A service improvement intervention for TIA pathways increased digital referrals, with TIA diagnosis (overall rate 37.8%) strongly predicted by increasing age and consultant referrals.
Observational (n=2,167)
No
Does a service improvement intervention in the TIA pathway alter referral patterns and diagnostic outcomes in patients evaluated for TIA?
Service changes in the TIA pathway improved referral standardization, with digital pathways becoming dominant and clinical judgment remaining crucial for diagnostic yield.
p-value: p=<0.05
ABSTRACT Background and Aims Timely diagnosis of Transient Ischaemic Attack (TIA) is critical for stroke prevention. This study evaluated referral patterns, demographic predictors, and diagnostic outcomes before and after a service improvement intervention at North Tees and Hartlepool NHS Foundation Trust. Methods A retrospective observational study was conducted using 2,167 patient records from 2021 to 2024. Demographic and referral data were analysed using IBM SPSS Statistics v27. Chi‐square analyses were used to assess associations between TIA diagnosis and age group, gender, local authority, and referral source (two‐sided, p < 0.05). A multivariable logistic regression was performed to identify independent predictors, with odds ratios (ORs) and 95% confidence intervals (CIs) used to assess the strength and precision of associations. Results The TIA diagnosis rate was 37.8%. Older adults (≥ 65 years) accounted for 72.3% of TIA cases. Digital referrals (Email and WebICE) increased significantly post‐intervention, replacing GP and consultant routes. Consultant referrals, though rare, had the highest diagnostic yield (53.8%). Chi‐square analysis showed significant associations between TIA diagnosis and age group, gender, local authority, and referral source ( p < 0.05). In regression analysis ( N = 1959), increasing age and consultant referrals were associated with higher odds of diagnosis. Middle deprivation was associated with slightly lower odds (OR = 0.77, p = 0.05). Gender was not a statistically significant predictor ( p = 0.16). Conclusion TIA diagnosis is strongly associated with age and referral source. Service changes improved referral standardisation, with digital pathways becoming the dominant mode of referral. Clinical judgment appears to play an important role, as reflected in the higher diagnostic yield of consultant referrals. These findings highlight the importance of considering key demographic and system‐level factors in stroke prevention pathways.
Wejinya et al. (Fri,) conducted a observational in Transient Ischaemic Attack (TIA) (n=2,167). Service improvement intervention (TIA pathway) vs. Pre-intervention was evaluated on TIA diagnosis (p=<0.05). A service improvement intervention for TIA pathways increased digital referrals, with TIA diagnosis (overall rate 37.8%) strongly predicted by increasing age and consultant referrals.
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