Prioritizing gaps in stroke care: A two-round Delphi process

Elke Ge Mathijssen; Jaap Ca Trappenburg; Mark J Alberts; Angelique Balguid; Robert J Dempsey; Mayank Goyal; Bianca Ta de Greef; Marjan J Hummel; Koji Iihara; Enrique C Leira; Winston Lim; Gregory Yh Lip; Paolo Madeddu; Randolph S Marshall; Dominick Jh McCabe; Ahmad S Muda; Dimitrios N Nikas; George Ntaios; Terence J Quinn; Marta Rubiera; Tatjana Rundek; Shashank Shekhar; Wen-Jun Tu; Pearl Vyas; Wim van Zwam; Johannes B Reitsma; Ewoud Schuit

doi:10.1177/23969873251329841

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Prioritizing gaps in stroke care: A two-round Delphi process

Journal article

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Peer reviewed

Prioritizing gaps in stroke care: A two-round Delphi process

Elke Ge Mathijssen, Jaap Ca Trappenburg, Mark J Alberts, Angelique Balguid, Robert J Dempsey, Mayank Goyal, Bianca Ta de Greef, Marjan J Hummel, Koji Iihara, Enrique C Leira, …

European stroke journal, Vol.10(4), pp.1479-1488

12/01/2025

DOI: 10.1177/23969873251329841

PMCID: PMC11969492

PMID: 40178329

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Abstract

Despite international recognition of stroke as a significant health priority, discrepancies persist between the target values for stroke quality measures and the actual values that are achieved in clinical practice, referred to as gaps. This study aimed to reach consensus among international experts on prioritizing gaps in stroke care. A two-round Delphi process was conducted, surveying an international expert panel in the field of stroke care and cerebrovascular medicine, including patient representatives, healthcare professionals, researchers, policymakers, and medical directors. Experts scored the importance and required effort to close 13 gaps throughout the stroke care continuum and proposed potential solutions. Data were analyzed using descriptive statistics and qualitative analysis methods. In the first and second Delphi rounds, 35 and 30 experts participated, respectively. Expert consensus was reached on the high importance of closing 11 out of 13 gaps. Two out of 13 gaps were considered moderately important to close, with expert consensus for one of these two gaps. Expert consensus indicated that only one gap, related to the prevention of complications after stroke, requires moderate effort to close, whereas the others were considered to require high effort to close. Key focus areas for potential solutions included: "Care infrastructure," "Geographic disparities," "Interdisciplinary collaboration," and "Advocacy and funding." While closing gaps in stroke care primarily requires high effort and substantial resources, targeted interventions in the identified key focus areas may provide feasible and clinically meaningful improvements.

Stroke

quality indicators

Delphi technique

quality measures

health services

quality improvement

Details

Title: Subtitle: Prioritizing gaps in stroke care: A two-round Delphi process
Creators: Elke Ge Mathijssen - Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
Jaap Ca Trappenburg - Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
Mark J Alberts - Hartford Financial Services (United States)
Angelique Balguid - Philips Healthcare, Eindhoven, The Netherlands
Robert J Dempsey - University of Wisconsin–Madison
Mayank Goyal - University of Calgary
Bianca Ta de Greef - Philips Healthcare, Eindhoven, The Netherlands
Marjan J Hummel - Philips Healthcare, Eindhoven, The Netherlands
Koji Iihara - National Cerebral and Cardiovascular Center
Enrique C Leira - University of Iowa
Winston Lim - Singapore General Hospital
Gregory Yh Lip - Aalborg University
Paolo Madeddu - University of Bristol
Randolph S Marshall - Columbia University Irving Medical Center
Dominick Jh McCabe - Trinity College Dublin
Ahmad S Muda - Department of Radiology, Faculty of Medicine and Health Sciences, Hospital Pengajar, University Putra Malaysia, Serdang, Malaysia
Dimitrios N Nikas - 1st Cardiology Department, University General Hospital of Ioannina, Ioannina, Greece
George Ntaios - University of Thessaly
Terence J Quinn - University of Glasgow
Marta Rubiera - Stroke Unit, Department of Neurology, Hospital Vall d'Hebron, Barcelona, Spain
Tatjana Rundek - University of Miami
Shashank Shekhar - Duke University School of Medicine
Wen-Jun Tu - Capital Medical University
Pearl Vyas - Philips Healthcare, Eindhoven, The Netherlands
Wim van Zwam - Maastricht University
Johannes B Reitsma - Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
Ewoud Schuit - Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
Resource Type: Journal article
Publication Details: European stroke journal, Vol.10(4), pp.1479-1488
DOI: 10.1177/23969873251329841
PMID: 40178329
PMCID: PMC11969492
NLM abbreviation: Eur Stroke J
ISSN: 2396-9881
eISSN: 2396-9881
Publisher: SAGE PUBLICATIONS LTD
Grant note: Philips Healthcare, Eindhoven, The Netherlands
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Funding for this study was provided by Philips Healthcare, Eindhoven, The Netherlands. The funder of this study had no role in study design, data collection, data analysis and interpretation, or writing the report.
Language: English
Electronic publication date: 04/03/2025
Date published: 12/01/2025
Academic Unit: Neurology; Epidemiology; Iowa Neuroscience Institute; Neurosurgery
Record Identifier: 9984805009102771

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