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Working Groups Basic Science, Drug Development, and Technology Stroke Prevention: Broadening the Approach and Intensifying the Efforts Acute Stroke Management: Applying and Expanding What We Know Brain Recovery and Rehabilitation: Harnessing the Regenerative Powers of the Brain and the Individual Into the 21st Century: The Web, Technology, and Communications: New Tools for Progress Fostering Cooperation Among Stakeholders to Enhance Stroke Care Educating and Energizing Professionals, Patients, the Public, and Policymakers The coordinator of each group. The work of the coordinators is deemed to have been equal. The other authors are listed according to the sequence of their groups and alphabetically, and their work is also deemed to be equal to each other’s Department of Clinical Neurological Sciences, London Health Sciences Center, University of Western Ontario, and St. Joseph’s Healthcare London, London, Ont Toronto Rehabilitation Institute, Toronto, Ont., and The Canadian Stroke Network, The University of Ottawa and the Ottawa Hospital Research Institute, Ottawa, Ont., Canada Florey Neurosciences Institutes, Carlton South Victoria, and Director of Neurology, Royal Melbourne Hospital and University of Melbourne, Melbourne, Vic., and Royal Perth Hospital, Perth, W.A., Australia University of Illinois at Chicago, Chicago, Ill Southern Illinois Healthcare, Carbondale, Ill University of California – Irvine, Orange, Calif Pomona Valley Hospital Medical Center, Pomona, Calif InTouch Health, Goleta, Calif University of California at Los Angeles Stroke Center, Los Angeles, Calif University of Massachusetts Medical School, Worcester, Mass Massachusetts General Hospital, Charlestown, Mass Biotrofix, Inc., Waltham, Mass Novo Nordisk, Princeton, N.J Washington University School of Medicine, St. Louis, Mo President-elect, AHA, University of Miami, Miami, Fla University of Florida, Gainesville, Fla Center for Cardiovascular Science and Medicine, University of North Carolina, Chapel Hill, N.C Duke University, Durham, N.C GlaxoSmithKline, Durham, N.C Duke University and Durham VA Medical Center, Durham, N.C Weill Cornell Medical College, New York, N.Y Neuroscience Research Unit, Pfizer Inc., Groton, Conn University of Texas at Austin, Austin, Tex National Center for Medical Rehabilitation, National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Md., and American Heart Association, Dallas, Tex., USA University of Heidelberg, Heidelberg University of Freiburg, Freiburg, and Max Planck Institute for Neurological Research, Köln, Germany Helsinki University Central Hospital, University of Helsinki Terveystalo Medical Center, and University of Helsinki, Helsinki, Finland University Donau-Universität Krems, Krems, Austria University of Oxford, and John Radcliffe Hospital, Oxford Newcastle University, Newcastle upon Tyne, and Kings College London, London, UK Karolinska Institute, Stockholm, and Lund University Hospital, Lund, Sweden President-elect, World Heart Federation, Geneva, Switzerland Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa Hospital De Clinicas, Porto Alegre, Brazil Russian State Research Stroke Institute, Moscow, Russian Federation Tachikawa Hospital, Tokyo, Japan Chinese University of Hong Kong, Sha Tin, Hong Kong, China Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel University Lille Nord de France, Lille, France |
| Abstract |
Background and Purpose: The aim of the Synergium was to devise and prioritize new ways of accelerating progress in reducing the risks, effects, and consequences of stroke. Methods: 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. Results: 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 (e.g., 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. Conclusions: 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.
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