Evidence mapPaperPMID 39236303Full record

SynthesisEuropean journal of neurology2024

From guidelines to clinical practice in care for ischaemic stroke patients: A systematic review and expert opinion.

Charlotte Lens, Jelle Demeestere, Barbara Casolla, Hanne Christensen, Urs Fischer, Peter Kelly, Carlos Molina, Simona Sacco, Else Charlotte Sandset, Daniel Strbian and 6 more

Abstract readSystematic Review
In one paragraph

Synthesis in European journal of neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 2 pooled it
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.

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

2 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
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

16 authors.

Charlotte LensDepartment of Public Health, Leuven Institute for Healthcare Policy, KU Leuven-University of Leuven, Leuven, Belgium.ORCID 0000-0003-2902-1510
Jelle DemeestereDepartment of Neurosciences, Experimental Neurology, KU Leuven-University of Leuven, Leuven, Belgium.
Barbara CasollaUniversité Cote d'Azur UR2CA-URRIS, Unité Neurovasculaire, CHU Hôpital Pasteur 2, Nice, France.
Hanne ChristensenDepartment of Neurology, Copenhagen University Hospital, Bispebjerg, Copenhagen, Denmark.
Urs FischerDepartment of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.
Peter KellyStroke Clinical Trials Network Ireland, University College Dublin, Dublin, Ireland.
Carlos MolinaStroke Unit, Vall d'Hebron Hospital, Barcelona, Spain.
Simona SaccoDepartment of Neurology, University of L'Aquila, L'Aquila, Italy.
Else Charlotte SandsetDepartment of Neurology, Oslo University Hospital, Oslo, Norway.ORCID 0000-0003-4312-4778
Daniel StrbianDepartment of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Götz ThomallaDepartment of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Georgios TsivgoulisSecond Department of Neurology, 'Attikon' University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.ORCID 0000-0002-0640-3797
Kris VanhaechtDepartment of Public Health, Leuven Institute for Healthcare Policy, KU Leuven-University of Leuven, Leuven, Belgium.
Caroline WeltensDepartment of Oncology, University Hospitals Leuven, Leuven, Belgium.
Ellen CoeckelberghsDepartment of Public Health, Leuven Institute for Healthcare Policy, KU Leuven-University of Leuven, Leuven, Belgium.
Robin LemmensDepartment of Neurosciences, Experimental Neurology, KU Leuven-University of Leuven, Leuven, Belgium.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeGuidelines help physicians to provide optimal care for stroke patients, but implementation is challenging due to the quantity of recommendations. Therefore a practical overview related to applicability of recommendations can be of assistance.

methodsA systematic review was performed on ischaemic stroke guidelines published in scientific journals, covering the whole acute care process for patients with ischaemic stroke. After data extraction, experts rated the recommendations on dimensions of applicability, that is, actionability, feasibility and validity, on a 9-point Likert scale. Agreement was defined as a score of ≥8 by ≥80% of the experts.

resultsEighteen articles were identified and 48 recommendations were ultimately extracted. Papers were included only if they described the whole acute care process for patients with ischaemic stroke. Data extraction and analysis revealed variation in terms of both content and comprehensiveness of this description. Experts reached agreement on 34 of 48 (70.8%) recommendations in the dimension actionability, for 16 (33.3%) in feasibility and for 15 (31.3%) in validity. Agreement on all three dimensions was reached for seven (14.6%) recommendations: use of a stroke unit, exclusion of intracerebral haemorrhage as differential diagnosis, administration of intravenous thrombolysis, performance of electrocardiography/cardiac evaluation, non-invasive vascular examination, deep venous thrombosis prophylaxis and administration of statins if needed. DISCUSSION AND

conclusionSubstantial variation in agreement was revealed on the three dimensions of the applicability of recommendations. This overview can guide stroke physicians in improving the care process and removing barriers where implementation may be hampered by validity and feasibility.

Indexed as

Ischemic StrokePractice Guidelines as TopicHumansexpert testimonyguidelinesischaemic strokequality improvementsystematic review

Identifiers

PMID39236303
PMCPMC11554874

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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.