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    Usability and feasibility of PreventS-MD web app for stroke prevention
    (2023)
    Valery L Feigin
    ;
    Rita Krishnamurthi
    ;
    Oleg Medvedev
    ;
    Alexander Merkin
    ;
    Balakrishnan Nair
    <jats:sec><jats:title>Background:</jats:title><jats:p> Most strokes and cardiovascular diseases (CVDs) are potentially preventable if their risk factors are identified and well controlled. Digital platforms, such as the PreventS-MD web app (PreventS-MD) may aid health care professionals (HCPs) in assessing and managing risk factors and promoting lifestyle changes for their patients. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> This is a mixed-methods cross-sectional two-phase survey using a largely positivist (quantitative and qualitative) framework. During Phase 1, a prototype of PreventS-MD was tested internationally by 59 of 69 consenting HCPs of different backgrounds, age, sex, working experience, and specialties using hypothetical data. Collected comments/suggestions from the study HCPs in Phase 1 were reviewed and implemented. In Phase 2, a near-final version of PreventS-MD was developed and tested by 58 of 72 consenting HCPs using both hypothetical and real patient (n = 10) data. Qualitative semi-structured interviews with real patients (n = 10) were conducted, and 1 month adherence to the preventive recommendations was assessed by self-reporting. The four System Usability Scale (SUS) groups of scores (0–50 unacceptable; 51–68 poor; 68–80.3 good; &gt;80.3 excellent) were used to determine usability of PreventS-MD. </jats:p></jats:sec><jats:sec><jats:title>Findings:</jats:title><jats:p> Ninety-nine HCPs from 27 countries (45% from low- to middle-income countries) participated in the study, and out of them, 10 HCPs were involved in the development of PreventS before the study, and therefore were not involved in the survey. Of the remaining 89 HCPs, 69 consented to the first phase of the survey, and 59 of them completed the first phase of the survey (response rate 86%), and 58 completed the second phase of the survey (response rate 84%). The SUS scores supported good usability of the prototype (mean score = 80.2; 95% CI [77.0–84.0]) and excellent usability of the final version of PreventS-MD (mean score = 81.7; 95% CI [79.1–84.3]) in the field. Scores were not affected by the age, sex, working experience, or specialty of the HCPs. One-month follow-up of the patients confirmed the high level of satisfaction/acceptability of PreventS-MD and (100%) adherence to the recommendations. </jats:p></jats:sec><jats:sec><jats:title>Interpretation:</jats:title><jats:p> The PreventS-MD web app has a high level of usability, feasibility, and satisfaction by HCPs and individuals at risk of stroke/CVD. Individuals at risk of stroke/CVD demonstrated a high level of confidence and motivation in following and adhering to preventive recommendations generated by PreventS-MD. </jats:p></jats:sec>
    Scopus© Citations 9  2
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    Fighting Against Stroke in Latin America: A Joint Effort of Medical Professional Societies and Governments
    (2021)
    Sheila Cristina Ouriques Martins
    ;
    LAVADOS GERMAIN, PABLO MANUEL  
    ;
    Thaís Leite Secchi
    ;
    Michael Brainin
    ;
    Sebastian Ameriso
    <jats:p><jats:bold>Introduction:</jats:bold> Stroke is one of the leading causes of death in Latin America, a region with countless gaps to be addressed to decrease its burden. In 2018, at the first Latin American Stroke Ministerial Meeting, stroke physician and healthcare manager representatives from 13 countries signed the Declaration of Gramado with the priorities to improve the region, with the commitment to implement all evidence-based strategies for stroke care. The second meeting in March 2020 reviewed the achievements in 2 years and discussed new objectives. This paper will review the 2-year advances and future plans of the Latin American alliance for stroke.</jats:p><jats:p><jats:bold>Method:</jats:bold> In March 2020, a survey based on the Declaration of Gramado items was sent to the neurologists participants of the Stroke Ministerial Meetings. The results were confirmed with representatives of the Ministries of Health and leaders from the countries at the second Latin American Stroke Ministerial Meeting.</jats:p><jats:p><jats:bold>Results:</jats:bold> In 2 years, public stroke awareness initiatives increased from 25 to 75% of countries. All countries have started programs to encourage physical activity, and there has been an increase in the number of countries that implement, at least partially, strategies to identify and treat hypertension, diabetes, and lifestyle risk factors. Programs to identify and treat dyslipidemia and atrial fibrillation still remained poor. The number of stroke centers increased from 322 to 448, all of them providing intravenous thrombolysis, with an increase in countries with stroke units. All countries have mechanical thrombectomy, but mostly restricted to a few private hospitals. Pre-hospital organization remains limited. The utilization of telemedicine has increased but is restricted to a few hospitals and is not widely available throughout the country. Patients have late, if any, access to rehabilitation after hospital discharge.</jats:p><jats:p><jats:bold>Conclusion:</jats:bold> The initiative to collaborate, exchange experiences, and unite societies and governments to improve stroke care in Latin America has yielded good results. Important advances have been made in the region in terms of increasing the number of acute stroke care services, implementing reperfusion treatments and creating programs for the detection and treatment of risk factors. We hope that this approach can reduce inequalities in stroke care in Latin America and serves as a model for other under-resourced environments.</jats:p>
    Scopus© Citations 37  1
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    Priorities to reduce the burden of stroke in Latin American countries
    (2019)
    Sheila C Ouriques Martins
    ;
    Claudio Sacks
    ;
    Werner Hacke
    ;
    Michael Brainin
    ;
    Francisco de Assis Figueiredo
    Scopus© Citations 107  7
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      11Scopus© Citations 59
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    Scopus© Citations 34  23
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    Explanation and Elaboration of the Standards of Reporting of Neurological Disorders Checklist: A Guideline for the Reporting of Incidence and Prevalence Studies in Neuroepidemiology
    (2015)
    Derrick A. Bennett
    ;
    Carol Brayne
    ;
    Valery L. Feigin
    ;
    Suzanne Barker-Collo
    ;
    Michael Brainin
    <jats:p>&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; Incidence and prevalence studies of neurological disorders play an extremely important role in hypothesis-generation, assessing the burden of disease and planning of health services. However, the assessment of disease estimates is hindered by the poor quality of reporting for such studies. We developed the Standards of Reporting of Neurological Disorders (STROND) guideline in order to improve the quality of reporting of neurological disorders from which prevalence, incidence, and outcomes can be extracted for greater generalisability. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; The guideline was developed using a 3-round Delphi technique in order to identify the ‘basic minimum items' important for reporting, as well as some additional ‘ideal reporting items.' An e-consultation process was then used in order to gauge opinion by external neuroepidemiological experts on the appropriateness of the items included in the checklist. &lt;b&gt;&lt;i&gt;Findings:&lt;/i&gt;&lt;/b&gt; The resultant 15 items checklist and accompanying recommendations were developed using a similar process and structured in a similar manner to the Strengthening of the Reporting of Observational Studies in Epidemiology checklist for ease of use. This paper presents the STROND checklist with an explanation and elaboration for each item, as well as examples of good reporting from the neuroepidemiological literature. &lt;b&gt;&lt;i&gt;Conclusions:&lt;/i&gt;&lt;/b&gt; The introduction and use of the STROND checklist should lead to more consistent, transparent and contextualised reporting of descriptive neuroepidemiological studies that should facilitate international comparisons, and lead to more accessible information for multiple stakeholders, ultimately supporting better healthcare decisions for neurological disorders.</jats:p>
      10Scopus© Citations 13
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    Scopus© Citations 6042  1
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      2Scopus© Citations 1928