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Accelerating diagnosis of degenerative cervical myelopathy through improved education: a mixed-methods study protocol from Myelopathy.org RECODE-DCM to define stakeholders, knowledge requirements and an optimal intervention strategy

Por: Veremu · M. · Deakin · N. · Chauhan · R. V. · Lantz · J. M. · Toumbas · G. · Tabrah · J. · Kumar · V. · Zipser · C. M. · Plener · J. · Ammendolia · C. · Anderson · D. B. · dos Santos Rubio · E. J. · Tetreault · L. · Parnaik · R. · Rodrigues-Pinto · R. · Ongwen · O. M. · Sarewitz · E. · S
Introduction

Outcomes for degenerative cervical myelopathy (DCM) patients are limited by delayed and missed diagnoses, driven in part by poor professional awareness. Despite DCM being the most common cause of adult spinal cord injury, it remains under-recognised and undertaught in clinical education. Lessons from other common pathology like stroke and acute myocardial infarction highlight the potential of education to improve early diagnosis. This study will develop a professional education strategy to improve early DCM diagnosis. It will define key audiences and identify an effective delivery method, laying the groundwork for a sustained, targeted intervention.

Methods and analysis

The study aims to define who needs to know about DCM, what they need to know and how they can learn it. This will be carried out in three phases: phase 1—who and what: to establish the target population and to define core competencies for the educational intervention; phase 2—how: to create and review the educational intervention; phase 3—evaluation: to test whether the framework is an improvement to existing strategies.

Ethics and dissemination

Ethical approval is in place from the University of Cambridge (HBREC.2024.24). Results from the study will be disseminated through scientific publication, conference presentation, blog posts and podcasts.

PROSPERO registration number

CRD42023461838

Acute stroke management in the Caribbean: a scoping review protocol

Por: Clervius · H. · Wroblewski · T. H. · Bennett · N. · Wells · M. J. · Lee · M. · Crandon · D. · Then · R. · Aidoo-Frimpong · G. · Etienne · M. · Dos Santos Rubio · E. J. · March-Downer · T. · Inoa · V. · Barthelemy · E. J. · Gordon Perue · G.
Introduction

Stroke is a leading cause of death and disability in the Caribbean, yet there is limited published information on the availability and utilisation of diagnostic imaging and treatment methods. Inequities in healthcare infrastructure, access to neuroimaging and acute treatment options may contribute to poorer outcomes following stroke, particularly in the low-resource settings that characterise most of the Caribbean region. The objective of this review is to map the literature on access to diagnostic and therapeutic modalities for adult stroke care in the Caribbean to identify potential limitations in acute treatment and examine how restricted access may impact outcomes. The resulting data can help inform strategies for improving access to stroke care in resource-limited communities.

Methods and analysis

We will apply a three-step strategy based on the Joanna Briggs Institute methodological framework: first, a limited search to identify relevant articles; second, selection of key search terms; third, implementation into a comprehensive search strategy. The query will range from 1 January 1995 to 1 June 2025 (date of final search). Search results will be extracted and screened by two independent reviewers, and findings will be presented in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. We will consider studies focusing on ischaemic and haemorrhagic stroke in the Caribbean, emphasising access to diagnostic imaging, stroke centres, prehospital management and emergent treatment. Studies examining acute stroke management capacity within the region will be considered. Studies will be excluded if they: focus exclusively on primary stroke prevention, postacute care, longitudinal care pathways for stroke victims or paediatric populations; are unrelated to stroke diagnosis or treatment or are conducted outside the Caribbean.

Ethics and dissemination

This protocol aims to perform secondary analysis of previously published literature; therefore, ethical approval is not required. The results of this review will be disseminated through academic conferences and peer-reviewed publication.

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