Trial reportStroke1993
Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment.
Trial report in Stroke, 1993. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 10 registered trials, which are not on this map. Cited by 5,011 papers, 2 of them syntheses that pooled 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.
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.
Optimal Target Low-density Lipoprotein Cholesterol Level for Small Vessel Occlusion Stroke (SVO70)
Induction of Mucosal Tolerance to Human E-Selectin for the Secondary Prevention of Stroke
Observational Study on Cryptogenic Stroke and Atrial Fibrillation Detection Through Implantable Loop Recorder
Ischemia Care Biomarkers of Acute Stroke Etiology (BASE)
A Randomized, Single Blind, Controlled, Longitudinal Study of the Effects of Venlafaxine Hydrochloride Capsules on the Language Function of Stroke Patients With Subcortical Aphasia Using fMRI
Sleep Apnea Syndrome and Incidence of Major Adverse Cardiac and Cerebrovascular Events (MACCEs) After a First Stroke
Detecting the Vulnerable Carotid Plaque: "The Carotid Artery Multi-modality Imaging Prognostic (CAMP) Study" - Implications for Stroke and Cognitive Decline Prediction in Asymptomatic Carotid Artery Disease
Neurorehabilitation Through Hippotherapy on Neurofunctional Sequels of Brain Stroke: (i) Effect on Patient's Functional Independence, Sensorimotor and Cognitive Capacities and Quality of Life (ii) Effect on Caregivers' Quality of Life
Effect of Ankle Strategy Exercises on Gait Parameters and Balance Confidence in Patients With Chronic Stroke
Efficacy and Safety of Intravenous Thrombolysis in Branch Atheromatous Disease - a Retrospective Data Analysis
Who cites it
5,011 citing papers in PubMed, 2 syntheses or guidelines pooled it, 12,113 citations in OpenAlex.
- Association of methylenetetrahydrofolate reductase C677T polymorphism with lacunar infarction: A systematic review and meta-analysis.Medicine · 2026Pooled it
- Association of glomerular hyperfiltration with mortality in stroke: an analysis using pooled individual patient data.European stroke journal · 2026Pooled it
- Low-dose ticagrelor combined with aspirin for preventing early neurological deterioration in patients with high-risk non-disabling ischemic cerebrovascular events: a multicenter, prospective, randomized, open-label, clinical trial.Journal of neurology · 2026Trial
- Neuroanatomical correlates of stroke-related dizziness and vertigo: secondary analysis from the INSPiRE-TMS trial.Journal of neurology · 2026Trial
- Adjunctive Methylprednisolone After Thrombectomy: A Secondary Analysis Stratified by Admission White Blood Cell Count.CNS neuroscience & therapeutics · 2026Trial
- P2YJournal of atherosclerosis and thrombosis · 2026Trial
- Comprehensive Evaluation of Predictive Significance of FABP4 for Long-term Clinical Outcomes After Ischemic Stroke.Translational stroke research · 2026Trial
- Stroke in people living with HIV and 6-month outcomes in Northwestern Tanzania.Equity neuroscience · 2026Article
- The C-Reactive Protein-Triglyceride-Glucose Index and Functional Outcomes in Acute Ischemic Stroke Patients Following Endovascular Thrombectomy.Brain and behavior · 2026Article
- The Association Between Venous Sinus Opacification Time and Futile Recanalization in Patients with Large Vessel Occlusion Acute Ischemic Stroke.Neurology and therapy · 2026Article
- Serum ADAMTS18 Levels at Admission Are Associated With 3-Month Functional Outcome After Acute Ischemic Stroke.Journal of atherosclerosis and thrombosis · 2026Article
- Cuproptosis in Ischemic Stroke: Molecular Mechanisms and Therapeutic Potential.Molecules (Basel, Switzerland) · 2026Review
- Magnetic Resonance Imaging-Defined Cerebral Small Vessel Disease Burden and Longitudinal Neuropsychiatric and Functional Recovery After Stroke: A Prospective Cohort Study.Neurology international · 2026Article
- Intracranial Arterial Calcification and Its Impact on Subsequent Ischemic Cerebral Events: A Retrospective Cohort Study.Diagnostics (Basel, Switzerland) · 2026Article
- Systemic inflammatory profiles associated with early EEG abnormalities following ischemic stroke: a cohort study.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Observational
- Association of C-Reactive Protein with Functional Outcome After Acute Ischemic Stroke Across TOAST Subtypes.Journal of clinical medicine · 2026Article
- Identification of Plasma Protein Biomarkers for Early-Onset Stroke through Mendelian Randomization.medRxiv : the preprint server for health sciences · 2026Article
- Stent retrievers for acute ischemic stroke: technological advances, clinical applications, and future perspectives.Journal of neurology · 2026Review
- Autoantibodies targeting G protein-coupled receptors and clinical outcome after ischemic stroke (PROSCIS-B).Journal of neurology · 2026Observational
- Initial magnetic resonance imaging/magnetic resonance angiography may miss intracranial artery dissection in young adults with stroke: the role of subsequent imaging.European stroke journal · 2026Article
4,951 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
background and purposeThe etiology of ischemic stroke affects prognosis, outcome, and management. Trials of therapies for patients with acute stroke should include measurements of responses as influenced by subtype of ischemic stroke. A system for categorization of subtypes of ischemic stroke mainly based on etiology has been developed for the Trial of Org 10172 in Acute Stroke Treatment (TOAST).
methodsA classification of subtypes was prepared using clinical features and the results of ancillary diagnostic studies. "Possible" and "probable" diagnoses can be made based on the physician's certainty of diagnosis. The usefulness and interrater agreement of the classification were tested by two neurologists who had not participated in the writing of the criteria. The neurologists independently used the TOAST classification system in their bedside evaluation of 20 patients, first based only on clinical features and then after reviewing the results of diagnostic tests.
resultsThe TOAST classification denotes five subtypes of ischemic stroke: 1) large-artery atherosclerosis, 2) cardioembolism, 3) small-vessel occlusion, 4) stroke of other determined etiology, and 5) stroke of undetermined etiology. Using this rating system, interphysician agreement was very high. The two physicians disagreed in only one patient. They were both able to reach a specific etiologic diagnosis in 11 patients, whereas the cause of stroke was not determined in nine.
conclusionsThe TOAST stroke subtype classification system is easy to use and has good interobserver agreement. This system should allow investigators to report responses to treatment among important subgroups of patients with ischemic stroke. Clinical trials testing treatments for acute ischemic stroke should include similar methods to diagnose subtypes of stroke.
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What OpenQuestion holds
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.