Stroke: working toward a prioritized world agenda.
Stroke: working toward a prioritized world agenda.
复制标题
DOI：
10.1161/strokeaha.110.586156
复制
发表时间：
2010-06
期刊：
影响因子：
8.3
通讯作者：
Tuomilehto J
中科院分区：
文献类型：
--
作者：
Hachinski V;Donnan GA;Gorelick PB;Hacke W;Cramer SC;Kaste M;Fisher M;Brainin M;Buchan AM;Lo EH;Skolnick BE;Furie KL;Hankey GJ;Kivipelto M;Morris J;Rothwell PM;Sacco RL;Smith SC Jr;Wang Y;Bryer A;Ford GA;Iadecola C;Martins SC;Saver J;Skvortsova V;Bayley M;Bednar MM;Duncan P;Enney L;Finklestein S;Jones TA;Kalra L;Kleim J;Nitkin R;Teasell R;Weiller C;Desai B;Goldberg MP;Heiss WD;Saarelma O;Schwamm LH;Shinohara Y;Trivedi B;Wahlgren N;Wong LK;Hakim A;Norrving B;Prudhomme S;Bornstein NM;Davis SM;Goldstein LB;Leys D;Tuomilehto J
协同的目的是设计和优先考虑加快减少中风风险、影响和后果的进展的新方法。初步工作由7个中风领导人工作组进行，随后是一个有大约100名额外参与者的协同会议（协同工作论坛）。由此产生的文件草案得到了协同增效之外的贡献者的进一步投入。协同作用的建议是：基础科学、药物开发和技术：有必要发展：(1)共同工作的新系统，以打破普遍的“筒仓”心态；(2)基础、临床、流行病学学科垂直整合新模式；(3)识别其他相关科学领域的有效方法。预防中风：(1)建立以中风为主要重点的全球慢性疾病预防倡议。(2)不仅要识别突发性临床中风，还要识别微妙的亚临床中风，这是最常见的脑血管疾病类型，导致执行功能受损。(3)制定、实施和评估卒中预防的人群方法。(4)利用传统和新型（如社交媒体/营销）技术制定公共卫生传播战略。急性脑卒中管理：继续建立脑卒中中心、脑卒中单位、区域性脑卒中紧急护理系统和脑卒中远程网络。脑恢复和康复：(1)将最好的神经科学，包括动物和人类研究，转化为中风后恢复研究和临床护理。(2)基于最佳证据规范脑卒中后康复。(3)就标准化的临床和替代评估达成共识，然后实施。(4)开展严谨的临床研究，推进脑卒中康复。进入21世纪：网络、技术和通信：(1)致力于全球不受限制地获取卒中相关信息。(2)建立集中的电子档案和登记。促进利益攸关方（大型卒中组织、非政府组织、政府、患者组织和行业）之间的合作，以加强卒中护理。利用能够促进预防措施的“大脑健康”概念，教育和激励专业人员、患者、公众和决策者。要加快脑卒中防治的进展，我们必须在科学、观念和务实上超越现状。进步不仅可以通过行动来实现，也可以通过停止行动来实现。由未经证实的意见、未经证实的方法和经济收益所驱动的实践的终止，可以节省大量的时间、金钱和精力。将知识系统地整合到项目中，再加上仔细的评估，可以加快进展的步伐。
The aim of the Synergium was to devise and prioritize new ways of accelerating progress in reducing the risks, effects, and consequences of stroke. Preliminary work was performed by 7 working groups of stroke leaders followed by a synergium (a forum for working synergistically together) with approximately 100 additional participants. The resulting draft document had further input from contributors outside the synergium. Recommendations of the Synergium are: Basic Science, Drug Development and Technology: There is a need to develop: (1) New systems of working together to break down the prevalent “silo” mentality; (2) New models of vertically integrated basic, clinical, and epidemiological disciplines; and (3) Efficient methods of identifying other relevant areas of science. Stroke Prevention: (1) Establish a global chronic disease prevention initiative with stroke as a major focus. (2) Recognize not only abrupt clinical stroke, but subtle subclinical stroke, the commonest type of cerebrovascular disease, leading to impairments of executive function. (3) Develop, implement and evaluate a population approach for stroke prevention. (4) Develop public health communication strategies using traditional and novel (eg, social media/marketing) techniques. Acute Stroke Management: Continue the establishment of stroke centers, stroke units, regional systems of emergency stroke care and telestroke networks. Brain Recovery and Rehabilitation: (1) Translate best neuroscience, including animal and human studies, into poststroke recovery research and clinical care. (2) Standardize poststroke rehabilitation based on best evidence. (3) Develop consensus on, then implementation of, standardized clinical and surrogate assessments. (4) Carry out rigorous clinical research to advance stroke recovery. Into the 21st Century: Web, Technology and Communications: (1) Work toward global unrestricted access to stroke-related information. (2) Build centralized electronic archives and registries. Foster Cooperation Among Stakeholders (large stroke organizations, nongovernmental organizations, governments, patient organizations and industry) to enhance stroke care. Educate and energize professionals, patients, the public and policy makers by using a “Brain Health” concept that enables promotion of preventive measures. To accelerate progress in stroke, we must reach beyond the current status scientifically, conceptually, and pragmatically. Advances can be made not only by doing, but ceasing to do. Significant savings in time, money, and effort could result from discontinuing practices driven by unsubstantiated opinion, unproven approaches, and financial gain. Systematic integration of knowledge into programs coupled with careful evaluation can speed the pace of progress.