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Stroke Learning Health Systems: A Topical Narrative Review With Case Examples

DA. Cadilhac, DM. Bravata, JP. Bettger, R. Mikulik, B. Norrving, EO. Uvere, M. Owolabi, A. Ranta, MF. Kilkenny

. 2023 ; 54 (4) : 1148-1159. [pub] 20230130

Language English Country United States

Document type Journal Article, Review, Research Support, N.I.H., Extramural

Persistent link   https://www.medvik.cz/link/bmc23003678

Grant support
D43 TW012030 FIC NIH HHS - United States
R01 NS107900 NINDS NIH HHS - United States
R01 NS115944 NINDS NIH HHS - United States
U54 HG007479 NHGRI NIH HHS - United States
U24 HG009780 NHGRI NIH HHS - United States
R01 NS114045 NINDS NIH HHS - United States
R13 NS115395 NINDS NIH HHS - United States

To our knowledge, the adoption of Learning Health System (LHS) concepts or approaches for improving stroke care, patient outcomes, and value have not previously been summarized. This topical review provides a summary of the published evidence about LHSs applied to stroke, and case examples applied to different aspects of stroke care from high and low-to-middle income countries. Our attempt to systematically identify the relevant literature and obtain real-world examples demonstrated the dissemination gaps, the lack of learning and action for many of the related LHS concepts across the continuum of care but also elucidated the opportunity for continued dialogue on how to study and scale LHS advances. In the field of stroke, we found only a few published examples of LHSs and health systems globally implementing some selected LHS concepts, but the term is not common. A major barrier to identifying relevant LHS examples in stroke may be the lack of an agreed taxonomy or terminology for classification. We acknowledge that health service delivery settings that leverage many of the LHS concepts do so operationally and the lessons learned are not shared in peer-reviewed literature. It is likely that this topical review will further stimulate the stroke community to disseminate related activities and use keywords such as learning health system so that the evidence base can be more readily identified.

References provided by Crossref.org

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$a To our knowledge, the adoption of Learning Health System (LHS) concepts or approaches for improving stroke care, patient outcomes, and value have not previously been summarized. This topical review provides a summary of the published evidence about LHSs applied to stroke, and case examples applied to different aspects of stroke care from high and low-to-middle income countries. Our attempt to systematically identify the relevant literature and obtain real-world examples demonstrated the dissemination gaps, the lack of learning and action for many of the related LHS concepts across the continuum of care but also elucidated the opportunity for continued dialogue on how to study and scale LHS advances. In the field of stroke, we found only a few published examples of LHSs and health systems globally implementing some selected LHS concepts, but the term is not common. A major barrier to identifying relevant LHS examples in stroke may be the lack of an agreed taxonomy or terminology for classification. We acknowledge that health service delivery settings that leverage many of the LHS concepts do so operationally and the lessons learned are not shared in peer-reviewed literature. It is likely that this topical review will further stimulate the stroke community to disseminate related activities and use keywords such as learning health system so that the evidence base can be more readily identified.
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