https://scholars.lib.ntu.edu.tw/handle/123456789/611719
標題: | INFOMATAS multi-center systematic review and meta-analysis individual patient data of dynamic cerebral autoregulation in ischemic stroke | 作者: | Beishon L. Minhas J.S. Nogueira R. Castro P. Budgeon C. Aries M. Payne S. Robinson T.G. Panerai R.B. STEPHEN JOHN PAYNE |
關鍵字: | adult;Article;autoregulation;Barthel index;brain blood flow;brain infarction size;brain ischemia;clinical outcome;computer assisted tomography;controlled study;diagnostic accuracy;diagnostic test accuracy study;disease severity;end tidal carbon dioxide tension;Glasgow coma scale;heart rate;human;image analysis;length of stay;major clinical study;mean arterial pressure;mortality rate;neuroimaging;nuclear magnetic resonance imaging;predictive value;priority journal;prognosis;Rankin scale;receiver operating characteristic;sensitivity and specificity;cerebrovascular accident;complication;diagnostic imaging;homeostasis;meta analysis;Brain Ischemia;Homeostasis;Humans;Ischemic Stroke;Neuroimaging;Stroke | 公開日期: | 2020 | 卷: | 15 | 期: | 7 | 起(迄)頁: | 807-812 | 來源出版物: | International Journal of Stroke | 摘要: | Rationale: Disturbances in dynamic cerebral autoregulation after ischemic stroke may have important implications for prognosis. Recent meta-analyses have been hampered by heterogeneity and small samples. Aim and/or hypothesis: The aim of study is to undertake an individual patient data meta-analysis (IPD-MA) of dynamic cerebral autoregulation changes post-ischemic stroke and to determine a predictive model for outcome in ischemic stroke using information combined from dynamic cerebral autoregulation, clinical history, and neuroimaging. Sample size estimates: To detect a change of 2% between categories in modified Rankin scale requires a sample size of ?1500 patients with moderate to severe stroke, and a change of 1 in autoregulation index requires a sample size of 45 healthy individuals (powered at 80%, α = 0.05). Pooled estimates of mean and standard deviation derived from this study will be used to inform sample size calculations for adequately powered future dynamic cerebral autoregulation studies in ischemic stroke. Methods and design: This is an IPD-MA as part of an international, multi-center collaboration (INFOMATAS) with three phases. Firstly, univariate analyses will be constructed for primary (modified Rankin scale) and secondary outcomes, with key co-variates and dynamic cerebral autoregulation parameters. Participants clustering from within studies will be accounted for with random effects. Secondly, dynamic cerebral autoregulation variables will be validated for diagnostic and prognostic accuracy in ischemic stroke using summary receiver operating characteristic curve analysis. Finally, the prognostic accuracy will be determined for four different models combining clinical history, neuroimaging, and dynamic cerebral autoregulation parameters. Study outcome(s): The outcomes for this study are to determine the relationship between clinical outcome, dynamic cerebral autoregulation changes, and baseline patient demographics, to determine the diagnostic and prognostic accuracy of dynamic cerebral autoregulation parameters, and to develop a prognostic model using dynamic cerebral autoregulation in ischemic stroke. Discussion: This is the first international collaboration to use IPD-MA to determine prognostic models of dynamic cerebral autoregulation for patients with ischemic stroke. ? 2020 World Stroke Organization. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85081625467&doi=10.1177%2f1747493020907003&partnerID=40&md5=1e9a06db2f433093697ffd56135d6acd https://scholars.lib.ntu.edu.tw/handle/123456789/611719 |
ISSN: | 17474930 | DOI: | 10.1177/1747493020907003 |
顯示於: | 應用力學研究所 |
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