Can administrative data be used to reduce the risk of stroke?
Data access has been approved for a research project to develop a technique for monitoring how long patients wait for an endarterectomy using administrative data. This is an important measure, as the effectiveness of the procedure for preventing ischemic stroke significantly reduces over time.
Hardening of the arteries (atherosclerosis) involves the buildup of fatty plaques within blood vessel walls. As plaques grow, they weaken the thin shield (fibrous cap) that separates the plaque from flowing blood. If a plaque breaks through this cap (plaque rupture), then blood clot immediately starts to form over the injured plaque. These blood clots can cause an instant blockage of the artery (thrombosis) or break off and block a downstream artery (embolism).
Carotid endarterectomy (CEA) is a surgical procedure performed by vascular surgeons to reduce the risk of stroke by removing plaque from the carotid artery wall. This is usually done after a warning stroke (transient ischemic attack, TIA), which can be a sign of a recent plaque rupture. Only patients with significant narrowing (generally, more than 50%) can benefit from the surgery.
“In selected patients, carotid endarterectomy is highly effective for preventing ischemic stroke. However, the effectiveness of the procedure falls rapidly, with benefit reduced within two weeks and negligible by 12,” explains Dr. Stephen van Gaal, a Masters student at the University of British Columbia’s School of Population and Public Health. “Timeliness of carotid endarterectomy is therefore an important indicator of health care quality, however, it is not currently measured in British Columbia due to cost constraints. Current techniques for monitoring time are labor intensive and are therefore too expensive.”
Dr. Van Gaal aims to develop a technique for monitoring time to endarterectomy using administrative data, which is less expensive to collect. This study team will combine chart review data and administrative data in order to develop and test new methods for monitoring time to endarterectomy using administrative data.
For the study PopData will link three data sets from the BC Ministry of Health with chart review data from Vancouver Coastal Health Authority.