Medical management versus intravenous thrombolysis for patients with minor non-disabling acute ischemic stroke: A systematic review and meta-analysis
Bibliographic record
Abstract
Background: The efficacy and safety of thrombolysis therapy in patients with mild stroke, especially acute non-disabling stroke is controversial. We intend to conduct this systematic review and meta- analysis to evaluate the efficacy and safety of thrombolytic therapy compared to medical management in acute non-disabling stroke. Methods: We searched multiple databases to obtain articles related to medical management and intravenous thrombolysis therapy for minor non-disabling acute ischemic stroke from inception until November 28, 2023, and the search was conducted again on September 1, 2024. The primary outcome was functional independence (modified Rankin scale [mRS] score of 0 to 2) at 90 days. All analyses were performed using the random effect model. The quality of articles was evaluated through the Cochrane risk assessment tool and Newcastle-Ottawa scale. Results: 2 RCTs and 7 cohort studies met the inclusion criteria. The merge analysis showed that there was no significant difference in improving functional independence (mRS 0-2, RR: 1.01, 95% CI 0.98 - 1.04, P = 0.47) and excellent outcome (mRS 0-1) of patients with minor non-disabling acute ischemic stroke between IVT and medical management. However, IVT would increase the risk of early neurological deterioration (RR: 0.50, 95% CI 0.30 - 0.82, P = 0.007), compared to medical management. Analysis of the cohort studies showed that there was a significant correlation between IVT and sICH (RR: 0.20, 95% CI: 0.06 - 0.68, P=0.01). Conclusions: For patients with minor non-disabling acute ischemic stroke, medical management will not have a negative impact on functional recovery, and may be a safer alternative.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot 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.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.012 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
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".