Abstract
Stroke is a common condition with a substantial impact on health care. Using published
epidemiological data, a mathematical model was created to predict annual stroke incidence
in populations over 45 years old, utilizing age, gender, ethnicity, and stroke risk
factor prevalence (hypertension, atrial fibrillation, diabetes, smoking, and ischemic
heart disease). The purpose of this study is to assess the models ability to reliably
estimate the annual number of first strokes. The model was validated against two cohorts:
the Northern Manhattan Stroke Study (NM), performed in 1995 and 1996, and the Copenhagen
City Heart Study (CCHS), undertaken in 1980-84, 1984-88, and 1988-93. Both cohorts
provided the actual number of first strokes for respective years and risk factor prevalence.
The Mantel-Haenszel test compared actual to predicted incidence rates. The two cohorts
differed in risk factor prevalences, size, and demographics. For all cohort groups/years,
the predicted number of annual first strokes was not statistically different from
actual first stroke incidence (P >.05). In NM, the actual number of first strokes compared to predicted was 7 versus
13 (P =.18) for 1995 and 9 versus 18 (P =.08) for 1996. Actual and predicted annual strokes in CCHS for the time frames 1980-83,
1984-88, and 1988-93 were 65 versus 69 (P =.73), 72 versus 87 (P =.23), and 75 versus 93 (P =.16), respectively. The model provides a tool for estimating annual first strokes
within a population, with a tendency of bias toward overestimating the number of incident
strokes. This evidence-based model may be utilized by health policy makers to predict
stroke burden at a population level. Copyright © 2003 by National Stroke Association
Keywords
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Article info
Publication history
Accepted:
November 1,
2002
Received:
April 9,
2002
Footnotes
*Supported by Boehringer Ingelheim, GmbH, Ingelheim, Germany. The Northem Manhattan Stroke Study is supported by grants from NINDS (R01 NS 27517, 29993). The majority of the work was performed at Protocare Sciences in Santa Monica, CA.
**Address reprint requests to: Carol Zaher, MD, MBA, MPH, Protocare Sciences, 2400 Broadway, Suite 100, Santa Monica, CA 90404.
Identification
Copyright
© 2003 National Stroke Association. Published by Elsevier Inc. All rights reserved.
