Evidence map›Paper›PMID 30364030›Full record

ArticleNeurology research international2018

Knowledge and Attitudes of Saudi Emergency Physicians toward t-PA Use in Stroke.

Ali M Al Khathaami, Haya Aloraini, S Almudlej, Haifa Al Issa, Nourhan Elshammaa, Sami Alsolamy

Open access · goldAbstract read
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Article in Neurology research international, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed, 13 citations in OpenAlex.

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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

6 authors at 2 institutions in 1 country.

Ali M Al KhathaamiKing Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia.ORCID 0000-0002-5992-6807
Haya AlorainiCollege of Medicine, King Saud Bin Abdul Aziz University for Health Sciences, Riyadh, Saudi Arabia.
S AlmudlejCollege of Medicine, King Saud Bin Abdul Aziz University for Health Sciences, Riyadh, Saudi Arabia.
Haifa Al IssaCollege of Medicine, King Saud Bin Abdul Aziz University for Health Sciences, Riyadh, Saudi Arabia.
Nourhan ElshammaaKing Khalid University Hospital, Riyadh, Saudi Arabia.
Sami AlsolamyKing Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia.
King Saud bin Abdulaziz University for Health Sciences · SAKing Khalid University Hospital · SA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesTissue plasminogen activator (t-PA) within 4.5 hours from onset improves outcome in patients with ischemic stroke and has been recommended by several international guidelines. Since its approval in 1996, the debate among emergency physicians continues particularly around the result interpretation of the first positive randomized controlled trial, the National Institute of Neurological Disorders and Stroke (NINDS) clinical trial. This lack of consensus might negatively affect the delivery of effective stroke care. Here we aimed to assess the knowledge and attitude of Saudi emergency physicians toward t-PA use within 4.5 hours of onset in acute ischemic stroke.

methodsA web-based, self-administered, locally designed questionnaire was sent to all emergency physicians practicing in the city of Riyadh from January to September 2017.

resultsOut of 450 emergency physicians, 122 from ten hospitals in Riyadh participated in the survey, with a 27% response rate. The majority of participants were men (78%), and their mean age was 40 ± 8 years. Half of the participants were board certified, and 36% were consultants. Half of the participants consider the evidence for t-PA use in stroke within 4.5 hours of stroke onset to be controversial, and 41% recommend against its use due to lack of proven efficacy (37%), the risk of hemorrhagic complications (35%), lack of stroke expertise (21%), and medicolegal liability (9%). Nearly half were willing to administer IV t-PA for ischemic stroke in collaboration with remote stroke neurology consultation if telestroke is implemented.

conclusionOur study detected inadequate knowledge and a negative attitude among Saudi emergency physicians toward t-PA use in acute stroke. This might negatively impact patient outcome. Therefore, we recommend developing urgent strategies to improve emergency physicians' knowledge, attitudes, and beliefs in the management of acute stroke.

Identifiers

PMID30364030
PMCPMC6188773
OpenAlexW2895706505

What OpenQuestion holds

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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.