DOC Utility: Screening of Depression, Obstructive Sleep Apnea and Cognitive Impairment

Dr. Richard H. Swartz6,500 enrolled

Overview

The primary objective of this study is to determine whether baseline DOC screening can add to clinical and demographic data to predict the occurrence of a composite negative outcome (any of: recurrent stroke, myocardial infarction, death, or admission to a long-term care (LTC) / complex continuing care (CCC) facility) within one year of screening, in stroke prevention clinic patients.

The DOC screen will be routinely applied to all patients presenting to three high volume Regional Stroke Prevention Clinics (combined first visits \>2,800 patients per year). Data will be abstracted from the patient chart using methodologies developed and validated in the Registry of the Ontario Stroke Network. The investigators have REB approval to collect this data and to link with administrative datasets through the Institute for Clinical and Evaluative Sciences (ICES). The investigators will use regression models to determine whether DOC screen scores add to baseline clinical and demographic data to predict the main negative outcomes. The investigators hope to identify which patients presenting to TIA/stroke prevention clinics are at highest risk of adverse long-term events so focused interventions can be developed to improve survival, outcomes and function of stroke prevention clinic patients.

Study Type

OBSERVATIONAL

Enrollment

6,500

Conditions

Stroke Transient Ischemic Attack Depression Obstructive Sleep Apnea

Eligibility

Sex: ALL

Medical Language ↔ Plain English

Inclusion Criteria: * Consecutive patients referred to regional stroke prevention clinics. * This includes those discharged from hospital with a diagnosis of stroke or TIA, as well as emergency department referrals. * The DOC CRF will also be completed for patients who are unable to complete the screen due to severe aphasia, severe motor dysfunction and language barriers (those who are not fluent in English without translation available). Exclusion Criteria: * Patients whose reason for referral to the clinic is neither Stroke nor TIA, as well as those who have been admitted to LTC/CCC facilities at the time of clinic visit.

Outcomes

Primary Outcomes

Number of Participants with any Adverse Event

A composite negative outcome will be created, defined as the occurrence of any recurrent stroke, myocardial infarction, death, or admission to a long-term care (LTC) / complex continuing care (CCC) facility within one year of screening.