Evidence map›Paper›PMID 40356012›Full record

ArticleInternational journal of stroke : official journal of the International Stroke Society2025

International Care Bundle Evaluation in Cerebral Hemorrhage Research (I-CATCHER): Study protocol for a multicenter, batched, parallel, cluster-randomized trial with a baseline period.

Trine Apostolaki-Hansson, Menglu Ouyang, Dar Dowlatshahi, Valeria Caso, Alessandro Bufi, Zhe Kang Law, Laurent Billot, Bo Norrving, Craig S Anderson, Teresa Ullberg

Registry-linked trialAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of stroke : official journal of the International Stroke Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06429332 (International Care Bundle Evaluation in Cerebral Hemorrhage Research - a Batched Parallel Cluster-randomized Trial With a Baseline Period), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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.

NCT06429332 phase4recruitingnot on this map

International Care Bundle Evaluation in Cerebral Hemorrhage Research - a Batched Parallel Cluster-randomized Trial With a Baseline Period

TypeinterventionalSponsorRegion SkaneRan2025 to 2027Enrolled3,500ConditionsIntracerebral Hemorrhage, Intracerebral Haemorrhage, Intraventricular Hemorrhage, StrokeArmsReversal of Oral anticoagulation within 30 minutes, Early intensive blood pressure lowering, Treatment of pyrexia, Hyperglycemia treatment, Do-not-resuscitate (DNR) or withdrawal of care
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Time is brain: an expanded concept, not only for ischemic stroke A viewpoint of the Italian Association for Emergency Neurology (ANEU).Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Review
  2. Review
  3. The intracerebral hemorrhage checklist.Journal of neurology · 2025
    Article
  4. Article
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

10 authors.

Trine Apostolaki-HanssonDepartment of Neurology, Skåne University Hospital, Malmö, Sweden.ORCID 0000-0003-4063-5476
Menglu OuyangThe George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.ORCID 0000-0001-7917-6858
Dar DowlatshahiDepartment of Medicine (Neurology), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.ORCID 0000-0003-1379-3612
Valeria CasoStroke Unit, Department of Emergency and Vascular Medicine Santa Maria della MIsericordia Hospital, University of Perugia, Perugia, Italy.ORCID 0000-0002-2020-8891
Alessandro BufiStroke Unit, Department of Emergency and Vascular Medicine Santa Maria della MIsericordia Hospital, University of Perugia, Perugia, Italy.
Zhe Kang LawDepartment of Medicine, Faculty of Medicine, National University of Malaysia (UKM), Kuala Lumpur, Malaysia.ORCID 0000-0002-7900-9037
Laurent BillotThe George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.ORCID 0000-0002-4975-9793
Bo NorrvingDepartment of Clinical Sciences Lund, Lund University, Lund, Sweden.
Craig S AndersonThe George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.ORCID 0000-0002-7248-4863
Teresa UllbergDepartment of Neurology, Skåne University Hospital, Malmö, Sweden.ORCID 0000-0002-6717-0915

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

rationaleA care bundle approach to the management of spontaneous intracerebral hemorrhage (ICH) has been shown to benefit patients in low- and middle-income countries (LMIC), but uncertainty persists over the specific components and its applicability in high-income countries (HICs).

aimsAn international collaborative initiative aimed at determining whether implementation of a care bundle improves functional outcome for patients with ICH in HIC.

methodsAn international, multicenter, batched, parallel, cluster-randomized clinical trial focused on implementation and quality improvement for adults with spontaneous ICH ⩽ 24 h of symptom onset. The care bundle includes time- and target-based interventions: early intensive blood pressure lowering, hyperglycemia and pyrexia management, anticoagulation reversal, avoidance of do-not-resuscitate orders, repeat imaging, and referral pathways for intensive care and neurosurgery. An embedded process evaluation will assess the effectiveness and implementation of the care bundle. SAMPLE SIZE: A total of 110 hospitals with 3500 ICH participants is estimated to provide 90% power (α = 0.05) to detect a plausible treatment effect of 0.20 improvement in utility-weighted modified Rankin scale (UW-mRS) scores. OUTCOMES: The primary outcome is UW-mRS at 6 months. Secondary outcomes include death, functional status, and health-related quality of life. Implementation outcomes include adoption, fidelity, acceptability, sustainability, and integration. DISCUSSION: We aim to provide reliable evidence to accelerate practice change for integration of a multifaceted ICH care bundle as a critical component of acute stroke care worldwide.

trial registrationClinicaltrials.gov Identifier: NCT06429332.

Indexed as

Cerebral HemorrhagePatient Care BundlesHumansMulticenter Studies as TopicRandomized Controlled Trials as TopicTreatment Outcomeblood pressure loweringcare bundlecluster trialimplementationIntracerebral hemorrhageoutcome

Identifiers

PMID40356012
PMCPMC12264302

What OpenQuestion holds

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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.