Evidence map›Paper›PMID 17717313›Full record

Trial reportStroke2007

Clinical diagnosis of lacunar stroke in the first 6 hours after symptom onset: analysis of data from the glycine antagonist in neuroprotection (GAIN) Americas trial.

Stephen J Phillips, Dingwei Dai, Arnold Mitnitski, Gordon J Gubitz, Karen C Johnston, Walter J Koroshetz, Karen L Furie, Sandra Black, Darell E Heiselman, GAIN Americas Investigators

Open access · bronzeAbstract readRandomized Controlled TrialValidation Study
In one paragraph

Trial report in Stroke, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.8field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 13 citations in OpenAlex.

  1. Trial
  2. Review
  3. Risk Factors for Silent Lacunar Infarction in Patients with Transient Ischemic Attack.Medical science monitor : international medical journal of experimental and clinical research · 2016
    Article
  4. Article
  5. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Stephen J PhillipsQueen Elizabeth II Health Sciences Centre, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. stephen.phillips@dal.ca
Dingwei Dai
Arnold Mitnitski
Gordon J Gubitz
Karen C Johnston
Walter J Koroshetz
Karen L Furie
Sandra Black
Darell E Heiselman
GAIN Americas Investigators
University of Virginia · USNational Institute of Neurological Disorders and Stroke · USMassachusetts General Hospital · US

Funding

Glucose Regulation in Acute Stroke Patients (GRASP)R01NS050192 · NINDS · UNIVERSITY OF VIRGINIA CHARLOTTESVILLE · PI JOHNSTON, KAREN C · 2005 to 2007
$2.0M
NINDS NIH HHS R01 NS050192Wellcome Trust
6 · The paper itself

Abstract

background and purposeAlthough the pathophysiological heterogeneity of stroke may be highly relevant to the development of acute-phase therapies, discriminating between ischemic stroke subtypes soon after onset remains a challenge. We conducted a study of the accuracy of a clinical diagnosis of lacunar stroke in the first 6 hours after symptom onset.

methodsWe analyzed data from 1367 patients in the Glycine Antagonist In Neuroprotection (GAIN) Americas trial. The Trial of ORG10172 in Acute Stroke Treatment (TOAST) category "small vessel (lacunar)" disease at day 7 or at hospital discharge was used as the reference standard to determine the accuracy of a diagnosis of a lacunar stroke made within 6 hours of symptom onset using the Oxfordshire Community Stroke Project (OCSP) classification "LACS." Outcome was analyzed by comparing the proportions of patients classified as "LACS" at baseline or "small vessel (lacunar)" at 7 days who were dead or dependent at 3 months.

resultsThe positive predictive value of an OCSP diagnosis of a lacunar stroke was 76% (95% CI: 69% to 81%; sensitivity 64% [95% CI: 58% to 70%]; specificity 96% [95% CI: 95% to 97%]; negative predictive value 93% [95% CI: 92% to 94%]; accuracy 91% [95% CI: 89% to 92%]). The 3-month outcomes of patients classified as either OCSP "LACS" within 6 hours of onset or TOAST "small vessel (lacunar)" at 7 days were not significantly different.

conclusionsAn OCSP LACS diagnosis made within 6 hours of stroke onset is reasonably predictive of a final diagnosis of "small vessel (lacunar)" disease made using TOAST criteria and has a similar relationship to outcome at 3 months.

Indexed as

Acute DiseaseAgedAged, 80 and overBrain InfarctionEarly DiagnosisFemaleGlycine AgentsHumansIndolesMaleMiddle AgedNeuroprotective AgentsPredictive Value of TestsReproducibility of ResultsSensitivity and SpecificitySeverity of Illness Index3-(2-((phenylamino)carbonyl)ethenyl)-4,6-dichloroindole-2-carboxylic acidGlycine AgentsIndolesNeuroprotective Agents

Identifiers

PMID17717313
PMCPMC2747476
OpenAlexW2031685144

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.