The value of PRACTISE to improve thrombolysis rates for acute stroke

Abstract

> Practice is a means of inviting the perfection desired. > > — Martha Graham The challenge of generating high-quality clinical evidence on the efficacy of a treatment is humbling enough. But translating this clinical evidence into clinical practice takes a similarly dedicated effort and a rigorously derived evidence base of its own. Nowhere is this challenge more apparent than with the example of thrombolysis for acute ischemic stroke. Despite concerted and sustained efforts to increase access to this therapy in the 17 years since clinical efficacy was first demonstrated,1 thrombolysis for acute ischemic stroke has remained stubbornly underutilized.2 Although delays in initial presentation are perhaps the most important contributor to the unrealized potential of thrombolysis,3 the barriers to the effective and efficient delivery of this therapy at the hospital level have prompted efforts to develop and refine organized systems of care for acute stroke.4 Although …