Evidence map›Paper›PMID 38569894›Full record

ReviewStroke and vascular neurology2024

Design of trials in lacunar stroke and cerebral small vessel disease: review and experience with the LACunar Intervention Trial 2 (LACI-2).

Gordon Blair, Jason P Appleton, Iris Mhlanga, Lisa J Woodhouse, Fergus Doubal, Philip M Bath, Joanna M Wardlaw

Open access · goldAbstract readReview
In one paragraph

Review in Stroke and vascular neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.3field-weighted citation impact, top 12% of its field
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

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Review
  2. Review
  3. 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

7 authors at 3 institutions in 1 country.

Gordon BlairUniversity of Edinburgh, Edinburgh, UK.
Jason P AppletonStroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.ORCID 0000-0002-2604-4410
Iris MhlangaStroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.
Lisa J WoodhouseStroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.ORCID 0000-0002-4472-1999
Fergus DoubalUniversity of Edinburgh, Edinburgh, UK.ORCID 0000-0002-2769-3148
Philip M BathStroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.ORCID 0000-0003-2734-5132
Joanna M WardlawUniversity of Edinburgh, Edinburgh, UK joanna.wardlaw@ed.ac.uk.ORCID 0000-0002-9812-6642
University of Edinburgh · GBUniversity of Nottingham · GBNottingham University Hospitals NHS Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Cerebral small vessel disease (cSVD) causes lacunar stroke (25% of ischaemic strokes), haemorrhage, dementia, physical frailty, or is 'covert', but has no specific treatment. Uncertainties about the design of clinical trials in cSVD, which patients to include or outcomes to assess, may have delayed progress. Based on experience in recent cSVD trials, we reviewed ways to facilitate future trials in patients with cSVD.We assessed the literature and the LACunar Intervention Trial 2 (LACI-2) for data to inform choice of Participant, Intervention, Comparator, Outcome, including clinical versus intermediary endpoints, potential interventions, effect of outcome on missing data, methods to aid retention and reduce data loss. We modelled risk of missing outcomes by baseline prognostic variables in LACI-2 using binary logistic regression.Imaging versus clinical outcomes led to larger proportions of missing data. We present reasons for and against broad versus narrow entry criteria. We identified numerous repurposable drugs with relevant modes of action to test in various cSVD subtypes. Cognitive impairment is the most common clinical outcome after lacunar ischaemic stroke but was missing more frequently than dependency, quality of life or vascular events in LACI-2. Assessing cognitive status using Diagnostic and Statistical Manual for Mental Disorders Fifth Edition can use cognitive data from multiple sources and may help reduce data losses.Trials in patients with all cSVD subtypes are urgently needed and should use broad entry criteria and clinical outcomes and focus on ways to maximise collection of cognitive outcomes to avoid missing data.

Indexed as

Cerebral Small Vessel DiseasesResearch DesignStroke, LacunarClinical Trials as TopicCognitionEndpoint DeterminationHumansRisk FactorsTreatment OutcomeCerebrovascular DisordersClinical TrialCognitive DysfunctionStroke

Identifiers

PMID38569894
PMCPMC11791638
OpenAlexW4393853351

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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 Socratic graph.