In recent AskTrip activity we’re seeing clusters of related Q&As around stroke. These clusters may reflect how evidence is used in practice. We tried mapping the questions along a stroke care continuum – from Acute & Emergency through Secondary Prevention to Rehabilitation & Recovery – and then added logical “next questions” we haven’t been asked yet.
So, below are a list of Qs, those with a hyperlink have been asked already and suggested Qs are listed as ‘supplementary’.
As mentioned in the title this is a ‘thinking out loud’ post – seeing what things look like. It’s helpful to air these ideas…. One can see issues immediately, for instance ‘What are the most effective secondary prevention strategies for reducing stroke recurrence?‘ and ‘What are the current best practices for managing patients with a history of stroke to prevent recurrence?‘ are very similar in scope. But that’s the nature of posting this sort of thing – helps you highlight the issues.
While there are still some rough edges, the bottom-up nature of this approach feels refreshing. I can’t help but wonder: might this become part of Trip/AskTrip’s future?
A structured map of evidence questions from acute care to recovery
1. Acute & Emergency Management
- What is the best treatment for a cerebrovascular accident both pre-hospitally and in hospital?
- Supplementary questions:
- What are the time windows and eligibility criteria for thrombolysis and thrombectomy?
- How should blood pressure be managed acutely in ischemic vs. hemorrhagic stroke?
- What are the best pre-hospital stroke recognition tools (e.g., FAST vs. ROSIER)?
2. Secondary Prevention (Reducing Recurrence)
- What are the most effective secondary prevention strategies for reducing stroke recurrence?
- What are the current best practices for managing patients with a history of stroke to prevent recurrence?
- Is aspirin effective in treating and preventing stroke?
- What is the treatment for atrial fibrillation in secondary prevention?
- Supplementary questions:
- What is the role of dual antiplatelet therapy in secondary prevention?
- What are the blood pressure and lipid targets after stroke?
- How effective are lifestyle interventions (diet, smoking cessation, exercise) in reducing recurrence?
- When is carotid endarterectomy or stenting indicated after TIA or stroke?
3. Rehabilitation & Recovery
- What are the most effective interventions to enhance motor recovery after a stroke?
- What are the recommended exercise groups for patients recovering from a sub-acute stroke?
- Supplementary questions:
- What is the optimal timing to start rehabilitation post-stroke?
- Which approaches are most effective for speech and language recovery?
- What are the best interventions for post-stroke depression and anxiety?
- How effective is technology-assisted rehabilitation (robotics, VR, telerehab)?
Cross-cutting Priorities
- Supplementary questions:
- How should patients and caregivers be educated about stroke warning signs and secondary prevention?
- What are the cost-effective models of long-term follow-up in primary vs. specialist care?
- How can access to stroke rehab services be improved in underserved populations?
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