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Record W4386032499 · doi:10.1136/jnis-2023-esmint.198

P170/281  Endovascular thrombectomy with or without thrombolysis bridging in patients with acute ischemic stroke: a systematic review and meta-analysis of randomized trials

2023· review· en· W4386032499 on OpenAlexaff
Rami Z. Morsi, Yuan Zhang, Julian Carrion Penagos, Harsh Desai, Elie Tannous, Sachin Kothari, Assem M. Khamis, Andrea Darzi, Ammar Tarabichi, Reena Bastin, Layal Hneiny, Sonam Thind, Elisheva Coleman, James R. Brorson, Scott Mendelson, Ali Mansour, Shyam Prabhakaran, Tareq Kass‐Hout

Bibliographic record

VenueAbstracts · 2023
Typereview
Languageen
FieldMedicine
TopicAcute Ischemic Stroke Management
Canadian institutionsMcMaster University
Fundersnot available
KeywordsThrombolysisRandomized controlled trialMedicineMeta-analysisCochrane LibraryStroke (engine)Internal medicineBridging (networking)Relative riskCardiologyConfidence intervalMyocardial infarction

Abstract

fetched live from OpenAlex

<h3>Introduction</h3> An updated analysis comparing endovascular thrombectomy (EVT) alone versus endovascular therapy without bridging intravenous thrombolysis (IVT) has not been performed. <h3>Aim of Study</h3> To systematically update the evidence from randomized trials comparing endovascular thrombectomy (EVT) alone versus EVT with bridging intravenous thrombolysis (IVT). <h3>Methods</h3> We searched MEDLINE, EMBASE, and the Cochrane Library to identify randomized controlled trials (RCTs) comparing EVT with or without IVT in patients with stroke secondary to a large vessel occlusion. We conducted meta-analyses using random-effects models to compare functional independence, mortality, and symptomatic intracranial hemorrhage (sICH), between EVT and EVT with IVT. We assessed risk of bias using the Cochrane risk-of-bias tool and certainty of evidence for each outcome using the GRADE approach. <h3>Results</h3> Of 11,111 citations, we included 6 studies with a total of 2,336 participants. We found low-certainty evidence that there is possibly a small decrease in the proportion of patients with functional independence (risk difference [RD] -2.0%, 95% CI -5.9% to 2.0%), low-certainty evidence that there is possibly a small increase in mortality (RD 1.0%, 95% CI -2.2% to 4.7%), and moderate-certainty evidence that there is probably a decrease in sICH (RD -1.0%, 95% CI -1.6% to 0.7%) for patients with EVT alone compared to EVT plus IVT. <h3>Conclusion</h3> Low-certainty evidence shows a small possible decrease in functional independence, low-certainty evidence shows a small possible decrease in mortality, and moderate-certainty evidence that there is probably a decrease in sICH for patients with EVT alone compared to EVT plus IVT. <h3>Disclosure of Interest</h3> The authors have nothing to disclose.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.008
metaresearch head score (Gemma)0.003
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow), Meta-epidemiology (broad)
Consensus categoriesMeta-epidemiology (narrow)
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Meta-analysis · Consensus signal: Meta-analysis
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.323
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0080.003
Meta-epidemiology (narrow)0.0010.001
Meta-epidemiology (broad)0.0620.006
Bibliometrics0.0020.003
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.087
GPT teacher head0.360
Teacher spread0.273 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; both teacher heads agree on what is shown here.

Study designMeta-analysis
Domainnot available
GenreReview

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2023
Admission routes1
Has abstractyes

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