health record toolsRecurrent vascular eventsDiverse medical centersGuideline-recommended processesQuality improvement interventionsProportion of veteransHealth care systemImplementation periodIntervention associationsQI supportVascular eventsMost patientsPrimary outcomeMean ageCare existIntervention periodSymptom interventionMedical CenterQI interventionsMAIN OUTCOMEHigh riskTimely management
2019
Modelling care quality for patients after a transient ischaemic attack within the US Veterans Health Administration
Arling G, Sico JJ, Reeves MJ, Myers L, Baye F, Bravata DM. Modelling care quality for patients after a transient ischaemic attack within the US Veterans Health Administration. BMJ Open Quality 2019, 8: e000641. PMID: 31909209, PMCID: PMC6937041, DOI: 10.1136/bmjoq-2019-000641.Peer-Reviewed Original ResearchMeSH KeywordsAdministrative Claims, HealthcareAdultAgedAged, 80 and overEmergency Service, HospitalFemaleHumansIschemic Attack, TransientMaleMiddle AgedNeurologyPatient AdmissionQuality of Health CareReferral and ConsultationRetrospective StudiesStrokeTime FactorsUnited StatesUnited States Department of Veterans AffairsVeteransConceptsTransient ischemic attackCharlson Comorbidity IndexVeterans Health AdministrationHigher Charlson comorbidity indexUS Veterans Health AdministrationInpatient admissionsNeurological consultationNeurology consultationEmergency departmentIschemic attackPreventive careHealth AdministrationCare qualitySpeech deficitsHigher CCI scoresModerate potency statinRecurrent vascular eventsStroke center designationHistory of dementiaPreventive care qualityAntithrombotic medicationComorbidity indexCCI scoreED visitsRetrospective cohortThe protocol-guided rapid evaluation of veterans experiencing new transient neurological symptoms (PREVENT) quality improvement program: rationale and methods
Bravata D, Myers L, Homoya B, Miech E, Rattray N, Perkins A, Zhang Y, Ferguson J, Myers J, Cheatham A, Murphy L, Giacherio B, Kumar M, Cheng E, Levine D, Sico J, Ward M, Damush T. The protocol-guided rapid evaluation of veterans experiencing new transient neurological symptoms (PREVENT) quality improvement program: rationale and methods. BMC Neurology 2019, 19: 294. PMID: 31747879, PMCID: PMC6865042, DOI: 10.1186/s12883-019-1517-x.Peer-Reviewed Original ResearchConceptsElectronic health record toolsRecurrent vascular eventsTime-sensitive careProportion of patientsTransient neurological symptomsStepped-wedge trialProcess of careQuality improvement interventionsMulti-component interventionQuality Improvement ProgramElectronic quality measuresQI supportTIA careVascular eventsNeurological symptomsLearning healthcare systemAttack patientsClinical conditionsMedical CenterEffectiveness outcomesHigh riskTimely managementClinical protocolsImprovement interventionsClinical settingThe quality of medication optimization among patients with transient ischemic attack or minor stroke
Myers J, Bravata D, Sico J, Myers L, Chaturvedi S, Cheng E, Baye F, Zillich A. The quality of medication optimization among patients with transient ischemic attack or minor stroke. JACCP JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2019, 3: 36-46. DOI: 10.1002/jac5.1149.Peer-Reviewed Original ResearchTransient ischemic attackVeterans Health AdministrationMedication optimizationMinor strokeEligible patientsIschemic attackEmergency departmentAmerican Heart Association/American Stroke Association guidelinesGreater baseline disease severityAmerican Stroke Association guidelinesMultivariable logistic regression modelRecurrent vascular eventsVHA emergency departmentBaseline disease severityMinor stroke patientsPast medical historyEvidence-based guidelinesHigh-risk populationLogistic regression modelsMedication changesVascular eventsRetrospective cohortStroke patientsIndex eventInpatient stay
2018
Quality of Care for Veterans With Transient Ischemic Attack and Minor Stroke
Bravata DM, Myers LJ, Arling G, Miech EJ, Damush T, Sico JJ, Phipps MS, Zillich AJ, Yu Z, Reeves M, Williams LS, Johanning J, Chaturvedi S, Baye F, Ofner S, Austin C, Ferguson J, Graham GD, Rhude R, Kessler CS, Higgins DS, Cheng E. Quality of Care for Veterans With Transient Ischemic Attack and Minor Stroke. JAMA Neurology 2018, 75: 419-427. PMID: 29404578, PMCID: PMC5885264, DOI: 10.1001/jamaneurol.2017.4648.Peer-Reviewed Original ResearchConceptsTransient ischemic attackMinor strokeEmergency departmentElements of careDay 2Ischemic attackDay 7Federal fiscal year 2014Intensive care unit stayDeep vein thrombosis prophylaxisVeterans Health Administration systemCare qualityReceipt of thrombolysisRecurrent vascular eventsStroke care qualityVHA emergency departmentGuideline-concordant careLength of stayGuideline-recommended processesProcess of careHealth Administration systemQuality of careHemoglobin A1c measurementsElectronic quality measuresHealth care system