Evidence map›Paper›PMID 26658446›Full record

Trial reportStroke2016

Enrollment Yield and Reasons for Screen Failure in a Large Prehospital Stroke Trial.

Dae-Hyun Kim, Jeffrey L Saver, Sidney Starkman, David S Liebeskind, Latisha K Ali, Lucas Restrepo, May Kim-Tenser, Miguel Valdes-Sueiras, Marc Eckstein, Frank Pratt and 5 more

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Stroke, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00059332 (Field Administration of Stroke Therapy-Magnesium Trial), which is not on this map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

NCT00059332 phase3completednot on this map

Field Administration of Stroke Therapy-Magnesium Trial: A Randomized, Double-Blind, Placebo Controlled Trial of Neuroprotective Magnesium Sulfate Therapy for Acute Stroke Initiated Within 2 Hours of Onset by Paramedics in the Field

TypeinterventionalSponsorJeffrey L. SaverRan2005 to 2013Enrolled1,700ConditionsCerebrovascular AccidentArmsMagnesium Sulfate, Normal Saline
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. A systematic review of ambulance service-based randomised controlled trials in stroke.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2023
    Pooled it
  2. Article
  3. Review
  4. Neurological and Neuropsychiatric Impacts of COVID-19 Pandemic.The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques · 2021
    Review
  5. Article
  6. Cerebral collateral therapeutics in acute ischemic stroke: A randomized preclinical trial of four modulation strategies.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2017
    Article
  7. Stroke Chameleons and Stroke Mimics in the Emergency Department.Current neurology and neuroscience reports · 2017
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Dae-Hyun KimFrom the Department of Neurology, Busan-Ulsan Regional Cardiocerebrovascular Center, College of Medicine, Dong-A University, Busan, Republic of Korea (D.-H.K.); Departments of Neurology (J.L.S., D.S.L., L.K.A., L.R., M.V.-S.), Emergency Medicine and Neurology (S.S.), Comprehensive Stroke Center, and Department of Emergency Medicine, Los Angeles County Fire EMS Agency (F.P.), David Geffen School of Medicine, University of California, Los Angeles; Department of Neurology, Roxanna Todd Hodges Comprehensive Stroke Clinic (M.K.-T., N.S.) and Department of Emergency Medicine, Los Angeles Fire Department (M.E.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Emergency Medicine, Los Angeles EMS Agency, Orange County EMS Agency, Harbor-University of California, Los Angeles Medical Center (S.S.); Stanford University, Palo Alto, CA (S.H.); and National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.).
Jeffrey L SaverFrom the Department of Neurology, Busan-Ulsan Regional Cardiocerebrovascular Center, College of Medicine, Dong-A University, Busan, Republic of Korea (D.-H.K.); Departments of Neurology (J.L.S., D.S.L., L.K.A., L.R., M.V.-S.), Emergency Medicine and Neurology (S.S.), Comprehensive Stroke Center, and Department of Emergency Medicine, Los Angeles County Fire EMS Agency (F.P.), David Geffen School of Medicine, University of California, Los Angeles; Department of Neurology, Roxanna Todd Hodges Comprehensive Stroke Clinic (M.K.-T., N.S.) and Department of Emergency Medicine, Los Angeles Fire Department (M.E.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Emergency Medicine, Los Angeles EMS Agency, Orange County EMS Agency, Harbor-University of California, Los Angeles Medical Center (S.S.); Stanford University, Palo Alto, CA (S.H.); and National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.). jsaver@mednet.ucla.edu.
Sidney StarkmanFrom the Department of Neurology, Busan-Ulsan Regional Cardiocerebrovascular Center, College of Medicine, Dong-A University, Busan, Republic of Korea (D.-H.K.); Departments of Neurology (J.L.S., D.S.L., L.K.A., L.R., M.V.-S.), Emergency Medicine and Neurology (S.S.), Comprehensive Stroke Center, and Department of Emergency Medicine, Los Angeles County Fire EMS Agency (F.P.), David Geffen School of Medicine, University of California, Los Angeles; Department of Neurology, Roxanna Todd Hodges Comprehensive Stroke Clinic (M.K.-T., N.S.) and Department of Emergency Medicine, Los Angeles Fire Department (M.E.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Emergency Medicine, Los Angeles EMS Agency, Orange County EMS Agency, Harbor-University of California, Los Angeles Medical Center (S.S.); Stanford University, Palo Alto, CA (S.H.); and National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.).
David S LiebeskindFrom the Department of Neurology, Busan-Ulsan Regional Cardiocerebrovascular Center, College of Medicine, Dong-A University, Busan, Republic of Korea (D.-H.K.); Departments of Neurology (J.L.S., D.S.L., L.K.A., L.R., M.V.-S.), Emergency Medicine and Neurology (S.S.), Comprehensive Stroke Center, and Department of Emergency Medicine, Los Angeles County Fire EMS Agency (F.P.), David Geffen School of Medicine, University of California, Los Angeles; Department of Neurology, Roxanna Todd Hodges Comprehensive Stroke Clinic (M.K.-T., N.S.) and Department of Emergency Medicine, Los Angeles Fire Department (M.E.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Emergency Medicine, Los Angeles EMS Agency, Orange County EMS Agency, Harbor-University of California, Los Angeles Medical Center (S.S.); Stanford University, Palo Alto, CA (S.H.); and National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.).
Latisha K AliFrom the Department of Neurology, Busan-Ulsan Regional Cardiocerebrovascular Center, College of Medicine, Dong-A University, Busan, Republic of Korea (D.-H.K.); Departments of Neurology (J.L.S., D.S.L., L.K.A., L.R., M.V.-S.), Emergency Medicine and Neurology (S.S.), Comprehensive Stroke Center, and Department of Emergency Medicine, Los Angeles County Fire EMS Agency (F.P.), David Geffen School of Medicine, University of California, Los Angeles; Department of Neurology, Roxanna Todd Hodges Comprehensive Stroke Clinic (M.K.-T., N.S.) and Department of Emergency Medicine, Los Angeles Fire Department (M.E.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Emergency Medicine, Los Angeles EMS Agency, Orange County EMS Agency, Harbor-University of California, Los Angeles Medical Center (S.S.); Stanford University, Palo Alto, CA (S.H.); and National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.).
Lucas RestrepoFrom the Department of Neurology, Busan-Ulsan Regional Cardiocerebrovascular Center, College of Medicine, Dong-A University, Busan, Republic of Korea (D.-H.K.); Departments of Neurology (J.L.S., D.S.L., L.K.A., L.R., M.V.-S.), Emergency Medicine and Neurology (S.S.), Comprehensive Stroke Center, and Department of Emergency Medicine, Los Angeles County Fire EMS Agency (F.P.), David Geffen School of Medicine, University of California, Los Angeles; Department of Neurology, Roxanna Todd Hodges Comprehensive Stroke Clinic (M.K.-T., N.S.) and Department of Emergency Medicine, Los Angeles Fire Department (M.E.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Emergency Medicine, Los Angeles EMS Agency, Orange County EMS Agency, Harbor-University of California, Los Angeles Medical Center (S.S.); Stanford University, Palo Alto, CA (S.H.); and National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.).
May Kim-TenserFrom the Department of Neurology, Busan-Ulsan Regional Cardiocerebrovascular Center, College of Medicine, Dong-A University, Busan, Republic of Korea (D.-H.K.); Departments of Neurology (J.L.S., D.S.L., L.K.A., L.R., M.V.-S.), Emergency Medicine and Neurology (S.S.), Comprehensive Stroke Center, and Department of Emergency Medicine, Los Angeles County Fire EMS Agency (F.P.), David Geffen School of Medicine, University of California, Los Angeles; Department of Neurology, Roxanna Todd Hodges Comprehensive Stroke Clinic (M.K.-T., N.S.) and Department of Emergency Medicine, Los Angeles Fire Department (M.E.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Emergency Medicine, Los Angeles EMS Agency, Orange County EMS Agency, Harbor-University of California, Los Angeles Medical Center (S.S.); Stanford University, Palo Alto, CA (S.H.); and National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.).
Miguel Valdes-SueirasFrom the Department of Neurology, Busan-Ulsan Regional Cardiocerebrovascular Center, College of Medicine, Dong-A University, Busan, Republic of Korea (D.-H.K.); Departments of Neurology (J.L.S., D.S.L., L.K.A., L.R., M.V.-S.), Emergency Medicine and Neurology (S.S.), Comprehensive Stroke Center, and Department of Emergency Medicine, Los Angeles County Fire EMS Agency (F.P.), David Geffen School of Medicine, University of California, Los Angeles; Department of Neurology, Roxanna Todd Hodges Comprehensive Stroke Clinic (M.K.-T., N.S.) and Department of Emergency Medicine, Los Angeles Fire Department (M.E.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Emergency Medicine, Los Angeles EMS Agency, Orange County EMS Agency, Harbor-University of California, Los Angeles Medical Center (S.S.); Stanford University, Palo Alto, CA (S.H.); and National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.).
Marc EcksteinFrom the Department of Neurology, Busan-Ulsan Regional Cardiocerebrovascular Center, College of Medicine, Dong-A University, Busan, Republic of Korea (D.-H.K.); Departments of Neurology (J.L.S., D.S.L., L.K.A., L.R., M.V.-S.), Emergency Medicine and Neurology (S.S.), Comprehensive Stroke Center, and Department of Emergency Medicine, Los Angeles County Fire EMS Agency (F.P.), David Geffen School of Medicine, University of California, Los Angeles; Department of Neurology, Roxanna Todd Hodges Comprehensive Stroke Clinic (M.K.-T., N.S.) and Department of Emergency Medicine, Los Angeles Fire Department (M.E.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Emergency Medicine, Los Angeles EMS Agency, Orange County EMS Agency, Harbor-University of California, Los Angeles Medical Center (S.S.); Stanford University, Palo Alto, CA (S.H.); and National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.).
Frank PrattFrom the Department of Neurology, Busan-Ulsan Regional Cardiocerebrovascular Center, College of Medicine, Dong-A University, Busan, Republic of Korea (D.-H.K.); Departments of Neurology (J.L.S., D.S.L., L.K.A., L.R., M.V.-S.), Emergency Medicine and Neurology (S.S.), Comprehensive Stroke Center, and Department of Emergency Medicine, Los Angeles County Fire EMS Agency (F.P.), David Geffen School of Medicine, University of California, Los Angeles; Department of Neurology, Roxanna Todd Hodges Comprehensive Stroke Clinic (M.K.-T., N.S.) and Department of Emergency Medicine, Los Angeles Fire Department (M.E.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Emergency Medicine, Los Angeles EMS Agency, Orange County EMS Agency, Harbor-University of California, Los Angeles Medical Center (S.S.); Stanford University, Palo Alto, CA (S.H.); and National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.).
Samuel StrattonFrom the Department of Neurology, Busan-Ulsan Regional Cardiocerebrovascular Center, College of Medicine, Dong-A University, Busan, Republic of Korea (D.-H.K.); Departments of Neurology (J.L.S., D.S.L., L.K.A., L.R., M.V.-S.), Emergency Medicine and Neurology (S.S.), Comprehensive Stroke Center, and Department of Emergency Medicine, Los Angeles County Fire EMS Agency (F.P.), David Geffen School of Medicine, University of California, Los Angeles; Department of Neurology, Roxanna Todd Hodges Comprehensive Stroke Clinic (M.K.-T., N.S.) and Department of Emergency Medicine, Los Angeles Fire Department (M.E.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Emergency Medicine, Los Angeles EMS Agency, Orange County EMS Agency, Harbor-University of California, Los Angeles Medical Center (S.S.); Stanford University, Palo Alto, CA (S.H.); and National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.).
Scott HamiltonFrom the Department of Neurology, Busan-Ulsan Regional Cardiocerebrovascular Center, College of Medicine, Dong-A University, Busan, Republic of Korea (D.-H.K.); Departments of Neurology (J.L.S., D.S.L., L.K.A., L.R., M.V.-S.), Emergency Medicine and Neurology (S.S.), Comprehensive Stroke Center, and Department of Emergency Medicine, Los Angeles County Fire EMS Agency (F.P.), David Geffen School of Medicine, University of California, Los Angeles; Department of Neurology, Roxanna Todd Hodges Comprehensive Stroke Clinic (M.K.-T., N.S.) and Department of Emergency Medicine, Los Angeles Fire Department (M.E.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Emergency Medicine, Los Angeles EMS Agency, Orange County EMS Agency, Harbor-University of California, Los Angeles Medical Center (S.S.); Stanford University, Palo Alto, CA (S.H.); and National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.).
Robin ConwitFrom the Department of Neurology, Busan-Ulsan Regional Cardiocerebrovascular Center, College of Medicine, Dong-A University, Busan, Republic of Korea (D.-H.K.); Departments of Neurology (J.L.S., D.S.L., L.K.A., L.R., M.V.-S.), Emergency Medicine and Neurology (S.S.), Comprehensive Stroke Center, and Department of Emergency Medicine, Los Angeles County Fire EMS Agency (F.P.), David Geffen School of Medicine, University of California, Los Angeles; Department of Neurology, Roxanna Todd Hodges Comprehensive Stroke Clinic (M.K.-T., N.S.) and Department of Emergency Medicine, Los Angeles Fire Department (M.E.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Emergency Medicine, Los Angeles EMS Agency, Orange County EMS Agency, Harbor-University of California, Los Angeles Medical Center (S.S.); Stanford University, Palo Alto, CA (S.H.); and National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.).
Nerses SanossianFrom the Department of Neurology, Busan-Ulsan Regional Cardiocerebrovascular Center, College of Medicine, Dong-A University, Busan, Republic of Korea (D.-H.K.); Departments of Neurology (J.L.S., D.S.L., L.K.A., L.R., M.V.-S.), Emergency Medicine and Neurology (S.S.), Comprehensive Stroke Center, and Department of Emergency Medicine, Los Angeles County Fire EMS Agency (F.P.), David Geffen School of Medicine, University of California, Los Angeles; Department of Neurology, Roxanna Todd Hodges Comprehensive Stroke Clinic (M.K.-T., N.S.) and Department of Emergency Medicine, Los Angeles Fire Department (M.E.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Emergency Medicine, Los Angeles EMS Agency, Orange County EMS Agency, Harbor-University of California, Los Angeles Medical Center (S.S.); Stanford University, Palo Alto, CA (S.H.); and National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.).
Field Administration of Stroke Therapy–Magnesium (FAST-MAG) Trial Nurse-Coordinators and Investigators

Funding

Field Administration of Stroke Therapy-Magnesium Trial (FAST-MAG)U01NS044364 · NINDS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI SAVER, JEFFREY L · 2003 to 2013
$46.4M
NINDS NIH HHS U01 NS044364NINDS NIH HHS U01 NS 44364
6 · The paper itself

Abstract

background and purposeThe enrollment yield and reasons for screen failure in prehospital stroke trials have not been well delineated.

methodsThe Field Administration of Stroke Therapy-Magnesium (FAST-MAG) trial identified patients for enrollment using a 2 stage screening process-paramedics in person followed by physician-investigators by cell phone. Outcomes of consecutive screening calls from paramedics to enrolling physician-investigators were prospectively recorded.

resultsFrom 2005 to 2012, 4458 phone calls were made by paramedics to physician-investigators, an average of 1 call per vehicle every 135.7 days. A total of 1700 (38.1%) calls resulted in enrollments. The rate of enrollment of stroke mimics was 3.9%. Among the 2758 patients not enrolled, 3140 reasons for screen failure were documented. The most common reasons for nonenrollment were >2 hours from last known well (17.2%), having a prestroke condition causing disability (16.1%), and absence of a consent provider (9.5%). Novel barriers for phone informed consent specific to the prehospital setting were infrequent, but included: cell phone connection difficulties (3.2%), patient being hard of hearing (1.4%), insufficient time to complete consent (1.3%), or severely dysarthric (1.3%).

conclusionsIn this large, multicenter prehospital trial, nearly 40% of every calls from the field to physician-investigators resulted in trial enrollments. The most common reasons for nonenrollment were out of window last known well time, prestroke confounding medical condition, and absence of a consent provider. CLINICAL

trial registrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT00059332.

Indexed as

Patient SelectionAdultEmergency Medical ServicesFemaleHumansMaleMass ScreeningMiddle AgedStrokeTreatment Outcomecell phonesclinical trialinformed consentphysicianstroke

Identifiers

PMID26658446
PMCPMC4909489

What OpenQuestion holds

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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.