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
2022
Blood Pressure Trajectories and Outcomes for Veterans Presenting at VA Medical Centers with a Stroke or Transient Ischemic Attack
Arling G, Perkins A, Myers LJ, Sico JJ, Bravata DM. Blood Pressure Trajectories and Outcomes for Veterans Presenting at VA Medical Centers with a Stroke or Transient Ischemic Attack. The American Journal Of Medicine 2022, 135: 889-896.e1. PMID: 35292287, DOI: 10.1016/j.amjmed.2022.02.012.Peer-Reviewed Original ResearchConceptsSystolic blood pressure trajectoriesTransient ischemic attackSystolic blood pressureBlood pressure trajectoriesBlood pressureAntihypertensive medicationsIschemic attackPressure trajectoriesHigher systolic blood pressureLower systolic blood pressureCox proportional hazards modelBlood pressure reductionBlood pressure controlEmergency department visitsHazard of mortalityProportional hazards modelVA Medical CenterMedication intensificationCause mortalityVascular eventsIschemic strokeRetrospective cohortDepartment visitsHypertension managementIndex event
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
The 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
Uncertainty as a Key Influence in the Decision To Admit Patients with Transient Ischemic Attack
Homoya BJ, Damush TM, Sico JJ, Miech EJ, Arling GW, Myers LJ, Ferguson JB, Phipps MS, Cheng EM, Bravata DM. Uncertainty as a Key Influence in the Decision To Admit Patients with Transient Ischemic Attack. Journal Of General Internal Medicine 2018, 34: 1715-1723. PMID: 30484102, PMCID: PMC6712185, DOI: 10.1007/s11606-018-4735-9.Peer-Reviewed Original ResearchConceptsTransient ischemic attackVA Medical CenterTIA patientsChart review dataAdmission ratesTIA admissionsTIA careABCD2 scoreIschemic attackChart reviewAdministrative dataSubsequent vascular eventsSecondary prevention strategiesSubset of patientsQuality improvement interventionsHigher admission ratesQuality of careKey ResultsProvidersTimely workupVascular eventsEmergency departmentInpatient settingMedical CenterHigh riskPatients