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(Stroke. 2008;39:1667.)
© 2008 American Heart Association, Inc.

Editorials

Improving Onset to Needle Time

Knowledge Is Not Enough

Richard I. Lindley, MBBS, MD, FRCP(Edin), FRACP

From the Moran Foundation for Older Australians; The University of Sydney; Western Clinical School; Westmead Hospital (C24); The University of Sydney, Australia.

Correspondence to Richard Lindley, Moran Foundation for Older Australians; The University of Sydney; Western Clinical School; Westmead Hospital (C24); The University of Sydney; NSW 2006. E-mail Richard_lindley@wmi.usyd.edu.au

Key Words: diagnostic methods • hospital stay • stroke delivery • treatment • public health

An extract of the first 250 words of the full text is provided, because this article has no abstract.

See related article, pages 1844–1849.

Mikulik and colleagues present important new data that will inform future public health stroke education campaigns.¹ They conducted a survey of lay public stroke knowledge and likely behaviors with a large representative sample of over 40-year-olds in the Czech Republic. One major driver for this work was the low use of recombinant tissue plasminogen activator within the Czech Republic (only 1%), which is unfortunately similar to many other nations, including Australia. One commonly stated reason for such low rates is late presentation to hospital, and their survey aimed to identify factors that would more likely trigger a request for an emergency ambulance transfer to hospital for people with suspected stroke. Lack of stroke knowledge was considered to be the main reason for poor ambulance response rates before their study. A key component of their survey was the completion of the Stroke Action Test (STAT). This test includes 21 stroke warning signs and 7 nonstroke distractors and respondents had to state whether they would call an ambulance (the "correct" response) or call a doctor, or wait an hour, or a day ("incorrect" responses). The authors specified that a >50% STAT score was adequate and clinically meaningful, ie, respondents had to get at least 11/21 of the stroke signs correct ("call an ambulance"). Their results are fascinating. Knowledge of stroke symptoms was not statistically associated with an increased chance of calling an ambulance. In univariate analysis, age, education, having diabetes, knowledge of stroke pathophysiology, knowing . . . [Full Text of this Article]

Related Article:

Calling 911 in Response to Stroke: A Nationwide Study Assessing Definitive Individual Behavior

Robert Mikulík, Laura Bunt, Daniel Hrdlicka, Ladislav Dusek, Daniel Václavík, and Jirí Kryza
Stroke 2008 39: 1844-1849. [Abstract] [Full Text] [PDF]