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Health care delivery for vascular risk reduction and diagnosis and treatment of vascular disease

 

Understanding vascular risk prediction is fundamental to reducing the burden of chronic disease. The HSPR group is collaborating with the University of Newcastle, New South Wales, Australia on a prospective population-based study based in primary care to map process of care for patients with transient ischaemic attack (TIA) and stroke. Data from general practices and secondary care clinics will be used to understand causes of delay in diagnosis and treatment. Similar data has been collected in the UK, Oxford Vascular Study (OXVASC), and this will form the basis of a healthcare systems comparison with Australia. Initial work in Newcastle has revealed that the current optimal evidence-based tool for predicting stroke risk after TIA (the ABCD2 score derived from OXVASC data), does not validate well in the TIA population in the Hunter Valley. Early recurrent stroke risk prediction tools, as well as referral support tools that improve diagnostic accuracy, determine optimal management in primary care and need derivation data collected from general practices. The ABCD2 tool has informed stroke service policy in the UK and in other developed healthcare systems but its ability to discriminate between high and low risk patients may differ according to the healthcare setting. The Newcastle study will aim to derive and validate predictive tools for early recurrent stroke risk prediction as well a referral support tool to refine the referred population from primary care thereby utilising less secondary care resource whilst maintaining optimal stroke prevention at population level. This study aims to generate the key evidence to inform stroke care policy in Australia.

 Selected Publications