Evidence map›Paper›PMID 33053953›Full record

ArticleJournal of stroke2020

Decision-Making Visual Aids for Late, Imaging-Guided Endovascular Thrombectomy for Acute Ischemic Stroke.

Pouria Moshayedi, David S Liebeskind, Ashutosh Jadhav, Reza Jahan, Maarten Lansberg, Latisha Sharma, Raul G Nogueira, Jeffrey L Saver

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of stroke, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.6field-weighted citation impact, top 30% 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, 7 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

8 authors at 4 institutions in 1 country.

Pouria MoshayediDepartment of Neurology and Comprehensive Stroke Center, University of California Los Angeles, Los Angeles, CA, USA.
David S LiebeskindDepartment of Neurology and Comprehensive Stroke Center, University of California Los Angeles, Los Angeles, CA, USA.
Ashutosh JadhavDepartment of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Reza JahanDepartment of Radiology and Comprehensive Stroke Center, University of California Los Angeles, Los Angeles, CA, USA.
Maarten LansbergDepartment of Neurology, Stanford University, Stanford, CA, USA.
Latisha SharmaDepartment of Neurology and Comprehensive Stroke Center, University of California Los Angeles, Los Angeles, CA, USA.
Raul G NogueiraDepartment of Neurology, Emory University, Atlanta, GA, USA.
Jeffrey L SaverDepartment of Neurology and Comprehensive Stroke Center, University of California Los Angeles, Los Angeles, CA, USA.
University of California, Los Angeles · USEmory University · USStanford University · USUniversity of Pittsburgh Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeSpeedy decision-making is important for optimal outcomes from endovascular thrombectomy (EVT) for acute ischemic stroke (AIS). Figural decision aids facilitate rapid review of treatment benefits and harms, but have not yet been developed for late-presenting patients selected for EVT based on multimodal computed tomography or magnetic resonance imaging.

methodsFor combined pooled study-level randomized trial (DAWN and DEFUSE 3) data, as well as each trial singly, 100 person-icon arrays (Kuiper-Marshall personographs) were generated showing beneficial and adverse effects of EVT for patients with AIS and large vessel occlusion using automated (algorithmic) and expert-guided joint outcome table specification.

resultsAmong imaging-selected patients 6 to 24 hours from last known well, for the full 7-category modified Rankin Scale (mRS), EVT had number needed to treat to benefit 1.9 (interquartile range [IQR], 1.9 to 2.1) and number needed to harm 40.0 (IQR, 29.2 to 58.3). Visual displays of treatment effects among 100 patients showed that, with EVT: 52 patients have better disability outcome, including 32 more achieving functional independence (mRS 0 to 2); three patients have worse disability outcome, including one more experiencing severe disability or death (mRS 5 to 6), mediated by symptomatic intracranial hemorrhage and infarct in new territory. Similar features were present in person-icon figures based on a 6-level mRS (levels 5 and 6 combined) rather than 7-level mRS, and based on the DAWN trial alone and DEFUSE 3 trial alone.

conclusionsPersonograph visual decision aids are now available to rapidly educate patients, family, and healthcare providers regarding benefits and risks of EVT for late-presenting, imaging-selected AIS patients.

Indexed as

InterventionStrokeThrombectomy

Identifiers

PMID33053953
PMCPMC7568977
OpenAlexW3089731831

What OpenQuestion holds

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LicenceCC BY-NC
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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.