Cardiovascular
Effectiveness in Stroke Management
July 2002
Clinical Focus*
Echocardiography
- Which clinically inapparent abnormalities identified by echocardiography among patients presenting with a new ischemic brain syndrome represent risk factors for recurrent stroke?
- What is the yield of echocardiography in detecting potential sources of cardioembolism among patients with a new ischemic brain syndrome?
- What are the operating characteristics of transthoracic and transesophageal echocardiography in detecting potential source of cardioembolic stroke?
- What are the incidence and nature of complications associated with transesophageal echocardiography?
- What is the efficacy of anticoagulant therapy in reducing the rate of recurrent stroke among patients with potential sources of cardioembolism?
- What is the incidence of complications associated with anticoagulant therapy in patients with stroke?
Carotid Imaging
- What are the operating characteristics (sensitivities, specificities, and likelihood ratios) of carotid ultrasound and magnetic resonance angiography, used separately or in combination, in measuring carotid artery stenosis?
- What is the incidence of complications associated with cerebral angiography?
- What is the efficacy of carotid endarterectomy in reducing the rate of recurrent stroke among patients with carotid artery stenosis?
- Does the timing of carotid endarterectomy affect clinical outcomes? What is the incidence of complications associated with carotid endarterectomy?
Cost-Effectiveness
- What is the cost-effectiveness of routine vs. selective imaging procedures in new stroke patients?
- What is the most cost-effective strategy to reduce the risk of recurrent stroke associated with modifiable risk factors potentially identifiable by imaging?
- How do cost-effectiveness estimates change with differences in clinical and demographic factors indicated by the initial stroke workup?
- How do cost-effectiveness estimates change with differences in treatment effectiveness?
- How do cost-effectiveness estimates change with differences in other uncertain model parameters?
*Addressed in the summary or evidence report.
Effectiveness and Cost-Effectiveness of Echocardiography and Carotid Imaging in the Management of Stroke
Summary (Publication No. 02-E021, July 2002)
Evidence Report (Publication No. 02-E022, July 2002)
(File Download)
EPC: Oregon Health & Science University
Topic Nominator: American Academy of Neurology
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