Chaturvedi, SeemantOfner, SusanBaye, FitsumMyers, Laura J.Phipps, MikeSico, Jason J.Damush, TeresaMiec, EdwardReeves, MatJohanning, JasonWilliams, Linda S.Arling, GregCheng, EricYu, ZhangshengBravata, Dawn2018-06-062018-06-062017-01-17Chaturvedi, S., Ofner, S., Baye, F., Myers, L. J., Phipps, M., Sico, J. J., … Bravata, D. (2017). Have clinicians adopted the use of brain MRI for patients with TIA and minor stroke? Neurology, 88(3), 237–244. http://doi.org/10.1212/WNL.0000000000003503https://hdl.handle.net/1805/16367BACKGROUND: Use of MRI with diffusion-weighted imaging (DWI) can identify infarcts in 30%-50% of patients with TIA. Previous guidelines have indicated that MRI-DWI is the preferred imaging modality for patients with TIA. We assessed the frequency of MRI utilization and predictors of MRI performance. METHODS: A review of TIA and minor stroke patients evaluated at Veterans Affairs hospitals was conducted with regard to medical history, use of diagnostic imaging within 2 days of presentation, and in-hospital care variables. Chart abstraction was performed in a subset of hospitals to assess clinical variables not available in the administrative data. RESULTS: A total of 7,889 patients with TIA/minor stroke were included. Overall, 6,694 patients (84.9%) had CT or MRI, with 3,396/6,694 (50.7%) having MRI. Variables that were associated with increased odds of CT performance were age >80 years, prior stroke, history of atrial fibrillation, heart failure, coronary artery disease, anxiety, and low hospital complexity, while blood pressure >140/90 mm Hg and high hospital complexity were associated with increased likelihood of MRI. Diplopia (87% had MRI, p = 0.03), neurologic consultation on the day of presentation (73% had MRI, p < 0.0001), and symptom duration of >6 hours (74% had MRI, p = 0.0009) were associated with MRI performance. CONCLUSIONS: Within a national health system, about 40% of patients with TIA/minor stroke had MRI performed within 2 days. Performance of MRI appeared to be influenced by several patient and facility-level variables, suggesting that there has been partial acceptance of the previous guideline that endorsed MRI for patients with TIA.en-USPublisher PolicyMyocardial infarctionPreferred imaging modalityTransient ischemic attackMinor strokesPatient variablesMagnetic resonance imagingDiffusion magnetic resonance imagingHospitals, VeteransTomography, X-Ray ComputedBrain -- PathologyArticle