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Intracranial stenting compared to medical treatment alone for intracranial atherosclerosis patients: An updated meta-analysis

2023· article· en· W4389147397 on OpenAlexaff
Adam A. Dmytriw, Jerry C. Ku, Ahmed Y. Azzam, Osman Elamin, Nicole M Cancelliere, Anish Kapadia, James D. Rabinov, Christopher J. Stapleton, Robert W. Regenhardt, Vítor Mendes Pereira, Aman B. Patel, Victor X. D. Yang

Bibliographic record

VenueJournal of Cerebrovascular and Endovascular Neurosurgery · 2023
Typearticle
Languageen
FieldMedicine
TopicCerebrovascular and Carotid Artery Diseases
Canadian institutionsLondon Health Sciences CentreHealth Sciences CentreUniversity of TorontoSt. Michael's HospitalWestern UniversitySunnybrook Health Science Centre
Fundersnot available
KeywordsMedicineStroke (engine)Cochrane LibraryMeta-analysisRandomized controlled trialMEDLINECarotid stentingIntracerebral hemorrhageStenosisInternal medicineCarotid endarterectomySubarachnoid hemorrhage

Abstract

fetched live from OpenAlex

OBJECTIVE: Stroke is the second-leading cause of death globally. Intracranial atherosclerotic stenosis (ICAS) represents 10-15% of ischemic strokes in Western countries and up to 47% in Asian countries. Patients with ICAS have an especially high risk of stroke recurrence. The aim of this meta-analysis is to reassess recurrent stroke, transient ischemic attack (TIA), and other outcomes with stenting versus best medical management for symptomatic ICAS. METHODS: The search protocol was developed a priori according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The OVID Medline, Embase, Web of Science, and Cochrane Library databases were searched from inception to August 14th, 2022. RESULTS: This Meta-analysis Included Four Randomized Controlled Trials (Rcts), With A Total Number Of 991 Patients. The Mean Age Of Participants Was 57 Years. The Total Number Of Intracranial Stenting Patients Was 495, And The Number Of Medical Treatment Patients Was 496. The Included Studies Were Published Between 2011 And 2022. Two Studies Were Conducted In The Usa, And The Other Two In China. All Included Studies Compared Intracranial Stenting To Medical Treatment For Icas. CONCLUSIONS: In patients with ischemic stroke due to symptomatic severe intracranial atherosclerosis, the rate of 30-day ischemic stroke, 30-day intracerebral hemorrhage, one-year stroke in territory or mortality favored the medical treatment alone without intracranial stenting. The risk of same-territory stroke at last follow-up, disabling stroke at last follow-up, and mortality did not significantly favor either group. Intracranial stenting for atherosclerosis did not result in significant benefit over medical treatment.

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 machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.012
metaresearch head score (Gemma)0.024
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Meta-analysis · Consensus signal: Meta-analysis
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.018
Threshold uncertainty score0.063

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0120.024
Meta-epidemiology (narrow)0.0030.001
Meta-epidemiology (broad)0.0180.062
Bibliometrics0.0060.005
Science and technology studies0.0010.001
Scholarly communication0.0030.002
Open science0.0020.001
Research integrity0.0030.002
Insufficient payload (model declined to judge)0.0050.000

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 head0.047
GPT teacher head0.288
Teacher spread0.241 · 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; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designMeta-analysis
Domainnot available
GenreEmpirical

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

Citations3
Published2023
Admission routes1
Has abstractyes

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