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Circulation. 2010 Sep 14;122(11):1116-23. doi: 10.1161/CIRCULATIONAHA.110.936526. Epub 2010 Aug 30.

Get With the Guidelines-Stroke performance indicators: surveillance of stroke care in the Taiwan Stroke Registry: Get With the Guidelines-Stroke in Taiwan.

Collaborators (190)

Jeng JS, Yeh SJ, Tsai LK, Chiu HC, Lien LM, Chen WH, Bai CH, Huang TH, Lau CI, Wu YY, Yuan RY, Hu CJ, Sheu JJ, Yu JM, Ho CS, Chung WT, Sung JY, Chen CI, Weng HY, Han YH, Huang CP, Lin HJ, Ke DS, Chang CY, Yeh PS, Lin KC, Cheng TJ, Chou CH, Yang CM, Lo YK, Lin YT, Lin CH, Lin JC, Hsu YD, Denq JC, Peng GS, Lee JT, Hsu CH, Lin CC, Yen CH, Cheng CA, Sung YF, Chen YL, Lien MT, Chou CH, Liu CC, Yang FC, Wu YC, Tso AC, Lai Y, Chiang CI, Tsai CK, Liu MT, Lin YC, Hsu YC, Liu CH, Tsai CH, Huang WS, Lu CT, Tsai TC, Tseng CH, Lin KH, Shyn WC, Yang YW, Liu YL, Cho DY, Chen CC, Sun MH, Yu SC, Ke LY, Lai ML, Chen CH, Chen JR, Tsai SY, Chiang TR, Lee MC, Lin SK, Tseng YF, Lee JE, Hsiao CL, Liang JF, Chen CM, Wu CH, Chen YW, Lee KY, Lin YY, Li CH, Smith EE, Tsai HF, Hsieh CF, Yang CD, Liaw SJ, Liao HC, Hu HH, Wong WJ, Luk YO, Chern CM, Hsu LC, Chung CP, Sun MC, Wu SL, Tseng HP, Liu CH, Lin CL, Lin HC, Lai TC, Yin JH, Wang CJ, Wang KC, Chen LM, Jong-Chyou Denq JC, Chan L, Lee SP, Sun Y, Huang CC, Liu CH, Lin CH, Lu CJ, Yeh SJ, Wu LL, Hsieh LP, Lee YH, Chen CW, Chen PL, Lee YS, Chen SY, Chen HJ, Hsu SP, Chang CS, Kuo HC, Wu SL, Tsui HW, Tsou JC, Chou FH, Lin PJ, Tung CS, Lu K, Liliang PC, Tsai YD, Liang CL, Wang KW, Wang HK, Chen TY, Hsin YL, Lin CY, Yip BS, Tsai PC, Chou PC, Kuo TM, Lee YC, Chiu YP, Tsai KC, Lin RT, Chen CH, Khor GT, Chao AC, Lin HF, Lin IS, Yan SH, Lin YC, Chen PY, Hsiao SH, Po HL, Lin YJ, Tu HC, Tang SC, Lin FY, Chen PK, Chiu PY, Yip PK, Wang VC, Wang KC, Tsai CF, Chen CC, Chen CH, Liu YC, Yeh CH, Pan CH, Jih SY, Chan PC, Hsu MH, Shoung HM, Lo YC, Wang FH, Wei CY, Lee JY, Lin RH, Chu CH, Hu CJ, Hsu MC.

Author information

School of Public Health, Taipei Medical University, Taipei, Taiwan.



Stroke is a leading cause of death around the world. Improving the quality of stroke care is a global priority, despite the diverse healthcare economies across nations. The American Heart Association/American Stroke Association Get With the Guidelines-Stroke program (GWTG-Stroke) has improved the quality of stroke care in 790 US academic and community hospitals, with broad implications for the rest of the country. The generalizability of GWTG-Stroke across national and economic boundaries remains to be tested. The Taiwan Stroke Registry, with 30 599 stroke admissions between 2006 and 2008, was used to assess the applicability of GWTG-Stroke in Taiwan, which spends ≈ 1/10 of what the United States does in medical costs per new or recurrent stroke.


Taiwan Stroke Registry, sponsored by the Taiwan Department of Health, engages 39 academic and community hospitals and covers the entire country with 4 steps of quality control to ensure the reliability of entered data. Five GWTG-Stroke performance measures and 1 safety indicator are applicable to assess Taiwan Stroke Registry quality of stroke care. Demographic and outcome figures are comparable between GWTG-Stroke and Taiwan Stroke Registry. Two indicators (early and discharge antithrombotics) are close to GWTG-Stroke standards, while 3 other indicators (intravenous tissue plasminogen activator, anticoagulation for atrial fibrillation, lipid-lowering medication) and 1 safety indicator fall behind. Preliminary analysis shows that compliance with selected GWTG-Stroke guidelines is associated with better outcomes.


Results suggest that GWTG-Stroke performance measures, with modification for ethnic factors, can become global standards across national and economic boundaries for assessing and improving quality of stroke care and outcomes. GWTG-Stroke can be incorporated into ongoing stroke registries across nations.

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