Development and implementation of a rapid, accurate, and cost-effective protocol for national stroke prevention screening

Background: Three medical conditions- cervical carotid artery disease, atrial fibrillation, and hypertension- cause the majority of strokes. Discovering these silent, immediate causes of stroke through screening, so they can be treated before stroke occurs, can poteritially prevent strokes on an epidemiologic scale. Methods: A rapid, accurate, and cost-effective stroke prevention screening (SPS) protocol was developed. Results: The SPS protocol was used to screen 6,073-seniors residing in the central valley of California, at Madigan Army Medical Center, at New York University, and by the American Vascular Association at 68 leading institutions. The screening was estimated to have prevented 30 strokes and to have saved the health care system >$2 million. Conclusions: Implementation of a national SPS for seniors can discover the silent, immediate causes of strokes,so they can be managed before stroke occurs and can potentially prevent the majority of strokes that we are currently not preventing. (C) 2004 Excerpta Medica Inc. All rights reserved.