Brittle N 1, Mant J 2, McManus R 1, Lasserson D 3, Sackley C 1 Are TIAs as transient as the name suggests?

Background Annual incidence of probable and definite TIA, per thousand = 1.08 (0.95–1.21), standardised to the 2005 population of England (Giles & Rothwell 2007). Annual incidence of probable and definite TIA, per thousand = 1.08 (0.95–1.21), standardised to the 2005 population of England (Giles & Rothwell 2007). National stroke guidelines recommend that people with a suspected TIA are referred to TIA clinics and managed according to their risk of further stroke. National stroke guidelines recommend that people with a suspected TIA are referred to TIA clinics and managed according to their risk of further stroke. By definition the neurological symptoms associated with Transient Ischemic Attack (TIA), should persist for no longer than 24 hours. By definition the neurological symptoms associated with Transient Ischemic Attack (TIA), should persist for no longer than 24 hours. Little is known about the long term impact of TIA on patient reported outcomes. Little is known about the long term impact of TIA on patient reported outcomes.

Objectives i) To investigate whether patients have depressed mood, and/or residual functional or cognitive problems that adversely influence their day to day living, after being diagnosed with TIA? ii) To investigate the economic impact of TIA on the NHS where is money best spent to maximise patient outcomes? where is money best spent to maximise patient outcomes? iii) To inform future trial design by providing information such as the suitability of outcome measures.

Methodology Design: Prospective cohort study Recruitment: TIA clinics: TIA diagnosis (group A) or TIA “mimic” (Group B) TIA clinics: TIA diagnosis (group A) or TIA “mimic” (Group B) GP practices: Age/gender/postcode/deprivation matched controls (Group C) GP practices: Age/gender/postcode/deprivation matched controls (Group C) We aim to recruit 600 people (200 in each group) over a 12month period. GroupABC Inclusion Criteria Diagnosis confirmed by consultant stroke physician or neurologist at TIA clinic Diagnosis confirmed by consultant stroke physician or neurologist at TIA clinic Diagnosis made within 14 days of event Diagnosis made within 14 days of event New episode (not follow-up appointment) New episode (not follow-up appointment) No known severe cognitive impairment that would prohibit self-completion of postal questionnaires No known severe cognitive impairment that would prohibit self-completion of postal questionnaires No Past medical history of stroke/TIA No Past medical history of stroke/TIA

Data collection: Baseline data Baseline data Questionnaire (demographics, social history, past medical history) Questionnaire (demographics, social history, past medical history) Clinic data collection form for groups A & B (details of presenting condition, investigations and medical management) Clinic data collection form for groups A & B (details of presenting condition, investigations and medical management) Outcome data Outcome data Questionnaire at 0, 3, 6 and 12 months (function, anxiety, depression, service use and CV Risk factors) Questionnaire at 0, 3, 6 and 12 months (function, anxiety, depression, service use and CV Risk factors) face-to-face cognitive screen at 0 and 12 months. face-to-face cognitive screen at 0 and 12 months.

Progress to date The study has been given favourable ethical approval by BEN REC All study wide checks have been undertaken by the lead R&D office (BBC CLRN) Study is eligible to be included in the NIHR Clinical Research Network (CRN) Portfolio Study is in process of being reviewed for adoption by SRN and PCRN Site specific assessments are underway at collaborating NHS sites

Contact details Nicola Brittle Study Coordinator/PhD student Primary Care Clinical Sciences Department School of Health and Population Sciences University of Birmingham Edgbaston campus Birmingham B15 2TT Tel

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