Evidence map›Paper›PMID 24914136›Full record

Trial reportBlood2014

Magnetic resonance imaging/angiography and transcranial Doppler velocities in sickle cell anemia: results from the SWiTCH trial.

Kathleen J Helton, Robert J Adams, Karen L Kesler, Alex Lockhart, Banu Aygun, Catherine Driscoll, Matthew M Heeney, Sherron M Jackson, Lakshmanan Krishnamurti, Scott T Miller and 4 more

2 registry-linked trialsAbstract readClinical Trial, Phase IIIMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Blood, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 48 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
48citing papers in PubMed, 6 pooled it
5.6field-weighted citation impact, top 3% 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.

NCT00122980 phase3terminatednot on this map

Stroke With Transfusions Changing to Hydroxyurea

TypeinterventionalSponsorSt. Jude Children's Research HospitalRan2006 to 2010Enrolled134ConditionsHemochromatosis, Cerebrovascular Accident, Anemia, Sickle Cell, Hematologic DiseasesArmsRed Cell Transfusions, Iron Chelation, Hydroxyurea, Phlebotomy
NCT06498726 unknown statusnot on this mapstarted 2024, after this paper: background citation

Role of Transcranial Doppler and Magnetic Resonance Angiography for Future Management of Sickle Cell Anemia CNS.

TypeobservationalSponsorEman Abdul-HaiRan2024 to 2025Enrolled18ConditionsBlood Disease, Brain InjuriesArmstranscranial doppler
3 · Its place in the literature

Who cites it

48 citing papers in PubMed, 6 syntheses or guidelines pooled it, 86 citations in OpenAlex.

  1. Hydroxyurea (hydroxycarbamide) for sickle cell disease.The Cochrane database of systematic reviews · 2022
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  14. Cerebral arteries in mice with sickle cell disease are exposed to larger areas of low wall shear stress.American journal of physiology. Heart and circulatory physiology · 2026
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  19. Brain Magnetic Resonance Imaging and Angiography in Children with Sickle Cell Anaemia in Uganda in a Cross-Sectional Sample.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2022
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 10 institutions in 1 country.

Kathleen J HeltonSt. Jude Children's Research Hospital, Memphis, TN;
Robert J AdamsMedical University of South Carolina, Charleston, SC;
Karen L KeslerRho Inc., Chapel Hill, NC;
Alex LockhartRho Inc., Chapel Hill, NC;
Banu AygunCohen Children's Medical Center, New Hyde Park, NY;
Catherine DriscollMontefiore Medical Center, New York, NY;
Matthew M HeeneyChildren's Hospital Boston, Boston, MA;
Sherron M JacksonMedical University of South Carolina, Charleston, SC;
Lakshmanan KrishnamurtiPittsburgh Children's Hospital, Pittsburgh, PA;
Scott T MillerSUNY-Downstate, Brooklyn, NY;
Sharada A SarnaikWayne State University, Detroit, MI; and.
William H SchultzCincinnati Children's Hospital, Cincinnati, OH.
Russell E WareCincinnati Children's Hospital, Cincinnati, OH.
SWiTCH Investigators
Cincinnati Children's Hospital Medical Center · USMedical University of South Carolina · USRho (United States) · USBoston Children's Museum · USChildren's Hospital of Pittsburgh · USCohen Children's Medical Center · USMontefiore Medical Center · USSt. Jude Children's Research Hospital · USSUNY Downstate Health Sciences University · USWayne State University · US

Funding

Stroke with Transfusions Changing to HydroxyureaU01HL078787 · NHLBI · ST. JUDE CHILDREN'S RESEARCH HOSPITAL · PI WARE, RUSSELL E · 2005 to 2010
$15.5M
Stroke with Transfusions Changing to Hydroxyurea (SWITCH) Trial Data CoordinatingU01HL078987 · NHLBI · RHO FEDERAL SYSTEMS DIVISION, INC. · PI HELMS, RONALD W. · 2005 to 2010
$4.2M
NHLBI NIH HHS U01 HL078787NHLBI NIH HHS U01-HL078787NHLBI NIH HHS U01 HL078987NHLBI NIH HHS U01-HL078987
6 · The paper itself

Abstract

The Stroke With Transfusions Changing to Hydroxyurea (SWiTCH) trial compared standard (transfusions/chelation) to alternative (hydroxyurea/phlebotomy) treatment to prevent recurrent stroke and manage iron overload in children chronically transfused over 7 years before enrollment. Standardized brain magnetic resonance imaging/magnetic resonance angiography (MRA) and transcranial Doppler (TCD) exams were performed at entry and exit, with a central blinded review. A novel MRA vasculopathy grading scale demonstrated frequent severe baseline left/right vessel stenosis (53%/41% ≥Grade 4); 31% had no vessel stenosis on either side. Baseline parenchymal injury was prevalent (85%/79% subcortical, 53%/37% cortical, 50%/35% subcortical and cortical). Most children had low or uninterpretable baseline middle cerebral artery TCD velocities, which were associated with worse stenoses (incidence risk ratio [IRR] = 5.1, P ≤ .0001 and IRR = 4.1, P < .0001) than normal velocities; only 2% to 12% had any conditional/abnormal velocity. Patients with adjudicated stroke (7) and transient ischemic attacks (19 in 11 standard/8 alternative arm subjects) had substantial parenchymal injury/vessel stenosis. At exit, 1 child (alternative arm) had a new silent infarct, and another had worse stenosis. SWiTCH neuroimaging data document severe parenchymal and vascular abnormalities in children with SCA and stroke and support concerns about chronic transfusions lacking effectiveness for preventing progressive cerebrovascular injury. The novel SWiTCH vasculopathy grading scale warrants validation testing and consideration for use in future clinical trials. This trial was registered at www.clinicaltrials.gov as #NCT00122980.

Indexed as

Magnetic Resonance AngiographyMagnetic Resonance ImagingUltrasonography, Doppler, TranscranialAdolescentAnemia, Sickle CellBlood Flow VelocityBlood TransfusionBrainCerebrovascular CirculationChildChild, PreschoolFemaleFunctional NeuroimagingHumansHydroxyureaMaleHydroxyurea

Identifiers

PMID24914136
PMCPMC4126329
OpenAlexW1966362593

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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.