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Wayne State embarks on study to improve identification of women at high risk of stroke

DETROIT A team of Wayne State University School of Medicine physicians will seek to develop methods to better identify women at increased risk for stroke using a new type of professional education grant.

The study, "Improving the Identification of Women at Increased Risk for Stroke in an Urban Medical Center," is funded by a $492,800 grant from Pfizer Inc. and will be overseen by Seemant Chaturvedi, M.D., WSU professor of neurology. Others involved in the study include Lavoisier Cardozo, M.D., F.A.C.P., F.R.C.P., professor of internal medicine and chief of the Division of Geriatric Medicine; Diane Levine, M.D., associate professor of internal medicine; Neelima Thati, M.D., professor of internal medicine; Maribeth Mateo, M.D., assistant professor of family medicine and public health sciences; and Ramesh Madhavan, M.D., D.M., assistant professor of neurology.

Chaturvedi and the team will study the rate of compliance for following recommended guidelines to identify women at risk for stroke by WSU and Wayne State University Physician Group (WSUPG) doctors in five WSUPG clinics. The findings will lead to a variety of live and online Continuing Medical Education activities designed to educate doctors on how to improve compliance with these guidelines. Later, the rate of patients receiving the appropriate screening and treatments to prevent stroke will be reassessed.

"The study will try to identify areas where stroke risk factor reduction is suboptimal," said Chaturvedi, who also serves as director of the Wayne State University/Detroit Medical Center Stroke Program. "For example, we will identify patients with hypertension not under control, patients with obesity not exercising, and patients with atrial fibrillation not being treated with anticoagulants. With education and medical alerts, we hope to improve treatment of these risk factors and more."

The study is part of a new emerging concept. Previously, pharmaceutical companies awarded much smaller grants for didactic CME sessions such as grand rounds or a one-day symposium.

David Pieper, Ph.D., assistant dean for Continuing Medical Education (CME) for the School of Medicine, said there has been a nationwide movement by the CME community to try to integrate CME into clinical quality improvement initiatives. One method for accomplishing this is a new type of CME called "Performance Improvement CME," in which physicians can receive up to 20 category 1 CME credits for measuring the percentage of their patients meeting treatment guidelines for certain conditions, designing methods to improve, and then re-measuring percent compliance.

Pfizer officials, Pieper explained, recently decided to move in this direction by changing the way the company contributes to CME programs. The company now spends 10 percent of its CME funds on grand rounds or symposiums. The remaining 90 percent is invested in projects in which Pfizer announces requests for proposals and CME providers submit proposals for large projects designed to improve physician performance in certain areas of patient care.

"There are a lot of advantages for us to participate in this kind of project," Pieper said. "We will attempt to improve the screening and treatments our patients receive. Our physicians receive a lot of CME credits (without leaving their practice site). The projects will facilitate our residency programs in meeting new accreditation standards involving quality improvement, and may enhance our clinics in reaching certain quality benchmarks."


Contact: Julie O'Connor
Wayne State University - Office of the Vice President for Research

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