Editorial Comment—Stroke Incidence Studies One Step Closer to the Elusive Gold Standard?
Key result
Core plus supplementary ascertainment methods identified 126 incident strokes compared to 108 identified by core methods alone, demonstrating that supplementary methods minimize underascertainment.
Why the study?
Does the use of core plus supplementary ascertainment methods improve the completeness of stroke identification compared to core methods alone in a population-based study?
Population
90,542 individuals in a population-based stroke incidence study, including a high-risk subset of 1,103…
Comparison
Core plus supplementary methods of stroke… vs Core methods of ascertainment alone.
Design
Cohort
Authors
Discussion
Loading...
Member takes
Implication
Supplementary methods of stroke ascertainment, including imaging and TIA referrals, significantly improve the completeness of identifying incident strokes in population-based studies compared to core methods alone.
Key Points
- This commentary addresses the validity of stroke incidence comparisons by evaluating ascertainment methods' completeness.
- Assessed completeness of two ascertainment strategies: core methods and core plus supplementary methods.
- Analyzed 90,542 anonymized electronic patient records for the study population.
- Interviewed and followed up 1,103 high-risk individuals.
- Identified 126 strokes using core plus supplementary methods compared to 108 with core methods alone.
- Only 2 additional strokes were discovered via primary care patient records.
- All 16 incident strokes found in high-risk follow-up had already been ascertained with core plus supplementary methods.
Study Design
Type
Observational (n=90,542)
Structured PICO
Does the use of core plus supplementary ascertainment methods improve the completeness of stroke identification compared to core methods alone in a population-based study?
P
Population
90,542 individuals in a population-based stroke incidence study, including a high-risk subset of 1,103 patients aged >60 years with prior vascular events.
E
Exposure
Core plus supplementary methods of stroke ascertainment (including access to carotid and brain imaging referrals and assessment of patients referred as 'transient ischemic attack' or 'recurrent stroke').
C
Comparator
Core methods of ascertainment alone.
O
Outcome
Completeness of stroke ascertainment.
Main Result
Absolute Event Rate: 0.14% vs 0.12%
Supplementary methods of stroke ascertainment, including imaging and TIA referrals, significantly improve the completeness of identifying incident strokes in population-based studies compared to core methods alone.
Cite This Study
Feigin et al. (2004) conducted an observational in Stroke incidence (n=90,542). Core plus supplementary ascertainment methods vs. Core ascertainment methods alone was evaluated on Incident strokes identified. Core plus supplementary ascertainment methods identified 126 incident strokes compared to 108 identified by core methods alone, demonstrating that supplementary methods minimize underascertainment.