SynthesisBMC neurology2025
Development of a high-performing, cost-effective and inclusive Afrocentric predictive model for stroke: a meta-analysis approach.
Synthesis in BMC neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Characterization and risk stratification of coronary artery disease in people living with HIV: a global systematic review.Frontiers in cardiovascular medicine · 2025Pooled it
- Risk stratification of hypertension in South Africa: a systematic review with meta-analysis.Frontiers in cardiovascular medicine · 2026Review
- Developing and Validating an Inclusive and Cost-Effective Prediction Algorithm for Survival and Death Among People Living With HIV in Sub-Saharan Africa: Protocol for a Meta-Analysis and Case-Control and Cost-Effectiveness Study.JMIR research protocols · 2025Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPredicting stroke risk is critical for preventive interventions. Most validated prediction models do not include data from African populations and may not be appropriate for the region. Relying solely on statistical significance to identify predictors may compromise algorithm performance. Also, some of the existing models include expensive biomarkers that are unsuitable for resource-limited settings. This study aims to develop a cost-effective and inclusive Afrocentric predictive model for stroke (CAPMS).
methodsWe conducted a meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol and searched the PubMed, Scopus, African Journal, Medline, Cochrane Library, Web of Science, and Cumulative Index for Nursing and Allied Health Literature databases. We included case‒control and cohort studies reporting stroke risk factors and their estimates among African populations. Titles and abstracts were independently screened. Meta-analyses were performed using Comprehensive Meta-analysis version 3.
resultsMore than 50% of the eligible studies examined both ischemic and hemorrhagic stroke. More than 20 stroke risk factors were identified in Africa, with 18 eligible for meta-analysis. Homocysteine (risk weight [Rw] = 13.9, risk stability index [Ri] = 0.67), hypertension (Rw = 5.6, Ri = 0.94), and cardiac events (Rw = 3.1, Ri = 0.8) were the strongest independent predictors. Low green vegetable consumption (Rw = 2.4, Ri = 1.0), stress (Rw = 1.76, Ri = 1.0), and hypertension were the most clinically responsive risk factors. All risk factors/biomarkers except homocysteine cost between $2.8 and 12.2, indicating cost-effectiveness. A critical risk point of 12.7 was set at the 90th percentile. The cumulative Rw and costs for CAPMS 1 (20 and $1.2-4.6) and CAPMS 2 (22.4 and $6.5-17.3) indicate high performance and cost-effectiveness.
conclusionsTargeted screening via the CAPMS 1 and CAPMS 2 models offers a cost-effective solution for stroke screening in African clinics and communities. Immediate validation of the CAPMS is needed to evaluate its performance, feasibility, and acceptability in the region. REGISTRATION: The study protocol is registered with PROSPERO (ID: CRD42023430437).
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