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Record W4409133327 · doi:10.1177/23969873251329841

Prioritizing gaps in stroke care: A two-round Delphi process

2025· article· en· W4409133327 on OpenAlex
Elke Mathijssen, Jaap C.A. Trappenburg, Mark J. Alberts, Angelique Balguid, Robert J. Dempsey, Mayank Goyal, Bianca TA de Greef, Marjan Hummel, Koji Iihara, Enrique C. Leira, Winston Eng Hoe Lim, Gregory Y.H. Lip, Paolo Madeddu, Randolph S. Marshall, Dominick J. H. McCabe, Ahmad Sobri Muda, Dimitrios Nikas, George Ntaios, Terence J. Quinn, Marta Rubiera, Tatjana Rundek, Shashank Shekhar, Wen‐Jun Tu, Pearl Vyas, Wim H. van Zwam, Johannes B. Reitsma, Ewoud Schuit

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.

Bibliographic record

VenueEuropean Stroke Journal · 2025
Typearticle
Languageen
FieldMedicine
TopicAcute Ischemic Stroke Management
Canadian institutionsFoothills Medical CentreUniversity of Calgary
FundersNational Center for Advancing Translational SciencesPhilips
KeywordsDelphi methodDelphiPsychological interventionStroke (engine)Health careExpert opinionClosing (real estate)MedicineDescriptive statisticsQuality (philosophy)Process (computing)NursingMedical educationPsychologyFamily medicineBusinessPolitical scienceComputer scienceEngineeringIntensive care medicine

Abstract

fetched live from OpenAlex

BACKGROUND: Despite international recognition of stroke as a significant health priority, discrepancies persist between the target values for stroke quality measures and the actual values that are achieved in clinical practice, referred to as gaps. This study aimed to reach consensus among international experts on prioritizing gaps in stroke care. METHODS: A two-round Delphi process was conducted, surveying an international expert panel in the field of stroke care and cerebrovascular medicine, including patient representatives, healthcare professionals, researchers, policymakers, and medical directors. Experts scored the importance and required effort to close 13 gaps throughout the stroke care continuum and proposed potential solutions. Data were analyzed using descriptive statistics and qualitative analysis methods. RESULTS: In the first and second Delphi rounds, 35 and 30 experts participated, respectively. Expert consensus was reached on the high importance of closing 11 out of 13 gaps. Two out of 13 gaps were considered moderately important to close, with expert consensus for one of these two gaps. Expert consensus indicated that only one gap, related to the prevention of complications after stroke, requires moderate effort to close, whereas the others were considered to require high effort to close. Key focus areas for potential solutions included: "Care infrastructure," "Geographic disparities," "Interdisciplinary collaboration," and "Advocacy and funding." CONCLUSIONS: While closing gaps in stroke care primarily requires high effort and substantial resources, targeted interventions in the identified key focus areas may provide feasible and clinically meaningful improvements.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.519
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0010.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.011
GPT teacher head0.301
Teacher spread0.289 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it