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Centre for Evidence-
Based Medicine

Prognosis: Clinical Scenario

You see a 70 year old man in an outpatient clinical 3 months after he has been discharged from your service with an ischaemic (presumed thrombotic) stroke. He is in sinus rhythm, has mild residual left-sided weakness but is otherwise well. His only medication is aspirin and he has no allergies. He recently saw an article on the BMJ website describing the risk of seizure after a stroke and is concerned that this will happen to him. Together you form the question: "In patients with a history of stroke, what is the risk of seizure within the first year?"

You search MEDLINE using the terms "stroke" and "seizure" and find the article he was referring to. BMJ 1997;315:1582-7

Read the article and decide:

  1. Is this evidence about prognosis valid?
  2. Is this valid evidence about prognosis important?
  3. Can you apply this valid and important evidence about prognosis in caring for your patient?

Continue to completed worksheet