Author Affiliations: Kings College London (Dr Bray); Royal College of Physicians (Mrs Hoffman); Guys and St Thomas' National Health Service Foundation Trust (Dr Rudd), London; and Salford Royal National Health Service Foundation Trust, Salford (Dr Tyrrell), England.
The study by Palmer et al1 addresses an important question but also highlights the challenges in interpreting routine administrative data sets. The findings concerning thrombolysis rates and brain scanning are not consistent with national audit data. The study reports a thrombolysis rate for acute ischemic stroke of 2.7% compared with 5.8% in the 2010 Sentinel Audit.2 Similarly, 84% of patients in Sentinel received a brain scan within 24 hours and 61% within 12 hours. Therefore, the low rates of thrombolysis and same-day brain scans documented by Palmer et al may relate to the quality of data capture and coding rather than true deficiencies in care. Data to validate the accuracy of the data set used in the study to assess process measures of stroke care quality would be helpful.
Bray B, Hoffman A, Tyrrell P, Rudd A. Measuring Stroke Care and Quality in Routine Data Sets. JAMA Neurol. 2013;70(1):130-131. doi:10.1001/2013.jamaneurol.129