Resource distribution in stroke care must be rational and evidence-based, not driven by media coverage
There has been a sudden upsurge of interest in the availability of endovascular clot retrieval (ECR) for stroke treatment (Box). Recent newspaper articles published in New South Wales1,2 highlight the potential benefits as well as the financial and logistical challenges of providing around the clock ECR services in a vast country like Australia.
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- 1. Alexander H. Stroke patients missing out on life-saving treatment after hours. Sydney Morning Herald 2016; 10 Oct. http://www.smh.com.au/national/health/stroke-patients-missing-out-on-lifesaving-treatment-after-hours-20161005-grw1qh.html (accessed Oct 2016).
- 2. Brennan R. Stroke cases after hours in NSW ‘left to die’, specialist doctors not available. Daily Telegraph 2016; 29 Sep. http://www.dailytelegraph.com.au/news/nsw/stroke-cases-after-hours-in-nsw-left-to-die-specialist-doctors-not-available/news-story/bf9e93fa62421c33e3535d22e2067f47 (accessed Oct 2016).
- 3. Saver JL, Goyal M, van der Lugt A, et al. Time to treatment with endovascular thrombectomy and outcomes from ischemic stroke: a meta-analysis. JAMA 2016; 316: 1279-1288.
- 4. Powers WJ, Derdeyn CP, Biller J, et al. 2015 American Heart Association/American Stroke Association focused update of the 2013 guidelines for the early management of patients with acute ischemic stroke regarding endovascular treatment: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2015; 46: 3020-3035.
- 5. Australian Bureau of Statistics. Australian Demographic Statistics, Jun 2016 (ABS Cat. No. 3101.0). Canberra: ABS, 2016. http://www.abs.gov.au/ausstats/abs@.nsf/PrimaryMainFeatures/3101.0?OpenDocument (accessed Mar 2017).
- 6. Smith EE, Schwamm LH. Endovascular clot retrieval therapy implications for the organization of stroke systems of care in North America. Stroke 2015; 46: 1462-1467.
- 7. Stroke Foundation. National stroke audit: acute services report 2015. Melbourne: Stroke Foundation, 2015. https://informme.org.au/-/media/A3039E82D9FF4BC7803B5C67B42DBBB0.ashx?la=en (accessed Dec 2016).
- 8. Stroke Unit Trialists’ Collaboration. Organised inpatient (stroke unit) care for stroke. Cochrane Database Syst Rev 2013; 9: CD000197.
- 9. Morgan CD, Stephens M, Zuckerman S, et al. Physiologic imaging in acute stroke: patient selection. Interv Neuroradiol 2015; 21: 499-510.
- 10. Wardlaw JM, Murray V, Berge E, del Zoppo GJ. Thrombolysis for acute ischaemic stroke. Cochrane Database Syst Rev 2014; 7: CD000213.
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