Stroke units [[electronic resource] ] : an evidence based approach / / Peter Langhorne, Martin Dennis

• Record Nr.: UNISA996203968903316
• Autore: Langhorne Peter
• Pubbl/distr/stampa: London, : BMJ Books, 1998
• ISBN: 1-281-32172-9; 9786611321727; 0-470-76021-4; 0-470-75994-1
• Edizione: [1st ed.]
• Descrizione fisica: 1 online resource (130 p.)
• Altri autori (Persone): DennisMartin (Martin S.)
• Disciplina: 616.81
• Soggetti: Cerebrovascular disease; Cerebral ischemia
• Lingua di pubblicazione: Inglese
• Formato: Materiale a stampa
• Livello bibliografico: Monografia
• Note generali: Description based upon print version of record.
• Nota di bibliografia: Includes bibliographical references (p. 100-107) and index.
• Nota di contenuto: Stroke Units: An evidence based approach; Contents; Authorship; Contributors; Foreword by Iain Chalmers; Preface; 1 The stroke unit story; History of stroke unit care and its evaluation; Early studies; Definitions of a stroke unit; Stroke intensive care units; Later developments; The demands of evidence based practice; 2 How should we evaluate our interventions?; Levels of evidence; Sources of error; Systematic error (bias); Random error; Design of a reliable stroke unit trial; Why randomised trials may not be enough; Systematic reviews of randomised trials; Conduct of systematic reviews; Sources of bias in systematic reviewsInterpretation of systematic reviews; 3 Assembling evidence about stroke units; Formulating the stroke unit question; Defining the intervention; Defining the patient group; Defining the context; Defining the outcomes; Identifying the relevant trials; Locating information from relevant trials; The stroke unit trials; General comments; Stroke unit characteristics; Characteristics of different models of stroke unit; 4 Effectiveness of organised (stroke unit) care; Conventions of meta-analysis; What is meta-analysis?; What is an odds ratio?; Presentation of resultsCoping with different types of outcome; Meta-; analysis of the stroke unit trials; Can the risk of death be reduced?; Why were deaths reduced?; Preventing death at the expense of increased dependency among survivors?; Is the need for institutional care reduced?; Is dependency (disability) among survivors reduced?; Is quality of life among survivors improved?; What are the absolute benefits of stroke unit care?; Subgroup analysis; Which patients benefit?; What kind of stroke unit is effective?; Exploring the diversity of stroke unit trials; What general policies should be applied?5 Economics of stroke unit care; Economic analysis; Methods of economic analysis; Terminology; Sources of data for economic analysis; Costs of stroke; Identifying potential costs and benefits; Cost effectiveness analysis; Potential benefits; Potential costs; Measuring costs and benefits; Economic interpretation of results; Economic "balance sheet"; Factors missing from the analysis; Implications of the analysis; 6 Implications for planning stroke services; Evidence based stroke care; Comprehensive stroke services; What kind of stroke unit?; Stroke patients only or mixed rehabilitation service?Stroke ward or mobile stroke team?; Acute or rehabilitation unit?; Staffing of the stroke unit; In which department should the unit be established?; What staff are needed?; Stroke unit policies; Stroke unit size; Patient selection criteria; Duration of stay; Practices and procedures; Communication: Multidisciplinary team; Communication: Carers; Care pathways; Education, training, and beliefs; Overcoming resistance to change; 7 Implications for future research; Current state of knowledge; Outstanding questions; Appendix: Descriptions of stroke unit care
• Sommario/riassunto: Based on a major systematic review from international centres this concise text discusses the benefits of managing stroke patients in specialised units compared to management outside the hospital. It provides invaluable information in the most effective management for this chronically disabled sector