ArticleJournal of the American Heart Association2025
Cognitive Assessments in Randomized Controlled Trials of Acute or Secondary Prevention Stroke Treatments 2011 to 2024: A Scoping Review.
Article in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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.
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Who cites it
1 citing paper in PubMed.
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Authors and funding
21 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCognitive impairment after stroke is common and associated with poorer outcomes. However, cognition is rarely assessed in acute or secondary prevention randomized controlled trials (RCTs), and those that do have not been systematically synthesized. This review examines how often cognitive end points are used, specific assessments applied, domains tested, and rates of missing cognitive data.
methodsWe performed a search on EMBASE, PsycINFO, MEDLINE and Cumulative Index to Nursing and Allied Health for RCTs involving adult (≥18 years) participants with stroke, published from 2011 to 2024. Abstracts and full-text publications were screened for stroke RCTs with cognitive end points. These were categorized into acute, secondary prevention, and rehabilitation trials. Descriptive statistics summarized the frequency of cognitive end points, domains, and missing data rates in acute and prevention trials.
resultsOf 12 822 screened studies, 980 met criteria for full-text screening and 406 were stroke RCTs with a cognitive end point. Among these, 43 were acute and secondary prevention RCTs eligible for data extraction. The Mini-Mental State Examination (22/43 studies, 52%) and Montreal Cognitive Assessment (18/43 studies, 42%) were used in the most RCTs. There were 66 distinct cognitive tasks used, with greatest diversity in memory tasks (19), executive tasks (11) and global screens (11). Mean missing data were 22.2% (SD: 10.4%, range 0%-62%).
conclusionsCognitive tasks are infrequent outcomes in stroke RCTs. When used, the tasks and domains assessed vary widely and are heavily affected by missing data. More pragmatic approaches to measuring meaningful cognitive change in all clinical trial participants are needed.
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