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  • 1
    Online Resource
    Online Resource
    Multinational Comparisons of Stroke Epidemiology : Evaluation of Case Ascertainment in the WHO MONICA Stroke Study
    Ovid Technologies (Wolters Kluwer Health) ; 1995
    In:  Stroke Vol. 26, No. 3 ( 1995-03), p. 355-360
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 26, No. 3 ( 1995-03), p. 355-360
    Abstract: Background and Purpose As part of the WHO MONICA Project (World Health Organization Moni toring Trends and Determinants in Ca rdiovascular Disease), mortality and incidence rates of acute stroke in 14 centers covering 21 populations from 11 countries were compared. Methods In this report, coverage and quality of the MONICA stroke registers were evaluated on five key indicators using data submitted to the MONICA Data Center. Results A low ratio of MONICA stroke register to routine statistics of stroke mortality and a low proportion of nonfatal out-of-hospital events were the most common biases; they indicate that identifications of fatal cases and/or case finding of nonfatal events occurring outside the hospital were inadequate in many MONICA centers. In 10 populations, the data quality analyses suggested that clarification of possible biases would be needed before these populations can be included in a comparative study. Data from the remaining 11 populations meet the data quality standards for multinational comparisons with respect to case ascertainment. Conclusions These results show that multinational comparisons of stroke incidence involve considerable problems in developing and maintaining appropriate standards of data quality. However, after considerable efforts to ensure quality, comparisons of stroke data within the MONICA Project are possible among a large number of the MONICA populations. Our observations also indicate that results from multinational comparisons of stroke mortality based on routine statistics must be interpreted with caution.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/01.STR.26.3.355
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 1995
    detail.hit.zdb_id: 1467823-8
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  • 2
    Online Resource
    Online Resource
    Multinational Comparison of Diagnostic Procedures and Management of Acute Stroke: The WHO MONICA Study
    S. Karger AG ; 1996
    In:  Cerebrovascular Diseases Vol. 6, No. 2 ( 1996), p. 66-74
    Details
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 6, No. 2 ( 1996), p. 66-74
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    URL: Article
    DOI: 10.1159/000108000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 1996
    detail.hit.zdb_id: 1482069-9
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  • 3
    Online Resource
    Online Resource
    The worldwide problem of stroke
    Ovid Technologies (Wolters Kluwer Health) ; 1994
    In:  Current Opinion in Neurology Vol. 7, No. 1 ( 1994-02), p. 5-10
    Details
    In: Current Opinion in Neurology, Ovid Technologies (Wolters Kluwer Health), Vol. 7, No. 1 ( 1994-02), p. 5-10
    Type of Medium: Online Resource
    ISSN: 1350-7540
    URL: Article
    DOI: 10.1097/00019052-199402000-00003
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 1994
    detail.hit.zdb_id: 2026967-5
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  • 4
    Online Resource
    Online Resource
    A Multinational Comparison of Subarachnoid Hemorrhage Epidemiology in the WHO MONICA Stroke Study
    Ovid Technologies (Wolters Kluwer Health) ; 2000
    In:  Stroke Vol. 31, No. 5 ( 2000-05), p. 1054-1061
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 31, No. 5 ( 2000-05), p. 1054-1061
    Abstract: Background and Purpose —By official, mostly unvalidated statistics, mortality from subarachnoid hemorrhage (SAH) show large variations between countries. Using uniform criteria for case ascertainment and diagnosis, a multinational comparison of attack rates and case fatality rates of SAH has been performed within the framework of the WHO MONICA Project. Methods —In 25- to 64-year-old men and women, a total of 3368 SAH events were recorded during 35.9 million person-years of observation in 11 populations in Europe and China. Strict MONICA criteria were used for case ascertainment and diagnosis of stroke subtype. Case fatality was based on follow-up at 28 days after onset. Results —Age-adjusted average annual SAH attack rates varied 10-fold among the 11 populations studied, from 2.0 (95% CI 1.6 to 2.4) per 100 000 population per year in China-Beijing to 22.5 (95% CI 20.9 to 24.1) per 100 000 population per year in Finland. No consistent pattern was observed in the sex ratio of attack rates in the different populations. The overall 28-day case fatality rate was 42%, with 2-fold differences in age-adjusted rates between populations but little difference between men and women. Case fatality rates were consistently higher in Eastern than in Western Europe. Conclusions —Using a uniform methodology, the WHO MONICA Project has shown very large variations in attack rates of SAH across 11 populations in Europe and China. The generally accepted view that women have a higher risk of SAH than men does not apply to all populations. Marked differences in outcome of SAH add to the wide gap in the burden of stroke between East and West Europe.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/01.STR.31.5.1054
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2000
    detail.hit.zdb_id: 1467823-8
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  • 5
    Online Resource
    Online Resource
    Trends in Stroke and Coronary Heart Disease in the WHO MONICA Project
    Ovid Technologies (Wolters Kluwer Health) ; 2003
    In:  Stroke Vol. 34, No. 6 ( 2003-06), p. 1346-1352
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 34, No. 6 ( 2003-06), p. 1346-1352
    Abstract: Background and Purpose— Coronary heart disease (CHD) and stroke are leading causes of death and disability. Because they share major common risk factors, it would be expected that trends in mortality and incidence of these 2 major cardiovascular diseases would be similar. Methods— Data from the World Health Organization (WHO) Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) Project were used to compare 10-year trends in mortality, event rates, and case fatality from both CHD and stroke. Fifteen populations in the WHO MONICA Project provided data on both CHD (60 763 events) and stroke (10 442 events) in men and women aged 35 to 64 years (23.4 million person-years of observation in total). Results— Trends for the 2 cardiovascular diseases varied within and between populations, and when data from all populations were combined, trends in CHD and stroke mortality differed in men ( P =0.001) but not in women, whereas trends in event rates differed significantly in both men and women ( P 〈 0.001 and P =0.011, respectively). The differences in trends for CHD and stroke case fatality were not statistically significant in either men or women. In sensitivity analyses, differences in trends in event rates remained statistically significant in men ( P 〈 0.001) but not in women. Conclusions— Trends for CHD and stroke mortality rates, event rates, and case fatality differ substantially between and within the study populations.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/01.STR.0000069724.36173.4D
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2003
    detail.hit.zdb_id: 1467823-8
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