Evidence map›Paper›PMID 42088320›Full record

ArticleStroke (Hoboken, N.J.)2026

Prehospital Detection of Large Vessel Occlusion and Intracerebral Hemorrhage Using a Dual-Biomarker Point-of-Care Test.

Arnab Ghosh, Noah L A Nawabi, Diana Alcedo, Rodolfo E Alcedo Guardia, Juan Vicenty-Padilla, Saef Izzy, Nirav J Patel, Rose Du, Adam A Dmytriw, Alfred P See and 8 more

Registry-linked trialAbstract read
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In one paragraph

Article in Stroke (Hoboken, N.J.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04292600 (Testing of Identification Markers for Stroke), 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
–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.

NCT04292600 completednot on this map

Testing of Identification Markers for Stroke

TypeobservationalSponsorPOCKiT diagnostics LtdRan2021 to 2023Enrolled383ConditionsStroke, Ischemic, Infarction, Middle Cerebral Artery, Infarction, Anterior Circulation, BrainArmsPOCKiT diagnostics' algorithm for LVO detection
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. 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

18 authors.

Arnab GhoshMedical Sciences Division, University of Oxford, United Kingdom (A.G.).
Noah L A NawabiComputational Neuroscience Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (N.L.A.N.).
Diana AlcedoPonce Health Sciences University, Puerto Rico (D.A.).
Rodolfo E Alcedo GuardiaNeurosurgery Section, School of Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan (R.E.A.G., J.V.-P.).ORCID https://orcid.org/0009-0006-1845-263X
Juan Vicenty-PadillaNeurosurgery Section, School of Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan (R.E.A.G., J.V.-P.).ORCID https://orcid.org/0000-0002-1903-8485
Saef IzzyDepartment of Neurology (S.I.), Brigham and Women's Hospital, Boston, MA.ORCID https://orcid.org/0000-0002-2822-6736
Nirav J PatelDepartment of Neurosurgery (N.J.P., R.D., M.A.A.-S., E.F.T., A.C., L.S., J.D.B.), Brigham and Women's Hospital, Boston, MA.ORCID https://orcid.org/0000-0003-1725-3293
Rose DuDepartment of Neurosurgery (N.J.P., R.D., M.A.A.-S., E.F.T., A.C., L.S., J.D.B.), Brigham and Women's Hospital, Boston, MA.ORCID https://orcid.org/0000-0003-2641-6496
Adam A DmytriwNeurointerventional and Neuroanalytics Collaboration, School of Medicine, Toronto Metropolitan University, ON, Canada (A.A.D.).ORCID https://orcid.org/0000-0003-0131-5699
Alfred P SeeDepartment of Neurosurgery, Boston Children's Hospital, MA (A.P.S.).ORCID https://orcid.org/0000-0003-3634-4692
Mohammed Ali Aziz-SultanDepartment of Neurosurgery (N.J.P., R.D., M.A.A.-S., E.F.T., A.C., L.S., J.D.B.), Brigham and Women's Hospital, Boston, MA.ORCID https://orcid.org/0009-0000-0980-7511
Toby I GropenDepartment of Neurology, The University of Alabama at Birmingham Heersink School of Medicine (T.I.G.).
David LiebeskindComprehensive Stroke Center and Department of Neurology, University of California, Los Angeles (D.L.).ORCID https://orcid.org/0000-0002-5109-8736
Erickson F TorioDepartment of Neurosurgery (N.J.P., R.D., M.A.A.-S., E.F.T., A.C., L.S., J.D.B.), Brigham and Women's Hospital, Boston, MA.ORCID https://orcid.org/0000-0003-0958-704X
Anil CanDepartment of Neurosurgery (N.J.P., R.D., M.A.A.-S., E.F.T., A.C., L.S., J.D.B.), Brigham and Women's Hospital, Boston, MA.
Lennard SpanehlDepartment of Neurosurgery (N.J.P., R.D., M.A.A.-S., E.F.T., A.C., L.S., J.D.B.), Brigham and Women's Hospital, Boston, MA.ORCID https://orcid.org/0009-0009-9419-7302
Edoardo GaudePockit Diagnostics Ltd, University of Cambridge, CRUK Cambridge Institute, United Kingdom (E.G.).ORCID https://orcid.org/0000-0001-8523-7792
Joshua D BernstockDepartment of Neurosurgery (N.J.P., R.D., M.A.A.-S., E.F.T., A.C., L.S., J.D.B.), Brigham and Women's Hospital, Boston, MA.ORCID https://orcid.org/0000-0002-7814-3867

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTimely identification of stroke subtype is critical for triage and treatment. Existing prehospital stroke scales have limited diagnostic accuracy, especially in differentiating large vessel occlusion (LVO) from intracerebral hemorrhage (ICH). The LVOne point-of-care test measures d-dimer and GFAP (glial fibrillary acidic protein), biomarkers associated with thrombotic and hemorrhagic stroke, enabling biologically informed triage.

methodsWe validated a new version of the LVOne assay using plasma samples from 210 suspected stroke patients presenting within 6 hours of symptom onset, enrolled in the TIME (Testing of Identification Markers for Stroke) prospective observational cohort. This article reports a retrospective (secondary) laboratory analysis of these prospectively collected samples and clinical data. Samples were collected before neuroimaging or thrombolysis. LVOne version 1 combined d-dimer positivity, GFAP negativity, and Field Assessment Stroke Triage for Emergency Destination scoring for LVO detection only; version 2 uses improved GFAP measurement and a clinical decision rule enabling simultaneous diagnosis of LVO and ICH. Diagnostic performance (sensitivity, specificity, positive predictive value, negative predictive value) was calculated for each version. Receiver operating characteristic analyses and biomarker correlations with Field Assessment Stroke Triage for Emergency Destination were also performed.

resultsBoth LVOne versions achieved high accuracy for LVO detection (sensitivity, 0.75; specificity, 0.92; negative predictive value, 0.97). Version 2 improved ICH specificity (0.99 versus 0.90) and positive predictive value (0.83 versus 0.23) versus version 1. Biomarker levels correlated with Field Assessment Stroke Triage for Emergency Destination scores but with limited explanatory power (GFAP

conclusionsThe updated LVOne assay enables simultaneous biomarker-based identification of both LVO and ICH in suspected stroke patients. Its rapid, low-complexity format supports prehospital use and may improve triage, reduce time to treatment, and optimize outcomes. Prospective field validation is warranted. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04292600.

Indexed as

biomarkerscerebral hemorrhageglial fibrillary acidic proteinpredictive value of teststriage

Identifiers

PMID42088320
PMCPMC13138425

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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.