Limitations
TIA, stroke, acute stroke, Stroke
STROKE, STROKE, SECONDARY, ACUTE STROKE, TIA
There are additional limitations of our study worth considering. First, this was a single community, and thus our results may not be generalizable to other cities. Second, data were not available on patient eligibility for thrombolytics, including stroke onset to ED arrival times. Data on whether Flint patients with stroke or their social networks were exposed to Stroke Ready were also unavailable. Third, stroke and TIA diagnosis and acute stroke outcomes were obtained via diagnosis codes from the medical record. Fourth, we do not have measures of EMS use appropriateness. Fifth, the secondary outcome of EMS use was limited by missing data slightly greater in the postintervention period. Missing EMS data are more likely among patients who do not arrive to the ED by EMS and, thus, should be biased toward the null.