Stroke, Vol 22, 1108-1116, Copyright © 1991 by American Heart Association
WN Kernan, AR Feinstein and LM Brass
We analyzed existing research on the prognosis of patients who have had a
transient ischemic attack to identify studies that adhere to basic
methodological principles and to identify underinvestigated questions.
Studies were eligible for analysis if they were published in peer- reviewed
journals after 1950, written in English, and included at least 50 patients
with transient ischemia. Studies that included patients with stroke were
included only if they reported outcome rates separately for the subgroup of
patients with transient ischemia. All eligible studies were extracted by
one investigator who recorded adherence to six key methodological
principles. Among 60 eligible studies, 54 were observational cohort studies
and six were randomized trials. Adherence to the six methodological
principles was as follows: eight studies included an adequate description
of diagnostic criteria and of procedures used to assure adherence to the
criteria, 54 used appropriate end points, two assembled inception cohorts,
10 included an adequate description of end point surveillance, 22
adequately reported and analyzed censored patients, and 10 included a
multivariate analysis for predictive variables. No study adhered to all six
principles, but two adhered to the three most important ones (appropriate
end points, inception cohort, and adequate reporting and analysis of
censored patients). Aspects of prognosis after transient ischemia that have
not been completely investigated include the severity of subsequent strokes
and methods for estimating the outcome risk for individual patients. We
conclude that only a few published investigations on prognosis after
transient ischemia are methodologically complete. This finding helps
explain why it is difficult to interpret many studies. Further research is
needed and should target underinvestigated topics.
ARTICLES
A methodological appraisal of research on prognosis after transient ischemic attacks
Department of Medicine, Yale University School of Medicine, New Haven, Conn.
This article has been cited by other articles:
 |
|
 |
|
  J. A. Hayden, P. Cote, and C. Bombardier Evaluation of the quality of prognosis studies in systematic reviews. Ann Intern Med, March 21, 2006; 144(6): 427 - 437. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Daffertshofer, O. Mielke, A. Pullwitt, M. Felsenstein, and M. Hennerici Transient Ischemic Attacks Are More Than "Ministrokes" Stroke, November 1, 2004; 35(11): 2453 - 2458. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Flossmann and P. M. Rothwell Prognosis of vertebrobasilar transient ischaemic attack and minor stroke Brain, September 1, 2003; 126(9): 1940 - 1954. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.K. Lovett, M.S. Dennis, P.A.G. Sandercock, J. Bamford, C.P. Warlow, and P.M. Rothwell Very Early Risk of Stroke After a First Transient Ischemic Attack Stroke, August 1, 2003; 34 (8): e138 - e140. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R Meijer, D S Ihnenfeldt, J van Limbeek, M Vermeulen, and R J de Haan Prognostic factors in the subacute phase after stroke for the future residence after six months to one year. A systematic review of the literature Clinical Rehabilitation, May 1, 2003; 17(5): 512 - 520. [Abstract] [PDF]
|
|
|
|
|
|
R Meijer, D S Ihnenfeldt, I J. de Groot, J van Limbeek, M Vermeulen, and R J de Haan Prognostic factors for ambulation and activities of daily living in the subacute phase after stroke. A systematic review of the literature Clinical Rehabilitation, February 1, 2003; 17(2): 119 - 129. [Abstract] [PDF]
|
|
|
|
 |
|
 D. G Altman Systematic reviews in health care: Systematic reviews of evaluations of prognostic variables BMJ, July 28, 2001; 323(7306): 224 - 228. [Full Text] [PDF]
|
|
|
|
|
|
D. J. Webb, P. B. Fayad, C. Wilbur, A. Thomas, and L. M. Brass Effects of a Specialized Team on Stroke Care : The First Two Years of the Yale Stroke Program Stroke, August 1, 1995; 26(8): 1353 - 1357. [Abstract] [Full Text]
|
|