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Title: Diagnostic technologies for stroke related events : an economic evaluation
Author: Jackson, Daniel Lee
ISNI:       0000 0004 2742 4356
Awarding Body: University of Surrey
Current Institution: University of Surrey
Date of Award: 2012
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Abstract Stroke is a very serious medical condition, taking place when there is an interruption in the blood supply to the brain. A related condition, the transient ischaemic attack {TIA}, occurs when the brain's blood supply is temporarily interrupted, and a short episode of neurological dysfunction is experienced by the patient. Understanding the impact of Stroke and TIA on healthcare provision is important. One publication presented here reports a prospective telephone survey undertaken on healthcare providers in Europe and the United States of America, examining the current diagnosis and management of TIA patients. We identified similarities in practice patterns for TIA across countries, although there were variations, such as the patient's point of entry to care and their subsequent follow up. I also review the literature published {since 2000} to determine any trends seen in the incidence, prevalence and mortality associated with Stroke in Europe and the United States. This publication found that Stroke is still a very large public health burden, although there is a continued trend of decreasing Stroke mortality. Economic modelling was undertaken to assess the relative cost effectiveness of diagnostic techniques in rapidly identifying the appropriate patients for post-TIA care in the United Kingdom. This paper presents a deterministic 1 year economic model, and suggests that an alternative pathway of care incorporating rapid access to diagnostic technologies for TIA patient assessment realised cost savings when compared to a modelled current standard of care. Three papers presented here examine the relative cost effectiveness of employing additional diagnostic techniques to facilitate the rapid diagnosis, and subsequent appropriate treatment of acute Ischaemic Stroke patients, through the use of decision analytic techniques. I examine the relative cost effectiveness of the use of an additional MRI technique to identify ischemic stroke patients suitable for treatment in the United States, the cost-effectiveness of employing an additional CT perfusion imaging step to assess these patients, and finally I assess the relative cost-effectiveness of using either an additional MRI or an additional CT based selection technique within the context of the NHS in the UK. The findings from these papers suggest that if diagnostic equipment and facilities exist, then when employed within an appropriate clinical care pathway, their application in Stroke and TIA diagnosis and treatment can be considered to be one of their potentially cost effective uses. 2
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available