"There is a significant body of evidence in support of various therapies for stroke prevention but this information isn't being uniformly used in practice," says Dr. Sharon Straus, professor of medicine at the University of Toronto, clinician scientist at Toronto General Hospital, University Health Network, and lead author of the paper. "Stroke is the third leading cause of death in developed countries and that's why we need to bridge this gap between evidence and practice and why we reviewed all the evidence in support of stroke prevention."
Straus and her fellow researchers, Dr. Sumit Majumdar and Dr. Finlay McAlister of general internal medicine at the University of Alberta, reviewed over 350 clinical studies on primary and secondary stroke prevention published between 1998 and 2001. They found, for example, that anti-coagulation therapy has been shown in scientific literature to reduce the risk of stroke for people with atrial fibrillation (an irregular heart beat). This therapy is significantly under-utilized in people aged 75 or older, patients who would benefit the most because of their high risk of stroke.
Straus believes physicians are having a difficult time keeping up with scientific findings because of heavy workloads and the huge volume of studies being published. "Clinical literature is being generated at an exponential rate so it's difficult for clinicians to keep up-to-date with the evidence that's out there. As a general internist, if I wanted to keep current on research relevant to general internal medicine, I'd have to read 17 articles a day, 365 days out of the year."
Straus and colleagues hope their study will make the evidence accessible to clinicians. "There's a lot of evidence out there about how to minimize the risk of stroke. If physicians follow it, the hope is that it will lead to better health care."
The team's research was supported by the Ontario Ministry of Health, the Canadian Stroke Network and the Alberta Heritage Foundation for Medical Research.
ADDITIONAL CONTACT INFORMATION:
Dr. Sharon Straus
U of T Department of Medicine
416-340-4392
sstraus@mtsinai.on.ca
Journal
JAMA