Letter by Wolters Regarding Article, “Impact on Prehospital Delay of a Stroke Preparedness Campaign: A SW-RCT (Stepped-Wedge Cluster Randomized Controlled Trial)”

Timely medical assessment is vital after major stroke, as well as minor stroke and transient ischemic attack, but often hindered by extensive prehospital delays. Public education campaigns could improve patient outcomes by reducing time to seeking medical attention, and it is, therefore, with great interest that I read the article by Denti et al,1 describing the impact of a campaign that was rolled out in a step-wedge cluster randomized design in Italy. The scarcity of high-quality evidence on public education for stroke renders their study timely and most welcome.2 Although the trial showed no benefit of the intervention on the primary end point of hospital arrival within 2 hours after symptom onset, the secondary end points …