Stroke Learning Health Systems: A Topical Narrative Review With Case Examples

Dominique A. Cadilhac, Dawn M. Bravata, Janet Prvu Bettger, Robert Mikulik, Bo Norrving, Ezinne O. Uvere, Mayowa Owolabi, Annemarei Ranta, Monique F. Kilkenny

Research output: Contribution to journalReview ArticleResearchpeer-review

2 Citations (Scopus)


To our knowledge, the adoption of Learning Health System (LHS) concepts or approaches for improving stroke care, patient outcomes, and value have not previously been summarized. This topical review provides a summary of the published evidence about LHSs applied to stroke, and case examples applied to different aspects of stroke care from high and low-to-middle income countries. Our attempt to systematically identify the relevant literature and obtain real-world examples demonstrated the dissemination gaps, the lack of learning and action for many of the related LHS concepts across the continuum of care but also elucidated the opportunity for continued dialogue on how to study and scale LHS advances. In the field of stroke, we found only a few published examples of LHSs and health systems globally implementing some selected LHS concepts, but the term is not common. A major barrier to identifying relevant LHS examples in stroke may be the lack of an agreed taxonomy or terminology for classification. We acknowledge that health service delivery settings that leverage many of the LHS concepts do so operationally and the lessons learned are not shared in peer-reviewed literature. It is likely that this topical review will further stimulate the stroke community to disseminate related activities and use keywords such as learning health system so that the evidence base can be more readily identified.

Original languageEnglish
Pages (from-to)1148-1159
Number of pages12
Issue number4
Publication statusPublished - 1 Apr 2023


  • emergency medical services
  • ischemic attack, transient
  • learning health system
  • quality improvement
  • stroke

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