Evidence map›Paper›PMID 28615423›Full record

SynthesisNeurology2017

Diagnosis of DWI-negative acute ischemic stroke: A meta-analysis.

Brian L Edlow, Shelley Hurwitz, Jonathan A Edlow

Open access · greenAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Neurology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 101 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
101citing papers in PubMed, 3 pooled it
7.4field-weighted citation impact, top 2% 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

101 citing papers in PubMed, 3 syntheses or guidelines pooled it, 201 citations in OpenAlex.

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  19. Young stroke: An update on epidemiology, emerging risk factors, and future research directions.International journal of stroke : official journal of the International Stroke Society · 2026
    Review
  20. Article

41 more citing papers are in PubMed but not listed here.

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

3 authors at 1 institution in 1 country.

Brian L EdlowFrom the Department of Neurology (B.L.E.) and Athinoula A. Martinos Center for Biomedical Imaging (B.L.E.), Massachusetts General Hospital, Department of Medicine (S.H.), Brigham and Women's Hospital, and Department of Emergency Medicine (J.A.E.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. bedlow@mgh.harvard.edu.
Shelley HurwitzFrom the Department of Neurology (B.L.E.) and Athinoula A. Martinos Center for Biomedical Imaging (B.L.E.), Massachusetts General Hospital, Department of Medicine (S.H.), Brigham and Women's Hospital, and Department of Emergency Medicine (J.A.E.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Jonathan A EdlowFrom the Department of Neurology (B.L.E.) and Athinoula A. Martinos Center for Biomedical Imaging (B.L.E.), Massachusetts General Hospital, Department of Medicine (S.H.), Brigham and Women's Hospital, and Department of Emergency Medicine (J.A.E.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Athinoula A. Martinos Center for Biomedical Imaging · US

Funding

Brainstem Network Determinants of Recovery from Traumatic ComaK23NS094538 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI EDLOW, BRIAN L. · 2015 to 2019
$994k
NINDS NIH HHS K23 NS094538
6 · The paper itself

Abstract

objectiveTo determine the prevalence of diffusion-weighted imaging (DWI)-negative acute ischemic stroke (AIS) and to identify clinical characteristics of patients with DWI-negative AIS.

methodsWe systematically searched PubMed and Ovid/MEDLINE for relevant studies between 1992, the year that the DWI sequence entered clinical practice, and 2016. Studies were included based upon enrollment of consecutive patients presenting with a clinical diagnosis of AIS prior to imaging. Meta-analysis was performed to synthesize study-level data, estimate DWI-negative stroke prevalence, and estimate the odds ratios (ORs) for clinical characteristics associated with DWI-negative stroke.

resultsTwelve articles including 3,236 AIS patients were included. The meta-analytic synthesis yielded a pooled prevalence of DWI-negative AIS of 6.8%, 95% confidence interval (CI) 4.9-9.3. In the 5 studies that reported proportion data for DWI-negative and DWI-positive AIS based on the ischemic vascular territory (n = 1,023 AIS patients), DWI-negative stroke was strongly associated with posterior circulation ischemia, as determined by clinical diagnosis at hospital discharge or repeat imaging (OR 5.1, 95% CI 2.3-11.6,

conclusionsA small but significant percentage of patients with AIS have a negative DWI scan. Patients with neurologic deficits consistent with posterior circulation ischemia have 5 times the odds of having a negative DWI scan compared to patients with anterior circulation ischemia. AIS remains a clinical diagnosis and urgent reperfusion therapy should be considered even when an initial DWI scan is negative.

Indexed as

Diffusion Magnetic Resonance ImagingBrainBrain IschemiaHumansStroke

Identifiers

PMID28615423
PMCPMC5513816
OpenAlexW2626240064

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.