scholarly journals European Stroke Organisation guidelines for the management of post-stroke seizures and epilepsy

2017 ◽  
Vol 2 (2) ◽  
pp. 103-115 ◽  
Author(s):  
Martin Holtkamp ◽  
Ettore Beghi ◽  
Felix Benninger ◽  
Reetta Kälviäinen ◽  
Rodrigo Rocamora ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Antiepileptic Drugs ◽  
Observational Studies ◽  
Randomised Controlled Trials ◽  
Controlled Trials ◽  
Unprovoked Seizure ◽  
Post Stroke ◽  
Symptomatic Seizures ◽  
Randomised Controlled ◽  
Acute Symptomatic Seizures

Background Following stroke, acute symptomatic seizures (manifestation within seven days) and epilepsy, i.e. occurrence of at least one unprovoked seizure (manifestation after more than seven days), are reported in 3–6% and up to 12% of patients, respectively. Incidence of acute symptomatic seizures is higher in intracranial haemorrhage (10–16%) than in ischaemic stroke (2–4%). Acute symptomatic seizures and unprovoked seizure may be associated with unfavourable functional outcome and increased mortality. In view of the clinical relevance, the European Stroke Organisation has issued evidence-based guidelines on the management of post-stroke seizures and epilepsy. Method A writing committee of six clinicians and researchers from five European countries and Israel identified seven questions relating to prevention of (further) post-stroke seizures and epilepsy and to amelioration of functional outcome and prevention of mortality. Recommendations are based on findings in randomised controlled trials and observational studies using the grading of recommendations assessment, development and evaluation approach. Results In the absence of adequately powered randomised controlled trials, evidence for all recommendations is very low. Based on findings in observational studies, some weak recommendations have been made. In most instances, we suggest not to administer antiepileptic drugs. Due to high incidence of seizure recurrence after one post-stroke unprovoked seizure, secondary antiepileptic drugs prophylaxis needs to be considered. Conclusion Due to very low evidence, these guidelines only give some weak recommendations on prevention of occurrence and recurrence of post-stroke acute symptomatic seizures and unprovoked seizure. Adequately powered randomised controlled trials are required to assess interventions for post-stroke seizure management.

scholarly journals Measurement of long-term outcomes in observational and randomised controlled trials

2007 ◽  
Vol 191 (S50) ◽  
pp. s78-s84 ◽  
Author(s):  
Richard Hodgson ◽  
Chris Bushe ◽  
Robert Hunter
Keyword(s):  
Gold Standard ◽  
Observational Studies ◽  
Randomised Controlled Trials ◽  
Face Validity ◽  
Controlled Trials ◽  
Experimental Paradigm ◽  
Pragmatic Trials ◽  
Long Term Outcomes ◽  
Randomised Controlled

BackgroundRandomised controlled trials (RCTs) are the gold standard for evaluating treatment efficacy. However, the outcomes of RCTs often lackclinical utility and usually do not address real-world effectivenessAimsTo review how traditional RCTs may be triangulatedwith other methodologies such as observational studies and pragmatic trials by highlighting recently reported studies, outcomes used and their respective meritsMethodLiterature review focusing on drug treatmentResultsRecently reported observational and some pragmatic studies show a degree of consistency in reported results and use outcomes that have face validity for cliniciansConclusionsNo single experimental paradigm or outcome provides the necessary data to optimise treatment of mental illness in the clinical setting

Assessment of Reporting Quality in Randomised Controlled Trials of Acupuncture for Post-Stroke Rehabilitation Using the Consort Statement and Stricta Guidelines

2017 ◽  
Vol 35 (2) ◽  
pp. 100-106 ◽  
Author(s):  
Jingchun Zeng ◽  
Guohua Lin ◽  
Lixia Li ◽  
Liming Lu ◽  
Chuyun Chen ◽  
...  
Keyword(s):  
Stroke Rehabilitation ◽  
Randomised Controlled Trials ◽  
Reporting Quality ◽  
Consort Statement ◽  
Allocation Concealment ◽  
Controlled Trials ◽  
Quality Of Reporting ◽  
Post Stroke ◽  
Randomised Controlled

Objectives To evaluate the completeness of reporting of randomised controlled trials (RCTs) of acupuncture for post-stroke rehabilitation in order to provide information to facilitate transparent and more complete reporting of acupuncture RCTs in this field. Methods Multiple databases were searched from their inception through September 2015. Quality of reporting for included papers was assessed against a subset of criteria adapted from the Consolidated Standards for Reporting Trials (CONSORT) 2010 statement and the Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) guidelines. Each item was scored 1 if it was reported, or 0 if it was not clearly stated. Descriptive statistical analysis was performed. Cohen's κ-statistics were calculated to assess agreement between the two reviewers. Results A total of 87 RCTs were included in the full text. Based on CONSORT, good reporting was evident for items “Randomised’ in the title or abstract’, ‘Participants’, ‘Statistical methods’, ‘Recruitment’, ‘Baseline data’, and ‘Outcomes and estimation’, with positive rates >80%. However, the quality of reporting for the items ‘Trial design’, ‘Outcomes’, ‘Sample size’, ‘Allocation concealment’, ‘Implementation’, ‘Blinding’, ‘Flow chart’, ‘Intent-to-treat analysis’, and ‘Ancillary analyses’ was very poor with positive rates <10%. Based on STRICTA, the items ‘Number of needle insertions per subject per session’, ‘Responses sought’, and ‘Needle type’ had poor reporting with positive rates <50%. Substantial agreement was observed for most items and good agreement was observed for some items. Conclusions The reporting quality of RCTs in acupuncture for post-stroke rehabilitation is unsatisfactory and needs improvement.

scholarly journals The effect of iodine deficiency during pregnancy on child development

2019 ◽  
Vol 78 (02) ◽  
pp. 150-160 ◽  
Author(s):  
Sarah C. Bath
Keyword(s):  
School Performance ◽  
Iodine Deficiency ◽  
Public Health Policy ◽  
Observational Studies ◽  
Randomised Controlled Trials ◽  
Controlled Trials ◽  
Neurological Development ◽  
The Past ◽  
Randomised Controlled ◽  
In Pregnancy

It is well known that severe iodine deficiency during pregnancy may cause impaired brain development in the child, with effects on cognitive and motor function, hearing and speech. Whether mild-to-moderate deficiency also affects neurological development is less well known, but in the past decade a number of observational studies have been conducted to answer this question and these studies are reviewed in this article. The picture is now emerging that even mild-to-moderate iodine deficiency during pregnancy may be associated with subtle impairments in cognition and school performance, although the evidence from randomised controlled trials is still lacking. As global efforts to eradicate iodine deficiency in populations continue, it is more likely that mild-to-moderate, rather than severe, iodine deficiency will be the issue of concern in pregnancy, and therefore further research in regions of mild-to-moderate deficiency is required to strengthen the research base and to inform public-health policy.

Clinical Results

2015 ◽  
Author(s):  
John Goodfellow ◽  
John O'Connor ◽  
Hemant Pandit ◽  
Christopher Dodd ◽  
David Murray
Keyword(s):  
Observational Studies ◽  
Randomised Controlled Trials ◽  
Case Series ◽  
Clinical Results ◽  
Controlled Trials ◽  
Randomised Controlled

The results of UKA can be gathered from three main sources: the reports of the national registers, observational studies (both comparative and case series), and randomised controlled trials. In this chapter, we attempt an overview of the clinical results of UKA in general and OUKA in particular. It is important to note that the ‘result’ is of the whole arthroplasty which includes the indications, the technique as well as the implant.

scholarly journals Dysphagia treatment post stroke: a systematic review of randomised controlled trials

2008 ◽  
Vol 37 (3) ◽  
pp. 258-264 ◽  
Author(s):  
Norine Foley ◽  
Robert Teasell ◽  
Katherine Salter ◽  
Elizabeth Kruger ◽  
Rosemary Martino
Keyword(s):  
Systematic Review ◽  
Randomised Controlled Trials ◽  
Controlled Trials ◽  
Post Stroke ◽  
Dysphagia Treatment ◽  
Randomised Controlled
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