Development and Assessment of Services for Hyperacute Stroke (DASH) Objective II, and Implementation of COMPASS

From April 2013 to July 2014
Project Leader(s): Professor Richard Thomson, Dr Darren Flynn
Staff: Prof Gary Ford, Prof Helen Rodgers, Dr Peter McMeekin, Dr Madeleine Murtagh, Dr Lynne Stobbart, Mrs Joan Mackintosh, Mr Daniel Nesbitt, Professor Christian Kray, Dr Christopher Price, Dr Margaret Lawlor
Contact: Dr Darren Flynn (; tel 0191 2085415)
Sponsors: DASH II - National Institute for Health Research (NIHR) under its Programme Grants for Applied Research scheme (RP-PG-0606-1241),Implementation of COMPASS - North of England Cardiovascular Network and Institute of Health and Society, Newcastle University
Partners: North of England Cardiovascular Network and Fr3dom Health

Thrombolysis is a critically important treatment for acute ischaemic (blocked artery) strokes that needs to be administered as soon as possible and within 4.5 hours following stroke onset.  Evidence-based tools are needed to support rapid assessment of patient eligibility for thrombolysis and communication of benefits/risks to patients and relatives.


The DASH II team followed a structured development process to establish how patients with acute ischaemic stroke, their relatives and the clinical team can be best supported with their decision making about thrombolysis with recombinant tissue plasminogen activator (rt-PA) during the hyper-acute stroke period?


The systematic development process engaged stroke clinicians, stroke patients and their relatives in an iterative design process (informed by an interview study; ethnography study; literature review; statistical modelling [decision analytic model] to establish the likely balance of benefits and risks of thrombolysis in individual patients; and interactive group workshops to establish the optimal mode, form and content of a decision aid; and interactive usability testing in order to understand how a prototype decision aid could work in practice) to develop a beta prototype version of a COMPuterised decision Aid for Stroke thrombolySis (COMPASS). 


COMPASS allows stroke clinicians to input the details of an individual stroke patient into a tablet or smart phone and formulate numerical (percentages and natural frequencies - out of 100 patients) and graphical risk presentations (coloured pictograph, bar chart or flow diagram) showing the predicted likelihood of functional independence [complete recovery or minor disability], dependence [moderate to severe disability] and death at three months, with and without thrombolysis, including risk of symptomatic intracranial haemorrhage (SICH) and the impact of any SICH.



Dr Darren Flynn
Senior Research Associate

Joan Mackintosh
Research Associate

Dr Lynne Stobbart
Senior Research Associate

Professor Richard Thomson