Evidence map›Paper›PMID 38870459›Full record

ArticleNeurology2024

Journal Club: Prehospital Detection of Large Vessel Occlusion Stroke With Electroencephalography: Results of the ELECTRA-STROKE Study.

Marieta Peycheva, Andrea Seiler, Franca Wagner, Linxin Li, Mirjam R Heldner

Abstract read
In one paragraph

Article in Neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
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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

5 authors.

Marieta PeychevaFrom the Department of Neurology (M.P.), Medical University of Plovdiv; Research Institute at Medical University of Plovdiv (M.P.), Bulgaria; Department of Neurology (A.S., M.R.H.), and Institute of Diagnostic and Interventional Neuroradiology (F.W.), Inselspital, University Hospital and University of Bern, Switzerland; and Wolfson Centre for the Prevention of Stroke and Dementia (L.L.), Nuffield Department of Clinical Neurosciences, Wolfson Building-John Radcliffe Hospital, University of Oxford, United Kingdom.
Andrea SeilerFrom the Department of Neurology (M.P.), Medical University of Plovdiv; Research Institute at Medical University of Plovdiv (M.P.), Bulgaria; Department of Neurology (A.S., M.R.H.), and Institute of Diagnostic and Interventional Neuroradiology (F.W.), Inselspital, University Hospital and University of Bern, Switzerland; and Wolfson Centre for the Prevention of Stroke and Dementia (L.L.), Nuffield Department of Clinical Neurosciences, Wolfson Building-John Radcliffe Hospital, University of Oxford, United Kingdom.
Franca WagnerFrom the Department of Neurology (M.P.), Medical University of Plovdiv; Research Institute at Medical University of Plovdiv (M.P.), Bulgaria; Department of Neurology (A.S., M.R.H.), and Institute of Diagnostic and Interventional Neuroradiology (F.W.), Inselspital, University Hospital and University of Bern, Switzerland; and Wolfson Centre for the Prevention of Stroke and Dementia (L.L.), Nuffield Department of Clinical Neurosciences, Wolfson Building-John Radcliffe Hospital, University of Oxford, United Kingdom.ORCID 0000-0001-7502-4814
Linxin LiFrom the Department of Neurology (M.P.), Medical University of Plovdiv; Research Institute at Medical University of Plovdiv (M.P.), Bulgaria; Department of Neurology (A.S., M.R.H.), and Institute of Diagnostic and Interventional Neuroradiology (F.W.), Inselspital, University Hospital and University of Bern, Switzerland; and Wolfson Centre for the Prevention of Stroke and Dementia (L.L.), Nuffield Department of Clinical Neurosciences, Wolfson Building-John Radcliffe Hospital, University of Oxford, United Kingdom.ORCID 0000-0002-3636-8355
Mirjam R HeldnerFrom the Department of Neurology (M.P.), Medical University of Plovdiv; Research Institute at Medical University of Plovdiv (M.P.), Bulgaria; Department of Neurology (A.S., M.R.H.), and Institute of Diagnostic and Interventional Neuroradiology (F.W.), Inselspital, University Hospital and University of Bern, Switzerland; and Wolfson Centre for the Prevention of Stroke and Dementia (L.L.), Nuffield Department of Clinical Neurosciences, Wolfson Building-John Radcliffe Hospital, University of Oxford, United Kingdom.ORCID 0000-0002-3594-2159

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The ELECTRA-STROKE study investigated the potential of EEG for prehospital triage of patients with ischemic stroke due to large vessel occlusion (LVO), in which fast triage to stroke centers for endovascular treatment is crucial. The study was conducted in 4 phases, and this Journal Club article focuses on the fourth phase in the prehospital setting with suspected stroke patients. An EEG cap with dry electrodes was used to measure brain activity. The main focus was on the diagnostic accuracy of the theta/alpha ratio, which yielded an area under the receiver operator characteristic curve (AUC) of 0.80. Secondary endpoints, particularly the Brain Symmetry Index (a quantified EEG interhemispheric cortical power asymmetry index) in the delta frequency band, showed an AUC of 0.91. Despite the convenient study design and user-friendly EEG device, limitations include a single-arm design, a relatively small sample size, and exclusions due to data quality issues. The usefulness of EEG in the detection of neuronal changes based on brain ischemia was highlighted, but uncertainties remain regarding its use in certain patient groups. The improvements in the Brain Symmetry Index from phase 3 to 4 of the study indicate the potential for further refinement and investigation of combined methods to improve diagnostic accuracy. The study provides insight into the role of EEG in prehospital stroke detection, recognizing both the strengths and limitations. Overall, the study contributes to understanding the promise of EEG in optimizing LVO stroke triage and urges further refinement and exploration of complementary diagnostic approaches.

Indexed as

ElectroencephalographyEmergency Medical ServicesAgedBrain IschemiaFemaleHumansIschemic StrokeMaleStrokeTriage

Identifiers

PMID38870459
PMCPMC12296629

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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.