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In several clinical scenarios, US neurologists were significantly more likely than Canadian neurologists to use intravenous heparin. Fears regarding medicolegal consequences may partially explain the treatment disparity. Despite the public ation of 4 clinical trials, which have not shown any long-term benefit for patients with acute stroke and A FIB (International Stroke Trial, Heparin in Acute Embolic Stroke Trial ) or cardioembolic stroke (Trial of Org 10172 in Acute Stroke Treatment, the Tinzaparin in Acute Ischemic Stroke Trial), both US and Canadian neurologists would use intravenous heparin in large numbers for this condition. Further studies are warranted to investigate the lack of impact of "negative" studies on clinician behavior. |
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