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Göteborgs universitets publikationer

Beyond conventional stroke guidelines: setting priorities

Författare och institution:
Bo Norrving (-); Per Wester (-); Katharina S Sunnerhagen (Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap och rehabilitering); Andreas Terent (-); Anna Sohlberg (-); Fredrik Berggren (-); P. O. Wester (-); Kjell Asplund (-)
Publicerad i:
Stroke, 38 ( 7 ) s. 2185-90
Artikel, refereegranskad vetenskaplig
Sammanfattning (abstract):
BACKGROUND AND PURPOSE: Priorities in the care of stroke patients are often intuitive. An open and translucent priority-setting procedure would benefit patients, professionals, and decision-makers. Prioritization is an innovative part of the new Swedish national stroke guidelines. METHODS: Working groups identified diagnostic procedures, interventions and therapies in stroke care, assessed each one according to severity (needs), effect of action, level of scientific evidence and cost-effectiveness. The items were then ranked into priority groups from 1 (highest) to 10 (lowest). Procedures lacking evidence for routine clinical use were also identified (and entered a do-not-do list), as well as procedures in research and development. Resource allocations resulting from the priority-setting process were identified. RESULTS: Of 102 core procedures identified, 50 were assigned to high-priority groups (1-3), 29 to moderate priority groups (4-7) and 23 to low priority groups (8-10). Almost a quarter were graded 8 to 10, indicating that they may not necessarily be applied if resources are scarce. Twenty-eight procedures were assigned to the do-not-do list and 16 to the research and development list. CONCLUSIONS: In stroke services, it is possible to identify not only diagnostic procedures and interventions with high priority, but also a considerable number of items used today that have low priority or should not be used at all. Strict adherence to the guidelines would result in a substantial reallocation of resources from low-priority to high-priority areas.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
Klinisk medicin ->
*Cerebrovascular Accident/diagnosis/economics/therapy, Cost-Benefit Analysis, *Guidelines, Health Care Costs, *Health Care Rationing, *Health Priorities, Health Resources, *Health Services Needs and Demand, Humans, Sweden
Postens nummer:
Posten skapad:
2007-10-28 10:28
Posten ändrad:
2013-02-18 20:51

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