Ryan Eimear, Gill Harmeet, Doogue Róisín, McCann David, Murphy Andrew W, Hayes Peter
School of Medicine, University of Limerick, Limerick, Ireland.
Department of General Practice, University of Galway, Galway, Ireland.
Pilot Feasibility Stud. 2025 Jan 25;11(1):9. doi: 10.1186/s40814-025-01595-8.
Stroke has devastating consequences for survivors. Hypertension is the most important modifiable risk factor, and its management largely takes place in primary care. However, most stroke-based research does not occur in this setting. Ongoing hypertension and a risk of further stroke are a major concern for both patients and their general practitioners. We aim to assess whether it is feasible to assess prognosis in persons, with a previous stroke or transient ischemic attack (TIA), in general practice, and whether a well-powered observational study is possible.
We performed a search of the electronic health record of individuals previously identified as having had a stroke or TIA, to assess prognosis over 3 years. Feasibility was assessed by meeting five criteria: (1) all general practices approached participated, (2) greater than 90% of patient records were accessible, (3) all study outcomes were available to review, (4) that collection data was less than 15 min per patient, and (5) a power calculation for a planned observational study could take place.
All six general practices approached participated freely, and 193/196 patients' files were reidentified (98.5%). Twenty-eight cardiovascular events were recorded-most commonly a repeat TIA or ischemic stroke. Data collection took on average 5.5 min per file, and a power calculation for a planned observational study was completed.
This study demonstrates that the proposed methodology for a full cohort study within general practice of patients post-stroke/TIA is both acceptable to practices and feasible. An adequately powered, "time-to-event" study is possible.
中风给幸存者带来了毁灭性的后果。高血压是最重要的可改变风险因素，其管理主要在初级保健中进行。然而，大多数基于中风的研究并非在此背景下开展。持续性高血压和再次中风的风险是患者及其全科医生主要关注的问题。我们旨在评估在全科医疗中评估曾发生中风或短暂性脑缺血发作（TIA）患者的预后是否可行，以及是否能够开展一项有充分统计学效力的观察性研究。
我们对之前被确定为曾发生中风或TIA的个体的电子健康记录进行检索，以评估3年期间的预后情况。通过满足以下五条标准来评估可行性：（1）所有联系的全科医疗均参与；（2）超过90%的患者记录可获取；（3）所有研究结局均可用于审查；（4）每位患者的数据收集时间少于15分钟；（5）能够对计划开展的观察性研究进行效能计算。
所有联系的6家全科医疗均自愿参与，重新识别出了196例患者中的193例（98.5%）。记录到28起心血管事件，最常见的是再次发生TIA或缺血性中风。每份档案的数据收集平均用时5.5分钟，并且完成了对计划开展的观察性研究的效能计算。
本研究表明，针对中风/TIA后患者在全科医疗中开展完整队列研究的拟议方法，对医疗机构而言是可接受且可行的。开展一项有足够统计学效力的“事件发生时间”研究是可能的。
