Evidence map›Paper›PMID 29431141›Full record

Trial reportBMJ open2018

Does tranexamic acid lead to changes in MRI measures of brain tissue health in patients with spontaneous intracerebral haemorrhage? Protocol for a MRI substudy nested within the double-blind randomised controlled TICH-2 trial.

Rob A Dineen, Stefan Pszczolkowski, Katie Flaherty, Zhe K Law, Paul S Morgan, Ian Roberts, David J Werring, Rustam Al-Shahi Salman, Tim England, Philip M Bath and 1 more

Erratum issuedOpen access · goldAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 34% 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, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 2 countries.

Rob A DineenRadiological Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.
Stefan PszczolkowskiRadiological Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.ORCID 0000-0002-5859-3190
Katie FlahertyStroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.
Zhe K LawStroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.
Paul S MorganRadiological Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.
Ian RobertsClinical Trials Unit, London School of Hygiene and Tropical Medicine, London, UK.
David J WerringStroke Research Centre, University College London, London, UK.
Rustam Al-Shahi SalmanCentre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
Tim EnglandVascular Medicine, Division of Medical Sciences and GEM, University of Nottingham, Nottingham, UK.
Philip M BathStroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.
Nikola SpriggStroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.
University of Nottingham · GBNottingham University Hospitals NHS Trust · GBUniversity College London · GBUniversity of Edinburgh · GBUniversity of London · GB

Funding

British Heart Foundation PG/14/50/30891British Heart Foundation PG/14/96/31262British Heart Foundation SP/12/2/29422Department of Health 06/303/20Department of Health 11/129/109Department of Health HTA/14/190/01Medical Research Council G1002605Medical Research Council MR/M009211/1
6 · The paper itself

Abstract

objectivesTo test whether administration of the antifibrinolytic drug tranexamic acid (TXA) in patients with spontaneous intracerebral haemorrhage (SICH) leads to increased prevalence of diffusion-weighted MRI-defined hyperintense ischaemic lesions (primary hypothesis) or reduced perihaematomal oedema volume, perihaematomal diffusion restriction and residual MRI-defined SICH-related tissue damage (secondary hypotheses).

designMRI substudy nested within the double-blind randomised controlled Tranexamic Acid for Hyperacute Primary Intracerebral Haemorrhage (TICH)-2 trial (ISRCTN93732214).

settingInternational multicentre hospital-based study.

participantsEligible adults consented and randomised in the TICH-2 trial who were also able to undergo MRI scanning. To address the primary hypothesis, a sample size of n=280 will allow detection of a 10% relative increase in prevalence of diffusion-weighted imaging (DWI) hyperintense lesions in the TXA group with 5% significance, 80% power and 5% imaging data rejection.

interventionsTICH-2 MRI substudy participants will undergo MRI scanning using a standardised protocol at day ~5 and day ~90 after randomisation. Clinical assessments, randomisation to TXA or placebo and participant follow-up will be performed as per the TICH-2 trial protocol.

conclusionThe TICH-2 MRI substudy will test whether TXA increases the incidence of new DWI-defined ischaemic lesions or reduces perihaematomal oedema or final ICH lesion volume in the context of SICH. ETHICS AND DISSEMINATION: The TICH-2 trial obtained ethical approval from East Midlands - Nottingham 2 Research Ethics Committee (12/EM/0369) and an amendment to allow the TICH-2 MRI sub study was approved in April 2015 (amendment number SA02/15). All findings will be published in peer-reviewed journals. The primary outcome results will also be presented at a relevant scientific meeting. TRIAL REGISTRATION NUMBER: ISRCTN93732214; Pre-results.

Indexed as

Antifibrinolytic AgentsBrainCerebral HemorrhageDouble-Blind MethodHumansInternational CooperationLogistic ModelsMagnetic Resonance ImagingResearch DesignTranexamic AcidTreatment OutcomeAntifibrinolytic AgentsTranexamic Aciddiffusion weighted imaginghyperacute primary intracerebral haemorrhagemagnetic resonance imagingperihaematomal oedematranexamic acid

Identifiers

PMID29431141
PMCPMC5879748
OpenAlexW2785955226

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.