Trial reportStroke2020
Redefined Measure of Early Neurological Improvement Shows Treatment Benefit of Alteplase Over Placebo.
Trial report in Stroke, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Guidelines for Neuroprognostication in Critically ill Adults with Acute Ischemic Stroke.Neurocritical care · 2026Guideline
- Early neurological improvement with deferoxamine after intracerebral hemorrhage: A post hoc analysis of the i-DEF trial.International journal of stroke : official journal of the International Stroke Society · 2025Trial
- Twenty-Four-Hour Post-Thrombolysis NIHSS Score As the Strongest Prognostic Predictor After Acute Ischemic Stroke: ENCHANTED Study.Journal of the American Heart Association · 2024Trial
- Discharge NIHSS scores are predictive of poor 3-month outcomes in patients with acute Ischemic stroke receiving intravenous thrombolysis.Annals of medicine · 2026Article
- Remote Ischemic Conditioning in Patients With Acute Ischemic Stroke Ineligible for Recanalization Therapies: A Phase II Trial.Stroke (Hoboken, N.J.) · 2026Article
- Cut-off values of serum homocysteine and high-sensitivity CRP for predicting early neurological improvement after intravenous thrombolysis.BMC neurology · 2026Article
- [A prediction model for early neurological improvement after intravenous thrombolysis in patients with acute ischemic stroke].Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2026Article
- The Impact of Alteplase Coverage on Health Equity for the Treatment of Ischemic Stroke in the USA: A Distributional Cost-Effectiveness Analysis.Applied health economics and health policy · 2025Article
- Optimizing Surgical Strategies for Elderly Patients With Femoral Neck Fracture: The Critical Role of Comorbidities.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025Article
- Time-variant and tissue-level collaterals predict postoperative neurological recovery and clinical outcomes of patients with endovascular thrombectomy.Quantitative imaging in medicine and surgery · 2025Article
- Late neurological improvement during hospitalization is a predicative factor for acute ischemic stroke.European journal of medical research · 2025Article
- Early statin use might reduce the hemorrhagic transformation among acute ischemic stroke patients with recanalization therapy: a retrospective cohort study.Frontiers in pharmacology · 2025Article
- Prolonged venous transit is associated with worse neurological recovery in successfully reperfused large vessel strokes.Annals of clinical and translational neurology · 2025Article
- Timing Is Everything, Even for the ENCHANTED National Institutes of Health Stroke Scale.Journal of the American Heart Association · 2024Article
- Perfusion Abnormalities on 24-Hour Perfusion Imaging in Patients With Complete Endovascular Reperfusion.Stroke · 2024Article
- Machine learning-based predictive model for the development of thrombolysis resistance in patients with acute ischemic stroke.BMC neurology · 2024Article
- Decoding Molecular Mechanisms Underlying Outcomes After Ischemic Stroke Thrombectomy by RNA Sequencing of Retrieved Clots.Molecular diagnosis & therapy · 2024Article
- Investigating Neurologic Improvement After IV Thrombolysis: The Effect of Time From Stroke Onset vs Imaging-Based Tissue Clock.Neurology · 2023Observational
- Treatment of acute ischemic stroke in patients with active malignancy: insight from a comprehensive stroke center.Therapeutic advances in neurological disorders · 2023Article
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Authors and funding
19 authors.
Funding
Abstract
Background and Purpose- The first of the 2 NINDS (National Institute of Neurological Disorders and Stroke) Study trials did not show a significant increase in early neurological improvement, defined as National Institutes of Health Stroke Scale (NIHSS) improvement by ≥4, with alteplase treatment. We hypothesized that early neurological improvement defined as a percentage change in NIHSS (percent change NIHSS) at 24 hours is superior to other definitions in predicting 3-month functional outcomes and using this definition there would be treatment benefit of alteplase over placebo at 24 hours. Methods- We analyzed the NINDS rt-PA Stroke Study (Parts 1 and 2) trial data. Percent change NIHSS was defined as ([admission NIHSS score-24-hour NIHSS score]×100/admission NIHSS score] and delta NIHSS as (admission NIHSS score-24-hour NIHSS score). We compared early neurological improvement using these definitions between alteplase versus placebo patients. We also used receiver operating characteristic curve to determine the predictive association of early neurological improvement with excellent 3-month functional outcomes (Barthel Index score of 95-100 and modified Rankin Scale score of 0-1), good 3-month functional outcome (modified Rankin Scale score of 0-2), and 3-month infarct volume. Results- There was a significantly greater improvement in the 24-hour median percent change NIHSS among patients treated with alteplase compared with the placebo group (28% versus 15%;
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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.