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  1. Article ; Online: The Concept of Transient Ischemic Attack-Reply.

    Easton, J Donald / Johnston, S Claiborne

    JAMA

    2022  Volume 327, Issue 24, Page(s) 2457

    MeSH term(s) Humans ; Ischemic Attack, Transient
    Language English
    Publishing date 2022-06-28
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 2958-0
    ISSN 1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
    ISSN (online) 1538-3598
    ISSN 0254-9077 ; 0002-9955 ; 0098-7484
    DOI 10.1001/jama.2022.7630
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Time to Retire the Concept of Transient Ischemic Attack.

    Easton, J Donald / Johnston, S Claiborne

    JAMA

    2022  Volume 327, Issue 9, Page(s) 813–814

    MeSH term(s) Humans ; Ischemic Attack, Transient ; Terminology as Topic
    Language English
    Publishing date 2022-02-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2958-0
    ISSN 1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
    ISSN (online) 1538-3598
    ISSN 0254-9077 ; 0002-9955 ; 0098-7484
    DOI 10.1001/jama.2022.0300
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  3. Article ; Online: The Risk and Cost of Limited Clinician and Patient Accountability in Health Care.

    Johnston, S Claiborne

    JAMA

    2019  Volume 322, Issue 18, Page(s) 1759–1760

    Language English
    Publishing date 2019-09-28
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2958-0
    ISSN 1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
    ISSN (online) 1538-3598
    ISSN 0254-9077 ; 0002-9955 ; 0098-7484
    DOI 10.1001/jama.2019.14832
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  4. Article ; Online: Baseline Stroke Risk and Efficacy of Dual-Antiplatelet Therapy: A Post Hoc Analysis of the POINT Trial.

    Daghlas, Iyas / Johnston, S Claiborne / Easton, J Donald / Kim, Anthony S

    Stroke

    2024  Volume 55, Issue 2, Page(s) 385–391

    Abstract: Background: High-risk transient ischemic attacks and minor ischemic strokes are followed by a variable risk of ischemic stroke. We aimed to determine how baseline stroke risk modified the efficacy of clopidogrel-aspirin (referred to here as dual- ... ...

    Abstract Background: High-risk transient ischemic attacks and minor ischemic strokes are followed by a variable risk of ischemic stroke. We aimed to determine how baseline stroke risk modified the efficacy of clopidogrel-aspirin (referred to here as dual-antiplatelet therapy [DAPT]) for transient ischemic attack and minor ischemic stroke.
    Methods: We performed an unplanned secondary analysis of the POINT trial (Platelet-Oriented Inhibition in New Transient Ischemic Attack and Minor Ischemic Stroke). We first evaluated the associations of the CHA
    Results: A total of 4841 trial participants were included in this analysis, with 2400 participants assigned to treatment with short-term DAPT and 2430 participants to treatment with aspirin and placebo. The dichotomized SPI-II score, but not the CHA
    Conclusions: Stratification by baseline stroke risk identifies a patient subgroup that derives greater absolute benefit from treatment with DAPT.
    Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT00991029.
    MeSH term(s) Humans ; Aspirin/adverse effects ; Drug Therapy, Combination ; Hemorrhage/chemically induced ; Hemorrhage/epidemiology ; Hemorrhage/complications ; Ischemic Attack, Transient/drug therapy ; Ischemic Attack, Transient/epidemiology ; Ischemic Attack, Transient/complications ; Ischemic Stroke/drug therapy ; Platelet Aggregation Inhibitors/adverse effects ; Risk Factors ; Stroke/epidemiology ; Stroke/prevention & control ; Stroke/complications ; Treatment Outcome ; Clinical Trials as Topic
    Chemical Substances Aspirin (R16CO5Y76E) ; Platelet Aggregation Inhibitors
    Language English
    Publishing date 2024-01-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80381-9
    ISSN 1524-4628 ; 0039-2499 ; 0749-7954
    ISSN (online) 1524-4628
    ISSN 0039-2499 ; 0749-7954
    DOI 10.1161/STROKEAHA.123.044927
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  5. Article ; Online: The US Training System for Physicians-Need for Deeper Analysis.

    Johnston, S Claiborne

    JAMA

    2018  Volume 320, Issue 10, Page(s) 982–983

    MeSH term(s) Education, Medical ; Physicians
    Language English
    Publishing date 2018-09-11
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 2958-0
    ISSN 1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
    ISSN (online) 1538-3598
    ISSN 0254-9077 ; 0002-9955 ; 0098-7484
    DOI 10.1001/jama.2018.12879
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  6. Article ; Online: Academic Medical Centers: Too Large for Their Own Health?

    Johnston, S Claiborne

    JAMA

    2019  Volume 322, Issue 3, Page(s) 203–204

    MeSH term(s) Academic Medical Centers/economics ; Academic Medical Centers/organization & administration ; Academic Medical Centers/trends ; Biomedical Research/economics ; Biomedical Research/trends ; Economics, Hospital ; Fee-for-Service Plans ; Hospital Costs/trends ; Research Support as Topic ; Uncompensated Care/economics ; United States ; Value-Based Health Insurance
    Language English
    Publishing date 2019-06-17
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2958-0
    ISSN 1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
    ISSN (online) 1538-3598
    ISSN 0254-9077 ; 0002-9955 ; 0098-7484
    DOI 10.1001/jama.2019.6834
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  7. Article ; Online: Aligning academic medicine within the healthcare system: the APS-SPR virtual chat series.

    Shanley, Thomas / Brashear, Allison / Johnston, S Claiborne

    Pediatric research

    2022  Volume 93, Issue 3, Page(s) 503–510

    MeSH term(s) Surface Plasmon Resonance ; Delivery of Health Care ; Medicine
    Language English
    Publishing date 2022-02-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 4411-8
    ISSN 1530-0447 ; 0031-3998
    ISSN (online) 1530-0447
    ISSN 0031-3998
    DOI 10.1038/s41390-022-01963-7
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  8. Article ; Online: Leaving Tiny, Unruptured Intracranial Aneurysms Untreated: Why Is It So Hard?

    Johnston, S Claiborne

    JAMA neurology

    2017  Volume 75, Issue 1, Page(s) 13–14

    MeSH term(s) Humans ; Intracranial Aneurysm ; Risk Factors ; Subarachnoid Hemorrhage
    Language English
    Publishing date 2017-11-13
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 2702023-X
    ISSN 2168-6157 ; 2168-6149
    ISSN (online) 2168-6157
    ISSN 2168-6149
    DOI 10.1001/jamaneurol.2017.2559
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  9. Article ; Online: Anticipating and Training the Physician of the Future: The Importance of Caring in an Age of Artificial Intelligence.

    Johnston, S Claiborne

    Academic medicine : journal of the Association of American Medical Colleges

    2018  Volume 93, Issue 8, Page(s) 1105–1106

    Abstract: Artificial intelligence and other forms of information technology are only just beginning to change the practice of medicine. The pace of change is expected to accelerate as tools improve and as demands for analyzing a rapidly growing body of knowledge ... ...

    Abstract Artificial intelligence and other forms of information technology are only just beginning to change the practice of medicine. The pace of change is expected to accelerate as tools improve and as demands for analyzing a rapidly growing body of knowledge and array of data increase. The medical students of today will practice in a world where information technology is sophisticated and omnipresent. In this world, the tasks of memorization and analysis will be less important to them as practicing physicians. On the other hand, the nonanalytical, humanistic aspects of medicine-most importantly, the art of caring-will remain a critical function of the physician, and facility with improving systems of care will be required. Communication, empathy, shared decision making, leadership, team building, and creativity are all skills that will continue to gain importance for physicians. These skills should be further prioritized in medical school curricula to produce an even more effective physician for the future.
    MeSH term(s) Artificial Intelligence/standards ; Artificial Intelligence/trends ; Empathy ; Forecasting/methods ; Humans ; Physician-Patient Relations
    Language English
    Publishing date 2018-02-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 96192-9
    ISSN 1938-808X ; 1040-2446
    ISSN (online) 1938-808X
    ISSN 1040-2446
    DOI 10.1097/ACM.0000000000002175
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  10. Article ; Online: Vulnerable and Stabilized States After Cerebral Ischemic Events: Implications of Kinetic Modeling in the SOCRATES, POINT, and THALES Trials.

    Brorson, James R / Giurcanu, Mihai / Prabhakaran, Shyam / Johnston, S Claiborne

    Neurology

    2023  Volume 101, Issue 22, Page(s) e2205–e2214

    Abstract: Background and objectives: Trials of acute secondary prevention after minor stroke or transient ischemic attack (TIA), such as SOCRATES, POINT, and THALES, demonstrate a high initial rate of recurrence after ischemic events that drop quickly to a lower ... ...

    Abstract Background and objectives: Trials of acute secondary prevention after minor stroke or transient ischemic attack (TIA), such as SOCRATES, POINT, and THALES, demonstrate a high initial rate of recurrence after ischemic events that drop quickly to a lower rate, suggesting a transient vulnerable clinical state, which may call for different treatments than the subsequent stabilized state. A kinetic model incorporating vulnerable and stabilized states provides estimates of the distinct kinetic rates reflecting the temporal features of underlying stroke mechanisms. We aimed to compare these kinetic rates between treatments and across trials, asking whether these features point to common pathophysiologic processes underlying stroke recurrence, and inform the targeting and timing of enhanced antiplatelet therapy in recurrent stroke prevention.
    Methods: Kaplan-Meier recurrence-free survival curves in the SOCRATES, POINT, and THALES trials were estimated for each treatment group and fitted by nonlinear regression to the 2-state kinetic model, producing estimates of kinetic parameters, with standard errors estimated using the nonparametric bootstrap with repetitive resampling.
    Results: For each trial, the 2-state kinetic model fit the survival curves better than did the null (single-state) kinetic model or the Weibull model (
    Discussion: Across multiple trials of acute secondary prevention after minor stroke or TIA, recurrence of stroke is well-described by a 2-state kinetic model postulating vulnerable and stabilized states, with similar kinetic parameters across trials. Enhanced antiplatelet regimens only affected the recurrence rates in the vulnerable state, over a brief period. This analysis suggests that 2 distinct states follow acute cerebral ischemic events, subject to differential impact of immediate or delayed therapies.
    MeSH term(s) Humans ; Aspirin/therapeutic use ; Cerebral Infarction/complications ; Drug Therapy, Combination ; Ischemic Attack, Transient/complications ; Platelet Aggregation Inhibitors/therapeutic use ; Stroke/complications
    Chemical Substances Aspirin (R16CO5Y76E) ; Platelet Aggregation Inhibitors
    Language English
    Publishing date 2023-11-27
    Publishing country United States
    Document type Clinical Trial ; Journal Article
    ZDB-ID 207147-2
    ISSN 1526-632X ; 0028-3878
    ISSN (online) 1526-632X
    ISSN 0028-3878
    DOI 10.1212/WNL.0000000000207904
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