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Responder analysis confirms results of a stroke transitional care trial but provides more interpretable results
Interpreting between-group differences in patient-reported outcome measures can be challenging. Responder analyses, which compare the proportions of patients who achieve a meaningful clinical change, represent a more interpretable approach. We conducted a secondary responder analysis of the Michigan Stroke Transitions Trial (MISTT).
Source: Journal of Clinical Epidemiology - February 2, 2023 Category: Epidemiology Authors: Brent Strong, Michele C. Fritz, Amanda Woodward, Allan Kozlowski, Mathew J. Reeves Tags: Original Article Source Type: research

No Short-Term Mortality from Benzodiazepine Use Post-Acute Ischemic Stroke After Accounting for Bias
Older adults receive benzodiazepines for agitation, anxiety, and insomnia after acute ischemic stroke (AIS). No trials have been conducted to determine if benzodiazepine use affects post-stroke mortality in the elderly.
Source: Journal of Clinical Epidemiology - December 22, 2022 Category: Epidemiology Authors: Lidia M.V.R. Moura, Zhiyu Yan, Maria A. Donahue, Louisa H. Smith, Lee H. Schwamm, John Hsu, Joseph P. Newhouse, Sebastien Haneuse, Deborah Blacker, Sonia Hernandez-Diaz Tags: Original Article Source Type: research

Feasibility of national living guideline methods: the Australian Stroke Guidelines
Key findingsIt is feasible to produce living evidence-based guidelines covering a wide range of topics related to management of stroke or transient ischaemic attack.What this adds to what is knownLiving evidence synthesis methods are becoming more common particularly in response to the COIVD-19 crisis. However, whether these methods can be applied to a large national guideline was unclear. This work shows that it is possible to develop rigorous living guidelines and update them by considering all major randomised trials and systematic reviews each month.
Source: Journal of Clinical Epidemiology - November 13, 2021 Category: Epidemiology Authors: Kelvin Hill, Coralie English, Bruce C.V. Campbell, Steve McDonald, Loyal Pattuwage, Peta Bates, Chris Lassig, Living Stroke Guidelines Executive Group and Content Development Group Source Type: research

An emulated target trial analysis based on Medicare data suggested non-inferiority of Dabigatran versus Rivaroxaban
Atrial fibrillation (AF) is an abnormal heart rhythm characterized by rapid and irregular heart chamber beatings. It affects three to six million people in the U.S.1, among whom 85% to 90% are eligible for oral anticoagulation therapies2,3. As established in the literature, it is of great interest to properly choose among non-vitamin K antagonist oral anticoagulants (NOACs). Rivaroxaban and Dabigatran were approved by the U.S. FDA in November 2011 and October 2010, respectively. They were the first two NOACs for preventing stroke for non-valvular AF patients and have been widely used since marketing.
Source: Journal of Clinical Epidemiology - July 13, 2021 Category: Epidemiology Authors: Hao Mei, Jiping Wang, Shuangge Ma Source Type: research

Externally validated model predicting gait independence after stroke showed fair performance and improved after updating
Stroke is the leading cause of adult disability and the ability to walk is often affected.1, 2 Recovery of independent walking is a common goal of stroke rehabilitation.3 Although individual recovery patterns vary between individuals,4 studies suggest that recovery of gait can be predicted in the first days after stroke.5-8 Early and accurate predictions about a patient's recovery can provide clinicians, patients and relatives, with useful information to set realistic rehabilitation goals, prioritize treatments, and facilitate discharge planning.
Source: Journal of Clinical Epidemiology - March 31, 2021 Category: Epidemiology Authors: Anthonia J Langerak, Alana B McCambridge, Peter W Stubbs, Jesper Mortensen, Kris Rogers, Camila Quel de Oliveira, J ørgen Feldbæk Nielsen, Arianne P Verhagen Source Type: research

Composite Endpoints
Studies often combine several events, for example, death or myocardial infarction or stroke, into a single study outcome. This is called a composite endpoint. Composite endpoints make doing trials easier by reducing the sample size or follow-up period required to demonstrate the effectiveness of an intervention. However, interpreting the results composite endpoints can be confusing. To avoid misleading conclusions about the effectiveness of an intervention, it is important for readers of studies reporting a composite endpoint to ascertain that the clinical importance, the frequency of events, and the effect of the interven...
Source: Journal of Clinical Epidemiology - July 28, 2020 Category: Epidemiology Authors: Lia M. Palileo-Villanueva, Antonio L. Dans Tags: Original Article Source Type: research

Counterfactual clinical prediction models could help to infer individualized treatment effects in randomized controlled trials —An illustration with the International Stroke Trial
Causal treatment effects are estimated at the population level in randomized controlled trials, while clinical decision is often to be made at the individual level in practice. We aim to show how clinical prediction models used under a counterfactual framework may help to infer individualized treatment effects.
Source: Journal of Clinical Epidemiology - May 24, 2020 Category: Epidemiology Authors: Tri-Long Nguyen, Gary S. Collins, Paul Landais, Yannick Le Manach Tags: Original Article Source Type: research

Counterfactual Clinical Prediction Models Could help to Infer Individualised Treatment Effects in Randomised Controlled Trials – an Illustration with the International Stroke Trial
Causal treatment effects are estimated at the population level in randomised controlled trials (RCTs), whilst clinical decision is often to be made at the individual level in practice. We aim to show how clinical prediction models used under a counterfactual framework may help to infer individualised treatment effects.
Source: Journal of Clinical Epidemiology - May 24, 2020 Category: Epidemiology Authors: Tri-Long Nguyen, Gary S. Collins, Paul Landais, Yannick Le Manach Tags: Original Article Source Type: research

A systematic review and external validation of stroke prediction models demonstrates poor performance in dialysis patients
To systematically review and externally assess the predictive performance of models for ischemic stroke in incident dialysis patients.
Source: Journal of Clinical Epidemiology - March 29, 2020 Category: Epidemiology Authors: Ype de Jong, Chava L. Ramspek, Vera H.W. van der Endt, Maarten B. Rookmaaker, Peter J. Blankestijn, Robin W.M. Vernooij, Marianne C. Verhaar, Willem Jan W. Bos, Friedo W. Dekker, Gurbey Ocak, Merel van Diepen Tags: Review Source Type: research

Multimorbidity and Comorbidity are now separate MESH headings
Nicholson et  al. in a commentary point out that confusion continues within clinical epidemiology articles and elsewhere as to how to reliably distinguish between ‘comorbidity’ and ‘multimorbidity’. Although differentiated in a paper by van der Akker (AK was an author) [1], only now in January 2018 has MeSH designated definitions and a different classification term for multimorbidity, distinct from comorbidity. Nicholson et al. re-emphasize that this is more than a semantic difference. While both terms focus on the occurrence of multiple chronic conditions within the same individual, the term ‘ ‘comorbidityâ€...
Source: Journal of Clinical Epidemiology - December 4, 2018 Category: Epidemiology Authors: Peter Tugwell, J. Andr é Knottnerus Tags: Editorial Source Type: research

Latin American Clinical Epidemiology Network Series – Paper 2: Apixaban was cost-effective vs. acenocoumarol in patients with nonvalvular atrial fibrillation with moderate to severe risk of embolism in Chile
The objective of this study was to assess the incremental cost –utility ratio (ICUR) for apixaban vs. acenocoumarol in patients treated in Chile's public health system.
Source: Journal of Clinical Epidemiology - October 15, 2016 Category: Epidemiology Authors: Fernando Lanas, Constanza Castro, Carlos Vallejos, Luis Bustos, Catherine de La Puente, Monica Velasquez, Carlos Zaror Tags: Series: the Latin American Clinical Epidemiology Network (LatinCLEN) Source Type: research

Apixaban was cost-effective vs. acenocoumarol in patients with nonvalvular atrial fibrillation with moderate to severe risk of embolism in Chile
The objective of this study was to assess the incremental cost –utility ratio (ICUR) for apixaban vs. acenocoumarol in patients treated in Chile's public health system.
Source: Journal of Clinical Epidemiology - October 14, 2016 Category: Epidemiology Authors: Fernando Lanas, Constanza Castro, Carlos Vallejos, Luis Bustos, Catherine de La Puente, Monica Velasquez, Carlos Zaror Tags: Invited Paper Source Type: research

Apixaban was cost-effective vs acenocoumarol in patients with nonvalvular atrial fibrillation with moderate to severe risk of embolism in Chile
Nonvalvular atrial fibrillation (NVAF) is a risk factor for ischemic stroke and systemic embolism. New oral anticoagulants are currently available.
Source: Journal of Clinical Epidemiology - October 14, 2016 Category: Epidemiology Authors: F. Lanas, C. Castro, C. Vallejos, L. Bustos, C. de La Puente, M. Velasquez, C. Zaror Source Type: research

Developing a stroke severity index based on administrative data was feasible using data mining techniques
This study proposes a method for developing a stroke severity index (SSI) by using administrative data.
Source: Journal of Clinical Epidemiology - January 23, 2015 Category: Epidemiology Authors: Sheng-Feng Sung, Cheng-Yang Hsieh, Yea-Huei Kao Yang, Huey-Juan Lin, Chih-Hung Chen, Yu-Wei Chen, Ya-Han Hu Source Type: research

Common flaws exist in published cost-effectiveness models of pharmacologic stroke prevention in atrial fibrillation
Conclusion: Pharmacologic SPAF cost-effectiveness models have been extensively reported, but many may have flaws giving reason for decision makers to use caution. We provide 10 recommendations to avoid common flaws in SPAF cost-effectiveness models.
Source: Journal of Clinical Epidemiology - July 14, 2014 Category: Epidemiology Authors: Brendan L. Limone, William L. Baker, Elizabeth S. Mearns, C. Michael White, Jeffrey Kluger, Craig I. Coleman Tags: Review Articles Source Type: research

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