Evidence map›Paper›PMID 34983242›Full record

Trial reportStroke2022

Health Screening Program to Enhance Enrollment of Women and Minorities in CREST-2.

Brajesh K Lal, James F Meschia, Michael Jones, Herbert D Aronow, Angelica Lackey, Rachel Lake, George Howard, Thomas G Brott

Open access · bronzeAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Stroke, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.5field-weighted citation impact, top 38% 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

0 citing papers in PubMed, 3 citations in OpenAlex.

No citing paper in PubMed yet.

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.

Brajesh K LalDepartment of Vascular Surgery, University of Maryland School of Medicine and Baltimore VA Medical Center, Baltimore, MD (B.K.L., H.D.A., A.L., R.L.).
James F MeschiaDepartment of Neurology, Mayo Clinic, Jacksonville, FL (J.F.M., T.G.B.).
Michael JonesDepartment of Cardiology, Baptist Health, Lexington, KY (M.J.).ORCID 0000-0001-9118-755X
Herbert D AronowDepartment of Vascular Surgery, University of Maryland School of Medicine and Baltimore VA Medical Center, Baltimore, MD (B.K.L., H.D.A., A.L., R.L.).
Angelica LackeyDepartment of Vascular Surgery, University of Maryland School of Medicine and Baltimore VA Medical Center, Baltimore, MD (B.K.L., H.D.A., A.L., R.L.).ORCID 0000-0001-8521-9826
Rachel LakeDepartment of Vascular Surgery, University of Maryland School of Medicine and Baltimore VA Medical Center, Baltimore, MD (B.K.L., H.D.A., A.L., R.L.).ORCID 0000-0002-5983-5585
George HowardDepartment of Biostatistics, University of Alabama at Birmingham (G.H.).
Thomas G BrottDepartment of Neurology, Mayo Clinic, Jacksonville, FL (J.F.M., T.G.B.).
University of Maryland, Baltimore · USJacksonville College · USCentral Baptist Hospital · USUniversity of Alabama at Birmingham · US

Funding

CREST-2 Clinical Coordinating CenterU01NS080168 · NINDS · MAYO CLINIC JACKSONVILLE · PI Thomas G Brott, JAMES F MESCHIA · 2014 to 2026
$56.3M
NSTN National Clinical Coordinating CenterU01NS086872 · NINDS · UNIVERSITY OF CINCINNATI · PI Joseph Paul Broderick, Pooja Khatri · 2013 to 2026
$32.3M
CREST-2 Statistical and Data Coordinating Center - SDCCU01NS080165 · NINDS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI EDWARDS, LLOYD J · 2014 to 2025
$15.0M
Genetic variation in white matter hyperintensity and risk of ischemic strokeK23NS064052 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI ROST, NATALIA S · 2009 to 2013
$915k
CSRD VA I01 CX001621NINDS NIH HHS K23 NS064052NINDS NIH HHS U01 NS080165NINDS NIH HHS U01 NS080168NINDS NIH HHS U01 NS086872
6 · The paper itself

Abstract

background and purposeThe CREST-2 (Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis Trial) consists of 2 parallel randomized stroke prevention trials in patients with asymptomatic high-grade stenosis of the cervical carotid artery. The purpose of this report is to detail the outcomes of a health screening effort to increase trial enrollment of women and minorities.

methodsLife Line screening (LLS) conducts nationwide screening for vascular disease. Screenings within a 50-mile radius of each CREST-2 center were identified for participation in a joint CREST-LLS program over the course of one year (November 2018 to October 2019) whereby patients with an abnormal carotid ultrasound were referred to the local CREST-2 center for further workup, management, and potential consideration for trial enrollment.

resultsLLS completed the screening of 588 198 individuals in 29 732 zip codes across the United States. Of those, 230 021 individuals were screened at events occurring near a CREST-2 clinical center and 646 (0.3%) were found to have abnormal carotid ultrasound findings. Each of the 646 individuals was contacted by CREST-LLS program staff for permission to be referred to their local CREST-2 center; 200 (31%) consented to be contacted by CREST-2. Of those, 39 (19.5%) agreed to be, and were, evaluated at their local CREST-2 center. High-grade stenosis was confirmed in 27 patients. A total of 3 patients were eligible for the trial and were enrolled, one woman but no racial/ethnic minorities.

conclusionsThe LLS program appears to identify community-living individuals with high-grade carotid stenosis through ultrasonography. However, the prevalence of abnormal carotid findings was low. In addition, screening and offering participation into the CREST-2 trial had no substantial impact on the proportion of women and minorities enrolled in the trial. Additional innovative strategies are needed to promote enrollment of diverse patients with carotid stenosis into stroke prevention trials.

Indexed as

Endarterectomy, CarotidWomenAdultAgedCarotid StenosisFemaleHumansIndependent LivingMaleMass ScreeningMiddle AgedMinority HealthPrevalenceStrokeTreatment OutcomeUltrasonographycarotid arteriescarotid endarterectomycarotid stenosisprevalenceultrasonography

Identifiers

PMID34983242
PMCPMC9512267
OpenAlexW4205360398

What OpenQuestion holds

Textmetadata
LicenceTDM
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.