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July 17, 2018

Bridging the Evidence-to-Practice Gap in Stroke Care

Author Affiliations
  • 1Department of Clinical Neuroscience, Medicine, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada
  • 2Department of Clinical Neuroscience and Engineering, University of Calgary, Calgary, Alberta, Canada
  • 3Department of Medicine (Neurology), University of Alberta, Edmonton, Alberta, Canada
JAMA. 2018;320(3):236-237. doi:10.1001/jama.2018.8803

Stroke is particularly devastating globally. Although much progress on stroke has been made, stroke is the second leading cause of death worldwide and the leading cause of death in China, a country with a population greater than 1.5 billion.1 Indeed, the burden of stroke is substantial in Asian countries because of a higher stroke incidence and evolving access to modern stroke care.2 Stroke care may be one area of medicine that has a particularly large evidence-to-practice gap. Modern stroke treatment requires technology including imaging equipment, as well as stroke units and rehabilitation units, all of which can be prohibitively expensive. Stroke care requires organization and team-based delivery, which simply are not in place in much of the world. Worldwide, many patients with stroke do not receive up-to-date care for acute stroke or treatment to prevent stroke. What is known is not applied for multiple reasons.