原创力文档a cross-sectional study of individuals seeking information on transient ischemic attack and stroke symptoms online a target for intervention个人寻求信息的横向研究短暂性脑缺血发作和中风症状在线干预的目标.pdfVIP
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a cross-sectional study of individuals seeking information on transient ischemic attack and stroke symptoms online a target for intervention个人寻求信息的横向研究短暂性脑缺血发作和中风症状在线干预的目标
A Cross-Sectional Study of Individuals Seeking
Information on Transient Ischemic Attack and Stroke
Symptoms Online: A Target for Intervention?
1 1 1 1,2
Anthony S. Kim *, Sharon N. Poisson , J. Donald Easton , S. Claiborne Johnston
1 Department of Neurology, University of California San Francisco, San Francisco, California, United States of America, 2 Department of Epidemiology and Biostatistics,
University of California San Francisco, San Francisco, California, United States of America
Abstract
Background: Individuals with TIA/stroke symptoms often do not seek urgent medical attention. We assessed the feasibility
of identifying individuals searching for information on TIA/stroke symptoms online as a target for future interventions to
encourage urgent evaluation and we evaluated the performance of a self-reported risk score to identify subjects with true
TIA or stroke.
Methodology/Principal Findings: We placed online advertisements to target English-speaking adults in the United States
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
associations and model discrimination respectively. Over 122 days, 251 (1%) of 25,292 website visitors completed the online
questionnaire and 175 were reached by telephone (mean age 58.5 years; 63% women) for follow-up. Of these participants,
37 (21%) had symptoms within 24 hours, 60 (34%) had not had a medical evaluation yet, and 68 (39%) had TIA/stroke.
Applying a modified ABCD2 score yielded a c-statistic of 0.66, but 2 of 12 with a zero score had a TIA/stroke. Those with new
symptoms wer
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