Age, sex, and setting in the etiology of stroke study (ASSESS): Study design and protocol

Mahmoud Reza Azarpazhooh; Jennifer L Mandzia; Amanda G Thrift; Luciano A Sposato; Negar Morovatdar; Amin Amiri; Moira K Kapral; Nawaf Yassi; Cecilia Bahit; Subhash Kaul; Suvarna Alladi; Yongchai Nilanont; Mariano Coppola; Antonia Nucera; Brian Silver; David Werring; Robert Simister; Richard H Swartz; Mayowa O Owolabi; Bruce Ovbiagele; Vladimir Hachinski; ASSESS investigators

doi:10.1016/j.jns.2019.02.024

Age, sex, and setting in the etiology of stroke study (ASSESS): Study design and protocol

J Neurol Sci. 2019 Apr 15:399:209-213. doi: 10.1016/j.jns.2019.02.024. Epub 2019 Feb 14.

Authors

Mahmoud Reza Azarpazhooh¹, Jennifer L Mandzia², Amanda G Thrift³, Luciano A Sposato⁴, Negar Morovatdar⁵, Amin Amiri⁶, Moira K Kapral⁷, Nawaf Yassi⁸, Cecilia Bahit⁹, Subhash Kaul¹⁰, Suvarna Alladi¹¹, Yongchai Nilanont¹², Mariano Coppola¹³, Antonia Nucera¹⁴, Brian Silver¹⁵, David Werring¹⁶, Robert Simister¹⁷, Richard H Swartz¹⁸, Mayowa O Owolabi¹⁹, Bruce Ovbiagele²⁰, Vladimir Hachinski²¹; ASSESS investigators

Affiliations

¹ Department of Neurology, Ghaem hospital, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Clinical Neurological Sciences, University Hospital, London Health Sciences Center, Western University, ON, Canada; Department of Epidemiology and Biostatistics, Western University, ON, Canada.
² Department of Clinical Neurological Sciences, University Hospital, London Health Sciences Center, Western University, ON, Canada.
³ Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
⁴ Department of Clinical Neurological Sciences, University Hospital, London Health Sciences Center, Western University, ON, Canada; Department of Epidemiology and Biostatistics, Western University, ON, Canada; Department of Anatomy and Cell Biology, Western University, ON, Canada; Stroke, Dementia, and Heart Disease Lab, Western University, ON, Canada.
⁵ Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
⁶ Department of Neurology, Ghaem hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
⁷ Department of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
⁸ Departments of Medicine and Neurology, Royal Melbourne Hospital, University of Melbourne, Parkville, Australia.
⁹ Cardiology Department, INECO Neurociencias Oroño, Rosario, Santa Fe, Argentina.
¹⁰ Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, India.
¹¹ National Institute of Mental Health and Neurosciences, Bengaluru, India.
¹² Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
¹³ Hospital Ramon, Santamarin, Tandil, Argentina.
¹⁴ Department of Neurology, Saint Andrea Hospital, Stroke Unit, La Spezia, Italy.
¹⁵ Department of Neurology, The University of Massachusetts Medical School and UMass Memorial Medical Center, Worcester, MA, United States.
¹⁶ Stroke Research Centre, UCL Institute of Neurology, London, United Kingdom.
¹⁷ University College London Hospitals NHS Foundation Trust, London, United Kingdom.
¹⁸ Department of Medicine, Division of Neurology, Sunnybrook HSC, University of Toronto, Toronto, Canada.
¹⁹ Center for Genomic and Precision Medicine, University of Ibadan, Nigeria.
²⁰ Department of Neurology, University of California, San Francisco, USA.
²¹ Department of Clinical Neurological Sciences, University Hospital, London Health Sciences Center, Western University, ON, Canada; Department of Epidemiology and Biostatistics, Western University, ON, Canada. Electronic address: Vladimir.hachinski@lhsc.on.ca.

PMID: 30851659
DOI: 10.1016/j.jns.2019.02.024

Abstract

Rationale: Stroke etiology and risk factors vary by age, sex, setting (hospital or community-based) and by region. Identifying these differences would improve our understanding of stroke etiology, diagnosis, and treatment.

Aim: The Age, Sex and Setting in the Etiology of Stroke Study (ASSESS) is a multicenter cohort study to assess differences in stroke etiology.

Methods and design: Data from all centers will be categorized according to age, sex, setting, stroke subtypes. Centers with extensive hospital- or community-based data regarding stroke from Argentina, Australia, Canada, India, Iran, Italy, Ghana, Nigeria, Thailand, the United Kingdom and the United States have agreed to participate so far.

Study outcomes: The primary outcome includes differences in stroke etiology in study centers. The secondary outcomes include stroke incidence, risk factors, preventive strategies, and short- and long-term outcomes.

Conclusion: ASSESS will enable comparisons of data from different regions to determine the age and sex distribution of the most common causes of stroke in each setting. This will help clinicians to tailor the assessment and treatment of stroke patients on the basis of their specific local characteristics. It will also empower stroke epidemiologists to design preventive measures by targeting the specific characteristics of each population.

Keywords: Age; Community-based studies; Etiology; Hospital-based studies; Pool data analysis; Risk factors; Stroke; Stroke subtypes.

Publication types

Multicenter Study

MeSH terms

Age Distribution
Age Factors
Humans
Incidence
Research Design
Risk Factors
Sex Distribution
Sex Factors
Stroke / epidemiology
Stroke / etiology*