The value of stroke prevention and treatment.

Abstract:

:An emerging issue in stroke prevention and stroke treatment is that therapies shown to be effective in clinical trials are not being used or are being used suboptimally. One of many explanations relates to cost, ranging from concerns about inappropriate use of societal resources to more immediate concerns of organizations and individuals about their financial well-being. Assessing the cost impact of a new therapy, and thus the financial incentives faced by decision-makers, is crucial to understanding and influencing real-world treatment decisions. Assessing cost in the context of health benefits is the object of cost-effectiveness analysis. A cost-effectiveness analysis typically compares the new treatment with a less efficacious yet less costly alternative. This article provides a brief overview of the cost implications of stroke and stroke-related treatments. The example of stroke prevention is used to illustrate how to calculate an incremental cost-effectiveness ratio and help clarify what makes a treatment an especially good value. Because stroke is tremendously expensive and because severe strokes are especially expensive, treatments to prevent stroke and to diminish stroke disability are likely to be an excellent value.

journal_name

Neurology

journal_title

Neurology

authors

Matchar DB

doi

10.1212/wnl.51.3_suppl_3.s31

subject

Has Abstract

pub_date

1998-09-01 00:00:00

pages

S31-5

issue

3 Suppl 3

eissn

0028-3878

issn

1526-632X

journal_volume

51

pub_type

杂志文章,评审
  • Magnetic resonance imaging at the demyelinative foci in chronic inflammatory demyelinating polyneuropathy.

    abstract::Using MRI, we investigated the morphology and blood-nerve barrier function of the peripheral nerve trunk in 10 patients with chronic inflammatory demyelinating polyneuropathy (CIDP). Eight patients had a focal demyelinative segment in the median or ulnar nerve trunk that was defined by conduction block or abnormal tem...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.48.4.874

    authors: Kuwabara S,Nakajima M,Matsuda S,Hattori T

    更新日期:1997-04-01 00:00:00

  • Excessive daytime sleepiness in Parkinson disease: is it the drugs or the disease?

    abstract:OBJECTIVE:To examine associated demographic and clinical correlates and the development of excessive daytime sleepiness (EDS) over 8 years in a community-based cohort of patients with Parkinson disease (PD). METHODS:A total of 232 patients with PD were included in a population-based prevalence study in 1993. Patients ...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/01.wnl.0000233980.25978.9d

    authors: Gjerstad MD,Alves G,Wentzel-Larsen T,Aarsland D,Larsen JP

    更新日期:2006-09-12 00:00:00

  • Thalamic deep brain stimulation for tremor in Parkinson disease, essential tremor, and dystonia.

    abstract:OBJECTIVE:To report on the long-term outcomes of deep brain stimulation (DBS) of the thalamic ventral intermediate nucleus (VIM) in Parkinson disease (PD), essential tremor (ET), and dystonic tremor. METHODS:One hundred fifty-nine patients with PD, ET, and dystonia underwent VIM DBS due to refractory tremor at the Gre...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000004295

    authors: Cury RG,Fraix V,Castrioto A,Pérez Fernández MA,Krack P,Chabardes S,Seigneuret E,Alho EJL,Benabid AL,Moro E

    更新日期:2017-09-26 00:00:00

  • Neurofilament light and tau as blood biomarkers for sports-related concussion.

    abstract:OBJECTIVE:To compare neurofilament light (NfL) and tau as blood-based biomarkers for acute sports-related concussion (SRC) and determine whether their concentrations at different time points after the injury are associated with prolonged time to return to play (RTP). METHODS:A total of 288 professional hockey players ...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000005518

    authors: Shahim P,Tegner Y,Marklund N,Blennow K,Zetterberg H

    更新日期:2018-05-15 00:00:00

  • Cognitive effects of one season of head impacts in a cohort of collegiate contact sport athletes.

    abstract:OBJECTIVE:To determine whether exposure to repetitive head impacts over a single season negatively affects cognitive performance in collegiate contact sport athletes. METHODS:This is a prospective cohort study at 3 Division I National Collegiate Athletic Association athletic programs. Participants were 214 Division I ...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0b013e3182582fe7

    authors: McAllister TW,Flashman LA,Maerlender A,Greenwald RM,Beckwith JG,Tosteson TD,Crisco JJ,Brolinson PG,Duma SM,Duhaime AC,Grove MR,Turco JH

    更新日期:2012-05-29 00:00:00

  • Age and education correction of Mini-Mental State Examination for English and Spanish-speaking elderly.

    abstract::Previous research has shown that the Mini-Mental State Examination (MMS) is biased as a measure of cognitive impairment in minority and low-education patients. The purpose of this study was to (1) develop a statistical correction for effects of age and education and (2) test the efficacy of the statistically adjusted ...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.46.3.700

    authors: Mungas D,Marshall SC,Weldon M,Haan M,Reed BR

    更新日期:1996-03-01 00:00:00

  • Search for autonomously proliferating spinal fluid lymphocytes in patients with multiple sclerosis.

    abstract::Recently published reports have suggested that multiple sclerosis (MS) may be associated with human retrovirus infection. Indeed, an autonomously proliferating T-cell clone was isolated from the CSF of an MS patient, an observation interpreted as indicating an infection with human T lymphotropic virus I (HTLV I). In v...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.38.1.28

    authors: Birnbaum G,Aubitz S,Kotilinek L

    更新日期:1988-01-01 00:00:00

  • A randomized trial of 3,4-diaminopyridine in Lambert-Eaton myasthenic syndrome.

    abstract:OBJECTIVES:The authors report the results of a prospective, placebo-controlled, randomized study to evaluate the effectiveness of 3,4-diaminopyridine (DAP) in patients with Lambert-Eaton myasthenic syndrome (LEMS) and to determine the acute and long-term side effects of DAP. METHODS:Twenty-six patients with LEMS compl...

    journal_title:Neurology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1212/wnl.54.3.603

    authors: Sanders DB,Massey JM,Sanders LL,Edwards LJ

    更新日期:2000-02-08 00:00:00

  • Decreased striatal monoaminergic terminals in Huntington disease.

    abstract:OBJECTIVE:To evaluate the integrity of the dorsal striatal dopaminergic innervation in rigid and choreic Huntington disease (HD). BACKGROUND:Some patients with HD have an akinetic-rigid phenotype. It has been suggested that nigrostriatal in addition to striatal pathology is present in this subgroup. The authors sought...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.54.9.1753

    authors: Bohnen NI,Koeppe RA,Meyer P,Ficaro E,Wernette K,Kilbourn MR,Kuhl DE,Frey KA,Albin RL

    更新日期:2000-05-09 00:00:00

  • Neurology and neurologic practice in China.

    abstract::In the wake of dramatic economic success during the past 2 decades, the specialized field of neurology has undergone a significant transformation in China. With an increase in life expectancy, the problems of aging and cognition have grown. Lifestyle alterations have been associated with an epidemiologic transition bo...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0b013e31823a0ed3

    authors: Shi FD,Jia JP

    更新日期:2011-11-29 00:00:00

  • Nonpainful remote electrical stimulation alleviates episodic migraine pain.

    abstract:OBJECTIVE:To evaluate the efficacy of remote nonpainful electrical upper arm skin stimulation in reducing migraine attack pain. METHODS:This is a prospective, double-blinded, randomized, crossover, sham-controlled trial. Migraineurs applied skin electrodes to the upper arm soon after attack onset for 20 minutes, at va...

    journal_title:Neurology

    pub_type: 杂志文章,随机对照试验

    doi:10.1212/WNL.0000000000003760

    authors: Yarnitsky D,Volokh L,Ironi A,Weller B,Shor M,Shifrin A,Granovsky Y

    更新日期:2017-03-28 00:00:00

  • Lesion of thalamic centromedian--parafascicular complex after chronic deep brain stimulation.

    abstract::A patient with PD who exhibited disabling tremor and prominent dyskinesia underwent deep brain stimulation (DBS) of the left thalamic ventral intermediate nucleus. The electrode migrated and was replaced but with suboptimal clinical response. Two years later, postmortem analysis found the second electrode tip had ente...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.56.11.1576

    authors: Henderson JM,O'Sullivan DJ,Pell M,Fung VS,Hely MA,Morris JG,Halliday GM

    更新日期:2001-06-12 00:00:00

  • Multitracer model for staging cortical amyloid deposition using PET imaging.

    abstract:OBJECTIVE:To develop and evaluate a model for staging cortical amyloid deposition using PET with high generalizability. METHODS:Three thousand twenty-seven individuals (1,763 cognitively unimpaired [CU], 658 impaired, 467 with Alzheimer disease [AD] dementia, 111 with non-AD dementia, and 28 with missing diagnosis) fr...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000010256

    authors: Collij LE,Heeman F,Salvadó G,Ingala S,Altomare D,de Wilde A,Konijnenberg E,van Buchem M,Yaqub M,Markiewicz P,Golla SSV,Wottschel V,Wink AM,Visser PJ,Teunissen CE,Lammertsma AA,Scheltens P,van der Flier WM,Boellaard R

    更新日期:2020-09-15 00:00:00

  • Effects of oral choline on human complex partial seizures.

    abstract::We carried out an open study of the effects of large doses (12 to 16 gm per day) of oral choline on medically intractable human complex partial seizures (CPS). Marked increases of plasma choline concentration (75 to 300%) in three subjects were associated with (1) shorter duration of CPS, (2) less postseizure fatigue,...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.30.12.1334

    authors: McNamara JO,Carwile S,Hope V,Luther J,Miller P

    更新日期:1980-12-01 00:00:00

  • Critically re-evaluating a common technique: Accuracy, reliability, and confirmation bias of EMG.

    abstract:OBJECTIVES:(1) To assess the diagnostic accuracy of EMG in radiculopathy. (2) To evaluate the intrarater reliability and interrater reliability of EMG in radiculopathy. (3) To assess the presence of confirmation bias in EMG. METHODS:Three experienced academic electromyographers interpreted 3 compact discs with 20 EMG ...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000002292

    authors: Narayanaswami P,Geisbush T,Jones L,Weiss M,Mozaffar T,Gronseth G,Rutkove SB

    更新日期:2016-01-19 00:00:00

  • Physiologic events initiating REM sleep in patients with the postpolio syndrome.

    abstract:BACKGROUND:We previously studied the occurrence of muscle tone reduction (MTR), sawtooth waves (STW), and REM in sleep, and found a stereotypical sequence of these events in normal subjects. Patients with the postpolio syndrome may have involvement of the reticular formation in the brainstem, an area known to mediate i...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.52.3.516

    authors: Siegel H,McCutchen C,Dalakas MC,Freeman A,Graham B,Alling D,Sato S

    更新日期:1999-02-01 00:00:00

  • Circulating cortisol and cognitive and structural brain measures: The Framingham Heart Study.

    abstract:OBJECTIVE:To assess the association of early morning serum cortisol with cognitive performance and brain structural integrity in community-dwelling young and middle-aged adults without dementia. METHODS:We evaluated dementia-free Framingham Heart Study (generation 3) participants (mean age 48.5 years, 46.8% men) who u...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000006549

    authors: Echouffo-Tcheugui JB,Conner SC,Himali JJ,Maillard P,DeCarli CS,Beiser AS,Vasan RS,Seshadri S

    更新日期:2018-11-20 00:00:00

  • Reduplicative paramnesia.

    abstract::A striking behavioral abnormality is described in three individuals who had severe head trauma. At a point when general mnestic capabilities had returned to a near normal level, the patients persistently relocated the hospital at another geographical site, even in the face of compelling counter-evidence. The strong pa...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.26.2.147

    authors: Benson DF,Gardner H,Meadows JC

    更新日期:1976-02-01 00:00:00

  • Progressive myoclonic epilepsies: it takes a village to make a diagnosis.

    abstract::The progressive myoclonus epilepsies (PMEs) are a devastating group of rare disorders(1) that manifest with increasing action myoclonus, which is also present at rest but activates with stimuli such as noise, light, or touch. Ultimately, patients become wheelchair-bound and experience early death. Neurologic signs tha...

    journal_title:Neurology

    pub_type: 评论,杂志文章

    doi:10.1212/WNL.0000000000000091

    authors: Knupp K,Wirrell E

    更新日期:2014-02-04 00:00:00

  • Education Research: Physician identification and patient satisfaction on an academic neurology inpatient service.

    abstract:OBJECTIVE:To determine the relationship between neurology inpatient satisfaction and (1) number of physicians involved in the patient's care and (2) patients' ability to identify their physicians. METHODS:A 10-item questionnaire addressing patient satisfaction and identification of physicians on the care team was admi...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000004961

    authors: Leon Guerrero CR,Anderson T,Zazulia AR

    更新日期:2018-02-13 00:00:00

  • Vestibular function assessment using the NIH Toolbox.

    abstract:OBJECTIVE:Development of an easy to administer, low-cost test of vestibular function. METHODS:Members of the NIH Toolbox Sensory Domain Vestibular, Vision, and Motor subdomain teams collaborated to identify 2 tests: 1) Dynamic Visual Acuity (DVA), and 2) the Balance Accelerometry Measure (BAM). Extensive work was comp...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0b013e3182872c6a

    authors: Rine RM,Schubert MC,Whitney SL,Roberts D,Redfern MS,Musolino MC,Roche JL,Steed DP,Corbin B,Lin CC,Marchetti GF,Beaumont J,Carey JP,Shepard NP,Jacobson GP,Wrisley DM,Hoffman HJ,Furman G,Slotkin J

    更新日期:2013-03-12 00:00:00

  • PRRT2 mutations: a major cause of paroxysmal kinesigenic dyskinesia in the European population.

    abstract:OBJECTIVE:Paroxysmal kinesigenic dyskinesia (PKD) is a rare disorder characterized by recurrent attacks of hyperkinetic movements. PKD can be isolated or associated with benign infantile seizures as part of the infantile convulsions with choreoathetosis (ICCA) syndrome. Mutations in the PRRT2 gene were recently identif...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0b013e31825f06c3

    authors: Méneret A,Grabli D,Depienne C,Gaudebout C,Picard F,Dürr A,Lagroua I,Bouteiller D,Mignot C,Doummar D,Anheim M,Tranchant C,Burbaud P,Jedynak CP,Gras D,Steschenko D,Devos D,Billette de Villemeur T,Vidailhet M,Brice A,

    更新日期:2012-07-10 00:00:00

  • Exercise tolerance in carnitine palmitoyltransferase II deficiency with IV and oral glucose.

    abstract:BACKGROUND:Patients with carnitine palmitoyltransferase II (CPT II) deficiency often experience muscle pain and myoglobinuria during prolonged exercise because of impaired oxidation of long-chain fatty acids. OBJECTIVE:To investigate whether IV or oral glucose can improve exercise tolerance in CPT II deficiency. METH...

    journal_title:Neurology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1212/wnl.59.7.1046

    authors: Ørngreen MC,Olsen DB,Vissing J

    更新日期:2002-10-08 00:00:00

  • Transdermal nicotine in PD: a randomized, double-blind, placebo-controlled study.

    abstract:BACKGROUND:An inverse association between cigarette smoking and the risk of idiopathic PD has been found in many epidemiologic studies. The therapeutic and possible neuroprotective effects of nicotine formulations on parkinsonian symptoms are controversial. METHODS:In a 12-week, randomized, double-blind, placebo-contr...

    journal_title:Neurology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1212/wnl.57.6.1032

    authors: Vieregge A,Sieberer M,Jacobs H,Hagenah JM,Vieregge P

    更新日期:2001-09-25 00:00:00

  • Sex difference in prevalence of depression after stroke.

    abstract:OBJECTIVE:This study investigated the sex difference in prevalence of depression at 90 days after first-ever stroke. METHODS:Patients with first-ever stroke (n = 786) were identified from the population-based Brain Attack Surveillance in Corpus Christi project (2011-2016). Poststroke depressive symptoms were assessed ...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000009394

    authors: Dong L,Sánchez BN,Skolarus LE,Stulberg E,Morgenstern LB,Lisabeth LD

    更新日期:2020-05-12 00:00:00

  • Autoimmunity and ALS.

    abstract::Significant evidence has accrued suggesting that antibodies to voltage-gated calcium channel are observed in at least some patients with sporadic ALS (SALS) and that such antibodies alter the function of these ion channels in vitro and in vivo. Further, passive transfer of these immunoglobulin-containing fractions int...

    journal_title:Neurology

    pub_type: 杂志文章,评审

    doi:10.1212/wnl.47.4_suppl_2.40s

    authors: Smith RG,Siklos L,Alexianu ME,Engelhardt JI,Mosier DR,Colom L,Habib Mohamed A,Appel SH

    更新日期:1996-10-01 00:00:00

  • Sixty hertz pallidal deep brain stimulation for primary torsion dystonia.

    abstract:OBJECTIVE:To evaluate the safety and efficacy of 60 Hz deep brain stimulation (DBS) of the globus pallidus internus (GPi) in 15 consecutive patients with primary dystonia. METHODS:We conducted a retrospective analysis of clinic charts relative to 15 consecutive patients with medically refractory primary dystonia who u...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/01.wnl.0000267430.95106.ff

    authors: Alterman RL,Miravite J,Weisz D,Shils JL,Bressman SB,Tagliati M

    更新日期:2007-08-14 00:00:00

  • Cranial dystonia: double-blind crossover study of anticholinergics.

    abstract::In patients with cranial dystonia, we compared the effects of central anticholinergic, peripheral anticholinergic, and placebo treatments in a double-blind crossover study. One of the nine patients who completed the study improved markedly with central anticholinergic therapy. The three treatments were indistinguishab...

    journal_title:Neurology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1212/wnl.34.2.215

    authors: Nutt JG,Hammerstad JP,deGarmo P,Carter J

    更新日期:1984-02-01 00:00:00

  • Relationship of motor symptoms to intellectual deficits in Parkinson disease.

    abstract::We studied 60 patients with idiopathic Parkinson disease with motor and neuropsychologic tests to ascertain whether the severity of motor symptoms was associated with the degree of neuropsychologic deficity. Significant correlations were found between the severity of brady kinesia and impaired performance on tests ass...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.32.2.133

    authors: Mortimer JA,Pirozzolo FJ,Hansch EC,Webster DD

    更新日期:1982-02-01 00:00:00

  • Reactivity of T cells from seronegative patients with myasthenia gravis to T cell epitopes of the human acetylcholine receptor.

    abstract::Seronegative (SN) patients with myasthenia gravis (MG) have clinical and electrophysiologic features similar to those of seropositive (SP) patients, and they respond to the same therapeutic measures. However, because SN patients lack detectable (by standard radioimmunoassays) serum antibodies to acetylcholine receptor...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.48.6.1638

    authors: Karni A,Zisman E,Katz-Levy Y,Paas-Rozner M,Dayan M,Brautbar C,Abramsky O,Sela M,Mozes E

    更新日期:1997-06-01 00:00:00