Evidence-based medicine (EBM) has been emphasized in Japan for these years. In management of acute stroke, prospective stroke registries and randomized controlled trials have provided evidence that helps us examine and treat patients with acute stroke. Unfortunately evidence in stroke management has almost always been imported into Japan from the Western countries.
In order to obtain reliable large-scale data on stroke management, the Japan Multicenter Stroke Investigators' Collaboration (J-MUSIC) conducted a multicenter study. A total of 16, 922 patients with acute ischemic stroke admitted to 156 hospitals within 7 days after stroke onset were prospectively registered during the study period of one year. The study clearly demonstrated age, sex, onset to arrival time, neurological deficits, stroke subtypes, length of hospital stay, and clinical outcome of the patients and the current status of acute ischemic management. The study provided results supporting potential efficacy of hyperacute local thrombolytic therapy with urokinase.
In order to succeed to the fruits of the J-MUSIC study, the Japanese Standard Stroke Registration Study (JSSRS) was organized and completed a computer software for electronically collected database of acute stroke patients. The JSSRS database will be used for the nation-wide stroke registry, so-called Japan Acute Stroke Data Bank, and will help establish EBM for acute stroke in Japan.
