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Article ; Online: Prevalence of spontaneous recanalisation of complete internal carotid occlusion

Dar Dowlatshahi / Robert Fahed / Brian Dewar / Michel Shamy / Risa Shorr / Sarah Y Zhang

BMJ Open, Vol 13, Iss

protocol for a systematic scoping review

2023 Volume 3

Abstract: Introduction Although previously thought to be a rare occurrence, spontaneous recanalisation is not uncommon, with a growing number of reports describing this phenomenon. However, the frequency, time course and mechanism of spontaneous recanalisation ... ...

Abstract	Introduction Although previously thought to be a rare occurrence, spontaneous recanalisation is not uncommon, with a growing number of reports describing this phenomenon. However, the frequency, time course and mechanism of spontaneous recanalisation remain unknown. A better characterisation of these events is essential to ensuring adequate identification and proper future trial design for treatment.Objective To describe the current body of literature around spontaneous recanalisation following internal carotid occlusion.Methods and analysis With the assistance of an information specialist, we will search MEDLINE, Embase, Cochrane Central Register for Controlled Trials and Web of Science for studies of adults with spontaneous recanalisation or transient occlusion of the internal carotid artery. Two reviewers will independently collect data on included studies pertaining to publication data, study population information, timepoints of initial presentation, recanalisation and subsequent follow-up.Ethics and dissemination Primary data will not be collected; therefore, formal ethics is not required. The findings of this study will be disseminated through peer-reviewed publications and presentations at academic conferences.
Keywords	Medicine ; R
Subject code	306
Language	English
Publishing date	2023-03-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Advance consent for participation in randomised controlled trials for emergency conditions

Ronda Lun / Dar Dowlatshahi / Brian Dewar / Michel Shamy / Naomi Niznick / Jeffrey Perry

BMJ Open, Vol 13, Iss

a scoping review

2023 Volume 2

Abstract: Objective Advance consent is a recognised method of obtaining informed consent for participation in research, whereby a potential participant provides consent for future involvement in a study contingent on qualifying for the study’s inclusion criteria ... ...

Abstract	Objective Advance consent is a recognised method of obtaining informed consent for participation in research, whereby a potential participant provides consent for future involvement in a study contingent on qualifying for the study’s inclusion criteria on a later date. The goal of this study is to map the existing literature on the use of advance consent for enrolment in randomised controlled trials (RCTs) for emergency conditions.Design Scoping review designed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses–Extension for Scoping Reviews guidelines.Data sources We searched electronic databases including MEDLINE, Embase, Web of Science and the Cochrane Register of Clinical Trials from inception to 10 February 2020.Eligibility criteria Eligible studies included articles that discussed or employed the use of advance consent for enrolment in RCTs related to emergency conditions. There were no restrictions on the type of eligible study. Data were extracted directly from included papers using a standardised data charting form. We produced a narrative review including article type and authors’ dispositions towards advance consent.Results Our search yielded 1039 titles with duplicates removed. Six articles met inclusion criteria. Three articles discussed the theoretical use of research advance directives in emergency conditions; one article evaluated stakeholders’ perceptions of advance consent; and one article described a method for patients to document their preferences for participation in future research. Only one study employed advance consent to enrol participants into a clinical trial for an emergency condition.Conclusion Our review demonstrates that there has been minimal exploration of advance consent for enrolment in RCTs for emergency conditions. Future studies could aim to assess the acceptability of advance consent to participants, along with the feasibility of enrolling research participants using this method of consent.Protocol The protocol for this scoping review ...
Keywords	Medicine ; R
Subject code	001
Language	English
Publishing date	2023-02-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Mobile tablet-based therapies following stroke

Michael Pugliese / Tim Ramsay / Dylan Johnson / Dar Dowlatshahi

PLoS ONE, Vol 13, Iss 1, p e

A systematic scoping review of administrative methods and patient experiences.

2018 Volume 0191566

Abstract: Stroke survivors are often left with deficits requiring rehabilitation to recover function and yet, many are unable to access rehabilitative therapies. Mobile tablet-based therapies (MTBTs) may be a resource-efficient means of improving access to timely ... ...

Abstract	Stroke survivors are often left with deficits requiring rehabilitation to recover function and yet, many are unable to access rehabilitative therapies. Mobile tablet-based therapies (MTBTs) may be a resource-efficient means of improving access to timely rehabilitation. It is unclear what MTBTs have been attempted following stroke, how they were administered, and how patients experienced the therapies. The review summarizes studies of MTBTs following stroke in terms of administrative methods and patient experiences to inform treatment feasibility.Articles were eligible if they reported the results of an MTBT attempted with stroke participants. Six research databases were searched along with grey literature sources, trial registries, and article references. Intervention administration details and patient experiences were summarized.The search returned 903 articles of which 23 were eligible for inclusion. Most studies were small, observational, and enrolled chronic stroke patients. Interventions commonly targeted communication, cognition, or fine-motor skills. Therapies tended to be personalized based on patient deficits using commercially available applications. The complexity of therapy instructions, fine-motor requirements, and unreliability of internet or cellular connections were identified as common barriers to tablet-based care.Stroke patients responded positively to MTBTs in both the inpatient and home settings. However, some support from therapists or caregivers may be required for patients to overcome barriers to care. Feasibility studies should continue to identify the administrative methods that minimize barriers to care and maximize patient adherence to prescribed therapy regiments.
Keywords	Medicine ; R ; Science ; Q
Subject code	616
Language	English
Publishing date	2018-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Quality and transparency of reporting derivation and validation prognostic studies of recurrent stroke in patients with TIA and minor stroke

Kasim E. Abdulaziz / Jeffrey J. Perry / Krishan Yadav / Dar Dowlatshahi / Ian G. Stiell / George A. Wells / Monica Taljaard

Diagnostic and Prognostic Research, Vol 6, Iss 1, Pp 1-

a systematic review

2022 Volume 13

Abstract: Abstract Background Clinical prediction models/scores help clinicians make optimal evidence-based decisions when caring for their patients. To critically appraise such prediction models for use in a clinical setting, essential information on the ... ...

Abstract	Abstract Background Clinical prediction models/scores help clinicians make optimal evidence-based decisions when caring for their patients. To critically appraise such prediction models for use in a clinical setting, essential information on the derivation and validation of the models needs to be transparently reported. In this systematic review, we assessed the quality of reporting of derivation and validation studies of prediction models for the prognosis of recurrent stroke in patients with transient ischemic attack or minor stroke. Methods MEDLINE and EMBASE databases were searched up to February 04, 2020. Studies reporting development or validation of multivariable prognostic models predicting recurrent stroke within 90 days in patients with TIA or minor stroke were included. Included studies were appraised for reporting quality and conduct using a select list of items from the Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis (TRIPOD) Statement. Results After screening 7026 articles, 60 eligible articles were retained, consisting of 100 derivation and validation studies of 27 unique prediction models. Four models were newly derived while 23 were developed by validating and updating existing models. Of the 60 articles, 15 (25%) reported an informative title. Among the 100 derivation and validation studies, few reported whether assessment of the outcome (24%) and predictors (12%) was blinded. Similarly, sample size justifications (49%), description of methods for handling missing data (16.1%), and model calibration (5%) were seldom reported. Among the 96 validation studies, 17 (17.7%) clearly reported on similarity (in terms of setting, eligibility criteria, predictors, and outcomes) between the validation and the derivation datasets. Items with the highest prevalence of adherence were the source of data (99%), eligibility criteria (93%), measures of discrimination (81%) and study setting (65%). Conclusions The majority of derivation and validation studies for ...
Keywords	Prediction models ; Prediction rules ; Clinical decision rules ; Risk scores ; Recurrent stroke ; Transient ischemic attack ; Medicine (General) ; R5-920
Subject code	690
Language	English
Publishing date	2022-05-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Direct oral anticoagulants in treatment of cerebral venous thrombosis

Gauruv Bose / Justin Graveline / Vignan Yogendrakumar / Dean Fergusson / Dar Dowlatshahi

Systematic Reviews, Vol 8, Iss 1, Pp 1-

a systematic review protocol

2019 Volume 4

Abstract: Abstract Background and purpose Cerebral venous thrombosis causes disability from venous infarct and hemorrhage and potential mortality. Anticoagulation improves survival and disability outcomes, yet direct oral anticoagulants are currently not indicated ...

Abstract	Abstract Background and purpose Cerebral venous thrombosis causes disability from venous infarct and hemorrhage and potential mortality. Anticoagulation improves survival and disability outcomes, yet direct oral anticoagulants are currently not indicated in cerebral venous thrombosis due to lack of evidence, despite being on the market for nearly a decade. This systematic review will collate evidence of reported safety and efficacy of direct oral anticoagulant therapy in cerebral venous thrombosis. Methods A search strategy was developed with a research librarian and registered on a protocol database (PROSPERO CRD42017078398). All published studies from MEDLINE and EMBASE up to February 2019 containing patients diagnosed with cerebral venous thrombosis who were treated with a direct oral anticoagulant (dabigatran, rivaroxaban, apixaban, or edoxaban) will be included. A risk of bias analysis will be performed to evaluate quality of studies overall. Discussion Current guidelines in the treatment of cerebral vein thrombosis dating back to 2011 from the American Heart Association/American Stroke Association endorse the utility of anticoagulation for the treatment of cerebral vein thrombosis; however, they did not support the use of direct oral anticoagulants. Updated guidelines from the European Stroke Organization, endorsed by the European Academy of Neurology in 2017, also refute utilization of direct oral anticoagulants due to a lack of evidence. There have been nearly 10 years of experience with direct oral anticoagulants in the treatment of venous thrombosis and prevention of stroke in patients with atrial fibrillation, with purported efficacy and safety in comparison with heparins and vitamin K antagonists. Our goal is to undertake a systematic review to assess the effectiveness and safety of direct oral anticoagulants in patients with cerebral vein thrombosis to help guide clinical decision-making for patients unable to take heparins or vitamin K antagonists and to direct future studies to contribute further ...
Keywords	Medicine ; R
Subject code	610
Language	English
Publishing date	2019-04-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Recurrence of cervical artery dissection

Dean A Fergusson / Dar Dowlatshahi / Brian Dewar / Michel Shamy / Alexandra Davis / Elizabeth Lounsbury

BMJ Open, Vol 10, Iss

protocol for a systematic review

2020 Volume 9

Keywords	Medicine ; R
Language	English
Publishing date	2020-09-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Prevalence of non-contrast CT abnormalities in adults with reversible cerebral vasoconstriction syndrome

Dean A Fergusson / Dar Dowlatshahi / Brian Dewar / Michel Shamy / Risa Shorr / Ryan Daniel Gotesman

BMJ Open, Vol 10, Iss

protocol for a systematic review and meta-analysis

2020 Volume 9

Keywords	Medicine ; R
Language	English
Publishing date	2020-09-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Mobile tablet-based therapies following stroke

Michael Pugliese / Dylan Johnson / Dar Dowlatshahi / Tim Ramsay

Systematic Reviews, Vol 6, Iss 1, Pp 1-

a systematic scoping review protocol of attempted interventions and the challenges encountered

2017 Volume 7

Abstract: Abstract Background Stroke is a growing global epidemic limiting the ability of millions to function independently due to post-stroke deficits and complications. Although specialized stroke rehabilitation improves the recovery of functional abilities, ... ...

Abstract	Abstract Background Stroke is a growing global epidemic limiting the ability of millions to function independently due to post-stroke deficits and complications. Although specialized stroke rehabilitation improves the recovery of functional abilities, accessing rehabilitation services has become increasingly challenging as the number of stroke survivors continues to increase and rehabilitation resources remain scarce. Mobile tablet-based therapies (MTBTs) may be a resource-efficient platform for providing stroke rehabilitation services. The feasibility and challenges of offering MTBTs to stroke survivors should be well understood before expensive, large-scale clinical trials are undertaken to study treatment efficacy. Method A systematic scoping review will be conducted to describe attempted MTBTs following stroke and the challenges encountered by survivors and study staff. Studies of interest will evaluate MTBTs offered to adult stroke patients in response to post-stroke complications or deficits. Journal databases, gray literature sources, clinical trial registries, relevant organizational websites, and reference lists of eligible studies will be searched to identify suitable studies. Study characteristics, barriers to care, methodological challenges, patient-reported outcomes, and health outcomes will be extracted to describe MTBTs and understand the challenges encountered in context. Results will be presented using descriptive statistics, tables, figures, and narrative description to summarize the scope of the field. Discussion Trends in MTBT feasibility and common challenges will be discussed to summarize major findings and highlight research gaps. Solutions to common challenges experienced by intervention participants and study staff will be proposed. Implications for the conduct of randomized clinical trials of MTBT efficacy and the appropriateness of a systematic review and meta-analysis of completed trials will be discussed. Systematic review registration uO Research ( http://hdl.handle.net/10393/35696 ...
Keywords	Stroke rehabilitation ; mHealth ; iPad ; Tablet computer ; CVA ; Disability ; Medicine ; R
Subject code	306
Language	English
Publishing date	2017-11-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Incidence of stroke in the first year after diagnosis of cancer-A protocol for systematic review and meta-analysis.

Ronda Lun / Danielle Carole Roy / Tim Ramsay / Deborah Siegal / Risa Shorr / Dean Fergusson / Dar Dowlatshahi

PLoS ONE, Vol 16, Iss 9, p e

2021 Volume 0256825

Abstract: Introduction There is an increased risk of stroke in patients with cancer-this risk is particularly heightened around the time of cancer diagnosis, although no studies have systematically quantified this risk in the literature. Patients newly diagnosed ... ...

Abstract	Introduction There is an increased risk of stroke in patients with cancer-this risk is particularly heightened around the time of cancer diagnosis, although no studies have systematically quantified this risk in the literature. Patients newly diagnosed with cancer without prior stroke represent a highly susceptible population in whom there is a window of opportunity to study and implement primary prevention strategies. Therefore, the objective of this systematic review and meta-analysis is to identify the cumulative incidence of ischemic and hemorrhagic strokes during the first year after a diagnosis of cancer. Methods and analysis MEDLINE, EMBASE, and PubMed will be searched with the assistance from a medical information specialist, from 1980 until present. Eligible studies will include observational studies that have enrolled adult patients newly diagnosed with cancer and report outcomes of stroke during the first year of cancer diagnosis. We will exclude all randomized and non-randomized interventional studies. Data on participant characteristics, study design, baseline characteristics, and outcome characteristics will be extracted. Study quality will be assessed using the Newcastle-Ottawa Scale for cohort studies, and heterogeneity will be assessed using the I2 statistic. Pooled cumulative incidence will be calculated for ischemic and hemorrhagic strokes separately using a random-effects model. Ethics and dissemination No formal research ethics approval is necessary as primary data collection will not be done. We will disseminate our findings through scientific conference presentations, peer-reviewed publications, and social media/the press. The findings from this review will inform clinicians and patients regarding the risk of stroke in patients newly diagnosed with cancer by quantifying the cumulative incidence of each subtype of stroke during the first year after a diagnosis of cancer. This represents a window of opportunity to implement prevention strategies in a susceptible population. Registration id with open science framework osf.io/ucwy9.
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Ticagrelor vs Clopidogrel in addition to Aspirin in minor ischemic stroke/ transient ischemic attack-Protocol for a systematic review and network meta-analysis.

Gabriele Zitikyte / Danielle Carole Roy / Shan Dhaliwal / Ronda Lun / Brian Hutton / Risa Shorr / Dar Dowlatshahi

PLoS ONE, Vol 16, Iss 4, p e

2021 Volume 0250553

Abstract: Introduction Patients with minor ischemic stroke or transient ischemic attack represent a high-risk population for recurrent stroke. No direct comparison exists comparing dual antiplatelet therapy regimens-namely, Ticagrelor and Aspirin versus ... ...

Abstract	Introduction Patients with minor ischemic stroke or transient ischemic attack represent a high-risk population for recurrent stroke. No direct comparison exists comparing dual antiplatelet therapy regimens-namely, Ticagrelor and Aspirin versus Clopidogrel and Aspirin. This systematic review and network meta-analysis (NMA) will examine the efficacy of these two different antiplatelet regimens in preventing recurrent stroke and mortality up to 30 days. Methods and analysis MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) will be searched with the assistance of a medical information specialist. Two independent reviewers will screen studies for inclusion; eligible studies will include randomized controlled trials that enrolled adults presenting with acute minor ischemic stroke or transient ischemic attack and compared one or more of the interventions against each other and/or a control. The primary outcomes will be recurrent ischemic stroke up to 30 days from symptom onset. Secondary outcomes will include safety outcomes (I.e. major bleeding and mortality), functional disability, and outcomes up to 90 days from symptom onset. A Bayesian approach to NMA will be implemented using the BUGSnet function in R Software. Between group comparisons for time-to-event (TTE) and dichotomous outcomes will be presented in terms of hazard ratios and odds ratios with 95% credible intervals, respectively. Secondary effect measures of treatment ranking will also be estimated. Ethics and dissemination No formal research ethics approval are necessary. We will disseminate our findings through scientific conference presentations, peer-reviewed publications, and social media/the press. The findings from this review will aid clinicians in decision-making on the choice of antithrombotic therapy in a high-risk stroke population and could be important in the development of future treatment trials and guidelines. Registration ID with Open Science Framework: 10.17605/OSF.IO/XDJYZ.
Keywords	Medicine ; R ; Science ; Q
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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