Department of Clinical Neurological Sciences, London Health Sciences Center, University of Western Ontario, and St. Joseph's Healthcare London, Ontario, Canada.
Cerebrovasc Dis. 2010;30(2):127-47. doi: 10.1159/000315099. Epub 2010 May 24.
The aim of the Synergium was to devise and prioritize new ways of accelerating progress in reducing the risks, effects, and consequences of stroke.
Preliminary work was performed by 7 working groups of stroke leaders followed by a synergium (a forum for working synergistically together) with approximately 100 additional participants. The resulting draft document had further input from contributors outside the synergium.
Recommendations of the Synergium are: Basic Science, Drug Development and Technology: There is a need to develop: (1) New systems of working together to break down the prevalent 'silo' mentality; (2) New models of vertically integrated basic, clinical, and epidemiological disciplines; and (3) Efficient methods of identifying other relevant areas of science. Stroke Prevention: (1) Establish a global chronic disease prevention initiative with stroke as a major focus. (2) Recognize not only abrupt clinical stroke, but subtle subclinical stroke, the commonest type of cerebrovascular disease, leading to impairments of executive function. (3) Develop, implement and evaluate a population approach for stroke prevention. (4) Develop public health communication strategies using traditional and novel (e.g., social media/marketing) techniques. Acute Stroke Management: Continue the establishment of stroke centers, stroke units, regional systems of emergency stroke care and telestroke networks. Brain Recovery and Rehabilitation: (1) Translate best neuroscience, including animal and human studies, into poststroke recovery research and clinical care. (2) Standardize poststroke rehabilitation based on best evidence. (3) Develop consensus on, then implementation of, standardized clinical and surrogate assessments. (4) Carry out rigorous clinical research to advance stroke recovery. Into the 21st Century: Web, Technology and Communications: (1) Work toward global unrestricted access to stroke-related information. (2) Build centralized electronic archives and registries. Foster Cooperation Among Stakeholders (large stroke organizations, nongovernmental organizations, governments, patient organizations and industry) to enhance stroke care. Educate and energize professionals, patients, the public and policy makers by using a 'Brain Health' concept that enables promotion of preventive measures.
To accelerate progress in stroke, we must reach beyond the current status scientifically, conceptually, and pragmatically. Advances can be made not only by doing, but ceasing to do. Significant savings in time, money, and effort could result from discontinuing practices driven by unsubstantiated opinion, unproven approaches, and financial gain. Systematic integration of knowledge into programs coupled with careful evaluation can speed the pace of progress.
协同作用的目的是设计和优先考虑新的方法，以加速减少中风风险、影响和后果的进展。
7 个卒中领导者工作组进行了初步工作，随后协同作用（协同工作的论坛）有大约 100 名额外参与者参加。协同作用之外的贡献者进一步提供了对草案文件的意见。
协同作用的建议是：基础科学、药物开发和技术：需要开发：(1) 新的合作系统，打破普遍存在的“筒仓”思维；(2) 垂直整合基础、临床和流行病学学科的新模式；(3) 有效识别其他相关科学领域的方法。卒中预防：(1) 建立一个以卒中为重点的全球慢性病预防倡议。(2) 不仅要认识到突然的临床卒中，还要认识到常见的脑血管疾病亚临床卒中，即执行功能障碍。(3) 制定、实施和评估预防卒中的人群方法。(4) 使用传统和新颖的（如社交媒体/营销）技术制定公共卫生沟通策略。急性卒中管理：继续建立卒中中心、卒中单元、区域卒中急救系统和远程卒中网络。大脑恢复和康复：(1) 将最佳神经科学，包括动物和人类研究，转化为卒中后恢复研究和临床护理。(2) 基于最佳证据标准化卒中后康复。(3) 就标准化临床和替代评估达成共识，然后实施。(4) 开展严格的临床研究，推进卒中康复。进入 21 世纪：网络、技术和通信：(1) 努力实现全球无障碍获取卒中相关信息。(2) 建立集中的电子档案和登记处。促进利益相关者（大型卒中组织、非政府组织、政府、患者组织和工业）之间的合作，以加强卒中护理。通过“大脑健康”的概念，教育和激励专业人员、患者、公众和决策者，促进预防措施的实施。
为了加速卒中的进展，我们必须在科学、概念和实践上超越当前的状态。不仅可以通过行动，而且可以通过停止行动来取得进展。通过停止基于未经证实的意见、未经证实的方法和经济利益的做法，可以显著节省时间、金钱和精力。系统地将知识纳入计划，并进行仔细评估，可以加快进展速度。
