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急性缺血性卒中机械取栓术中报告的通用数据元素:对正在进行的临床试验的系统评价

Common Data Elements Reported in Mechanical Thrombectomy for Acute Ischemic Stroke: A Systematic Review of Active Clinical Trials.

作者信息

Ghozy Sherief, Hardy Nicole, Sutphin Daniel J, Kallmes Kevin M, Kadirvel Ramanathan, Kallmes David F

机构信息

Department of Radiology, Mayo Clinic, Rochester, MN 55902, USA.

Nested Knowledge, St. Paul, MN 55117, USA.

出版信息

Brain Sci. 2022 Dec 7;12(12):1679. doi: 10.3390/brainsci12121679.

Abstract

BACKGROUND

New trials are planned regularly to provide the highest quality of evidence and invade new occlusion territories, which requires a pre-defined reporting strategy with consistent, common data elements for more straightforward collective evidence synthesis. We sought to review all active endovascular thrombectomy trials to investigate their patient selection criteria, intervention description, and reported outcomes.

METHODS

A literature search was systematically conducted on clinicaltrials.gov for active trials and all intervention, inclusion criteria, and outcomes reported were extracted. A qualitative synthesis of the frequency of study design types and data elements are graphically and narratively presented.

RESULTS

A total of 32 studies were tagged and included in the final qualitative analysis. The inclusion criteria were highly variable, including different cut-offs for the last well-known baseline National Institutes of Health Stroke Scale, Alberta Stroke Program Early CT Score, and modified Rankin scale (mRS). Half of the studies (16/32) mentioned "thrombectomy" without defining which technique or device was used, and the final thrombolysis in cerebral infarction scale was provided in 19 (59.4%) studies. Heterogeneity was also present among the studies reporting a first-pass effect, both in how studies defined the outcome and in used ranges for mRS. Mortality and intracerebral hemorrhage (ICH) were more homogenous in their presentation and follow-up.

CONCLUSIONS

There is a great degree of heterogeneity in the active thrombectomy trials concerning inclusion criteria, interventions used, and how outcomes are being reported.

摘要

背景

定期开展新的试验以提供最高质量的证据并开拓新的闭塞领域,这需要一个预先定义的报告策略,包含一致的通用数据元素,以便更直接地进行集体证据综合分析。我们试图回顾所有正在进行的血管内血栓切除术试验,以研究其患者选择标准、干预描述和报告的结果。

方法

在clinicaltrials.gov上系统地检索正在进行的试验,并提取所有报告的干预措施、纳入标准和结果。以图表和叙述的方式对研究设计类型和数据元素的频率进行定性综合分析。

结果

共有32项研究被标记并纳入最终的定性分析。纳入标准差异很大,包括最后已知的基线国立卫生研究院卒中量表、阿尔伯塔卒中项目早期CT评分和改良Rankin量表(mRS)的不同临界值。一半的研究(16/32)提到了“血栓切除术”,但未定义使用的技术或设备,19项(59.4%)研究提供了最终的脑梗死溶栓量表。在报告首次通过效应的研究中,无论是在结果的定义方式还是mRS的使用范围方面,均存在异质性。死亡率和脑出血(ICH)在呈现和随访方面更为一致。

结论

在正在进行的血栓切除术试验中,关于纳入标准、使用的干预措施以及结果报告方式存在很大程度的异质性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b4d/9775042/f647a73f7dbf/brainsci-12-01679-g001a.jpg

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