In two recent posts,  we have drawn attention to the implications for the service of recent findings on the startling effectiveness of thrombectomy in selected ischaemic strokes. We have called for a modelling exercise to identify the ideal configurations. Relevant information to inform such models comes from two recent papers on the centralisation of acute stroke services in two metropolitan areas – Greater London and Manchester. Using a difference in difference approach (before and after, and interventions versus control sites) shows that mortality (at least in London) and length of stay (both centres) are reduced. A cause and effect association is supported by process measures taken from the intervention areas and one control area.
— Richard Lilford, CLAHRC WM Director
- Lilford R. Provocative Idea for Thrombectomy Services in Acute Stroke. NIHR CLAHRC West Midlands News Blog. 14 August 2015.
- Lilford R. First the Heart, Now the Brain. NIHR CLAHRC West Midlands News Blog. 10 April 2015.
- Morris S, Hunter RM, Ramsay AIG, et al. Impact of centralising acute stroke services in English metropolitan areas on mortality and length of hospital stay: difference-in-difference analysis. BMJ. 2014;349:g4757.
- Ramsay A, Morris S, Hoffman A, et al. Effects of centralizing acute stroke services on stroke care provision in two large metropolitan areas in England. Stroke. 2015;46(8);2244-50.