Article type
Year
Abstract
Background: Cerebrovascular accident is responsible for the deaths of 5.5 million people and the loss of 49 million years of life due to disability worldwide per year. Diagnostic and therapeutic approaches for ischemic stroke remain complicated and relatively obscure, causing high mortality rates and high incidence and prevalence of patients with sequels.
Objectives: To evaluate the percentage of attending physicians of urgent and emergency care who recognize diagnostic and therapeutic approaches based on best evidence available for the management of two typical clinical cases of ischemic stroke.
Methods: This cross-sectional study carried out in 2014 is part of an evidence-based medicine initiative for several health specialties and health services in the Brazilian Amazon region (Pará State, Brazil). Thirteen public health services with non-specialized urgency and emergency units attended our inclusion criteria. Data collection was performed by means of a questionnaire with two hypothetical, but typical, clinical cases of ischemic stroke to the attending physicians. The best evidence for the diagnosis and treatment of ischemic stroke were based in eight international clinical guidelines and ten Cochrane Systematic Reviews.
Results: Only 110 participants from six hospitals agreed to participate in the study. Physicians with no specialty were the most frequent respondents (52.7%), followed by general surgeons (28.2%) and neurosurgeons (8.2%). All the other specialties contributed with 10.9% of the participant physicians. No physician (0%) was able to properly diagnose and treat any of the two hypothetical clinical cases, due to adoption of unnecessary and/or not recommended procedures, and/or non-adoption of recommendable procedures.
Conclusions: The unsatisfactory percentage of physicians able to diagnose and treat typical cases of ischemic stroke shows the actual but amendable precarious medical assistance for ischemic stroke in the Brazilian Amazon region. Thus, we are planning to offer continuous, but short-term and objective evidence-based educational strategies for diagnosis and treatment of ischemic stroke in these health services.
Objectives: To evaluate the percentage of attending physicians of urgent and emergency care who recognize diagnostic and therapeutic approaches based on best evidence available for the management of two typical clinical cases of ischemic stroke.
Methods: This cross-sectional study carried out in 2014 is part of an evidence-based medicine initiative for several health specialties and health services in the Brazilian Amazon region (Pará State, Brazil). Thirteen public health services with non-specialized urgency and emergency units attended our inclusion criteria. Data collection was performed by means of a questionnaire with two hypothetical, but typical, clinical cases of ischemic stroke to the attending physicians. The best evidence for the diagnosis and treatment of ischemic stroke were based in eight international clinical guidelines and ten Cochrane Systematic Reviews.
Results: Only 110 participants from six hospitals agreed to participate in the study. Physicians with no specialty were the most frequent respondents (52.7%), followed by general surgeons (28.2%) and neurosurgeons (8.2%). All the other specialties contributed with 10.9% of the participant physicians. No physician (0%) was able to properly diagnose and treat any of the two hypothetical clinical cases, due to adoption of unnecessary and/or not recommended procedures, and/or non-adoption of recommendable procedures.
Conclusions: The unsatisfactory percentage of physicians able to diagnose and treat typical cases of ischemic stroke shows the actual but amendable precarious medical assistance for ischemic stroke in the Brazilian Amazon region. Thus, we are planning to offer continuous, but short-term and objective evidence-based educational strategies for diagnosis and treatment of ischemic stroke in these health services.