A Cross-Sectional Study of Individuals Seeking Information on Transient Ischemic Attack and Stroke Symptoms Online A Target for Intervention 英文参考文献.docVIP

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A Cross-Sectional Study of Individuals Seeking Information on Transient Ischemic Attack and Stroke Symptoms Online A Target for Intervention 英文参考文献.doc

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A Cross-Sectional Study of Individuals Seeking Information on Transient Ischemic Attack and Stroke Symptoms Online A Target for Intervention 英文参考文献

ACross-SectionalStudyofIndividualsSeeking InformationonTransientIschemicAttackandStroke SymptomsOnline:ATargetforIntervention? AnthonyS.Kim1*,SharonN.Poisson1,J.DonaldEaston1,S.ClaiborneJohnston1,2 1DepartmentofNeurology,UniversityofCaliforniaSanFrancisco,SanFrancisco,California,UnitedStatesofAmerica,2DepartmentofEpidemiologyandBiostatistics, UniversityofCaliforniaSanFrancisco,SanFrancisco,California,UnitedStatesofAmerica Abstract Background:IndividualswithTIA/strokesymptomsoftendonotseekurgentmedicalattention.Weassessedthefeasibility ofidentifyingindividualssearchingforinformationonTIA/strokesymptomsonlineasatargetforfutureinterventionsto encourageurgentevaluationandweevaluatedtheperformanceofaself-reportedriskscoretoidentifysubjectswithtrue TIAorstroke. Methodology/PrincipalFindings:WeplacedonlineadvertisementstotargetEnglish-speakingadultsintheUnitedStates searching for TIA/stroke-related keywords. After completing an online questionnaire, participants were telephoned by a vascular neurologist to assess the likelihood of TIA/stroke. We used logistic regression and the c-statistic to assess associationsandmodeldiscriminationrespectively.Over122days,251(1%)of25,292websitevisitorscompletedtheonline questionnaireand175werereachedbytelephone(meanage58.5years;63%women)forfollow-up.Oftheseparticipants, 37 (21%) had symptoms within 24 hours, 60 (34%) had not had a medical evaluation yet, and 68 (39%) had TIA/stroke. ApplyingamodifiedABCD2scoreyieldedac-statisticof0.66,but2of12withazeroscorehadaTIA/stroke.Thosewithnew symptomsweremorelikelytohaveTIA/stroke(OR4.90,95%CI2.5629.09). Conclusions/Significance: IndividualswithTIA/stroke thatareseekingreal-timeinformationonsymptomsonlinecanbe readilyidentified,insomecasesbeforetheyhavesoughtformalmedicalevaluation.Althoughasimpleself-reportedrisk score was unable to identify a low-risk population in this selected group, this population may still present an attractive targetforfutureinterventionsdesignedtoencourageurgentmedical