Evidence map›Paper›PMID 38347736›Full record

ArticleEuropean stroke journal2024

Swiss trial of decompressive craniectomy versus best medical treatment of spontaneous supratentorial intracerebral haemorrhage (SWITCH): an international, multicentre, randomised-controlled, two-arm, assessor-blinded trial.

Urs Fischer, Christian Fung, Seraina Beyeler, Lukas Bütikofer, Werner Z'Graggen, Florian Ringel, Jan Gralla, Karl Schaller, Nikolaus Plesnila, Daniel Strbian and 12 more

Registry-linked trialOpen access · bronzeAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in European stroke journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02258919 (Swiss Trial of Decompressive Craniectomy Versus Best Medical Treatment of Spontaneous Supratentorial Intracerebral Hemorrhage), which is not on this map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
3.7field-weighted citation impact, top 7% 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.

NCT02258919 nacompletednot on this map

Swiss Trial of Decompressive Craniectomy Versus Best Medical Treatment of Spontaneous Supratentorial Intracerebral Hemorrhage (SWITCH): a Randomized Controlled Trial

TypeinterventionalSponsorInsel Gruppe AG, University Hospital BernRan2014 to 2024Enrolled201ConditionsCerebral HemorrhageArmsDecompressive craniectomy (DC) and best medical treatment, Best medical treatment
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Surgery for spontaneous supratentorial intracerebral haemorrhage.The Cochrane database of systematic reviews · 2025
    Pooled it
  2. Trial
  3. Review
  4. Article
  5. Article
  6. Article
  7. Specific Reversal Agents for Direct Oral Anticoagulants in Acute Stroke.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    Review
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

22 authors at 10 institutions in 5 countries.

Urs FischerDepartment of Neurology, University Hospital and University of Bern, Bern, Switzerland.ORCID 0000-0003-0521-4051
Christian FungDepartment of Neurosurgery, University Hospital and University of Bern, Bern, Switzerland.
Seraina BeyelerDepartment of Neurology, University Hospital and University of Bern, Bern, Switzerland.
Lukas BütikoferCTU Bern, Department of Clinical Research, University of Bern, Bern, Switzerland.
Werner Z'GraggenDepartment of Neurology, University Hospital and University of Bern, Bern, Switzerland.ORCID 0000-0002-5684-4419
Florian RingelDepartment of Neurosurgery, University Medical Center Mainz, Germany.
Jan GrallaInstitute of Diagnostic and Interventional Neuroradiology, University Hospital and University of Bern, Bern, Switzerland.
Karl SchallerDepartment of Neurosurgery, University of Geneva, Geneva, Switzerland.
Nikolaus PlesnilaInstitute for Stroke and Dementia Research, University Hospital Munich, Munich, Germany.
Daniel StrbianDepartment of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.ORCID 0000-0001-9095-2344
Marcel ArnoldDepartment of Neurology, University Hospital and University of Bern, Bern, Switzerland.
Werner HackeDepartment of Neurology, University Hospital Heidelberg, Heidelberg, Germany.
Peter JüniDepartment of Medicine, University of Toronto, Toronto, ON, Canada.
Alexander David MendelowDepartment of Neurosurgery, Newcastle General Hospital, Newcastle Upon Tyne, UK.
Christian StapfDepartment of Neurosciences, Université de Montréal, and Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.
Rustam Al-Shahi SalmanCentre for Clinical Brain Sciences, The University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, UK.ORCID 0000-0002-2108-9222
Jenny BressanDepartment of Neurology, University Hospital and University of Bern, Bern, Switzerland.ORCID 0000-0002-5078-569X
Stefanie LerchDepartment of Neurology, University Hospital and University of Bern, Bern, Switzerland.
Claudio L A BassettiDepartment of Neurology, University Hospital and University of Bern, Bern, Switzerland.
Heinrich P MattleDepartment of Neurology, University Hospital and University of Bern, Bern, Switzerland.ORCID 0000-0001-7968-1731
Andreas RaabeDepartment of Neurosurgery, University Hospital and University of Bern, Bern, Switzerland.
Jürgen BeckDepartment of Neurosurgery, University Hospital and University of Bern, Bern, Switzerland.
University of Bern · CHCentre Hospitalier de l’Université de Montréal · CAEdinburgh Royal Infirmary · GBHeidelberg University · DEJohannes Gutenberg University Mainz · DEMünchen Klinik · DENorth Tyneside General Hospital · GBUniversity of Geneva · CHUniversity of Helsinki · FIUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

rationaleDecompressive craniectomy (DC) is beneficial in people with malignant middle cerebral artery infarction. Whether DC improves outcome in spontaneous intracerebral haemorrhage (ICH) is unknown.

aimTo determine whether DC without haematoma evacuation plus best medical treatment (BMT) in people with ICH decreases the risk of death or dependence at 6 months compared to BMT alone. METHODS AND

designSWITCH is an international, multicentre, randomised (1:1), two-arm, open-label, assessor-blinded trial. Key inclusion criteria are age ⩽75 years, stroke due to basal ganglia or thalamic ICH that may extend into cerebral lobes, ventricles or subarachnoid space, Glasgow coma scale of 8-13, NIHSS score of 10-30 and ICH volume of 30-100 mL. Randomisation must be performed <66 h after onset and DC <6 h after randomisation. Both groups will receive BMT. Participants randomised to the treatment group will receive DC of at least 12 cm in diameter according to institutional standards. SAMPLE SIZE: A sample of 300 participants randomised 1:1 to DC plus BMT versus BMT alone provides over 85% power at a two-sided alpha-level of 0.05 to detect a relative risk reduction of 33% using a chi-squared test. OUTCOMES: The primary outcome is the composite of death or dependence, defined as modified Rankin scale score 5-6 at 6 months. Secondary outcomes include death, functional status, quality of life and complications at 180 days and 12 months. DISCUSSION: SWITCH will inform physicians about the outcomes of DC plus BMT in people with spontaneous deep ICH, compared to BMT alone.

trial registrationClinicalTrials.gov Identifier: NCT02258919.

Indexed as

Cerebral HemorrhageDecompressive CraniectomyAdultAgedFemaleHumansMaleMiddle AgedMulticenter Studies as TopicRandomized Controlled Trials as TopicSwitzerlandTreatment Outcomedecompressive craniectomyIntracerebral haemorrhagerandomised-controlled trial

Identifiers

PMID38347736
PMCPMC11418560
OpenAlexW4391785225

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.