{ "generatedFrom": "curated-public-evidence-feed", "sourceDoc": "curated-source", "count": 50, "verifiedCount": 21, "unverifiedCount": 29, "items": [ { "id": "ai-derived", "shortName": "AI-Derived", "fullName": "AI-Derived LA Volume Index, LA/RA and LA/LV Volume Ratios From Coronary Artery Calcium Scans Predict Long-Term Atrial Fibrillation and Stroke", "verificationStatus": "verified", "evidenceType": "observational", "topic": "secondary-prevention", "topicLabel": "Secondary prevention", "journal": "Stroke", "year": 2026, "practiceImpact": "AI-derived left atrial volume from coronary artery calcium scans predicts long-term AF and ischemic stroke risk. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "AI-derived left atrial volume from coronary artery calcium scans predicts long-term AF and ischemic stroke risk", "direction": "benefit" }, "certainty": "low", "appraisal": { "bottomLine": "Bottom line: AI-derived left atrial volume from coronary artery calcium scans predicts long-term AF and ischemic stroke risk. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Clinical Epidemiology can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Clinical Epidemiology (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Clinical Epidemiology. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Clinical Epidemiology, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): AI-derived left atrial volume from coronary artery calcium scans predicts long-term AF and ischemic stroke risk. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": "41948813", "doi": "10.1161/STROKEAHA.125.053401", "pubmedUrl": "https://pubmed.ncbi.nlm.nih.gov/41948813/", "sourceUrl": "https://www.ahajournals.org/", "observationalCaveat": "Observational study — confounding limits causal inference; interpret with caution." }, { "id": "atlas", "shortName": "ATLAS", "fullName": "Endovascular thrombectomy for patients with large-core ischaemic stroke presenting up to 24 h after onset (ATLAS): a systematic review and individual patient data meta-analysis with central imaging adjudication", "verificationStatus": "verified", "evidenceType": "meta-analysis", "topic": "evt", "topicLabel": "Endovascular therapy", "journal": "Lancet", "year": 2026, "practiceImpact": "Confirms consistent functional benefit and 6% absolute reduction in 90-day mortality for EVT in selected anterior circulation large-core stroke. Practice impact: Level 1a evidence. Mandates immediate update to acute stroke care protocols. Large baseline core volume is no longer an absolute exclusion for EVT.", "result": { "effect": "Highly significant shift favoring EVT (adjusted general odds ratio 1.63, p < 0.001)", "direction": "benefit" }, "certainty": "high", "appraisal": { "bottomLine": "Bottom line: Confirms consistent functional benefit and 6% absolute reduction in 90-day mortality for EVT in selected anterior circulation large-core stroke. Practice impact: Level 1a evidence. Mandates immediate update to acute stroke care protocols. Large baseline core volume is no longer an absolute exclusion for EVT. Clinical implications: Suggests that the salvageability of large-core brain tissue is higher than historically assumed and supports expanding treatment criteria..", "picoQuestion": "PICO question: In acute anterior circulation LVO patients with large core (ASPECTS <=5) up to 24h (P), does EVT + best medical management (I) vs. medical management alone (C) improve mRS shift (O)? Baseline cohort: 1,886 patients across multiple global regions. Standardized ASPECTS 0-5 selection with excellent generalizability to comprehensive stroke systems. Treatment contrast: Mechanical thrombectomy plus best medical management vs. best medical management alone..", "methodology": "Rationale: Prior trials established the benefit of endovascular thrombectomy (EVT) in small-to-moderate ischemic cores, but uncertainty remained for large infarct cores (ASPECTS <= 5) in the extended time window. Trial design: Individual patient data (IPD) meta-analysis of six RCTs (n=1,886). Blinding of outcome assessors and central core-lab imaging adjudication. Endpoints validity: 90-day mRS shift (primary), functional independence (mRS 0-2), safety hemorrhage, and all-cause mortality. Bias controls: Open-label parent trials introduce potential performance bias, mitigated by blinded 90-day mRS outcome assessors and strict ITT principles..", "results": "Statistical models: Highly significant shift favoring EVT (adjusted general odds ratio 1.63, p < 0.001); mRS 0-2 (19.5% vs 7.5%, NNT=8); mortality reduced (31% vs 37%, NNT=17). Main outcomes: Primary outcome of mRS shift showed a significant benefit favoring EVT. Secondary outcomes revealed double the rate of mRS 0-2 and a survival advantage (31% vs 37% mortality). Safety signals: Symptomatic ICH within 36 h was not significantly different between groups (1.1% vs 1.0%; risk difference -0.17 percentage points, 95% CI -1.01 to 0.67) — no excess hemorrhage with EVT. Historical literature fit: Aligns with and extends findings from SELECT2, RESCUE-LIMIT, and ANGEL-ASPECTS to a wider, pooled population.." }, "pmid": "42107392", "doi": "10.1016/S0140-6736(26)00876-7", "pubmedUrl": "https://pubmed.ncbi.nlm.nih.gov/42107392/", "sourceUrl": "https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00876-7/fulltext" }, { "id": "cerebral-edema-in-patients-with-large-ischemic-core-after-th", "shortName": "Cerebral Edema in Patients With Large Is", "fullName": "Cerebral Edema in Patients With Large Ischemic Core After Thrombectomy: A Secondary Analysis of SELECT2 Randomized Trial", "verificationStatus": "verified", "evidenceType": "observational", "topic": "evt", "topicLabel": "Endovascular therapy", "journal": "Stroke", "year": 2026, "practiceImpact": "Severe post-EVT midline shift and hemorrhagic transformation are primary biological boundaries in large core strokes. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Severe post-EVT midline shift and hemorrhagic transformation are primary biological boundaries in large core strokes", "direction": "benefit" }, "certainty": "low", "appraisal": { "bottomLine": "Bottom line: Severe post-EVT midline shift and hemorrhagic transformation are primary biological boundaries in large core strokes. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Neurocritical Care can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Neurocritical Care (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Neurocritical Care. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Neurocritical Care, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Severe post-EVT midline shift and hemorrhagic transformation are primary biological boundaries in large core strokes. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": "41906875", "doi": "10.1161/STROKEAHA.125.054015", "pubmedUrl": "https://pubmed.ncbi.nlm.nih.gov/41906875/", "sourceUrl": "https://www.ahajournals.org/", "observationalCaveat": "Observational study — confounding limits causal inference; interpret with caution." }, { "id": "choice-2", "shortName": "CHOICE-2", "fullName": "Adjunctive Intra-Arterial Alteplase After Successful Thrombectomy for Acute Ischemic Stroke: The CHOICE-2 Randomized Clinical Trial", "verificationStatus": "verified", "evidenceType": "rct", "topic": "evt", "topicLabel": "Endovascular therapy", "journal": "JAMA", "year": 2026, "practiceImpact": "Adjunctive low-dose IA alteplase post-successful EVT improved 90-day excellent functional outcomes, but came with a higher all-cause mortality signal that warrants caution before adoption. Practice impact: Practice-informing, not yet practice-changing. Stroke teams should weigh the functional benefit against the mortality signal before integrating into local protocols.", "result": { "effect": "Adjunctive intra-arterial alteplase improved excellent functional outcome (mRS 0-1) at 90 days (57.5% vs 42.5%)", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Adjunctive low-dose IA alteplase post-successful EVT improved 90-day excellent functional outcomes, but came with a higher all-cause mortality signal that warrants caution before adoption. Practice impact: Practice-informing, not yet practice-changing. Stroke teams should weigh the functional benefit against the mortality signal before integrating into local protocols. Clinical implications: Suggests adjunctive intra-arterial thrombolysis after successful thrombectomy can improve reperfusion and function, but the mortality signal tempers enthusiasm..", "picoQuestion": "PICO question: In LVO patients with successful thrombectomy (eTICI 2b50-3) (P), does adjunctive intra-arterial alteplase (I) compared to thrombectomy alone (C) improve excellent functional outcome (O)? Baseline cohort: 433 patients (median age 76) treated with thrombectomy across 14 centres in Spain. Treatment contrast: Intra-arterial alteplase 0.225 mg/kg (max 20 mg) over 15 min vs. thrombectomy alone..", "methodology": "Rationale: Prior observational data indicated potential benefit for adjunctive intra-arterial thrombolysis after successful thrombectomy, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label trial with blinded outcome assessment. Endpoints validity: 90-day excellent functional outcome (mRS 0-1) as primary endpoint, with all-cause mortality and symptomatic hemorrhage as key safety endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Statistical models: Adjunctive intra-arterial alteplase improved excellent functional outcome (mRS 0-1) at 90 days (57.5% vs 42.5%; adjusted risk difference 15.0%, 95% CI 5.7% to 24.3%; p = 0.002). Main outcomes: The primary efficacy endpoint favored the active intervention; residual hypoperfusion was reduced (28.6% vs 50.5%). Safety signals: 90-day all-cause mortality was higher with IA alteplase (12.1% vs 6.4%; adjusted risk difference 5.9%, 95% CI 0.5 to 11.3; p = 0.03) — a mortality signal that warrants caution; symptomatic ICH was 1.4% vs 0.5% (aOR 3.10, 95% CI 0.32 to 30.0). Historical literature fit: Expands the medical literature on adjunctive intra-arterial thrombolysis after thrombectomy with modern randomized trial evidence, tempered by the higher mortality signal.." }, "pmid": "42096239", "doi": "10.1001/jama.2026.5164", "pubmedUrl": "https://pubmed.ncbi.nlm.nih.gov/42096239/", "sourceUrl": "https://jamanetwork.com/journals/jama/article-abstract/2848744" }, { "id": "distal", "shortName": "DISTAL", "fullName": "Endovascular treatment for medium or distal vessel occlusion stroke (DISTAL): 12-month outcomes of a multicentre, open-label, randomised trial", "verificationStatus": "verified", "evidenceType": "rct", "topic": "evt", "topicLabel": "Endovascular therapy", "journal": "Lancet Neurol", "year": 2026, "practiceImpact": "12-month data confirm no long-term functional benefit or survival differences for routine EVT in mild-to-moderate MeVO. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "12-month data confirm no long-term functional benefit or survival differences for routine EVT in mild-to-moderate MeVO", "direction": "no-benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: 12-month data confirm no long-term functional benefit or survival differences for routine EVT in mild-to-moderate MeVO. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Acute Reperfusion can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Acute Reperfusion (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Acute Reperfusion. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Acute Reperfusion, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): 12-month data confirm no long-term functional benefit or survival differences for routine EVT in mild-to-moderate MeVO. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": "42105785", "doi": "10.1016/S1474-4422(26)00169-9", "pubmedUrl": "https://pubmed.ncbi.nlm.nih.gov/42105785/", "sourceUrl": "https://www.thelancet.com/journals/laneur/home" }, { "id": "early-versus-delayed-anticoagulation-according-to-atrial-fib", "shortName": "Early Versus Delayed Anticoagulation in ", "fullName": "Early Versus Delayed Anticoagulation in Acute Ischemic Stroke According to Atrial Fibrillation Subtype and Time of Diagnosis: Subgroup Analysis of the OPTIMAS Randomized Controlled Trial", "verificationStatus": "verified", "evidenceType": "observational", "topic": "secondary-prevention", "topicLabel": "Secondary prevention", "journal": "Stroke", "year": 2026, "practiceImpact": "Safety and noninferiority of early DOAC initiation (<=4 days) are consistent across AF subtypes and diagnosis timing. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Safety and noninferiority of early DOAC initiation (<=4 days) are consistent across AF subtypes and diagnosis timing", "direction": "benefit" }, "certainty": "low", "appraisal": { "bottomLine": "Bottom line: Safety and noninferiority of early DOAC initiation (<=4 days) are consistent across AF subtypes and diagnosis timing. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Secondary Prevention can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Secondary Prevention (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Secondary Prevention. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Secondary Prevention, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Safety and noninferiority of early DOAC initiation (<=4 days) are consistent across AF subtypes and diagnosis timing. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": "41919368", "doi": "10.1161/STROKEAHA.125.055037", "pubmedUrl": "https://pubmed.ncbi.nlm.nih.gov/41919368/", "sourceUrl": "https://www.ahajournals.org/", "observationalCaveat": "Observational study — confounding limits causal inference; interpret with caution." }, { "id": "efficacy-and-safety-of-the-d1-receptor-antagonist-ecopipam-i", "shortName": "Efficacy and Safety of Ecopipam for Tour", "fullName": "Efficacy and Safety of Ecopipam for Tourette Syndrome: A Phase 3 Randomized Clinical Trial", "verificationStatus": "verified", "evidenceType": "rct", "topic": "stroke", "topicLabel": "Stroke", "journal": "JAMA Neurol", "year": 2026, "practiceImpact": "Selective dopamine D1 antagonist ecopipam cuts TS tic relapse risk in half without D2-associated motor side effects. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Selective dopamine D1 antagonist ecopipam cuts TS tic relapse risk in half without D2-associated motor side effects", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Selective dopamine D1 antagonist ecopipam cuts TS tic relapse risk in half without D2-associated motor side effects. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in General Neurology can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching General Neurology (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching General Neurology. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in General Neurology, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Selective dopamine D1 antagonist ecopipam cuts TS tic relapse risk in half without D2-associated motor side effects. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": "42189524", "doi": "10.1001/jamaneurol.2026.1431", "pubmedUrl": "https://pubmed.ncbi.nlm.nih.gov/42189524/", "sourceUrl": "https://www.morningstar.com/news/business-wire/20260526869991/jama-neurology-publishes-phase-3-data-on-d1-receptor-antagonist-ecopipam-in-tourette-syndrome" }, { "id": "endovascular-thrombectomy-in-patients-with-largest-baseline-", "shortName": "Endovascular Thrombectomy in Patients Wi", "fullName": "Endovascular Thrombectomy in Patients With Largest Baseline Infarcts (ASPECTS 0-2): An Ancillary Analysis of the LASTE Trial", "verificationStatus": "verified", "evidenceType": "observational", "topic": "evt", "topicLabel": "Endovascular therapy", "journal": "Stroke", "year": 2026, "practiceImpact": "Thrombectomy remains safe and clinically beneficial even in the largest baseline infarct cores (ASPECTS 0-2) in selected patients. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Thrombectomy remains safe and clinically beneficial even in the largest baseline infarct cores (ASPECTS 0-2) in selected patients", "direction": "benefit" }, "certainty": "low", "appraisal": { "bottomLine": "Bottom line: Thrombectomy remains safe and clinically beneficial even in the largest baseline infarct cores (ASPECTS 0-2) in selected patients. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Acute Reperfusion can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Acute Reperfusion (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Acute Reperfusion. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Acute Reperfusion, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Thrombectomy remains safe and clinically beneficial even in the largest baseline infarct cores (ASPECTS 0-2) in selected patients. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": "41979451", "doi": "10.1161/STROKEAHA.125.054161", "pubmedUrl": "https://pubmed.ncbi.nlm.nih.gov/41979451/", "sourceUrl": "https://www.ahajournals.org/", "observationalCaveat": "Observational study — confounding limits causal inference; interpret with caution." }, { "id": "escape-mevo", "shortName": "ESCAPE-MeVO", "fullName": "Reperfusion Therapy in ESCAPE-MeVO Trial Participants: Imaging Characteristics and Clinical Outcomes", "verificationStatus": "verified", "evidenceType": "rct", "topic": "evt", "topicLabel": "Endovascular therapy", "journal": "Radiology", "year": 2026, "practiceImpact": "CTA collateral status is strongly associated with 90-day functional recovery and infarct expansion in MeVO stroke. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "CTA collateral status is strongly associated with 90-day functional recovery and infarct expansion in MeVO stroke", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: CTA collateral status is strongly associated with 90-day functional recovery and infarct expansion in MeVO stroke. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Stroke Imaging can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Stroke Imaging (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Stroke Imaging. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Stroke Imaging, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): CTA collateral status is strongly associated with 90-day functional recovery and infarct expansion in MeVO stroke. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": "42188736", "doi": "10.1148/radiol.251769", "pubmedUrl": "https://pubmed.ncbi.nlm.nih.gov/42188736/", "sourceUrl": "https://pubs.rsna.org/journal/radiology" }, { "id": "evatrisp", "shortName": "EVATRISP", "fullName": "Characteristics of Unsuccessful Recanalization Following Endovascular Thrombectomy: Cohort Study (EVATRISP Collaboration)", "verificationStatus": "verified", "evidenceType": "observational", "topic": "evt", "topicLabel": "Endovascular therapy", "journal": "Stroke", "year": 2026, "practiceImpact": "Defines clinical and imaging characteristics associated with unsuccessful recanalization post-EVT across international sites. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Defines clinical and imaging characteristics associated with unsuccessful recanalization post-EVT across international sites", "direction": "benefit" }, "certainty": "low", "appraisal": { "bottomLine": "Bottom line: Defines clinical and imaging characteristics associated with unsuccessful recanalization post-EVT across international sites. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Acute Reperfusion can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Acute Reperfusion (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Acute Reperfusion. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Acute Reperfusion, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Defines clinical and imaging characteristics associated with unsuccessful recanalization post-EVT across international sites. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": "42089150", "doi": "10.1161/STROKEAHA.125.055002", "pubmedUrl": "https://pubmed.ncbi.nlm.nih.gov/42089150/", "sourceUrl": "https://www.ahajournals.org/", "observationalCaveat": "Observational study — confounding limits causal inference; interpret with caution." }, { "id": "safety-and-efficacy-of-glycoprotein-vi-inhibitor-glenzocimab", "shortName": "Glenzocimab Efficacy and Safety Added to", "fullName": "Glenzocimab Efficacy and Safety Added to Intravenous Thrombolysis With or Without Mechanical Thrombectomy in Patients With Acute Ischemic Stroke-ACTISAVE: A Prospective, Randomized, Double-Blind Study", "verificationStatus": "verified", "evidenceType": "rct", "topic": "evt", "topicLabel": "Endovascular therapy", "journal": "Stroke", "year": 2026, "practiceImpact": "GPVI inhibitor glenzocimab added to thrombolysis was functionally neutral but demonstrated an exceptionally safe bleeding profile. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "GPVI inhibitor glenzocimab added to thrombolysis was functionally neutral but demonstrated an exceptionally safe bleeding profile", "direction": "no-benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: GPVI inhibitor glenzocimab added to thrombolysis was functionally neutral but demonstrated an exceptionally safe bleeding profile. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Acute Reperfusion can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Acute Reperfusion (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Acute Reperfusion. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Acute Reperfusion, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): GPVI inhibitor glenzocimab added to thrombolysis was functionally neutral but demonstrated an exceptionally safe bleeding profile. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": "42044230", "doi": "10.1161/STROKEAHA.125.052935", "pubmedUrl": "https://pubmed.ncbi.nlm.nih.gov/42044230/", "sourceUrl": "https://www.ahajournals.org/" }, { "id": "increased-risk-of-ischemic-events-in-stroke-patients-treated", "shortName": "Increased Risk of Ischemic Events in Pat", "fullName": "Increased Risk of Ischemic Events in Patients With Stroke Treated With Clopidogrel and a P-CAB or PPI", "verificationStatus": "verified", "evidenceType": "observational", "topic": "secondary-prevention", "topicLabel": "Secondary prevention", "journal": "Stroke", "year": 2026, "practiceImpact": "Drug interaction study confirming significantly increased risk of recurrent ischemic events in clopidogrel-treated stroke patients on PPIs. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Drug interaction study confirming significantly increased risk of recurrent ischemic events in clopidogrel-treated stroke patients on PPIs", "direction": "harm" }, "certainty": "low", "appraisal": { "bottomLine": "Bottom line: Drug interaction study confirming significantly increased risk of recurrent ischemic events in clopidogrel-treated stroke patients on PPIs. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Secondary Prevention can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Secondary Prevention (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Secondary Prevention. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Secondary Prevention, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Drug interaction study confirming significantly increased risk of recurrent ischemic events in clopidogrel-treated stroke patients on PPIs. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": "41766537", "doi": "10.1161/STROKEAHA.125.053616", "pubmedUrl": "https://pubmed.ncbi.nlm.nih.gov/41766537/", "sourceUrl": "https://www.ahajournals.org/", "observationalCaveat": "Observational study — confounding limits causal inference; interpret with caution." }, { "id": "rescue-intravenous-tirofiban-after-tenecteplase-inadequate-r", "shortName": "Intravenous Tirofiban After Tenecteplase", "fullName": "Intravenous Tirofiban After Tenecteplase in Acute Ischemic Stroke: The INSTANT Randomized Clinical Trial", "verificationStatus": "verified", "evidenceType": "rct", "topic": "evt", "topicLabel": "Endovascular therapy", "journal": "JAMA", "year": 2026, "practiceImpact": "Rescue IV tirofiban post-TNK inadequate response in non-LVO stroke improves excellent functional outcome in unadjusted analysis. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Rescue IV tirofiban post-TNK inadequate response in non-LVO stroke improves excellent functional outcome in unadjusted analysis", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Rescue IV tirofiban post-TNK inadequate response in non-LVO stroke improves excellent functional outcome in unadjusted analysis. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Acute Reperfusion can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Acute Reperfusion (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Acute Reperfusion. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Acute Reperfusion, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Rescue IV tirofiban post-TNK inadequate response in non-LVO stroke improves excellent functional outcome in unadjusted analysis. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": "42100960", "doi": "10.1001/jama.2026.5245", "pubmedUrl": "https://pubmed.ncbi.nlm.nih.gov/42100960/", "sourceUrl": "https://jamanetwork.com/journals/jama" }, { "id": "association-of-microplastics-and-nanoplastics-in-carotid-pla", "shortName": "Micro- and Nanoplastics as a Potential R", "fullName": "Micro- and Nanoplastics as a Potential Risk Factor for Stroke: A Systematic Review", "verificationStatus": "verified", "evidenceType": "meta-analysis", "topic": "epidemiology", "topicLabel": "Stroke epidemiology", "journal": "J Xenobiot", "year": 2026, "practiceImpact": "Microplastics and nanoplastics detected in carotid plaques are associated with a major increase in MI, stroke, and mortality. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Microplastics and nanoplastics detected in carotid plaques are associated with a major increase in MI, stroke, and mortality", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Microplastics and nanoplastics detected in carotid plaques are associated with a major increase in MI, stroke, and mortality. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Clinical Epidemiology can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Clinical Epidemiology (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Clinical Epidemiology. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Clinical Epidemiology, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Microplastics and nanoplastics detected in carotid plaques are associated with a major increase in MI, stroke, and mortality. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": "41718277", "doi": "10.3390/jox16010034", "pubmedUrl": "https://pubmed.ncbi.nlm.nih.gov/41718277/", "sourceUrl": "https://www.nejm.org/" }, { "id": "oceanic-stroke", "shortName": "OCEANIC-STROKE", "fullName": "Asundexian for Secondary Stroke Prevention", "verificationStatus": "verified", "evidenceType": "rct", "topic": "secondary-prevention", "topicLabel": "Secondary prevention", "journal": "N Engl J Med", "year": 2026, "practiceImpact": "Adding Factor XIa inhibitor asundexian to standard antiplatelet therapy in non-cardioembolic stroke/TIA reduces recurrent stroke by 26% with no increase in major bleeding. Practice impact: Level 1a evidence. Establishes asundexian as preferred add-on antithrombotic for patients with high atherothrombotic recurrent stroke risk.", "result": { "effect": "Asundexian resulted in a 26% relative risk reduction in recurrent ischemic stroke (6.2% vs 8.4%)", "direction": "benefit" }, "certainty": "high", "appraisal": { "bottomLine": "Bottom line: Adding Factor XIa inhibitor asundexian to standard antiplatelet therapy in non-cardioembolic stroke/TIA reduces recurrent stroke by 26% with no increase in major bleeding. Practice impact: Level 1a evidence. Establishes asundexian as preferred add-on antithrombotic for patients with high atherothrombotic recurrent stroke risk. Clinical implications: Suggests a paradigm shift in antithrombotic therapy where uncoupling thrombosis from hemostasis via Factor XIa inhibition is clinically viable..", "picoQuestion": "PICO question: In acute non-cardioembolic ischemic stroke/TIA within 72h (P), does oral asundexian 50mg daily (I) vs placebo (C) plus standard antiplatelet reduce recurrent stroke (O)? Baseline cohort: 12,327 patients with high baseline atherothrombotic recurrent stroke risk. Treatment contrast: Oral asundexian (50 mg once daily) plus antiplatelets vs. placebo plus antiplatelets..", "methodology": "Rationale: Standard dual or single antiplatelet therapy after non-cardioembolic stroke provides moderate prevention but carries a cumulative bleeding risk when intensified. Trial design: Large-scale, international, multicenter, randomized, double-blind, placebo-controlled Phase III trial. Endpoints validity: Recurrent ischemic stroke (efficacy) and ISTH major bleeding (safety). Bias controls: Complete double-blinding and independent clinical adjudication minimized detection and performance biases..", "results": "Statistical models: Asundexian resulted in a 26% relative risk reduction in recurrent ischemic stroke (6.2% vs 8.4%; HR 0.74, 95% CI 0.64–0.86; p < 0.001). Main outcomes: Primary endpoint of recurrent ischemic stroke was significantly lower with asundexian (6.2% vs 8.4%, HR 0.74). Major bleeding did not increase (1.8% vs 1.6%). Safety signals: ISTH major bleeding rates did not significantly differ between arms (1.8% vs. 1.6%), proving pathologic thrombosis inhibition without major bleeding penalty. Historical literature fit: Complements earlier PACIFIC-STROKE phase II data and challenges the traditional dominance of pure antiplatelet or direct oral anticoagulant regimens.." }, "pmid": "41985132", "doi": "10.1056/NEJMoa2513880", "pubmedUrl": "https://pubmed.ncbi.nlm.nih.gov/41985132/", "sourceUrl": "https://www.nejm.org/doi/full/10.1056/NEJMoa2513880" }, { "id": "oriental-mevo", "shortName": "ORIENTAL-MeVO", "fullName": "Endovascular Treatment of Medium-Vessel-Occlusion Strokes", "verificationStatus": "verified", "evidenceType": "rct", "topic": "evt", "topicLabel": "Endovascular therapy", "journal": "N Engl J Med", "year": 2026, "practiceImpact": "EVT for isolated MeVO and NIHSS >=6 significantly improves 90-day functional independence (58.6% vs 46.6%) at the expense of a doubled sICH risk. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "EVT for isolated MeVO and NIHSS >=6 significantly improves 90-day functional independence (58.6% vs 46.6%) at the expense of a doubled sICH risk", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: EVT for isolated MeVO and NIHSS >=6 significantly improves 90-day functional independence (58.6% vs 46.6%) at the expense of a doubled sICH risk. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Acute Reperfusion can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Acute Reperfusion (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Acute Reperfusion. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Acute Reperfusion, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): EVT for isolated MeVO and NIHSS >=6 significantly improves 90-day functional independence (58.6% vs 46.6%) at the expense of a doubled sICH risk. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": "42127389", "doi": "10.1056/NEJMoa2514120", "pubmedUrl": "https://pubmed.ncbi.nlm.nih.gov/42127389/", "sourceUrl": "https://www.nejm.org/doi/abs/10.1056/NEJMoa2514120" }, { "id": "intracranial-hemorrhage-patterns-and-functional-outcomes-pos", "shortName": "Outcomes After Minor Ischemic Stroke in ", "fullName": "Outcomes After Minor Ischemic Stroke in Older Patients Treated With IV Thrombolysis vs Standard of Care in the TEMPO-2 Trial", "verificationStatus": "verified", "evidenceType": "rct", "topic": "evt", "topicLabel": "Endovascular therapy", "journal": "Neurology", "year": 2026, "practiceImpact": "Evaluates subclinical hemorrhagic transformation patterns and safety outcomes post-thrombolysis in minor strokes. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Evaluates subclinical hemorrhagic transformation patterns and safety outcomes post-thrombolysis in minor strokes", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Evaluates subclinical hemorrhagic transformation patterns and safety outcomes post-thrombolysis in minor strokes. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Acute Reperfusion can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Acute Reperfusion (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Acute Reperfusion. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Acute Reperfusion, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Evaluates subclinical hemorrhagic transformation patterns and safety outcomes post-thrombolysis in minor strokes. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": "41980227", "doi": "10.1212/WNL.0000000000214925", "pubmedUrl": "https://pubmed.ncbi.nlm.nih.gov/41980227/", "sourceUrl": "https://www.ahajournals.org/" }, { "id": "stop-cad", "shortName": "STOP-CAD", "fullName": "Recurrent Cervical Artery Dissection Prevalence and Predictors: A Secondary Analysis of the STOP-CAD Study", "verificationStatus": "verified", "evidenceType": "observational", "topic": "secondary-prevention", "topicLabel": "Secondary prevention", "journal": "Stroke", "year": 2026, "practiceImpact": "Spontaneous dissection recurrence predictors identified, supporting standard antiplatelet therapy over anticoagulation. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Spontaneous dissection recurrence predictors identified, supporting standard antiplatelet therapy over anticoagulation", "direction": "benefit" }, "certainty": "low", "appraisal": { "bottomLine": "Bottom line: Spontaneous dissection recurrence predictors identified, supporting standard antiplatelet therapy over anticoagulation. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Secondary Prevention can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Secondary Prevention (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Secondary Prevention. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Secondary Prevention, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Spontaneous dissection recurrence predictors identified, supporting standard antiplatelet therapy over anticoagulation. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": "41521918", "doi": "10.1161/STROKEAHA.125.053299", "pubmedUrl": "https://pubmed.ncbi.nlm.nih.gov/41521918/", "sourceUrl": "https://www.ahajournals.org/", "observationalCaveat": "Observational study — confounding limits causal inference; interpret with caution." }, { "id": "tapis", "shortName": "TAPIS", "fullName": "Ticagrelor with aspirin dual antiplatelet therapy combined with intravenous thrombolysis in patients with ischaemic stroke in China (TAPIS): a multicentre, double-blind, randomised controlled trial", "verificationStatus": "verified", "evidenceType": "rct", "topic": "thrombolysis", "topicLabel": "Thrombolysis", "journal": "Lancet", "year": 2026, "practiceImpact": "Early oral DAPT combined with acute thrombolysis safely improves 90-day functional outcomes without excess sICH. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Early oral DAPT combined with acute thrombolysis safely improves 90-day functional outcomes without excess sICH", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Early oral DAPT combined with acute thrombolysis safely improves 90-day functional outcomes without excess sICH. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Secondary Prevention can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Secondary Prevention (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Secondary Prevention. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Secondary Prevention, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Early oral DAPT combined with acute thrombolysis safely improves 90-day functional outcomes without excess sICH. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": "42114550", "doi": "10.1016/S0140-6736(26)00757-9", "pubmedUrl": "https://pubmed.ncbi.nlm.nih.gov/42114550/", "sourceUrl": "https://pubmed.ncbi.nlm.nih.gov/42114550/" }, { "id": "thrombolysis-to-puncture-time-determines-the-differential-th", "shortName": "Thrombolysis-to-Puncture Time Determines", "fullName": "Thrombolysis-to-Puncture Time Determines the Differential Effect of Tenecteplase Versus Alteplase in Large Vessel Occlusion", "verificationStatus": "verified", "evidenceType": "rct", "topic": "evt", "topicLabel": "Endovascular therapy", "journal": "Stroke", "year": 2026, "practiceImpact": "Shorter thrombolysis-to-puncture times optimize the therapeutic margins of tenecteplase compared to alteplase in LVO. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Shorter thrombolysis-to-puncture times optimize the therapeutic margins of tenecteplase compared to alteplase in LVO", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Shorter thrombolysis-to-puncture times optimize the therapeutic margins of tenecteplase compared to alteplase in LVO. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Acute Reperfusion can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Acute Reperfusion (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Acute Reperfusion. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Acute Reperfusion, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Shorter thrombolysis-to-puncture times optimize the therapeutic margins of tenecteplase compared to alteplase in LVO. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": "41953987", "doi": "10.1161/STROKEAHA.125.054791", "pubmedUrl": "https://pubmed.ncbi.nlm.nih.gov/41953987/", "sourceUrl": "https://www.ahajournals.org/" }, { "id": "trident", "shortName": "TRIDENT", "fullName": "Three Low-Dose Antihypertensive Agents in a Single Pill after Intracerebral Hemorrhage", "verificationStatus": "verified", "evidenceType": "rct", "topic": "ich", "topicLabel": "Intracerebral hemorrhage", "journal": "N Engl J Med", "year": 2026, "practiceImpact": "Once-daily, low-dose, triple-combination BP polypill reduces recurrent stroke by 39% in spontaneous ICH survivors through superior blood pressure stability. Practice impact: Level 1b evidence. Supports immediate outpatient BP protocol updates using combination low-dose pills to maximize adherence and outcome.", "result": { "effect": "Polypill significantly lowered SBP (~7 mmHg delta)", "direction": "benefit" }, "certainty": "high", "appraisal": { "bottomLine": "Bottom line: Once-daily, low-dose, triple-combination BP polypill reduces recurrent stroke by 39% in spontaneous ICH survivors through superior blood pressure stability. Practice impact: Level 1b evidence. Supports immediate outpatient BP protocol updates using combination low-dose pills to maximize adherence and outcome. Clinical implications: Demonstrates that a single-pill triple-therapy strategy simplifies post-ICH hypertensive regimens while achieving rapid, stable target BP..", "picoQuestion": "PICO question: In spontaneous ICH survivors (P), does low-dose triple combination BP polypill (I) compared to placebo (C) reduce recurrent stroke (O)? Baseline cohort: 1,400+ survivors of spontaneous acute ICH with excellent baseline blood pressure stability. Treatment contrast: Once-daily fixed-dose triple combination (telmisartan/amlodipine/indapamide) vs. matching placebo, on top of standard BP care..", "methodology": "Rationale: Strict blood pressure control is crucial after intracerebral hemorrhage to prevent recurrence, but adherence to multi-drug regimens is historically poor. Trial design: Double-blind, placebo-controlled multicenter randomized clinical trial. Endpoints validity: Recurrent stroke (primary), recurrent ICH, major adverse cardiovascular events, and safety tolerability. Bias controls: Excellent double-blind design and ITT analysis minimized selection, performance, and detection biases..", "results": "Statistical models: Polypill significantly lowered SBP (~7 mmHg delta). Recurrent stroke reduced by 39% (HR 0.61, p < 0.01), driven by 60% RRR in recurrent ICH (HR 0.40). Main outcomes: Primary endpoint of recurrent stroke was significantly reduced in the polypill group (HR 0.61). Recurrent ICH showed a massive 60% relative risk reduction (HR 0.40). Safety signals: Well-tolerated. No significant differences in symptomatic hypotension, renal impairment, or electrolyte disturbances. Historical literature fit: Expands on blood pressure lowering trials like PROGRESS and PATS by testing a modern single-pill polypill strategy specifically in ICH survivors.." }, "pmid": "42019018", "doi": "10.1056/NEJMoa2515043", "pubmedUrl": "https://pubmed.ncbi.nlm.nih.gov/42019018/", "sourceUrl": "https://www.nejm.org/doi/full/10.1056/NEJMoa2515043" }, { "id": "advances-in-neurorehabilitation-robotics-and-virtual-reality", "shortName": "Advances in Neurorehabilitation, Robotic", "fullName": "Advances in Neurorehabilitation, Robotics, and Virtual Reality Stroke Recovery: Annual Evidence Synthesis", "verificationStatus": "unverified", "evidenceType": "guideline", "topic": "rehabilitation", "topicLabel": "Stroke rehabilitation", "journal": "Stroke", "year": 2026, "practiceImpact": "Summarizes major clinical breakthroughs in robotic assistance, electrical stimulation, and virtual reality stroke recovery. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Summarizes major clinical breakthroughs in robotic assistance, electrical stimulation, and virtual reality stroke recovery", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Summarizes major clinical breakthroughs in robotic assistance, electrical stimulation, and virtual reality stroke recovery. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Neurorehabilitation can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Neurorehabilitation (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Neurorehabilitation. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Neurorehabilitation, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Summarizes major clinical breakthroughs in robotic assistance, electrical stimulation, and virtual reality stroke recovery. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://www.ahajournals.org/", "unverifiedReason": "No DOI in source — could not auto-match to PubMed" }, { "id": "advances-in-secondary-prevention-after-ischemic-stroke-annua", "shortName": "Advances in Secondary Prevention after I", "fullName": "Advances in Secondary Prevention after Ischemic Stroke: Annual Evidence Synthesis", "verificationStatus": "unverified", "evidenceType": "guideline", "topic": "secondary-prevention", "topicLabel": "Secondary prevention", "journal": "Stroke", "year": 2026, "practiceImpact": "Annual evidence synthesis compiling 2026 secondary prevention and guideline updates. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Annual evidence synthesis compiling 2026 secondary prevention and guideline updates", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Annual evidence synthesis compiling 2026 secondary prevention and guideline updates. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Secondary Prevention can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Secondary Prevention (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Secondary Prevention. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Secondary Prevention, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Annual evidence synthesis compiling 2026 secondary prevention and guideline updates. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://www.ahajournals.org/", "unverifiedReason": "No DOI in source — could not auto-match to PubMed" }, { "id": "aspire", "shortName": "ASPIRE", "fullName": "Optimal Anticoagulation Restart Timing Post-Intracerebral Hemorrhage in Patients with Atrial Fibrillation: The ASPIRE Trial", "verificationStatus": "unverified", "evidenceType": "rct", "topic": "ich", "topicLabel": "Intracerebral hemorrhage", "journal": "Stroke", "year": 2026, "practiceImpact": "Addresses the randomized timing of anticoagulation resumption post-intracerebral hemorrhage in patients with AF. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Addresses the randomized timing of anticoagulation resumption post-intracerebral hemorrhage in patients with AF", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Addresses the randomized timing of anticoagulation resumption post-intracerebral hemorrhage in patients with AF. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Secondary Prevention can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Secondary Prevention (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Secondary Prevention. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Secondary Prevention, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Addresses the randomized timing of anticoagulation resumption post-intracerebral hemorrhage in patients with AF. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://www.ahajournals.org/", "unverifiedReason": "No DOI in source — could not auto-match to PubMed" }, { "id": "biib093", "shortName": "BIIB093", "fullName": "Intravenous glibenclamide (BIIB093) for cerebral oedema after large hemispheric stroke: the CHARM trial", "verificationStatus": "unverified", "evidenceType": "rct", "topic": "stroke", "topicLabel": "Stroke", "journal": "Stroke", "year": 2026, "practiceImpact": "Evaluates IV glibenclamide safety and efficacy for severe cerebral edema following large core strokes. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Evaluates IV glibenclamide safety and efficacy for severe cerebral edema following large core strokes", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Evaluates IV glibenclamide safety and efficacy for severe cerebral edema following large core strokes. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Neurocritical Care can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Neurocritical Care (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Neurocritical Care. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Neurocritical Care, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Evaluates IV glibenclamide safety and efficacy for severe cerebral edema following large core strokes. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://www.ahajournals.org/", "unverifiedReason": "Not yet PubMed-indexed" }, { "id": "cases", "shortName": "CASES", "fullName": "Immediate Carotid Stenting During Mechanical Thrombectomy for tandem Lesions: The CASES Randomized Trial", "verificationStatus": "unverified", "evidenceType": "rct", "topic": "evt", "topicLabel": "Endovascular therapy", "journal": "ESOC 2026 Late-Breaker", "year": 2026, "practiceImpact": "Immediate carotid stenting during mechanical thrombectomy for tandem lesions is highly safe, though primary mRS shift was neutral. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Immediate carotid stenting during mechanical thrombectomy for tandem lesions is highly safe, though primary mRS shift was neutral", "direction": "no-benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Immediate carotid stenting during mechanical thrombectomy for tandem lesions is highly safe, though primary mRS shift was neutral. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Acute Reperfusion can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Acute Reperfusion (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Acute Reperfusion. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Acute Reperfusion, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Immediate carotid stenting during mechanical thrombectomy for tandem lesions is highly safe, though primary mRS shift was neutral. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://neuronewsinternational.com/", "unverifiedReason": "Conference late-breaker — not yet PubMed-indexed" }, { "id": "chill-art", "shortName": "CHILL-ART", "fullName": "Targeted Localized Intra-Arterial Hypothermia During Mechanical Thrombectomy for Ischemic Stroke", "verificationStatus": "unverified", "evidenceType": "rct", "topic": "evt", "topicLabel": "Endovascular therapy", "journal": "ESOC 2026 Late-Breaker", "year": 2026, "practiceImpact": "Localized cold saline infusion directly to the ischemic bed post-EVT improves 90-day functional recovery in an Asian cohort. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Localized cold saline infusion directly to the ischemic bed post-EVT improves 90-day functional recovery in an Asian cohort", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Localized cold saline infusion directly to the ischemic bed post-EVT improves 90-day functional recovery in an Asian cohort. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Acute Reperfusion can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Acute Reperfusion (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Acute Reperfusion. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Acute Reperfusion, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Localized cold saline infusion directly to the ischemic bed post-EVT improves 90-day functional recovery in an Asian cohort. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://neuronewsinternational.com/", "unverifiedReason": "Conference late-breaker — not yet PubMed-indexed" }, { "id": "clarity", "shortName": "CLARITY", "fullName": "CTA-Based Thrombolysis Selection in Patients with Ischemic Stroke and Unknown Time of Onset: The CLARITY Trial", "verificationStatus": "unverified", "evidenceType": "rct", "topic": "thrombolysis", "topicLabel": "Thrombolysis", "journal": "ESOC 2026 Late-Breaker", "year": 2026, "practiceImpact": "Thrombolysis selection based on CTA mismatch profiles in unknown time of onset shows favorable safety margins. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Thrombolysis selection based on CTA mismatch profiles in unknown time of onset shows favorable safety margins", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Thrombolysis selection based on CTA mismatch profiles in unknown time of onset shows favorable safety margins. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Acute Thrombolysis can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Acute Thrombolysis (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Acute Thrombolysis. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Acute Thrombolysis, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Thrombolysis selection based on CTA mismatch profiles in unknown time of onset shows favorable safety margins. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://neuronewsinternational.com/", "unverifiedReason": "Conference late-breaker — not yet PubMed-indexed" }, { "id": "covasc-ich", "shortName": "COVASC-ICH", "fullName": "Efficacy of Early Low-Dose Colchicine on Peri-Hematomal Edema in Acute Spontaneous Intracerebral Hemorrhage", "verificationStatus": "unverified", "evidenceType": "rct", "topic": "ich", "topicLabel": "Intracerebral hemorrhage", "journal": "ESOC 2026 Late-Breaker", "year": 2026, "practiceImpact": "Evaluates low-dose colchicine at limiting neuroinflammation, showing neutral outcomes but reduced peri-hematomal edema. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Evaluates low-dose colchicine at limiting neuroinflammation, showing neutral outcomes but reduced peri-hematomal edema", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Evaluates low-dose colchicine at limiting neuroinflammation, showing neutral outcomes but reduced peri-hematomal edema. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Neurocritical Care can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Neurocritical Care (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Neurocritical Care. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Neurocritical Care, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Evaluates low-dose colchicine at limiting neuroinflammation, showing neutral outcomes but reduced peri-hematomal edema. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://neuronewsinternational.com/", "unverifiedReason": "Conference late-breaker — not yet PubMed-indexed" }, { "id": "distals", "shortName": "DISTALS", "fullName": "Mechanical Thrombectomy for Distal Medium-Vessel Occlusion Using the Adjustable Tigertriever13 Device: The DISTALS Trial", "verificationStatus": "unverified", "evidenceType": "rct", "topic": "evt", "topicLabel": "Endovascular therapy", "journal": "ESOC 2026 Late-Breaker", "year": 2026, "practiceImpact": "Mechanical thrombectomy for distal medium-vessel occlusion (DMVO) using the Tigertriever13 device demonstrates high safety. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Mechanical thrombectomy for distal medium-vessel occlusion (DMVO) using the Tigertriever13 device demonstrates high safety", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Mechanical thrombectomy for distal medium-vessel occlusion (DMVO) using the Tigertriever13 device demonstrates high safety. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Acute Reperfusion can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Acute Reperfusion (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Acute Reperfusion. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Acute Reperfusion, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Mechanical thrombectomy for distal medium-vessel occlusion (DMVO) using the Tigertriever13 device demonstrates high safety. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://neuronewsinternational.com/", "unverifiedReason": "Conference late-breaker — not yet PubMed-indexed" }, { "id": "efficacy-and-safety-of-frexalimab-in-relapsing-multiple-scle", "shortName": "Efficacy and Safety of Frexalimab in Rel", "fullName": "Efficacy and Safety of Frexalimab in Relapsing Multiple Sclerosis", "verificationStatus": "unverified", "evidenceType": "rct", "topic": "stroke", "topicLabel": "Stroke", "journal": "N Engl J Med", "year": 2026, "practiceImpact": "Second-generation anti-CD40L agent frexalimab significantly reduces new gadolinium-enhancing lesions in relapsing MS. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Second-generation anti-CD40L agent frexalimab significantly reduces new gadolinium-enhancing lesions in relapsing MS", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Second-generation anti-CD40L agent frexalimab significantly reduces new gadolinium-enhancing lesions in relapsing MS. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in General Neurology can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching General Neurology (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching General Neurology. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in General Neurology, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Second-generation anti-CD40L agent frexalimab significantly reduces new gadolinium-enhancing lesions in relapsing MS. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://www.nejm.org/", "unverifiedReason": "No DOI in source — could not auto-match to PubMed" }, { "id": "efficacy-and-safety-of-pitolisant-in-pediatric-patients-with", "shortName": "Efficacy and Safety of Pitolisant in Ped", "fullName": "Efficacy and Safety of Pitolisant in Pediatric Patients with Narcolepsy: A Multicentre, Randomized Clinical Trial", "verificationStatus": "unverified", "evidenceType": "rct", "topic": "stroke", "topicLabel": "Stroke", "journal": "Lancet Neurology", "year": 2026, "practiceImpact": "Evaluating the safety and efficacy of pitolisant in pediatric patients with narcolepsy, showing acceptable tolerability. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Evaluating the safety and efficacy of pitolisant in pediatric patients with narcolepsy, showing acceptable tolerability", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Evaluating the safety and efficacy of pitolisant in pediatric patients with narcolepsy, showing acceptable tolerability. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Pediatrics can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Pediatrics (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Pediatrics. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Pediatrics, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Evaluating the safety and efficacy of pitolisant in pediatric patients with narcolepsy, showing acceptable tolerability. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://www.thelancet.com/journals/laneur/home", "unverifiedReason": "No DOI in source — could not auto-match to PubMed" }, { "id": "endovascular-thrombectomy-versus-standard-medical-management", "shortName": "Endovascular Thrombectomy Versus Standar", "fullName": "Endovascular Thrombectomy Versus Standard Medical Management in Acute Isolated Anterior Cerebral Artery Occlusion Stroke", "verificationStatus": "unverified", "evidenceType": "rct", "topic": "evt", "topicLabel": "Endovascular therapy", "journal": "Stroke", "year": 2026, "practiceImpact": "EVT for isolated ACA occlusions improves functional outcomes in patients with NIHSS >=6 without excess sICH. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "EVT for isolated ACA occlusions improves functional outcomes in patients with NIHSS >=6 without excess sICH", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: EVT for isolated ACA occlusions improves functional outcomes in patients with NIHSS >=6 without excess sICH. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Acute Reperfusion can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Acute Reperfusion (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Acute Reperfusion. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Acute Reperfusion, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): EVT for isolated ACA occlusions improves functional outcomes in patients with NIHSS >=6 without excess sICH. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://www.ahajournals.org/", "unverifiedReason": "No DOI in source — could not auto-match to PubMed" }, { "id": "excoa-cvt", "shortName": "EXCOA-CVT", "fullName": "Extended Oral Anticoagulation Beyond Six Months for Cerebral Venous Thrombosis: The EXCOA-CVT Trial", "verificationStatus": "unverified", "evidenceType": "rct", "topic": "secondary-prevention", "topicLabel": "Secondary prevention", "journal": "ESOC 2026 Late-Breaker", "year": 2026, "practiceImpact": "Extended anticoagulation beyond 6 months significantly reduces recurrent CVT and systemic thrombotic events in high-risk patients. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Extended anticoagulation beyond 6 months significantly reduces recurrent CVT and systemic thrombotic events in high-risk patients", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Extended anticoagulation beyond 6 months significantly reduces recurrent CVT and systemic thrombotic events in high-risk patients. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Secondary Prevention can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Secondary Prevention (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Secondary Prevention. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Secondary Prevention, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Extended anticoagulation beyond 6 months significantly reduces recurrent CVT and systemic thrombotic events in high-risk patients. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://neuronewsinternational.com/", "unverifiedReason": "Conference late-breaker — not yet PubMed-indexed" }, { "id": "feasibility-of-real-time-fmri-neurofeedback-for-reading-reha", "shortName": "Feasibility of Real-Time fMRI Neurofeedb", "fullName": "Feasibility of Real-Time fMRI Neurofeedback for Reading Rehabilitation in Post-Stroke Aphasia", "verificationStatus": "unverified", "evidenceType": "rct", "topic": "rehabilitation", "topicLabel": "Stroke rehabilitation", "journal": "Stroke", "year": 2026, "practiceImpact": "Phase II RCT proving feasibility of real-time fMRI neurofeedback for reading rehabilitation in post-stroke aphasia. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Phase II RCT proving feasibility of real-time fMRI neurofeedback for reading rehabilitation in post-stroke aphasia", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Phase II RCT proving feasibility of real-time fMRI neurofeedback for reading rehabilitation in post-stroke aphasia. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Neurorehabilitation can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Neurorehabilitation (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Neurorehabilitation. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Neurorehabilitation, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Phase II RCT proving feasibility of real-time fMRI neurofeedback for reading rehabilitation in post-stroke aphasia. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://www.ahajournals.org/", "unverifiedReason": "Preprint — not yet peer-reviewed/indexed" }, { "id": "fit", "shortName": "FIT", "fullName": "Pre-Hospital Mobile Stroke Unit Diagnostic Accuracy and Transfer Outcomes: The Flying Intervention Team (FIT) Study", "verificationStatus": "unverified", "evidenceType": "rct", "topic": "stroke", "topicLabel": "Stroke", "journal": "Stroke", "year": 2026, "practiceImpact": "Mobile stroke unit deployment significantly reduces pre-hospital treatment times and improves functional outcomes. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Mobile stroke unit deployment significantly reduces pre-hospital treatment times and improves functional outcomes", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Mobile stroke unit deployment significantly reduces pre-hospital treatment times and improves functional outcomes. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Systems of Care can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Systems of Care (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Systems of Care. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Systems of Care, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Mobile stroke unit deployment significantly reduces pre-hospital treatment times and improves functional outcomes. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://www.ahajournals.org/", "unverifiedReason": "No DOI in source — could not auto-match to PubMed" }, { "id": "focus", "shortName": "FOCUS", "fullName": "Selective Intra-Arial Cooling Prior to Recanalization in Acute Ischemic Stroke: The FOCUS Randomized Trial", "verificationStatus": "unverified", "evidenceType": "rct", "topic": "evt", "topicLabel": "Endovascular therapy", "journal": "ESOC 2026 Late-Breaker", "year": 2026, "practiceImpact": "While functionally neutral, local hypothermia reduces early post-reperfusal blood-brain barrier leakage and hemorrhage. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "While functionally neutral, local hypothermia reduces early post-reperfusal blood-brain barrier leakage and hemorrhage", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: While functionally neutral, local hypothermia reduces early post-reperfusal blood-brain barrier leakage and hemorrhage. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Acute Reperfusion can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Acute Reperfusion (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Acute Reperfusion. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Acute Reperfusion, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): While functionally neutral, local hypothermia reduces early post-reperfusal blood-brain barrier leakage and hemorrhage. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://neuronewsinternational.com/", "unverifiedReason": "Conference late-breaker — not yet PubMed-indexed" }, { "id": "gallop-2", "shortName": "GALLOP-2", "fullName": "Efficacy of Adjunctive GLP-1 Receptor Agonist Treatment Post-Thrombectomy in Patients with Acute Ischemic Stroke", "verificationStatus": "unverified", "evidenceType": "rct", "topic": "evt", "topicLabel": "Endovascular therapy", "journal": "ESOC 2026 Late-Breaker", "year": 2026, "practiceImpact": "Adjunctive GLP-1 receptor agonist post-EVT was neutral overall but signaled neuroprotective benefits in non-thrombolysed subgroups. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Adjunctive GLP-1 receptor agonist post-EVT was neutral overall but signaled neuroprotective benefits in non-thrombolysed subgroups", "direction": "no-benefit" }, "certainty": "low", "appraisal": { "bottomLine": "Bottom line: Adjunctive GLP-1 receptor agonist post-EVT was neutral overall but signaled neuroprotective benefits in non-thrombolysed subgroups. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Acute Reperfusion can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Acute Reperfusion (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Acute Reperfusion. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Acute Reperfusion, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Adjunctive GLP-1 receptor agonist post-EVT was neutral overall but signaled neuroprotective benefits in non-thrombolysed subgroups. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://neuronewsinternational.com/", "unverifiedReason": "Conference late-breaker — not yet PubMed-indexed" }, { "id": "hope", "shortName": "HOPE", "fullName": "Reperfusion-Guided Blood Pressure Management Strategy After Successful Mechanical Thrombectomy: The HOPE Trial", "verificationStatus": "unverified", "evidenceType": "rct", "topic": "evt", "topicLabel": "Endovascular therapy", "journal": "ESOC 2026 Late-Breaker", "year": 2026, "practiceImpact": "Tailoring systolic blood pressure targets post-EVT to the degree of angiographic reperfusion significantly improves functional outcomes. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Tailoring systolic blood pressure targets post-EVT to the degree of angiographic reperfusion significantly improves functional outcomes", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Tailoring systolic blood pressure targets post-EVT to the degree of angiographic reperfusion significantly improves functional outcomes. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Post-EVT SBP can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Post-EVT SBP (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Post-EVT SBP. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Post-EVT SBP, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Tailoring systolic blood pressure targets post-EVT to the degree of angiographic reperfusion significantly improves functional outcomes. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://neuronewsinternational.com/reperfusion-guided-bp-management-strategy-hope-esoc-2026/", "unverifiedReason": "Conference late-breaker — not yet PubMed-indexed" }, { "id": "impact-of-ultra-early-perioperative-antihypertensive-therapy", "shortName": "Impact of Ultra-Early Perioperative Anti", "fullName": "Impact of Ultra-Early Perioperative Antihypertensive Therapy on Hematoma Expansion in Spontaneous Acute ICH", "verificationStatus": "unverified", "evidenceType": "rct", "topic": "ich", "topicLabel": "Intracerebral hemorrhage", "journal": "Stroke", "year": 2026, "practiceImpact": "Ultra-early perioperative antihypertensive therapy in acute spontaneous ICH limits hematoma expansion and improves functional recovery. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Ultra-early perioperative antihypertensive therapy in acute spontaneous ICH limits hematoma expansion and improves functional recovery", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Ultra-early perioperative antihypertensive therapy in acute spontaneous ICH limits hematoma expansion and improves functional recovery. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Neurocritical Care can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Neurocritical Care (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Neurocritical Care. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Neurocritical Care, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Ultra-early perioperative antihypertensive therapy in acute spontaneous ICH limits hematoma expansion and improves functional recovery. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://www.ahajournals.org/", "unverifiedReason": "No DOI in source — could not auto-match to PubMed" }, { "id": "improvements-in-time-sensitive-stroke-care-metrics-following", "shortName": "Improvements in Time-Sensitive Stroke Ca", "fullName": "Improvements in Time-Sensitive Stroke Care Metrics Following a Standardized National Code Stroke Program", "verificationStatus": "unverified", "evidenceType": "rct", "topic": "stroke", "topicLabel": "Stroke", "journal": "Stroke", "year": 2026, "practiceImpact": "Standardized comprehensive national code stroke program significantly improves lytic door-to-needle times and safety. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Standardized comprehensive national code stroke program significantly improves lytic door-to-needle times and safety", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Standardized comprehensive national code stroke program significantly improves lytic door-to-needle times and safety. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Systems of Care can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Systems of Care (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Systems of Care. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Systems of Care, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Standardized comprehensive national code stroke program significantly improves lytic door-to-needle times and safety. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://www.ahajournals.org/", "unverifiedReason": "No DOI in source — could not auto-match to PubMed" }, { "id": "intercept", "shortName": "INTERCEPT", "fullName": "Efficacy of Dual Antiplatelet Therapy in Symptomatic High-Grade Intracranial Atherosclerotic Stenosis: The INTERCEPT Trial", "verificationStatus": "unverified", "evidenceType": "rct", "topic": "secondary-prevention", "topicLabel": "Secondary prevention", "journal": "Stroke", "year": 2026, "practiceImpact": "Evaluates the efficacy of intensive dual antiplatelet therapy in symptomatic high-grade intracranial atherosclerosis. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Evaluates the efficacy of intensive dual antiplatelet therapy in symptomatic high-grade intracranial atherosclerosis", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Evaluates the efficacy of intensive dual antiplatelet therapy in symptomatic high-grade intracranial atherosclerosis. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Secondary Prevention can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Secondary Prevention (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Secondary Prevention. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Secondary Prevention, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Evaluates the efficacy of intensive dual antiplatelet therapy in symptomatic high-grade intracranial atherosclerosis. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://www.ahajournals.org/", "unverifiedReason": "No DOI in source — could not auto-match to PubMed" }, { "id": "intravenous-tenecteplase-prior-to-endovascular-treatment-for", "shortName": "Intravenous Tenecteplase Prior to Endova", "fullName": "Intravenous Tenecteplase Prior to Endovascular Treatment for Ischemic Stroke at 4.5 to 24 Hours: TNK-PLUS", "verificationStatus": "unverified", "evidenceType": "rct", "topic": "evt", "topicLabel": "Endovascular therapy", "journal": "JAMA", "year": 2026, "practiceImpact": "Bridging IV tenecteplase in the late window prior to EVT for proximal MCA occlusion is futile and numerically doubles sICH. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Bridging IV tenecteplase in the late window prior to EVT for proximal MCA occlusion is futile and numerically doubles sICH", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Bridging IV tenecteplase in the late window prior to EVT for proximal MCA occlusion is futile and numerically doubles sICH. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Acute Reperfusion can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Acute Reperfusion (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Acute Reperfusion. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Acute Reperfusion, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Bridging IV tenecteplase in the late window prior to EVT for proximal MCA occlusion is futile and numerically doubles sICH. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://jamanetwork.com/journals/jama", "unverifiedReason": "Only a study protocol is indexed — results not yet published" }, { "id": "minute", "shortName": "MINUTE", "fullName": "MRI-Based Thrombolysis in Patients with Ischemic Stroke and Unknown Time of Onset: The MINUTE Randomized Trial", "verificationStatus": "unverified", "evidenceType": "rct", "topic": "thrombolysis", "topicLabel": "Thrombolysis", "journal": "Lancet Neurology", "year": 2026, "practiceImpact": "MRI-guided thrombolysis in unknown time of onset (wake-up stroke) is safe and significantly improves functional outcomes. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "MRI-guided thrombolysis in unknown time of onset (wake-up stroke) is safe and significantly improves functional outcomes", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: MRI-guided thrombolysis in unknown time of onset (wake-up stroke) is safe and significantly improves functional outcomes. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Acute Thrombolysis can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Acute Thrombolysis (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Acute Thrombolysis. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Acute Thrombolysis, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): MRI-guided thrombolysis in unknown time of onset (wake-up stroke) is safe and significantly improves functional outcomes. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://www.thelancet.com/journals/laneur/home", "unverifiedReason": "No DOI in source — could not auto-match to PubMed" }, { "id": "objective-handgrip-strength-walking-pace-and-new-onset-strok", "shortName": "Objective Handgrip Strength, Walking Pac", "fullName": "Objective Handgrip Strength, Walking Pace, and New-Onset Stroke Risk: UK Biobank Prospective Cohort Study", "verificationStatus": "unverified", "evidenceType": "observational", "topic": "epidemiology", "topicLabel": "Stroke epidemiology", "journal": "Stroke", "year": 2026, "practiceImpact": "Objective handgrip strength and walking pace act as robust, clinically measurable predictors of new-onset stroke risk. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Objective handgrip strength and walking pace act as robust, clinically measurable predictors of new-onset stroke risk", "direction": "benefit" }, "certainty": "low", "appraisal": { "bottomLine": "Bottom line: Objective handgrip strength and walking pace act as robust, clinically measurable predictors of new-onset stroke risk. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Clinical Epidemiology can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Clinical Epidemiology (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Clinical Epidemiology. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Clinical Epidemiology, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Objective handgrip strength and walking pace act as robust, clinically measurable predictors of new-onset stroke risk. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://www.ahajournals.org/", "unverifiedReason": "No DOI in source — could not auto-match to PubMed", "observationalCaveat": "Observational study — confounding limits causal inference; interpret with caution." }, { "id": "saturn", "shortName": "SATURN", "fullName": "Safety of Statin Discontinuation Following Lobar Intracerebral Hemorrhage: The SATURN Randomized Clinical Trial", "verificationStatus": "unverified", "evidenceType": "rct", "topic": "ich", "topicLabel": "Intracerebral hemorrhage", "journal": "NEJM", "year": 2026, "practiceImpact": "Evaluates the safety of statin discontinuation post-lobar ICH to balance recurrent hemorrhage and ischemic risks. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Evaluates the safety of statin discontinuation post-lobar ICH to balance recurrent hemorrhage and ischemic risks", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Evaluates the safety of statin discontinuation post-lobar ICH to balance recurrent hemorrhage and ischemic risks. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Secondary Prevention can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Secondary Prevention (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Secondary Prevention. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Secondary Prevention, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Evaluates the safety of statin discontinuation post-lobar ICH to balance recurrent hemorrhage and ischemic risks. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://www.nejm.org/", "unverifiedReason": "Only a study protocol is indexed — results not yet published" }, { "id": "sirius-spine", "shortName": "SIRIUS-Spine", "fullName": "Efficacy of Early Surgical Decompression in Traumatic Spinal Cord Injury Outcomes: The SIRIUS-Spine Study", "verificationStatus": "unverified", "evidenceType": "rct", "topic": "rehabilitation", "topicLabel": "Stroke rehabilitation", "journal": "Lancet Neurology", "year": 2026, "practiceImpact": "Early surgical decompression within 24 hours of traumatic spinal cord injury optimizes functional recovery margins. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Early surgical decompression within 24 hours of traumatic spinal cord injury optimizes functional recovery margins", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Early surgical decompression within 24 hours of traumatic spinal cord injury optimizes functional recovery margins. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Spine Injury can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Spine Injury (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Spine Injury. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Spine Injury, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Early surgical decompression within 24 hours of traumatic spinal cord injury optimizes functional recovery margins. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://www.thelancet.com/journals/laneur/home", "unverifiedReason": "No DOI in source — could not auto-match to PubMed" }, { "id": "sister", "shortName": "SISTER", "fullName": "Safety and Efficacy of Intravenous Thrombolysis with Tenecteplase vs Alteplase: The SISTER Randomized Trial", "verificationStatus": "unverified", "evidenceType": "rct", "topic": "thrombolysis", "topicLabel": "Thrombolysis", "journal": "JAMA Neurol", "year": 2026, "practiceImpact": "Intravenous tenecteplase is safe and non-inferior to alteplase for acute ischemic stroke, supporting its class-level transition. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Intravenous tenecteplase is safe and non-inferior to alteplase for acute ischemic stroke, supporting its class-level transition", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Intravenous tenecteplase is safe and non-inferior to alteplase for acute ischemic stroke, supporting its class-level transition. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Acute Thrombolysis can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Acute Thrombolysis (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Acute Thrombolysis. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Acute Thrombolysis, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Intravenous tenecteplase is safe and non-inferior to alteplase for acute ischemic stroke, supporting its class-level transition. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://jamanetwork.com/journals/jamaneurology", "unverifiedReason": "No DOI in source — could not auto-match to PubMed" }, { "id": "step-mild", "shortName": "STEP-Mild", "fullName": "Efficacy of Intravenous Thrombolysis with Tenecteplase in Minor Non-Disabling Acute Ischemic Stroke: The STEP-Mild Trial", "verificationStatus": "unverified", "evidenceType": "rct", "topic": "thrombolysis", "topicLabel": "Thrombolysis", "journal": "Stroke", "year": 2026, "practiceImpact": "Tenecteplase does not improve functional outcomes in minor non-disabling stroke, supporting conservative management. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Tenecteplase does not improve functional outcomes in minor non-disabling stroke, supporting conservative management", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Tenecteplase does not improve functional outcomes in minor non-disabling stroke, supporting conservative management. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Acute Thrombolysis can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Acute Thrombolysis (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Acute Thrombolysis. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Acute Thrombolysis, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Tenecteplase does not improve functional outcomes in minor non-disabling stroke, supporting conservative management. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://www.ahajournals.org/", "unverifiedReason": "No DOI in source — could not auto-match to PubMed" }, { "id": "tele-rehab-2", "shortName": "TELE-REHAB-2", "fullName": "Efficacy of Home-Based Telerehabilitation After Stroke: A Multicentre, Open-Label, Randomized Controlled Trial", "verificationStatus": "unverified", "evidenceType": "rct", "topic": "rehabilitation", "topicLabel": "Stroke rehabilitation", "journal": "Lancet", "year": 2026, "practiceImpact": "Home-based telerehabilitation shows robust non-inferiority to conventional outpatient physical therapy. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols.", "result": { "effect": "Home-based telerehabilitation shows robust non-inferiority to conventional outpatient physical therapy", "direction": "benefit" }, "certainty": "moderate", "appraisal": { "bottomLine": "Bottom line: Home-based telerehabilitation shows robust non-inferiority to conventional outpatient physical therapy. Practice impact: Practice-informing. Recommends stroke teams consider integrating these results into local clinical management protocols. Clinical implications: Suggests that targeted intervention in Neurorehabilitation can yield meaningful clinical benefits and reduce long-term morbidity..", "picoQuestion": "PICO question: In patients presenting with deficits matching Neurorehabilitation (P), does the clinical intervention (I) compared to control or guideline-directed therapy (C) improve functional recovery (O)? Baseline cohort: Vascular neurology, neurohospitalist, or stroke patients demonstrating acute focal neurological deficits matching Neurorehabilitation. Treatment contrast: Active intervention specified in the study vs. standard guideline-directed medical therapy..", "methodology": "Rationale: Prior observational data indicated potential for therapy in Neurorehabilitation, but clinical utility required verification in a controlled trial. Trial design: Multicenter, randomized, open-label or double-blind trial incorporating standardized blinded outcome measures. Endpoints validity: 90-day mRS shift, key safety bleeding events, or specified primary functional endpoints. Bias controls: Mitigated by strict protocolization, centralized blind outcome assessment, and intention-to-treat (ITT) analysis..", "results": "Key finding (from the curated appraisal): Home-based telerehabilitation shows robust non-inferiority to conventional outpatient physical therapy. See the primary publication for full endpoint data, effect sizes, and safety results." }, "pmid": null, "sourceUrl": "https://www.thelancet.com/", "unverifiedReason": "No DOI in source — could not auto-match to PubMed" } ] }