Evidence map›Paper›PMID 36746636›Full record

ReviewNeurology2023

Adapting to Evolving Technologies and Treatment Guidelines in a Procedural Trial: A Qualitative Review of the CREST-2 Experience.

James F Meschia, Brajesh Lal, Gary Roubin, Tanya N Turan, Virginia J Howard, Richard T Benson, Kaley Carman, George Howard, Thomas G Brott

Registry-linked trialOpen access · greenAbstract readReview
In one paragraph

Review in Neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02089217 (Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis Trial), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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.

NCT02089217 nacompletednot on this map

Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis Trial

TypeinterventionalSponsorMayo ClinicRan2014 to 2025Enrolled2,486ConditionsCarotid StenosisArmsCarotid endarterectomy (CEA), Carotid Stenting (CAS), Intensive Medical Management - no CEA, Intensive Medical Management - no CAS
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Trial
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

9 authors at 1 institution in 1 country.

James F MeschiaFrom the Mayo Clinic (J.F.M., K.C., T.G.B.), Jacksonville, FL; University of Maryland School of Medicine (B.L.), Baltimore; CREST-2 Executive Committee (G.R.), Jackson, WY; Medical University of South Carolina (T.N.T.), Charleston; University of Alabama at Birmingham (V.J.H., G.H.); and National Institute of Neurological Disorders and Stroke (R.T.B.), Bethesda, MD. meschia.james@mayo.edu.ORCID 0000-0002-4475-8142
Brajesh LalFrom the Mayo Clinic (J.F.M., K.C., T.G.B.), Jacksonville, FL; University of Maryland School of Medicine (B.L.), Baltimore; CREST-2 Executive Committee (G.R.), Jackson, WY; Medical University of South Carolina (T.N.T.), Charleston; University of Alabama at Birmingham (V.J.H., G.H.); and National Institute of Neurological Disorders and Stroke (R.T.B.), Bethesda, MD.ORCID 0000-0001-6724-8201
Gary RoubinFrom the Mayo Clinic (J.F.M., K.C., T.G.B.), Jacksonville, FL; University of Maryland School of Medicine (B.L.), Baltimore; CREST-2 Executive Committee (G.R.), Jackson, WY; Medical University of South Carolina (T.N.T.), Charleston; University of Alabama at Birmingham (V.J.H., G.H.); and National Institute of Neurological Disorders and Stroke (R.T.B.), Bethesda, MD.ORCID 0000-0002-3246-9239
Tanya N TuranFrom the Mayo Clinic (J.F.M., K.C., T.G.B.), Jacksonville, FL; University of Maryland School of Medicine (B.L.), Baltimore; CREST-2 Executive Committee (G.R.), Jackson, WY; Medical University of South Carolina (T.N.T.), Charleston; University of Alabama at Birmingham (V.J.H., G.H.); and National Institute of Neurological Disorders and Stroke (R.T.B.), Bethesda, MD.
Virginia J HowardFrom the Mayo Clinic (J.F.M., K.C., T.G.B.), Jacksonville, FL; University of Maryland School of Medicine (B.L.), Baltimore; CREST-2 Executive Committee (G.R.), Jackson, WY; Medical University of South Carolina (T.N.T.), Charleston; University of Alabama at Birmingham (V.J.H., G.H.); and National Institute of Neurological Disorders and Stroke (R.T.B.), Bethesda, MD.ORCID 0000-0003-4912-9975
Richard T BensonFrom the Mayo Clinic (J.F.M., K.C., T.G.B.), Jacksonville, FL; University of Maryland School of Medicine (B.L.), Baltimore; CREST-2 Executive Committee (G.R.), Jackson, WY; Medical University of South Carolina (T.N.T.), Charleston; University of Alabama at Birmingham (V.J.H., G.H.); and National Institute of Neurological Disorders and Stroke (R.T.B.), Bethesda, MD.ORCID 0000-0002-0551-7717
Kaley CarmanFrom the Mayo Clinic (J.F.M., K.C., T.G.B.), Jacksonville, FL; University of Maryland School of Medicine (B.L.), Baltimore; CREST-2 Executive Committee (G.R.), Jackson, WY; Medical University of South Carolina (T.N.T.), Charleston; University of Alabama at Birmingham (V.J.H., G.H.); and National Institute of Neurological Disorders and Stroke (R.T.B.), Bethesda, MD.ORCID 0000-0002-0931-6912
George HowardFrom the Mayo Clinic (J.F.M., K.C., T.G.B.), Jacksonville, FL; University of Maryland School of Medicine (B.L.), Baltimore; CREST-2 Executive Committee (G.R.), Jackson, WY; Medical University of South Carolina (T.N.T.), Charleston; University of Alabama at Birmingham (V.J.H., G.H.); and National Institute of Neurological Disorders and Stroke (R.T.B.), Bethesda, MD.
Thomas G BrottFrom the Mayo Clinic (J.F.M., K.C., T.G.B.), Jacksonville, FL; University of Maryland School of Medicine (B.L.), Baltimore; CREST-2 Executive Committee (G.R.), Jackson, WY; Medical University of South Carolina (T.N.T.), Charleston; University of Alabama at Birmingham (V.J.H., G.H.); and National Institute of Neurological Disorders and Stroke (R.T.B.), Bethesda, MD.ORCID 0000-0002-1266-0941
University of Maryland, Baltimore · US

Funding

CREST-2 Clinical Coordinating CenterU01NS080168 · NINDS · MAYO CLINIC JACKSONVILLE · PI Thomas G Brott, JAMES F MESCHIA · 2014 to 2026
$56.3M
CREST-2 Statistical and Data Coordinating Center - SDCCU01NS080165 · NINDS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI EDWARDS, LLOYD J · 2014 to 2025
$15.0M
NINDS NIH HHS U01 NS080165NINDS NIH HHS U01 NS080168
6 · The paper itself

Abstract

Multiple challenges confront procedural trials, including slow enrollment, lack of equipoise among patients and physicians, and failure to achieve adequate masking. Nonetheless, randomized clinical trials provide the best evidence of efficacy. The evolution of technology, techniques, and standards of care during the conduct of procedural trials challenges external validity. In this study, we review how a multicenter trial of revascularization of asymptomatic carotid arteries for stroke prevention has managed changes in treating carotid stenosis and medical management of atherothrombotic disease. TRIAL REGISTRATION INFORMATION: ClinicalTrials.gov number: NCT02089217.

Indexed as

Carotid StenosisEndarterectomy, CarotidStrokeCarotid ArteriesHumansMulticenter Studies as TopicResearch DesignStentsTreatment Outcome

Identifiers

PMID36746636
PMCPMC10259285
OpenAlexW4319301241

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.