Evidence map›Paper›PMID 41708286›Full record

SynthesisCanadian journal of surgery. Journal canadien de chirurgie

Assessing the fragility index of randomized controlled trials on carotid artery stenosis: a systematic review.

Eva Liu, Natalie Tilbury, Amy Zhou, Hsuan Ming Su, Braeden D Newton, Amit Persad, Uzair Ahmed, Lissa Ogieglo, Michael Kelly

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Canadian journal of surgery. Journal canadien de chirurgie. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

9 authors.

Eva LiuFrom the Division of Neurosurgery, Department of Surgery, University of Saskatchewan, Saskatoon, Sask. eva.liu@usask.ca.
Natalie TilburyFrom the Division of Neurosurgery, Department of Surgery, University of Saskatchewan, Saskatoon, Sask.
Amy ZhouFrom the Division of Neurosurgery, Department of Surgery, University of Saskatchewan, Saskatoon, Sask.
Hsuan Ming SuFrom the Division of Neurosurgery, Department of Surgery, University of Saskatchewan, Saskatoon, Sask.
Braeden D NewtonFrom the Division of Neurosurgery, Department of Surgery, University of Saskatchewan, Saskatoon, Sask.
Amit PersadFrom the Division of Neurosurgery, Department of Surgery, University of Saskatchewan, Saskatoon, Sask.
Uzair AhmedFrom the Division of Neurosurgery, Department of Surgery, University of Saskatchewan, Saskatoon, Sask.
Lissa OgiegloFrom the Division of Neurosurgery, Department of Surgery, University of Saskatchewan, Saskatoon, Sask.
Michael KellyFrom the Division of Neurosurgery, Department of Surgery, University of Saskatchewan, Saskatoon, Sask.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe fragility index (FI) measures the robustness of randomized controlled trials (RCTs) with dichotomous outcomes, calculated as the number of patients whose outcome would need to change for a significant result to become non-significant. Many RCTs have compared carotid endarterectomy (CEA) and carotid artery stenting (CAS), with variable results; thus, in this systematic review, we sought to explore the FI as a possible explanation for the variability in trial results between CEA and CAS.

methodsWe conducted a search in MEDLINE (1946 to Apr. 22, 2024), Embase (1974 to Apr. 22, 2024), and PubMed (up to Apr. 22, 2024) for RCTs comparing CEA and CAS. We included RCTs with statistically significant results and dichotomous primary outcomes.

resultsOur literature search identified 11 RCTs involving 5296 patients (

conclusionA small number of events is required to change the findings of RCTs comparing CEA to CAS from statistically significant to statistically nonsignificant. All studies that reported LTFU had LTFU greater than its FI, calling into question the robustness of these results.

Indexed as

Carotid StenosisEndarterectomy, CarotidRandomized Controlled Trials as TopicStentsHumansTreatment Outcome

Identifiers

PMID41708286
PMCPMC12948451

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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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.