An international standard set of patient-centered outcome measures after stroke

Joel Salinas, Sara M. Sprinkhuizen, Teri Ackerson, Julie Bernhardt, Charlie Davie, Mary G. George, Stephanie Gething, Adam G. Kelly, Patrice Lindsay, Liping Liu, Sheila C.O. Martins, Louise Morgan, Bo Norrving, Gerard M. Ribbers, Frank L. Silver, Eric E. Smith, Linda S. Williams, Lee H. Schwamm

Research output: Contribution to journalArticle

78 Scopus citations

Abstract

Background and Purpose - Value-based health care aims to bring together patients and health systems to maximize the ratio of quality over cost. To enable assessment of healthcare value in stroke management, an international standard set of patient-centered stroke outcome measures was defined for use in a variety of healthcare settings. Methods - A modified Delphi process was implemented with an international expert panel representing patients, advocates, and clinical specialists in stroke outcomes, stroke registers, global health, epidemiology, and rehabilitation to reach consensus on the preferred outcome measures, included populations, and baseline risk adjustment variables. Results - Patients presenting to a hospital with ischemic stroke or intracerebral hemorrhage were selected as the target population for these recommendations, with the inclusion of transient ischemic attacks optional. Outcome categories recommended for assessment were survival and disease control, acute complications, and patient-reported outcomes. Patient-reported outcomes proposed for assessment at 90 days were pain, mood, feeding, selfcare, mobility, communication, cognitive functioning, social participation, ability to return to usual activities, and health-related quality of life, with mobility, feeding, selfcare, and communication also collected at discharge. One instrument was able to collect most patient-reported subdomains (9/16, 56%). Minimum data collection for risk adjustment included patient demographics, premorbid functioning, stroke type and severity, vascular and systemic risk factors, and specific treatment/care-related factors. Conclusions - A consensus stroke measure Standard Set was developed as a simple, pragmatic method to increase the value of stroke care. The set should be validated in practice when used for monitoring and comparisons across different care settings.

Original languageEnglish (US)
Pages (from-to)180-186
Number of pages7
JournalStroke
Volume47
Issue number1
DOIs
StatePublished - Jan 1 2016

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Keywords

  • outcome
  • outcome and process assessment
  • patient-centered outcomes research
  • quality improvement
  • stroke
  • stroke care

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

Cite this

Salinas, J., Sprinkhuizen, S. M., Ackerson, T., Bernhardt, J., Davie, C., George, M. G., Gething, S., Kelly, A. G., Lindsay, P., Liu, L., Martins, S. C. O., Morgan, L., Norrving, B., Ribbers, G. M., Silver, F. L., Smith, E. E., Williams, L. S., & Schwamm, L. H. (2016). An international standard set of patient-centered outcome measures after stroke. Stroke, 47(1), 180-186. https://doi.org/10.1161/STROKEAHA.115.010898