{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T19:42:37Z","timestamp":1765827757951,"version":"build-2065373602"},"reference-count":15,"publisher":"BMJ","issue":"2","funder":[{"name":"\u2019Stichting Beroepsopleiding Huisartsen (SBOH)', employee of Dutch GP trainees"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,2,1]]},"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Suspected transient ischaemic attack (TIA) necessitates an urgent neurological consultation and a rapid start of antiplatelet therapy to reduce the risk of early ischaemic stroke following a TIA. Guidelines for general practitioners (GPs) emphasise the urgency to install preventive treatment as soon as possible. We aimed to give a contemporary overview of both patient and physician delay.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A survey at two rapid-access TIA outpatient clinics in Utrecht, the Netherlands. All patients suspected of TIA were interviewed to assess time delay to diagnosis and treatment, including the time from symptom onset to (1) the first contact with a medical service (patient delay), (2) consultation of the GP and (3) assessment at the TIA outpatient clinic. We used the diagnosis of the consulting neurologist as reference.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 93 included patients, 43 (46.2%) received a definite, 13 (14.0%) a probable, 11 (11.8%) a possible and 26 (28.0%) no diagnosis of TIA. The median time from symptom onset to the visit to the TIA service was 114.5 (IQR 44.0\u2013316.6)\u2009hours. Median patient delay was 17.5 (IQR 0.8\u201366.4)\u2009hours, with a delay of more than 24\u2009hours in 36 (38.7%) patients. The GP was first contacted in 76 (81.7%) patients, and median time from first contact with the GP practice to the actual GP consultation was 2.8 (0.5\u201318.5)\u2009hours. Median time from GP consultation to TIA service visit was 40.8 (IQR 23.1\u2013140.7)\u2009hours. Of the 62 patients na\u00efve to antithrombotic medication who consulted their GP, 27 (43.5%) received antiplatelet therapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>There is substantial patient and physician delay in the process of getting a confirmed TIA diagnosis, resulting in suboptimal prevention of an early ischaemic stroke.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-027161","type":"journal-article","created":{"date-parts":[[2019,2,28]],"date-time":"2019-02-28T05:09:21Z","timestamp":1551330561000},"page":"e027161","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Delay in patients suspected of transient ischaemic attack: a cross-sectional study"],"prefix":"10.1136","volume":"9","author":[{"given":"L Servaas","family":"Dolmans","sequence":"first","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L Jaap","family":"Kappelle","sequence":"additional","affiliation":[{"name":"Neurology, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie-Louise EL","family":"Bartelink","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arno W","family":"Hoes","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frans H","family":"Rutten","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,2,27]]},"reference":[{"key":"2025101811003000000_9.2.e027161.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61448-2"},{"key":"2025101811003000000_9.2.e027161.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30468-8"},{"key":"2025101811003000000_9.2.e027161.3","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2008.167924"},{"key":"2025101811003000000_9.2.e027161.4","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.109.576611"},{"key":"2025101811003000000_9.2.e027161.5","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/aft144"},{"key":"2025101811003000000_9.2.e027161.6","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0104289","article-title":"A time series evaluation of the FAST National Stroke Awareness Campaign in England","volume":"9","author":"Flynn","year":"2014","journal-title":"PLoS One"},{"key":"2025101811003000000_9.2.e027161.7","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1001\/jamaneurol.2018.1603","article-title":"Medical attention seeking after transient ischemic attack and minor stroke before and after the UK Face, Arm, Speech, Time (FAST) Public Education Campaign: results from the Oxford Vascular Study","volume":"75","author":"Wolters","year":"2018","journal-title":"JAMA Neurol"},{"key":"2025101811003000000_9.2.e027161.8","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.010454"},{"key":"2025101811003000000_9.2.e027161.9","first-page":"A7022","article-title":"[Summary of the \u2019Stroke' guideline of the Dutch College of General Practitioners' (NHG)]","volume":"158","author":"Verburg","year":"2014","journal-title":"Ned Tijdschr Geneeskd"},{"key":"2025101811003000000_9.2.e027161.10","unstructured":"National Collaborating Centre for Chronic Conditions. Stroke: national clinical guideline for diagnosis and initial management of acute stroke and transient ischaemic attack (TIA). London: Royal College of Physicians, 2008."},{"key":"2025101811003000000_9.2.e027161.11","doi-asserted-by":"publisher","DOI":"10.7861\/clinmedicine.17-2-154"},{"key":"2025101811003000000_9.2.e027161.12","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000230125.04355.e5"},{"key":"2025101811003000000_9.2.e027161.13","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.101668"},{"key":"2025101811003000000_9.2.e027161.14","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000217388.57851.62"},{"key":"2025101811003000000_9.2.e027161.15","doi-asserted-by":"crossref","first-page":"1462","DOI":"10.1002\/bjs.10199","article-title":"Delays in the presentation to stroke services of patients with transient ischaemic attack and minor stroke","volume":"103","author":"Hurst","year":"2016","journal-title":"Br J Surg"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2018-027161","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T18:00:38Z","timestamp":1760810438000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2018-027161"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2]]},"references-count":15,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2019,2,27]]},"published-print":{"date-parts":[[2019,2]]}},"alternative-id":["10.1136\/bmjopen-2018-027161"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2018-027161","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2019,2]]}}}