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A Cross-Sectional Study of Individuals Seeking Information on Transient Ischemic Attack and Stroke Symptoms Online: A Target for Intervention?

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  • Anthony S Kim
  • Sharon N Poisson
  • J Donald Easton
  • S Claiborne Johnston

Abstract

Background: Individuals with TIA/stroke symptoms often do not seek urgent medical attention. We assessed the feasibility of identifying individuals searching for information on TIA/stroke symptoms online as a target for future interventions to encourage urgent evaluation and we evaluated the performance of a self-reported risk score to identify subjects with true TIA or stroke. Methodology/Principal Findings: We placed online advertisements to target English-speaking adults in the United States searching for TIA/stroke-related keywords. After completing an online questionnaire, participants were telephoned by a vascular neurologist to assess the likelihood of TIA/stroke. We used logistic regression and the c-statistic to assess associations and model discrimination respectively. Over 122 days, 251 (1%) of 25,292 website visitors completed the online questionnaire and 175 were reached by telephone (mean age 58.5 years; 63% women) for follow-up. Of these participants, 37 (21%) had symptoms within 24 hours, 60 (34%) had not had a medical evaluation yet, and 68 (39%) had TIA/stroke. Applying a modified ABCD2 score yielded a c-statistic of 0.66, but 2 of 12 with a zero score had a TIA/stroke. Those with new symptoms were more likely to have TIA/stroke (OR 4.90, 95% CI 2.56−9.09). Conclusions/Significance: Individuals with TIA/stroke that are seeking real-time information on symptoms online can be readily identified, in some cases before they have sought formal medical evaluation. Although a simple self-reported risk score was unable to identify a low-risk population in this selected group, this population may still present an attractive target for future interventions designed to encourage urgent medical evaluation.

Suggested Citation

  • Anthony S Kim & Sharon N Poisson & J Donald Easton & S Claiborne Johnston, 2012. "A Cross-Sectional Study of Individuals Seeking Information on Transient Ischemic Attack and Stroke Symptoms Online: A Target for Intervention?," PLOS ONE, Public Library of Science, vol. 7(10), pages 1-6, October.
  • Handle: RePEc:plo:pone00:0047997
    DOI: 10.1371/journal.pone.0047997
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    References listed on IDEAS

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    1. Ira M. Wasserman & Marie Richmond‐Abbott, 2005. "Gender and the Internet: Causes of Variation in Access, Level, and Scope of Use," Social Science Quarterly, Southwestern Social Science Association, vol. 86(1), pages 252-270, March.
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