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class="bkr_bib"><h1 id="_NBK577863_"><span itemprop="name">Evidence review for aspirin</span></h1><div class="subtitle">Stroke and transient ischaemic attack in over 16s: diagnosis and initial management</div><p><b>Evidence review A</b></p><p><i>NICE Guideline, No. 128</i></p><p class="contrib-group"><h4>Authors</h4><span itemprop="author">National Guideline Centre (UK)</span>.</p><div class="half_rhythm">London: <a href="https://www.nice.org.uk" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Institute for Health and Care Excellence (NICE)</span></a>; <span itemprop="datePublished">2019 May</span>.<div class="small">ISBN-13: <span itemprop="isbn">978-1-4731-3386-0</span></div></div><div><a href="/books/about/copyright/">Copyright</a> © NICE 2019.</div></div><div class="bkr_clear"></div></div><div id="ch1.s1"><h2 id="_ch1_s1_">1. Aspirin for suspected transient ischaemic attack (TIA)</h2><div id="ch1.s1.1"><h3>1.1. Review question: Should people with a suspected TIA be advised to take aspirin prior to assessment in a TIA clinic?</h3></div><div id="ch1.s1.2"><h3>1.2. Introduction</h3><p>Aspirin is a well-recognised treatment for ischaemic stroke and TIA. It is also usual practice to administer aspirin to suspected TIA patients once they have been assessed by medical personnel. However, the timing of aspirin administration is much debated. For people with TIA and mild strokes, access to a specialist is often through the outpatient route. This increases the delay between symptom onset and specialist assessment, which results in the loss of critical time for the reduction and prevention of further damage to the brain.</p><p>Recently, there have been significant changes to service standards nationally, with an increased focus on delivering a 7-day service for people with TIA. However, current practice is to delay aspirin administration to people with TIA until detailed assessment takes place and delays in access to TIA clinics are known to occur. Therefore, this review seeks to examine the efficacy and safety of early aspirin administration, before expert assessment.</p></div><div id="ch1.s1.3"><h3>1.3. PICO table</h3><p>For full details see the review protocol in <a href="#ch1.appa">appendix A</a>.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch1tab1"><a href="/books/NBK577863/table/ch1.tab1/?report=objectonly" target="object" title="Table 1" class="img_link icnblk_img figpopup" rid-figpopup="figch1tab1" rid-ob="figobch1tab1"><img class="small-thumb" src="/books/NBK577863/table/ch1.tab1/?report=thumb" src-large="/books/NBK577863/table/ch1.tab1/?report=previmg" alt="Table 1. PICO characteristics of review question." /></a><div class="icnblk_cntnt"><h4 id="ch1.tab1"><a href="/books/NBK577863/table/ch1.tab1/?report=objectonly" target="object" rid-ob="figobch1tab1">Table 1</a></h4><p class="float-caption no_bottom_margin">PICO characteristics of review question. </p></div></div></div><div id="ch1.s1.4"><h3>1.4. Methods and process</h3><p>This evidence review was developed using the methods and process described in Developing NICE guidelines: the manual.<a class="bibr" href="#ch1.ref12" rid="ch1.ref12"><sup>12</sup></a> Methods specific to this review question are described in the review protocol in <a href="#ch1.appa">appendix A</a>.</p><p>Risk of bias was assessed using the ROBIS checklist for systematic reviews, including individual patient data (IPD) meta-analyses. IPD analyses were included in the same way as published systematic reviews, with the outcomes reported as described in the IPD analysis and risk of bias assessed for the IPD analysis per outcome.</p><p>Declarations of interest were recorded according to NICE’s 2014 conflicts of interest policy up to March 2018, and NICE’s 2018 conflicts of interest policy from April 2018.</p></div><div id="ch1.s1.5"><h3>1.5. Clinical evidence</h3><div id="ch1.s1.5.1"><h4>1.5.1. Included studies</h4><p>One study was included in the review;<a class="bibr" href="#ch1.ref27" rid="ch1.ref27"><sup>27</sup></a> this is summarised in <a class="figpopup" href="/books/NBK577863/table/ch1.tab2/?report=objectonly" target="object" rid-figpopup="figch1tab2" rid-ob="figobch1tab2">Table 2</a> below. Evidence from this study is summarised in the clinical evidence summary below (<a class="figpopup" href="/books/NBK577863/table/ch1.tab3/?report=objectonly" target="object" rid-figpopup="figch1tab3" rid-ob="figobch1tab3">Table 3</a>).</p><p>This study is an individual patient data (IPD) analysis, consisting of eleven studies that compared aspirin to a placebo. It is noted that it combines stroke with TIA and, in the subgroup analysis reported here, includes people with aspirin administered up to 48 hours after the index event. For this reason the study has been downgraded for indirectness during the quality assessment.</p><p>See also the study selection flow chart in <a href="#ch1.appc">appendix C</a>, study evidence tables in <a href="#ch1.appd">appendix D</a>, forest plots in <a href="#ch1.appe">appendix E</a> and GRADE tables in <a href="#ch1.appf">appendix F</a>.</p></div><div id="ch1.s1.5.2"><h4>1.5.2. Excluded studies</h4><p>See the excluded studies list in <a href="#ch1.apph">appendix H</a>.</p></div><div id="ch1.s1.5.3"><h4>1.5.3. Summary of clinical studies included in the evidence review</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch1tab2"><a href="/books/NBK577863/table/ch1.tab2/?report=objectonly" target="object" title="Table 2" class="img_link icnblk_img figpopup" rid-figpopup="figch1tab2" rid-ob="figobch1tab2"><img class="small-thumb" src="/books/NBK577863/table/ch1.tab2/?report=thumb" src-large="/books/NBK577863/table/ch1.tab2/?report=previmg" alt="Table 2. Summary of studies included in the evidence review." /></a><div class="icnblk_cntnt"><h4 id="ch1.tab2"><a href="/books/NBK577863/table/ch1.tab2/?report=objectonly" target="object" rid-ob="figobch1tab2">Table 2</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the evidence review. </p></div></div></div><div id="ch1.s1.5.4"><h4>1.5.4. Quality assessment of clinical studies included in the evidence review</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch1tab3"><a href="/books/NBK577863/table/ch1.tab3/?report=objectonly" target="object" title="Table 3" class="img_link icnblk_img figpopup" rid-figpopup="figch1tab3" rid-ob="figobch1tab3"><img class="small-thumb" src="/books/NBK577863/table/ch1.tab3/?report=thumb" src-large="/books/NBK577863/table/ch1.tab3/?report=previmg" alt="Table 3. Clinical evidence summary: Aspirin versus placebo." /></a><div class="icnblk_cntnt"><h4 id="ch1.tab3"><a href="/books/NBK577863/table/ch1.tab3/?report=objectonly" target="object" rid-ob="figobch1tab3">Table 3</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: Aspirin versus placebo. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch1tab4"><a href="/books/NBK577863/table/ch1.tab4/?report=objectonly" target="object" title="Table 4" class="img_link icnblk_img figpopup" rid-figpopup="figch1tab4" rid-ob="figobch1tab4"><img class="small-thumb" src="/books/NBK577863/table/ch1.tab4/?report=thumb" src-large="/books/NBK577863/table/ch1.tab4/?report=previmg" alt="Table 4. Clinical evidence summary: Continued aspirin versus placebo (in those who received aspirin prior to randomisation)." /></a><div class="icnblk_cntnt"><h4 id="ch1.tab4"><a href="/books/NBK577863/table/ch1.tab4/?report=objectonly" target="object" rid-ob="figobch1tab4">Table 4</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: Continued aspirin versus placebo (in those who received aspirin prior to randomisation). </p></div></div><p>See <a href="#ch1.appf">appendix F</a> for full GRADE tables.</p></div></div><div id="ch1.s1.6"><h3>1.6. Economic evidence</h3><div id="ch1.s1.6.1"><h4>1.6.1. Included studies</h4><p>No relevant health economic studies were identified.</p></div><div id="ch1.s1.6.2"><h4>1.6.2. Excluded studies</h4><p>No relevant health economic studies were identified.</p><p>See also the health economic study selection flow chart in <a href="#ch1.appg">appendix G</a>.</p></div><div id="ch1.s1.6.3"><h4>1.6.3. Unit costs</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch1tab5"><a href="/books/NBK577863/table/ch1.tab5/?report=objectonly" target="object" title="Table 5" class="img_link icnblk_img figpopup" rid-figpopup="figch1tab5" rid-ob="figobch1tab5"><img class="small-thumb" src="/books/NBK577863/table/ch1.tab5/?report=thumb" src-large="/books/NBK577863/table/ch1.tab5/?report=previmg" alt="Table 5. UK costs of aspirin, other antiplatelets and anticoagulants." /></a><div class="icnblk_cntnt"><h4 id="ch1.tab5"><a href="/books/NBK577863/table/ch1.tab5/?report=objectonly" target="object" rid-ob="figobch1tab5">Table 5</a></h4><p class="float-caption no_bottom_margin">UK costs of aspirin, other antiplatelets and anticoagulants. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch1tab6"><a href="/books/NBK577863/table/ch1.tab6/?report=objectonly" target="object" title="Table 6" class="img_link icnblk_img figpopup" rid-figpopup="figch1tab6" rid-ob="figobch1tab6"><img class="small-thumb" src="/books/NBK577863/table/ch1.tab6/?report=thumb" src-large="/books/NBK577863/table/ch1.tab6/?report=previmg" alt="Table 6. UK aspirin costs to people with TIA." /></a><div class="icnblk_cntnt"><h4 id="ch1.tab6"><a href="/books/NBK577863/table/ch1.tab6/?report=objectonly" target="object" rid-ob="figobch1tab6">Table 6</a></h4><p class="float-caption no_bottom_margin">UK aspirin costs to people with TIA. </p></div></div></div></div><div id="ch1.s1.7"><h3>1.7. Resource costs</h3><p>The recommendation made by the committee based on this review (see section <b>Error! Reference source not found.</b>) is not expected to have a substantial impact on resources.</p></div><div id="ch1.s1.8"><h3>1.8. Evidence statements</h3><div id="ch1.s1.8.1"><h4>1.8.1. Clinical evidence statements</h4><ul id="l53"><li id="lt137" class="half_rhythm"><div>Indirect evidence from individual patient data in 28552 people from 2 RCTs demonstrated a clinical benefit of aspirin compared to placebo early after stroke (including in subgroup analysis for those with mild ischaemic stroke; n=8464) for reducing the risk of recurrent stroke at 3 days, 7-14 days and 14 days among those who were not previously receiving aspirin (Very Low quality). However, no clinical difference was seen in risk of recurrent stroke at 24 hours after the index event (Very Low quality).</div></li><li id="lt138" class="half_rhythm"><div>Indirect evidence from individual patient data in 3292 people from 1 RCT demonstrated a clinical benefit of aspirin compared to placebo early after stroke for reducing the risk of recurrent stroke at 24 hours among those who were previously receiving aspirin (Very Low quality).</div></li></ul></div><div id="ch1.s1.8.2"><h4>1.8.2. Health economic evidence statements</h4><ul id="l54"><li id="lt139" class="half_rhythm"><div>No relevant economic evaluations were identified.</div></li></ul></div></div><div id="ch1.s1.9"><h3>1.9. The committee’s discussion of the evidence</h3><div id="ch1.s1.9.1"><h4>1.9.1. Interpreting the evidence</h4><div id="ch1.s1.9.1.1"><h5>1.9.1.1. The outcomes that matter most</h5><p>The critical outcomes for this review were risk of stroke and mortality. Important outcomes were identified as intra-cranial haemorrhage, major bleeding complications, degree of disability or dependence in daily activities (modified Rankin scale [mRS]) and quality of life.</p><p>Evidence was only available for the ‘risk of stroke’ outcome.</p></div><div id="ch1.s1.9.1.2"><h5>1.9.1.2. The quality of the evidence</h5><p>A post-hoc subgroup analysis from 1 study was included in the review. This study was a well-conducted individual patient data (IPD) meta-analysis, consisting of eleven studies that compared aspirin to a placebo. However, the population was indirect for this review because it included confirmed TIA and those with minor ischemic stroke and was based in secondary care, not when the patient had their first contact with healthcare professionals. The timing of the intervention is also indirect for this review as aspirin was given within 48 hours or as long as 1 month after diagnosis. Only one partially-applicable post-hoc subgroup analysis based on 2 large studies was included in the review in this guideline, as the majority of the evidence was too indirect to be considered. This included evidence for aspirin given within 48 hours of onset of acute ischaemic stroke, which is still an indirect population for first point of contact for suspected TIA. Some of the outcome data were imprecise, and there was unexplained heterogeneity for one outcome. Therefore, the evidence quality was rated as very low and the recommendations were largely based on consensus.</p></div><div id="ch1.s1.9.1.3"><h5>1.9.1.3. Benefits and harms</h5><p>The indirect evidence strongly suggested a benefit of aspirin for reducing risk of recurrent stroke. This was 3.2 times less likely at 3 days following the event and 1.5 times less likely at 14 days among those treated with aspirin compared to placebo. However, the effect was not seen at the 24 hour time point, except among those who had received aspirin prior to randomisation. The committee agreed that it makes biological sense that the earlier aspirin can be administered, the better, as there is greater opportunity for prevention of recurrent thrombo-embolism due to aspirin’s antiplatelet effect.</p><p>No other outcomes were reported for people given aspirin very early after the index event, and so no further evidence was available.</p><p>The committee agreed that once a diagnosis of TIA has been suspected by a healthcare professional, it should be safe to give aspirin without significantly increasing the risk of haemorrhage. Aspirin should not be self-administered for suspected TIA without first seeking professional medical advice, which could include NHS 111, paramedics, a GP, nurse, pharmacist or emergency department (ED) physician. The committee discussed the potential risk of giving aspirin to people with suspected TIA who actually have undiagnosed intracerebral haemorrhage. It was noted that the baseline risk of haemorrhage is greater with stroke than TIA, but that even in mild stroke (The National Institutes of Health Stroke Scale [NIHSS] <3) the risk of haemorrhage is <5%, as discussed in the included study. It was also recognised that intracerebral haemorrhage (including intracerebral haemorrhage or convexity subarachnoid haemorrhage) can cause transient focal neurological symptoms that can mimic TIA. The suspected TIA group are likely to have a much lower risk of intracerebral haemorrhage than patients with minor stroke, and therefore aspirin is more likely to be safe. The committee were also aware of some retrospective data suggesting that even when aspirin is given in cases of intracerebral haemorrhage, the clinical condition does not deteriorate. Therefore, taking all of these factors into account the risk of haemorrhage was agreed to be low. Other risks associated with administering aspirin in this group were discussed to be an aspirin allergy or GI bleed (particularly in people already taking anticoagulants) in common with aspirin use in any population, but it was agreed that a single 300 mg dose is likely to carry a low risk of causing or aggravating bleeding.</p><p>The committee also considered that patients should be seen in a TIA clinic within 24 hours thus limiting the time period during which an adverse event might occur.</p><p>Overall, the committee agreed that there was evidence for a benefit of aspirin in the early management of TIA or suspected TIA but that its use needs to be regulated to minimise any possible harm. Therefore, based on indirect evidence and on consensus they recommended that a healthcare professional contacted, whether this is in person or on the telephone, should offer aspirin immediately once TIA is suspected. Urgent expert assessment, for example in a TIA clinic or other secondary care setting, should also be arranged for a definitive diagnosis and, if appropriate, a management plan put in place including continuation of aspirin.</p><p>Please see evidence review B on risk scoring systems for people with TIA for a discussion on urgent expert assessment within 24 hours.</p></div></div><div id="ch1.s1.9.2"><h4>1.9.2. Cost effectiveness and resource use</h4><p>No relevant economic evaluations were identified which addressed the cost effectiveness of aspirin for people with suspected TIA prior to assessment in a TIA clinic.</p><p>In the absence of economic evidence, the committee considered the unit cost of aspirin; currently £0.10. The clinical evidence, in an indirect population, described a reduced risk of stroke when aspirin is given early after minor stroke or confirmed TIA. In considering the cost effectiveness of aspirin for people with suspected TIA, the committee discussed the expected cost savings produced by preventing strokes following TIA and the expected costs of adverse events resulting from inappropriate aspirin use.</p><p>The committee noted that there might be harms and costs associated with treating those given aspirin inappropriately. However, they thought that at a population level, these risks would most likely be offset by the benefits of giving aspirin quickly to those with suspected TIA.</p><p>The committee stressed that all people with TIA are at a high risk of stroke and so all those with suspected TIA should be assessed within 24 hours in a TIA clinic. Please see evidence review B on ‘risk scoring systems for TIA’ for a discussion of the cost effectiveness of assessing people with suspected TIA within 24 hours in a TIA clinic.</p><p>In conclusion, the committee chose to recommend that aspirin is offered immediately if a healthcare professional suspects TIA. The unit cost of aspirin is very low; currently £0.10. The committee agreed that the small unit cost of aspirin, coupled with both the reduced risk of stroke and low risk of adverse effects, would render aspirin cost effective.</p></div><div id="ch1.s1.9.3"><h4>1.9.3. Other factors the committee took into account</h4><p>It was noted that a large proportion (30-50%) of cases referred to a TIA clinic may ultimately not be diagnosed with a TIA. Common TIA mimics to be excluded were discussed, including migraine aura, seizure, and syncope.</p><p>A less common, but important TIA mimic was noted to be convexity subarachnoid haemorrhage (transient focal neurological episodes [TFNE] or ‘amyloid spells’, often presenting with recurrent, stereotyped attacks of a “positive” (tingling or “pins and needles”) sensory disturbance of spreading onset), which might have a high risk of more severe intracerebral haemorrhage if aspirin was administered. Convexity subarachnoid haemorrhage can be detected by both CT and MRI after specialist TIA assessment.</p><p>The committee discussed their experience that people with a TIA may delay seeking medical attention and may not get treatment in time even once TIA is suspected. It did not want the recommendation to give aspirin immediately to lessen the urgency for accessing a TIA clinic or to lead to prolonged aspirin use without specialist assessment.</p><p>The impact of prescribing aspirin was discussed. The recommendation requires that first-line healthcare professionals (e.g. paramedics, NHS 111, community pharmacists, GPs, nurses, ED physicians) advise people with a suspected TIA to take aspirin. General practices will need to ensure they have adequate supplies of aspirin to enable immediate administration.</p><p>The committee considered the option of proposing a research recommendation but agreed that it was unlikely that randomised trial in this area would ever be carried out. The committee believed that given the indirect evidence available and taking into account their experience, the interests of people with suspected TIA would be best served by making an active recommendation.</p></div></div></div><div id="ch1.rl.r1"><h2 id="_ch1_rl_r1_">References</h2><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1.</dt><dd><div class="bk_ref" id="ch1.ref1">Aglua
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HC, Cunha
|
|
L, Forbes
|
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C, Sivenius
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J, Smets
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P, Lowenthal
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A. European Stroke Prevention Study. 2. Dipyridamole and acetylsalicylic acid in the secondary prevention of stroke. Journal of the Neurological Sciences. 1996; 143(1-2):1–13 [<a href="https://pubmed.ncbi.nlm.nih.gov/8981292" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8981292</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>15.</dt><dd><div class="bk_ref" id="ch1.ref15">Easton
|
|
JD, Aunes
|
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M, Albers
|
|
GW, Amarenco
|
|
P, Bokelund-Singh
|
|
S, Denison
|
|
H
|
|
et al. Risk for major bleeding in patients receiving ticagrelor compared with aspirin after transient ischemic attack or acute ischemic stroke in the SOCRATES study (Acute Stroke or Transient Ischemic Attack Treated With Aspirin or Ticagrelor and Patient Outcomes). Circulation. 2017; 136(10):907–16 [<a href="https://pubmed.ncbi.nlm.nih.gov/28655834" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28655834</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>16.</dt><dd><div class="bk_ref" id="ch1.ref16">ESPS Group. European Stroke Prevention Study 2. Efficacy and safety data. Journal of the Neurological Sciences. 1997; 151 (Suppl):S1–77 [<a href="https://pubmed.ncbi.nlm.nih.gov/9276859" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9276859</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>17.</dt><dd><div class="bk_ref" id="ch1.ref17">Fields
|
|
WS, Lemak
|
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NA, Frankowski
|
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RF, Hardy
|
|
RJ. Controlled trial of aspirin in cerebral ischemia. Stroke. 1977; 8(3):301–14 [<a href="https://pubmed.ncbi.nlm.nih.gov/324036" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 324036</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>18.</dt><dd><div class="bk_ref" id="ch1.ref18">Huang
|
|
HP, Lin
|
|
WH, Chen
|
|
SG, Chen
|
|
LZ, Chen
|
|
MY, Che
|
|
CH. Comparative efficacy and safety of nine anti-platelet therapies for patients with ischemic stroke or transient ischemic attack: A mixed treatment comparisons. Molecular Neurobiology. 2017; 54(2):1456–66 [<a href="https://pubmed.ncbi.nlm.nih.gov/26846361" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26846361</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>19.</dt><dd><div class="bk_ref" id="ch1.ref19">Johnston
|
|
SC, Amarenco
|
|
P, Albers
|
|
GW, Denison
|
|
H, Easton
|
|
JD, Evans
|
|
S. Ticagrelor vs. aspirin in acute stroke or transient ischemic attack: primary results of the SOCRATES randomized trial. European Stroke Journal. 2016; 1:(Suppl 1):708–9</div></dd></dl><dl class="bkr_refwrap"><dt>20.</dt><dd><div class="bk_ref" id="ch1.ref20">Johnston
|
|
SC, Amarenco
|
|
P, Albers
|
|
GW, Denison
|
|
H, Easton
|
|
JD, Evans
|
|
SR
|
|
et al. Ticagrelor versus aspirin in acute stroke or transient ischemic attack. New England Journal of Medicine. 2016; 375(1):35–43 [<a href="https://pubmed.ncbi.nlm.nih.gov/27160892" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27160892</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>21.</dt><dd><div class="bk_ref" id="ch1.ref21">Johnston
|
|
SC, Amarenco
|
|
P, Albers
|
|
GW, Denison
|
|
H, Easton
|
|
JD, Held
|
|
P
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|
et al. Acute Stroke or Transient Ischemic Attack Treated with Aspirin or Ticagrelor and Patient Outcomes (SOCRATES) trial: rationale and design. International Journal of Stroke. 2015; 10(8):1304–8 [<a href="https://pubmed.ncbi.nlm.nih.gov/26311628" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26311628</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>22.</dt><dd><div class="bk_ref" id="ch1.ref22">Lavallee
|
|
PC, Meseguer
|
|
E, Abboud
|
|
H, Cabrejo
|
|
L, Olivot
|
|
JM, Simon
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O
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et al. A transient ischaemic attack clinic with round-the-clock access (SOS-TIA): feasibility and effects. Lancet Neurology. 2007; 6(11):953–60 [<a href="https://pubmed.ncbi.nlm.nih.gov/17928270" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17928270</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>23.</dt><dd><div class="bk_ref" id="ch1.ref23">Murakami
|
|
M, Toyokura
|
|
Y, Omae
|
|
T. The effect of ticlopidine and aspirin on TIA: twelve month double-blind trial. Journal of Clinical and Experimental Medicine. 1983; 127:950–971</div></dd></dl><dl class="bkr_refwrap"><dt>24.</dt><dd><div class="bk_ref" id="ch1.ref24">National Institute for Health and Care Excellence. Developing NICE guidelines: the manual. London. National Institute for Health and Care Excellence, 2014. Available from: <a href="http://www.nice.org.uk/article/PMG20/chapter/1%20Introduction%20and%20overview" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.nice.org.uk<wbr style="display:inline-block"></wbr>​/article/PMG20/chapter<wbr style="display:inline-block"></wbr>​/1%20Introduction%20and%20overview</a> [<a href="https://pubmed.ncbi.nlm.nih.gov/26677490" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26677490</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>25.</dt><dd><div class="bk_ref" id="ch1.ref25">A randomized trial of aspirin and sulfinpyrazone in threatened stroke. New England Journal of Medicine. 1978; 299(2):53–9 [<a href="https://pubmed.ncbi.nlm.nih.gov/351394" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 351394</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>26.</dt><dd><div class="bk_ref" id="ch1.ref26">Redman
|
|
AR, Ryan
|
|
GJ. Analysis of trials evaluating combinations of acetylsalicylic acid and dipyridamole in the secondary prevention of stroke. Clinical Therapeutics. 2001; 23(9):1391–408 [<a href="https://pubmed.ncbi.nlm.nih.gov/11589255" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11589255</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>27.</dt><dd><div class="bk_ref" id="ch1.ref27">Rothwell
|
|
PM, Algra
|
|
A, Chen
|
|
Z, Diener
|
|
HC, Norrving
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B, Mehta
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Z. Effects of aspirin on risk and severity of early recurrent stroke after transient ischaemic attack and ischaemic stroke: time-course analysis of randomised trials. Lancet. 2016; 388(10042):365–75 [<a href="/pmc/articles/PMC5321490/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5321490</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27209146" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27209146</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>28.</dt><dd><div class="bk_ref" id="ch1.ref28">Rothwell
|
|
PM, Giles
|
|
MF, Chandratheva
|
|
A, Marquardt
|
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L, Geraghty
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O, Redgrave
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JN
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et al. Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study): a prospective population-based sequential comparison. Lancet. 2007; 370(9596):1432–42 [<a href="https://pubmed.ncbi.nlm.nih.gov/17928046" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17928046</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>29.</dt><dd><div class="bk_ref" id="ch1.ref29">Sandercock
|
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PA, Counsell
|
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C, Tseng
|
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MC, Cecconi
|
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E. Oral antiplatelet therapy for acute ischaemic stroke. Cochrane Database of Systematic Reviews
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2014, Issue 3. Art. No.: 24668137. DOI: 10.1002/14651858.CD000029.pub3. [<a href="/pmc/articles/PMC6669270/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6669270</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24668137" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24668137</span></a>] [<a href="http://dx.crossref.org/10.1002/14651858.CD000029.pub3" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>30.</dt><dd><div class="bk_ref" id="ch1.ref30">Sorensen
|
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PS, Pedersen
|
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H, Marquardsen
|
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J, Petersson
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H, Heltberg
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A, Simonsen
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N
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et al. Acetylsalicylic acid in the prevention of stroke in patients with reversible cerebral ischemic attacks. A Danish cooperative study. Stroke. 1983; 14(1):15–22 [<a href="https://pubmed.ncbi.nlm.nih.gov/6337425" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 6337425</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>31.</dt><dd><div class="bk_ref" id="ch1.ref31">Stachenko
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SJ, Bravo
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G, Cote
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R, Boucher
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J, Battista
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RN. Aspirin in transient ischemic attacks and minor stroke: a meta-analysis. Family Practice Research Journal. 1991; 11(2):179–91 [<a href="https://pubmed.ncbi.nlm.nih.gov/1829313" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1829313</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>32.</dt><dd><div class="bk_ref" id="ch1.ref32">Study design of the International Stroke Trial (IST), baseline data, and outcome in 984 randomised patients in the pilot study. Journal of Neurology, Neurosurgery and Psychiatry. 1996; 60(4):371–6 [<a href="/pmc/articles/PMC1073886/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1073886</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/8774398" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8774398</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>33.</dt><dd><div class="bk_ref" id="ch1.ref33">Swedish Aspirin Low-Dose Trial (SALT) of 75 mg aspirin as secondary prophylaxis after cerebrovascular ischaemic events. The SALT Collaborative Group. Lancet. 1991; 338(8779):1345–9 [<a href="https://pubmed.ncbi.nlm.nih.gov/1682734" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1682734</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>34.</dt><dd><div class="bk_ref" id="ch1.ref34">Sze
|
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PC, Reitman
|
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D, Pincus
|
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MM, Sacks
|
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HS, Chalmers
|
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TC. Antiplatelet agents in the secondary prevention of stroke: meta-analysis of the randomized control trials. Stroke. 1988; 19(4):436–42 [<a href="https://pubmed.ncbi.nlm.nih.gov/3284017" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 3284017</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>35.</dt><dd><div class="bk_ref" id="ch1.ref35">Takahashi
|
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S, Mizuno
|
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O, Sakaguchi
|
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T, Yamada
|
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T, Inuyama
|
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L. Enteric-coated aspirin versus other antiplatelet drugs in acute non-cardioembolic ischemic stroke: post-marketing study in Japan. Advances in Therapy. 2014; 31(1):118–29 [<a href="https://pubmed.ncbi.nlm.nih.gov/24385407" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24385407</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>36.</dt><dd><div class="bk_ref" id="ch1.ref36">Thijs
|
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V, Lemmens
|
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R, Fieuws
|
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S. Network meta-analysis: simultaneous meta-analysis of common antiplatelet regimens after transient ischaemic attack or stroke. European Heart Journal. 2008; 29(9):1086–92 [<a href="https://pubmed.ncbi.nlm.nih.gov/18349026" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18349026</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>37.</dt><dd><div class="bk_ref" id="ch1.ref37">Tohgi
|
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H, Murakami
|
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M. The effect of ticlopidine on TIA compared with aspirin - A double-blind, twelve-month and open 24-month follow-up study. Japanese Journal of Medicine. 1987; 26(1):117–9 [<a href="https://pubmed.ncbi.nlm.nih.gov/3553381" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 3553381</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>38.</dt><dd><div class="bk_ref" id="ch1.ref38">The United Kingdom Transient Ischemic Attack (UK-TIA) aspirin trial: final results. Journal of Neurology, Neurosurgery and Psychiatry. 1991; 54:1044–54 [<a href="/pmc/articles/PMC1014676/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1014676</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/1783914" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1783914</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>39.</dt><dd><div class="bk_ref" id="ch1.ref39">Wa
|
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D, Zhu
|
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P, Long
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Z. Comparative efficacy and safety of anti-platelet agents in cerebral ischemic disease: A network meta-analysis. Journal of Cellular Biochemistry. 2017; Epublication [<a href="https://pubmed.ncbi.nlm.nih.gov/28409870" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28409870</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>40.</dt><dd><div class="bk_ref" id="ch1.ref40">Wang
|
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W, Zhang
|
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L, Liu
|
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W, Zhu
|
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Q, Lan
|
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Q, Zhao
|
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J. Antiplatelet agents for the secondary prevention of ischemic stroke or transient ischemic attack: A network meta-analysis. Journal of Stroke and Cerebrovascular Diseases. 2016; 25(5):1081–9 [<a href="https://pubmed.ncbi.nlm.nih.gov/26856461" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26856461</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>41.</dt><dd><div class="bk_ref" id="ch1.ref41">Wang
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Y, Minematsu
|
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K, Wong
|
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KS, Amarenco
|
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P, Albers
|
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GW, Denison
|
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H
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et al. Ticagrelor in acute stroke or transient ischemic attack in Asian patients: from the SOCRATES trial (Acute Stroke or Transient Ischemic Attack Treated With Aspirin or Ticagrelor and Patient Outcomes). Stroke. 2017; 48(1):167–73 [<a href="https://pubmed.ncbi.nlm.nih.gov/27899747" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27899747</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>42.</dt><dd><div class="bk_ref" id="ch1.ref42">Weinberger
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J. Adverse effects and drug interactions of antithrombotic agents used in prevention of ischaemic stroke. Drugs. 2005; 65(4):461–71 [<a href="https://pubmed.ncbi.nlm.nih.gov/15733010" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15733010</span></a>]</div></dd></dl></dl></div><div id="appendixesappgroup1"><h2 id="_appendixesappgroup1_">Appendices</h2><div id="ch1.appa"><h3>Appendix A. Review protocols</h3><p id="ch1.appa.tab1"><a href="/books/NBK577863/table/ch1.appa.tab1/?report=objectonly" target="object" rid-ob="figobch1appatab1" class="figpopup">Table 6. Review protocol: Aspirin</a></p><p id="ch1.appa.tab2"><a href="/books/NBK577863/table/ch1.appa.tab2/?report=objectonly" target="object" rid-ob="figobch1appatab2" class="figpopup">Table 7. Health economic review protocol</a></p></div><div id="ch1.appb"><h3>Appendix B. Literature search strategies</h3><p>The literature searches for this review are detailed below and complied with the methodology outlined in Developing NICE guidelines: the manual 2014, updated 2017 <a href="https://www.nice.org.uk/guidance/pmg20/resources/developing-nice-guidelines-the-manual-pdf-72286708700869" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www.nice.org.uk/guidance/pmg20/resources/developing-nice-guidelines-the-manual-pdf-72286708700869</a></p><p><i>For more detailed information, please see the</i> Methodology <i>Review</i>.</p><div id="ch1.appb.s1"><h4>B.1. Clinical search literature search strategy</h4><p>Searches were constructed using a PICO framework where population (P) terms were combined with Intervention (I) and in some cases Comparison (C) terms. Outcomes (O) are rarely used in search strategies for interventions as these concepts may not be well described in title, abstract or indexes and therefore difficult to retrieve. Search filters were applied to the search where appropriate.</p><p id="ch1.appb.tab1"><a href="/books/NBK577863/table/ch1.appb.tab1/?report=objectonly" target="object" rid-ob="figobch1appbtab1" class="figpopup">Table 8. Database date parameters and filters used</a></p><p id="ch1.appb.tab2"><a href="/books/NBK577863/table/ch1.appb.tab2/?report=objectonly" target="object" rid-ob="figobch1appbtab2" class="figpopup">Medline (Ovid) search terms</a></p><p id="ch1.appb.tab3"><a href="/books/NBK577863/table/ch1.appb.tab3/?report=objectonly" target="object" rid-ob="figobch1appbtab3" class="figpopup">Embase (Ovid) search terms</a></p><p id="ch1.appb.tab4"><a href="/books/NBK577863/table/ch1.appb.tab4/?report=objectonly" target="object" rid-ob="figobch1appbtab4" class="figpopup">Cochrane Library (Wiley) search terms</a></p></div><div id="ch1.appb.s2"><h4>B.2. Health Economics literature search strategy</h4><p>Health economic evidence was identified by conducting a broad search relating to the stroke population in NHS Economic Evaluation Database (NHS EED – this ceased to be updated after March 2015) and the Health Technology Assessment database (HTA) with no date restrictions. NHS EED and HTA databases are hosted by the Centre for Research and Dissemination (CRD). Additional searches were run on Medline and Embase for health economics studies.</p><p id="ch1.appb.tab5"><a href="/books/NBK577863/table/ch1.appb.tab5/?report=objectonly" target="object" rid-ob="figobch1appbtab5" class="figpopup">Table 9. Database data parameters and filters used</a></p><p id="ch1.appb.tab6"><a href="/books/NBK577863/table/ch1.appb.tab6/?report=objectonly" target="object" rid-ob="figobch1appbtab6" class="figpopup">Medline (Ovid) search terms</a></p><p id="ch1.appb.tab7"><a href="/books/NBK577863/table/ch1.appb.tab7/?report=objectonly" target="object" rid-ob="figobch1appbtab7" class="figpopup">Embase (Ovid) search terms</a></p><p id="ch1.appb.tab8"><a href="/books/NBK577863/table/ch1.appb.tab8/?report=objectonly" target="object" rid-ob="figobch1appbtab8" class="figpopup">NHS EED and HTA (CRD) search terms</a></p></div></div><div id="ch1.appc"><h3>Appendix C. Clinical evidence selection</h3><p id="ch1.appc.fig1"><a href="/books/NBK577863/figure/ch1.appc.fig1/?report=objectonly" target="object" rid-ob="figobch1appcfig1" class="figpopup">Figure 1. Flow chart of clinical study selection for the review of aspirin</a></p></div><div id="ch1.appd"><h3>Appendix D. Clinical evidence tables</h3><p id="ch1.appd.et1"><a href="/books/NBK577863/bin/ch1-appd-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (134K)</span></p></div><div id="ch1.appe"><h3>Appendix E. Forest plots</h3><div id="ch1.appe.s1"><h4>E.1. Aspirin vs placebo</h4><p id="ch1.appe.fig1"><a href="/books/NBK577863/figure/ch1.appe.fig1/?report=objectonly" target="object" rid-ob="figobch1appefig1" class="figpopup">Figure 2. Risk of recurrent stroke (hazard ratios)</a></p><p id="ch1.appe.fig2"><a href="/books/NBK577863/figure/ch1.appe.fig2/?report=objectonly" target="object" rid-ob="figobch1appefig2" class="figpopup">Figure 3. Risk of recurrent stroke at 14 days – mild initial neurological deficit</a></p><p id="ch1.appe.fig3"><a href="/books/NBK577863/figure/ch1.appe.fig3/?report=objectonly" target="object" rid-ob="figobch1appefig3" class="figpopup">Figure 4. Risk of recurrent stroke at 14 days – moderate initial neurological deficit</a></p></div><div id="ch1.appe.s2"><h4>E.2. Continued aspirin vs placebo in those with prior aspirin use</h4><p id="ch1.appe.fig4"><a href="/books/NBK577863/figure/ch1.appe.fig4/?report=objectonly" target="object" rid-ob="figobch1appefig4" class="figpopup">Figure 5. Risk of Recurrent Stroke (hazard ratios)</a></p></div></div><div id="ch1.appf"><h3>Appendix F. GRADE tables</h3><p id="ch1.appf.tab1"><a href="/books/NBK577863/table/ch1.appf.tab1/?report=objectonly" target="object" rid-ob="figobch1appftab1" class="figpopup">Table 10. Clinical evidence profile: Aspirin versus placebo</a></p><p id="ch1.appf.tab2"><a href="/books/NBK577863/table/ch1.appf.tab2/?report=objectonly" target="object" rid-ob="figobch1appftab2" class="figpopup">Table 11. Clinical evidence profile: Continued aspirin versus placebo in those with prior aspirin use</a></p></div><div id="ch1.appg"><h3>Appendix G. Health economic evidence selection</h3><p id="ch1.appg.fig1"><a href="/books/NBK577863/figure/ch1.appg.fig1/?report=objectonly" target="object" rid-ob="figobch1appgfig1" class="figpopup">Figure 6. Flow chart of health economic study selection for the guideline</a></p></div><div id="ch1.apph"><h3>Appendix H. Excluded studies</h3><div id="ch1.apph.s1"><h4>H.1. Excluded clinical studies</h4><p id="ch1.apph.tab1"><a href="/books/NBK577863/table/ch1.apph.tab1/?report=objectonly" target="object" rid-ob="figobch1apphtab1" class="figpopup">Table 12. Studies excluded from the clinical review</a></p></div></div></div></div><div class="fm-sec"><div><p>FINAL</p></div><div><p>Intervention evidence review</p><p>This evidence review was developed by the National Guideline Centre</p></div><div><p><b>Disclaimer</b>: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.</p><p>Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.</p><p>NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the <a href="http://wales.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Welsh Government</a>, <a href="http://www.scotland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Scottish Government</a>, and <a href="http://www.northernireland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Northern Ireland Executive</a>. All NICE guidance is subject to regular review and may be updated or withdrawn.</p></div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © NICE 2019.</div><div class="small"><span class="label">Bookshelf ID: NBK577863</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/35167206" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">35167206</a></span></div></div><div class="small-screen-prev"></div><div class="small-screen-next"></div></article><article data-type="table-wrap" id="figobch1tab1"><div id="ch1.tab1" class="table"><h3><span class="label">Table 1</span><span class="title">PICO characteristics of review question</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577863/table/ch1.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch1.tab1_lrgtbl__"><table><tbody><tr><th id="hd_b_ch1.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><td headers="hd_b_ch1.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">People aged over 16 with suspected TIA</td></tr><tr><th id="hd_b_ch1.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</th><td headers="hd_b_ch1.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Aspirin (any dose) given before expert assessment</td></tr><tr><th id="hd_b_ch1.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparisons</th><td headers="hd_b_ch1.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No aspirin or usual care (another antiplatelet or anticoagulant)</td></tr><tr><th id="hd_b_ch1.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><td headers="hd_b_ch1.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<u>Critical</u>
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</p>
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<p>Risk of stroke (stroke at 24, 72 hours and 14 days)</p>
|
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<p>Mortality</p>
|
|
<p>
|
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<u>Important</u>
|
|
</p>
|
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<p>Intra-cranial haemorrhage</p>
|
|
<p>Major bleeding complications – e.g. gastrointestinal bleed</p>
|
|
<p>Functional outcomes:
|
|
<ul id="l52"><li id="lt136" class="half_rhythm"><div>Modified Rankin scale (mRS) score</div></li></ul>
|
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Quality of life (both health- and social-related quality)</p>
|
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</td></tr><tr><th id="hd_b_ch1.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design</th><td headers="hd_b_ch1.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>Randomised controlled trials</p>
|
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<p>Prospective cohort studies</p>
|
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<p>Systematic reviews and meta-analyses of the above</p>
|
|
</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch1tab2"><div id="ch1.tab2" class="table"><h3><span class="label">Table 2</span><span class="title">Summary of studies included in the evidence review</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577863/table/ch1.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch1.tab2_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch1.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_ch1.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_ch1.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_ch1.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_ch1.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_ch1.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>Rothwell et al.<a class="bibr" href="#ch1.ref27" rid="ch1.ref27"><sup>27</sup></a></p>
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<p>[subgroup analysis for those given aspirin within 48 hours of stroke onset from the Chinese Acute Stroke Trial and the International Stroke Trial]</p>
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</td><td headers="hd_h_ch1.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Aspirin (n=15961); 160 mg or 300 mg (oral, nasogastric tube, rectal or intravenous) for 2-4 weeks.</p>
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<p>Vs</p>
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<p>Control (n=15883)</p>
|
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</td><td headers="hd_h_ch1.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>Adults aged 16 and over with acute stroke</p>
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<p>10% received aspirin within the 3 days prior to randomisation</p>
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<p>Multiple countries (Argentina, Australia, Austria, Belgium, Brazil, Canada, Chile, China, Czech Republic, Denmark, Finland, France, Greece, Hong Kong, Hungary, India, Israel, Italy, Japan, New Zealand, Norway, Poland, Portugal, Romania, Singapore, Slovak Republic, Slovenia, South Africa, Spain, Sri Lanka, Switzerland, Turkey, UK, USA)</p>
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</td><td headers="hd_h_ch1.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk of recurrent stroke</td><td headers="hd_h_ch1.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data are presented separately for those who had received aspirin within the 3 days prior to randomisation</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">See <a href="#ch1.appd">appendix D</a> for full evidence tables.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch1tab3"><div id="ch1.tab3" class="table"><h3><span class="label">Table 3</span><span class="title">Clinical evidence summary: Aspirin versus placebo</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577863/table/ch1.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch1.tab3_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch1.tab3_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_ch1.tab3_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_ch1.tab3_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_ch1.tab3_1_1_1_2" style="text-align:left;vertical-align:bottom;">No of Participants (studies) Follow up</th><th id="hd_h_ch1.tab3_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_ch1.tab3_1_1_1_3" style="text-align:left;vertical-align:bottom;">Quality of the evidence (GRADE)</th><th id="hd_h_ch1.tab3_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch1.tab3_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_ch1.tab3_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th></tr><tr><th headers="hd_h_ch1.tab3_1_1_1_5" id="hd_h_ch1.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk with Placebo</th><th headers="hd_h_ch1.tab3_1_1_1_5" id="hd_h_ch1.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk difference with Aspirin (95% CI)</th></tr></thead><tbody><tr><td headers="hd_h_ch1.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk of Recurrent Stroke - 24 hours [excluding those who received aspirin prior to randomisation]</td><td headers="hd_h_ch1.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>28552</p>
|
|
<p>(1 syudy)</p>
|
|
<p>24 hours</p>
|
|
</td><td headers="hd_h_ch1.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊝⊝⊝</p>
|
|
<p>VERY LOW<sup>1</sup><sup>,</sup><sup>2</sup><sup>,</sup><sup>3</sup></p>
|
|
<p>due to risk of bias, indirectness, imprecision</p>
|
|
</td><td headers="hd_h_ch1.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>HR 0.94</p>
|
|
<p>(0.67-1.32)</p>
|
|
</td><td headers="hd_h_ch1.tab3_1_1_1_5 hd_h_ch1.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch1.tab3_1_1_1_5 hd_h_ch1.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not available<sup>4</sup></td></tr><tr><td headers="hd_h_ch1.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk of Recurrent Stroke - 3 days [excluding those who received aspirin prior to randomisation]</td><td headers="hd_h_ch1.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>28552</p>
|
|
<p>(1 syudy)</p>
|
|
<p>72 hours</p>
|
|
</td><td headers="hd_h_ch1.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊝⊝</p>
|
|
<p>VERY LOW<sup>1</sup><sup>,</sup><sup>2</sup></p>
|
|
<p>due to risk of bias, indirectness</p>
|
|
</td><td headers="hd_h_ch1.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>HR 0.31</p>
|
|
<p>(0.16 to 0.6)</p>
|
|
</td><td headers="hd_h_ch1.tab3_1_1_1_5 hd_h_ch1.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch1.tab3_1_1_1_5 hd_h_ch1.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not available<sup>4</sup></td></tr><tr><td headers="hd_h_ch1.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk of Recurrent Stroke - 7-14 days [excluding those who received aspirin prior to randomisation]</td><td headers="hd_h_ch1.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>28552</p>
|
|
<p>(1 study)</p>
|
|
<p>14 days</p>
|
|
</td><td headers="hd_h_ch1.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊝⊝⊝</p>
|
|
<p>VERY LOW<sup>1</sup><sup>,</sup><sup>2</sup><sup>,</sup><sup>3</sup></p>
|
|
<p>due to risk of bias, indirectness, imprecision</p>
|
|
</td><td headers="hd_h_ch1.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>HR 0.64</p>
|
|
<p>(0.45 to 0.91)</p>
|
|
</td><td headers="hd_h_ch1.tab3_1_1_1_5 hd_h_ch1.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch1.tab3_1_1_1_5 hd_h_ch1.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not available<sup>4</sup></td></tr><tr><td headers="hd_h_ch1.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk of recurrent ischaemic stroke at 14 days - Mild initial neurological deficit</td><td headers="hd_h_ch1.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>8464</p>
|
|
<p>(2 studies)</p>
|
|
</td><td headers="hd_h_ch1.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊝⊝</p>
|
|
<p>VERY LOW<sup>1</sup><sup>,</sup><sup>2</sup></p>
|
|
<p>due to risk of bias, indirectness</p>
|
|
</td><td headers="hd_h_ch1.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RR 0.5</p>
|
|
<p>(0.33 to 0.76)</p>
|
|
</td><td headers="hd_h_ch1.tab3_1_1_1_5 hd_h_ch1.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16 per 1000</td><td headers="hd_h_ch1.tab3_1_1_1_5 hd_h_ch1.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>8 fewer per 1000</p>
|
|
<p>(from 4 fewer to 11 fewer)</p>
|
|
</td></tr><tr><td headers="hd_h_ch1.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk of recurrent ischaemic stroke at 14 days - Moderate initial neurological deficit</td><td headers="hd_h_ch1.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>23380</p>
|
|
<p>(2 studies)</p>
|
|
</td><td headers="hd_h_ch1.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊝⊝⊝</p>
|
|
<p>VERY LOW<sup>1</sup><sup>,</sup><sup>2</sup><sup>,</sup><sup>3</sup><sup>,</sup><sup>5</sup></p>
|
|
<p>due to risk of bias, inconsistency, indirectness, imprecision</p>
|
|
</td><td headers="hd_h_ch1.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RR 0.61</p>
|
|
<p>(0.38 to 0.97)</p>
|
|
</td><td headers="hd_h_ch1.tab3_1_1_1_5 hd_h_ch1.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22 per 1000</td><td headers="hd_h_ch1.tab3_1_1_1_5 hd_h_ch1.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>9 fewer per 1000</p>
|
|
<p>(from 1 fewer to 14 fewer)</p>
|
|
</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch1.tab3_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, due to being a post-hoc sub group analysis and unclear review methodology (e.g. search strategy and data extraction).</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="ch1.tab3_2"><p class="no_margin">Downgraded by 1 or 2 increments because the majority of the evidence included an indirect or very indirect population respectively.</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="ch1.tab3_3"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs.</p></div></dd></dl><dl class="bkr_refwrap"><dt>4</dt><dd><div id="ch1.tab3_4"><p class="no_margin">Risk difference could not be calculated as only the summary statistics were reported.</p></div></dd></dl><dl class="bkr_refwrap"><dt>5</dt><dd><div id="ch1.tab3_5"><p class="no_margin">Downgraded by 2 increments because of heterogeneity, with I<sup>2</sup>=81%, p=0.02, unexplained by subgroup analysis</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch1tab4"><div id="ch1.tab4" class="table"><h3><span class="label">Table 4</span><span class="title">Clinical evidence summary: Continued aspirin versus placebo (in those who received aspirin prior to randomisation)</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577863/table/ch1.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch1.tab4_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch1.tab4_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_ch1.tab4_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_ch1.tab4_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_ch1.tab4_1_1_1_2" style="text-align:left;vertical-align:bottom;">No of Participants (studies) Follow up</th><th id="hd_h_ch1.tab4_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_ch1.tab4_1_1_1_3" style="text-align:left;vertical-align:bottom;">Quality of the evidence (GRADE)</th><th id="hd_h_ch1.tab4_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch1.tab4_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_ch1.tab4_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th></tr><tr><th headers="hd_h_ch1.tab4_1_1_1_5" id="hd_h_ch1.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk with Placebo</th><th headers="hd_h_ch1.tab4_1_1_1_5" id="hd_h_ch1.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk difference with Aspirin (95% CI)</th></tr></thead><tbody><tr><td headers="hd_h_ch1.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk of Recurrent Stroke at 24 hrs</td><td headers="hd_h_ch1.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>3292</p>
|
|
<p>(1 study)</p>
|
|
<p>24 hours</p>
|
|
</td><td headers="hd_h_ch1.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>⊕⊝⊝⊝</p>
|
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<p>VERY LOW<sup>1</sup><sup>,</sup><sup>2</sup><sup>,</sup><sup>3</sup></p>
|
|
<p>due to risk of bias, indirectness, imprecision</p>
|
|
</td><td headers="hd_h_ch1.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>HR 0.31</p>
|
|
<p>(0.11 to 0.87)</p>
|
|
</td><td headers="hd_h_ch1.tab4_1_1_1_5 hd_h_ch1.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch1.tab4_1_1_1_5 hd_h_ch1.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not available<sup>4</sup></td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch1.tab4_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias.</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="ch1.tab4_2"><p class="no_margin">Downgraded by 1 or 2 increments because the majority of the evidence included an indirect or very indirect population respectively.</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="ch1.tab4_3"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs.</p></div></dd></dl><dl class="bkr_refwrap"><dt>4</dt><dd><div id="ch1.tab4_4"><p class="no_margin">Risk difference could not be calculated as only the summary statistics were reported.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch1tab5"><div id="ch1.tab5" class="table"><h3><span class="label">Table 5</span><span class="title">UK costs of aspirin, other antiplatelets and anticoagulants</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577863/table/ch1.tab5/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch1.tab5_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch1.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Drug</th><th id="hd_h_ch1.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Assumed daily dose [BNF]<sup>(a)</sup></th><th id="hd_h_ch1.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Cost per unit (£)</th><th id="hd_h_ch1.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Cost per week (£)<sup>(b)</sup></th><th id="hd_h_ch1.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Source</th></tr></thead><tbody><tr><th headers="hd_h_ch1.tab5_1_1_1_1 hd_h_ch1.tab5_1_1_1_2 hd_h_ch1.tab5_1_1_1_3 hd_h_ch1.tab5_1_1_1_4 hd_h_ch1.tab5_1_1_1_5" id="hd_b_ch1.tab5_1_1_1_1" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">Antiplatelets</th></tr><tr><td headers="hd_h_ch1.tab5_1_1_1_1 hd_b_ch1.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Aspirin 300mg tablets</td><td headers="hd_h_ch1.tab5_1_1_1_2 hd_b_ch1.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">300mg once daily until diagnosis established</td><td headers="hd_h_ch1.tab5_1_1_1_3 hd_b_ch1.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£0.10</td><td headers="hd_h_ch1.tab5_1_1_1_4 hd_b_ch1.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£0.10 - £0.73(c)</td><td headers="hd_h_ch1.tab5_1_1_1_5 hd_b_ch1.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NHS Drug Tariff</td></tr><tr><td headers="hd_h_ch1.tab5_1_1_1_1 hd_b_ch1.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Clopidogrel 75mg tablets</td><td headers="hd_h_ch1.tab5_1_1_1_2 hd_b_ch1.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">75mg once daily</td><td headers="hd_h_ch1.tab5_1_1_1_3 hd_b_ch1.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£0.04</td><td headers="hd_h_ch1.tab5_1_1_1_4 hd_b_ch1.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£0.29</td><td headers="hd_h_ch1.tab5_1_1_1_5 hd_b_ch1.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NHS Drug Tariff</td></tr><tr><td headers="hd_h_ch1.tab5_1_1_1_1 hd_b_ch1.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ticagrelor 90mg tablets</td><td headers="hd_h_ch1.tab5_1_1_1_2 hd_b_ch1.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">180mg for 1 dose, then 90mg twice daily</td><td headers="hd_h_ch1.tab5_1_1_1_3 hd_b_ch1.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£0.98</td><td headers="hd_h_ch1.tab5_1_1_1_4 hd_b_ch1.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£14.63</td><td headers="hd_h_ch1.tab5_1_1_1_5 hd_b_ch1.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NHS Drug Tariff</td></tr><tr><td headers="hd_h_ch1.tab5_1_1_1_1 hd_b_ch1.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dipyridamole 100mg tablets</td><td headers="hd_h_ch1.tab5_1_1_1_2 hd_b_ch1.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">200mg twice daily</td><td headers="hd_h_ch1.tab5_1_1_1_3 hd_b_ch1.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£0.04</td><td headers="hd_h_ch1.tab5_1_1_1_4 hd_b_ch1.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£1.20</td><td headers="hd_h_ch1.tab5_1_1_1_5 hd_b_ch1.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NHS Drug Tariff</td></tr><tr><th headers="hd_h_ch1.tab5_1_1_1_1 hd_h_ch1.tab5_1_1_1_2 hd_h_ch1.tab5_1_1_1_3 hd_h_ch1.tab5_1_1_1_4 hd_h_ch1.tab5_1_1_1_5" id="hd_b_ch1.tab5_1_1_6_1" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">Anticoagulants</th></tr><tr><td headers="hd_h_ch1.tab5_1_1_1_1 hd_b_ch1.tab5_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Warfarin 3mg and 5 mg tablets</td><td headers="hd_h_ch1.tab5_1_1_1_2 hd_b_ch1.tab5_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>10mg on first day, then 9mg daily</p>
|
|
<p>[5-10mg on first day, lower induction dose given over 3-4 weeks; maintenance 3-9mg daily]</p>
|
|
</td><td headers="hd_h_ch1.tab5_1_1_1_3 hd_b_ch1.tab5_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£0.02<sup>(d)</sup></td><td headers="hd_h_ch1.tab5_1_1_1_4 hd_b_ch1.tab5_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£0.41</td><td headers="hd_h_ch1.tab5_1_1_1_5 hd_b_ch1.tab5_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NHS Drug Tariff</td></tr><tr><td headers="hd_h_ch1.tab5_1_1_1_1 hd_b_ch1.tab5_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Apixaban 5mg tablets</td><td headers="hd_h_ch1.tab5_1_1_1_2 hd_b_ch1.tab5_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5mg twice daily</td><td headers="hd_h_ch1.tab5_1_1_1_3 hd_b_ch1.tab5_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£0.95</td><td headers="hd_h_ch1.tab5_1_1_1_4 hd_b_ch1.tab5_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£13.30</td><td headers="hd_h_ch1.tab5_1_1_1_5 hd_b_ch1.tab5_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NHS Drug Tariff</td></tr><tr><td headers="hd_h_ch1.tab5_1_1_1_1 hd_b_ch1.tab5_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dabigatran etexilate 110mg capsules and 150mg capsules</td><td headers="hd_h_ch1.tab5_1_1_1_2 hd_b_ch1.tab5_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">110mg twice daily (aged 80+) - 110-150mg twice daily (aged 75-79) - 150mg twice daily (aged 18-74)</td><td headers="hd_h_ch1.tab5_1_1_1_3 hd_b_ch1.tab5_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£0.85<sup>(d)</sup></td><td headers="hd_h_ch1.tab5_1_1_1_4 hd_b_ch1.tab5_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£11.90</td><td headers="hd_h_ch1.tab5_1_1_1_5 hd_b_ch1.tab5_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NHS Drug Tariff</td></tr><tr><td headers="hd_h_ch1.tab5_1_1_1_1 hd_b_ch1.tab5_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Edoxaban 30mg and 60mg tablets</td><td headers="hd_h_ch1.tab5_1_1_1_2 hd_b_ch1.tab5_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30mg once daily (up to 61kg)- 60mg once daily (61kg and above)</td><td headers="hd_h_ch1.tab5_1_1_1_3 hd_b_ch1.tab5_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£1.75<sup>(d)</sup></td><td headers="hd_h_ch1.tab5_1_1_1_4 hd_b_ch1.tab5_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£12.25</td><td headers="hd_h_ch1.tab5_1_1_1_5 hd_b_ch1.tab5_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NHS Drug Tariff</td></tr><tr><td headers="hd_h_ch1.tab5_1_1_1_1 hd_b_ch1.tab5_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Rivaroxaban 20mg tablets</td><td headers="hd_h_ch1.tab5_1_1_1_2 hd_b_ch1.tab5_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20mg once daily</td><td headers="hd_h_ch1.tab5_1_1_1_3 hd_b_ch1.tab5_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£1.80</td><td headers="hd_h_ch1.tab5_1_1_1_4 hd_b_ch1.tab5_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£12.60</td><td headers="hd_h_ch1.tab5_1_1_1_5 hd_b_ch1.tab5_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NHS Drug Tariff</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>(a)</dt><dd><div id="ch1.tab5_1"><p class="no_margin">Dosages for adults</p></div></dd></dl><dl class="bkr_refwrap"><dt>(b)</dt><dd><div id="ch1.tab5_2"><p class="no_margin">Depending on number of units taken</p></div></dd></dl><dl class="bkr_refwrap"><dt>(c)</dt><dd><div id="ch1.tab5_3"><p class="no_margin">Range of costs per week depending on number of days taken to establish diagnosis: 1 day – 7 days</p></div></dd></dl><dl class="bkr_refwrap"><dt>(d)</dt><dd><div id="ch1.tab5_4"><p class="no_margin">Unit cost for all listed doses</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch1tab6"><div id="ch1.tab6" class="table"><h3><span class="label">Table 6</span><span class="title">UK aspirin costs to people with TIA</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577863/table/ch1.tab6/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch1.tab6_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch1.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Drug</th><th id="hd_h_ch1.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Assumed daily dose [BNF]<sup>(a)</sup></th><th id="hd_h_ch1.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Cost per unit (£)</th><th id="hd_h_ch1.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Cost per month (£)<sup>(b)</sup></th><th id="hd_h_ch1.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Source</th></tr></thead><tbody><tr><th headers="hd_h_ch1.tab6_1_1_1_1 hd_h_ch1.tab6_1_1_1_2 hd_h_ch1.tab6_1_1_1_3 hd_h_ch1.tab6_1_1_1_4 hd_h_ch1.tab6_1_1_1_5" id="hd_b_ch1.tab6_1_1_1_1" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">Antiplatelets</th></tr><tr><td headers="hd_h_ch1.tab6_1_1_1_1 hd_b_ch1.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Aspirin 300mg tablets</td><td headers="hd_h_ch1.tab6_1_1_1_2 hd_b_ch1.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">300mg once daily until diagnosis established</td><td headers="hd_h_ch1.tab6_1_1_1_3 hd_b_ch1.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£0.02</td><td headers="hd_h_ch1.tab6_1_1_1_4 hd_b_ch1.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£0.02 - £0.12<sup>(c)</sup></td><td headers="hd_h_ch1.tab6_1_1_1_5 hd_b_ch1.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Retail price from stockist<sup>(d)</sup></td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>(a)</dt><dd><div id="ch1.tab6_1"><p class="no_margin">Dosages for adults</p></div></dd></dl><dl class="bkr_refwrap"><dt>(b)</dt><dd><div id="ch1.tab6_2"><p class="no_margin">Depending on number of units taken</p></div></dd></dl><dl class="bkr_refwrap"><dt>(c)</dt><dd><div id="ch1.tab6_3"><p class="no_margin">Range of costs per week depending on number of days taken to establish diagnosis: 1 day – 7 days</p></div></dd></dl><dl class="bkr_refwrap"><dt>(d)</dt><dd><div id="ch1.tab6_4"><p class="no_margin">Retail price obtained from <a href="http://www.boots.com" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">www<wbr style="display:inline-block"></wbr>​.boots.com</a></p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch1appatab1"><div id="ch1.appa.tab1" class="table"><h3><span class="label">Table 6</span><span class="title">Review protocol: Aspirin</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577863/table/ch1.appa.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch1.appa.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Field</th><th id="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Content</th></tr></thead><tbody><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Review question</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Should people with a suspected TIA be advised to take aspirin prior to assessment in a TIA clinic?</td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Type of review question</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Intervention</p>
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<p>A review of health economic evidence related to the same review question was conducted in parallel with this review. For details see the health economic review protocol for this NICE guideline.</p>
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</td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Objective of the review</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">To determine whether aspirin for secondary prevention is safe and effective for early use in people with suspected TIA.</td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – population / disease / condition / issue / domain</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">People aged over 16 with suspected TIA</td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – intervention(s) / exposure(s) / prognostic factor(s)</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Aspirin (any dose) given before expert assessment</td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – comparator(s) / control or reference (gold) standard</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No aspirin or usual care (another antiplatelet or anticoagulant)</td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes and prioritisation</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
|
|
<u>Critical</u>
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</p>
|
|
<p>Risk of stroke (stroke at 24, 72 hours and 14 days)</p>
|
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<p>Mortality</p>
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<p>
|
|
<u>Important</u>
|
|
</p>
|
|
<p>Intra-cranial Haemorrhage</p>
|
|
<p>Major bleeding complications – e.g. GI bleed</p>
|
|
<p>Degree of disability or dependence in daily activities:
|
|
<ul id="l55"><li id="lt140" class="half_rhythm"><div>mRS score</div></li></ul>
|
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Quality of life (both health- and social-related quality)</p>
|
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</td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – study design</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Randomised controlled trials</p>
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<p>Prospective cohort studies</p>
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<p>Systematic reviews and meta-analyses of the above</p>
|
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</td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Other inclusion exclusion criteria</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>Inclusion</p>
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|
<p>Language: Restrict to English only</p>
|
|
<p>Settings: Emergency department, Other non-stroke unit/hospital wards in secondary care, Pre-hospital setting (paramedic / ambulance), General practice/walk in centres/primary care, Community pharmacies and NHS 111/999</p>
|
|
</td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Proposed sensitivity / subgroup analysis, or metaregression</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<u>Strata</u>
|
|
</p>
|
|
<p>Previous intra-cranial haemorrhage</p>
|
|
<p>People already taking anticoagulants/antiplatelets</p>
|
|
<p>
|
|
<u>Subgroups</u>
|
|
</p>
|
|
<p>No subgroups</p>
|
|
</td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Selection process – duplicate screening / selection / analysis</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Potentially significant publications obtained in full text are then assessed against the inclusion criteria specified in this protocol.</td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data management (software)</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="l56"><li id="lt141" class="half_rhythm"><div>EndNote will be used for reference management, sifting, citations and bibliographies.</div></li><li id="lt142" class="half_rhythm"><div>EviBASE will be used for data extraction and quality assessment for clinical studies.</div></li><li id="lt143" class="half_rhythm"><div>Pairwise meta-analyses will be performed using Cochrane Review Manager (RevMan5).</div></li><li id="lt144" class="half_rhythm"><div>GRADEpro will be used to assess the quality of evidence for each outcome.</div></li></ul></td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Information sources – databases and dates</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>Databases: Medline, Embase, Cochrane Library,</p>
|
|
<p>Language: Restrict to English only</p>
|
|
<p>Date restriction: none</p>
|
|
<p>Key papers
|
|
<ol id="l57"><li id="lt145" class="half_rhythm"><div>Rothwell PM, Giles MF, Chandratheva A et al. Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study): a prospective population-based sequential comparison. Lancet 2007;370(9596):1432–1442.</div></li><li id="lt146" class="half_rhythm"><div>Lavallee PC, Meseguer E, Abboud H et al. A transient ischaemic attack clinic with round-the-clock access (SOS-TIA): feasibility and effects. Lancet Neurology 2007;6(11):953–960.</div></li><li id="lt147" class="half_rhythm"><div>Rothwell PM, Algra A, Chen Z et al. (18-5-2016) Effects of aspirin on risk and severity of early recurrent stroke after transient ischaemic attack and ischaemic stroke: time-course analysis of randomised trials. Lancet.</div></li></ol></p>
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</td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Identify if an update</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>Recommendations made on TIA in CG68, but no specific question on early aspirin use.</p>
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<p>
|
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<b>Recommendations from CG68</b>
|
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</p>
|
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<p>1.1.2.2 People who have had a suspected TIA who are at high risk of stroke (that is, with an ABCD2 score of 4 or above) should have:
|
|
<ul id="l58"><li id="lt148" class="half_rhythm"><div>aspirin (300 mg daily) started immediately</div></li><li id="lt149" class="half_rhythm"><div>specialist assessment[10] and investigation within 24 hours of onset of symptoms</div></li><li id="lt150" class="half_rhythm"><div>measures for secondary prevention introduced as soon as the diagnosis is confirmed, including discussion of individual risk factors.</div></li></ul>
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1.1.2.4 People who have had a suspected TIA who are at lower risk of stroke (that is, an ABCD2 score of 3 or below) should have:
|
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<ul id="l59"><li id="lt151" class="half_rhythm"><div>aspirin (300 mg daily) started immediately</div></li><li id="lt152" class="half_rhythm"><div>specialist assessment[10] and investigation as soon as possible, but definitely within 1 week of onset of symptoms</div></li><li id="lt153" class="half_rhythm"><div>measures for secondary prevention introduced as soon as the diagnosis is confirmed, including discussion of individual risk factors.</div></li></ul></p>
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</td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Author contacts</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<a href="https://www.nice.org.uk/guidance/indevelopment/gid-ng10071" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.nice.org<wbr style="display:inline-block"></wbr>​.uk/guidance/indevelopment/gid-ng10071</a>
|
|
</td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Highlight if amendment to previous protocol</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see section 4.5 of <a href="https://www.nice.org.uk/article/pmg20/chapter/4-Developing-review-questions-and-planning-the-evidence-review#planning-the-evidence-review" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>.</td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Search strategy – for one database</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see <a href="#ch1.appb">appendix B</a></td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data collection process – forms / duplicate</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">A standardised evidence table format will be used, and published as <a href="#ch1.appd">appendix D</a> of the evidence report.</td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data items – define all variables to be collected</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see evidence tables in <a href="#ch1.appd">Appendix D</a> (clinical evidence tables) or <a href="#ch1.appd">H</a> (health economic evidence tables).</td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Methods for assessing bias at outcome / study level</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Standard study checklists were used to critically appraise individual studies. For details please see section 6.2 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a> The risk of bias across all available evidence was evaluated for each outcome using an adaptation of the ‘Grading of Recommendations Assessment, Development and Evaluation (GRADE) toolbox’ developed by the international GRADE working group <a href="http://www.gradeworkinggroup.org/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.gradeworkinggroup.org/</a></p>
|
|
<p>[Please document any deviations/alternative approach when GRADE isn’t used or if a modified GRADE approach has been used for non-intervention or non-comparative studies.]</p>
|
|
</td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Criteria for quantitative synthesis</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see section 6.4 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>.</td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Methods for quantitative analysis – combining studies and exploring (in)consistency</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see the separate Methods report for this guideline.</td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Meta-bias assessment – publication bias, selective reporting bias</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see section 6.2 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>.</td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Confidence in cumulative evidence</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see sections 6.4 and 9.1 of <a href="https://www.nice.org.uk/article/pmg20/chapter/1-Introduction-and-overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>.</td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Rationale / context – what is known</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see the introduction to the evidence review.</td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Describe contributions of authors and guarantor</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>A <a href="https://www.nice.org.uk/guidance/indevelopment/gid-ng10071/documents" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">multidisciplinary committee</a> developed the evidence review. The committee was convened by the National Guideline Centre (NGC) and chaired by Jason Kendall in line with section 3 of <a href="https://www.nice.org.uk/article/pmg20/chapter/1%20Introduction%20and%20overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>.</p>
|
|
<p>Staff from NGC undertook systematic literature searches, appraised the evidence, conducted meta-analysis and cost-effectiveness analysis where appropriate, and drafted the evidence review in collaboration with the committee. For details please see <a href="https://www.nice.org.uk/article/pmg20/chapter/1-Introduction-and-overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>.</p>
|
|
</td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sources of funding / support</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NGC is funded by NICE and hosted by the Royal College of Physicians.</td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Name of sponsor</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NGC is funded by NICE and hosted by the Royal College of Physicians.</td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Roles of sponsor</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NICE funds NGC to develop guidelines for those working in the NHS, public health and social care in England.</td></tr><tr><td headers="hd_h_ch1.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">PROSPERO registration number</td><td headers="hd_h_ch1.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not registered</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch1appatab2"><div id="ch1.appa.tab2" class="table"><h3><span class="label">Table 7</span><span class="title">Health economic review protocol</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577863/table/ch1.appa.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch1.appa.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_ch1.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Review question</th><th id="hd_h_ch1.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">All questions – health economic evidence</th></tr></thead><tbody><tr><td headers="hd_h_ch1.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<b>Objectives</b>
|
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</td><td headers="hd_h_ch1.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">To identify health economic studies relevant to any of the review questions.</td></tr><tr><td headers="hd_h_ch1.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<b>Search criteria</b>
|
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</td><td headers="hd_h_ch1.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul id="l60"><li id="lt154" class="half_rhythm"><div>Populations, interventions and comparators must be as specified in the clinical review protocol above.</div></li><li id="lt155" class="half_rhythm"><div>Studies must be of a relevant health economic study design (cost–utility analysis, cost-effectiveness analysis, cost–benefit analysis, cost–consequences analysis, comparative cost analysis).</div></li><li id="lt156" class="half_rhythm"><div>Studies must not be a letter, editorial or commentary, or a review of health economic evaluations. (Recent reviews will be ordered although not reviewed. The bibliographies will be checked for relevant studies, which will then be ordered.)</div></li><li id="lt157" class="half_rhythm"><div>Unpublished reports will not be considered unless submitted as part of a call for evidence.</div></li><li id="lt158" class="half_rhythm"><div>Studies must be in English.</div></li></ul></td></tr><tr><td headers="hd_h_ch1.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Search strategy</b>
|
|
</td><td headers="hd_h_ch1.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">A health economic study search will be undertaken using population-specific terms and a health economic study filter – see <a href="#ch1.appb.s2">appendix B2</a> of reviews. For questions being updated, the search will be run from 2007, which was the cut-off date for the searches conducted for NICE guideline CG68. For the new review question on endovascular therapy, the search will be run from 2007 as studies published before 2007 are not likely to be relevant.</td></tr><tr><td headers="hd_h_ch1.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Review strategy</b>
|
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</td><td headers="hd_h_ch1.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Studies not meeting any of the search criteria above will be excluded. Studies published before 2002, abstract-only studies and studies from non-OECD countries or the USA will also be excluded.</p><p>Studies published after 2002 that were included in the previous guideline will be reassessed for inclusion and may be included or selectively excluded based on their relevance to the questions covered in this update and whether more applicable evidence is also identified.</p><p>Each remaining study will be assessed for applicability and methodological limitations using the NICE economic evaluation checklist which can be found in <a href="#ch1.apph">appendix H</a> of Developing NICE guidelines: the manual (2014).<a class="bibr" href="#ch1.ref24" rid="ch1.ref24"><sup>24</sup></a></p><p><b>Inclusion and exclusion criteria</b>
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<ul id="l61"><li id="lt159" class="half_rhythm"><div>If a study is rated as both ‘Directly applicable’ and with ‘Minor limitations’ then it will be included in the guideline. A health economic evidence table will be completed and it will be included in the health economic evidence profile.</div></li><li id="lt160" class="half_rhythm"><div>If a study is rated as either ‘Not applicable’ or with ‘Very serious limitations’ then it will usually be excluded from the guideline. If it is excluded then a health economic evidence table will not be completed and it will not be included in the health economic evidence profile.</div></li><li id="lt161" class="half_rhythm"><div>If a study is rated as ‘Partially applicable’, with ‘Potentially serious limitations’ or both then there is discretion over whether it should be included.</div></li></ul></p>
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<p><b>Where there is discretion</b></p><p>The health economist will make a decision based on the relative applicability and quality of the available evidence for that question, in discussion with the guideline committee if required. The ultimate aim is to include health economic studies that are helpful for decision-making in the context of the guideline and the current NHS setting. If several studies are considered of sufficiently high applicability and methodological quality that they could all be included, then the health economist, in discussion with the committee if required, may decide to include only the most applicable studies and to selectively exclude the remaining studies. All studies excluded on the basis of applicability or methodological limitations will be listed with explanation as excluded health economic studies in <a href="#ch1.apph">appendix H</a>.</p><p>The health economist will be guided by the following hierarchies.</p><p><i>Setting:</i>
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<ul id="l62"><li id="lt162" class="half_rhythm"><div>UK NHS (most applicable).</div></li><li id="lt163" class="half_rhythm"><div>OECD countries with predominantly public health insurance systems (for example, France, Germany, Sweden).</div></li><li id="lt164" class="half_rhythm"><div>OECD countries with predominantly private health insurance systems (for example, Switzerland).</div></li><li id="lt165" class="half_rhythm"><div>Studies set in non-OECD countries or in the USA will be excluded before being assessed for applicability and methodological limitations.</div></li></ul>
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<i>Health economic study type:</i>
|
|
<ul id="l63"><li id="lt166" class="half_rhythm"><div>Cost–utility analysis (most applicable).</div></li><li id="lt167" class="half_rhythm"><div>Other type of full economic evaluation (cost–benefit analysis, cost-effectiveness analysis, cost–consequences analysis).</div></li><li id="lt168" class="half_rhythm"><div>Comparative cost analysis.</div></li><li id="lt169" class="half_rhythm"><div>Non-comparative cost analyses including cost-of-illness studies will be excluded before being assessed for applicability and methodological limitations.</div></li></ul>
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<i>Year of analysis:</i>
|
|
<ul id="l64"><li id="lt170" class="half_rhythm"><div>The more recent the study, the more applicable it will be.</div></li><li id="lt171" class="half_rhythm"><div>Studies published in 2002 or later (including any such studies included in the previous guideline) but that depend on unit costs and resource data entirely or predominantly from before 2002 will be rated as ‘Not applicable’.</div></li><li id="lt172" class="half_rhythm"><div>Studies published before 2002 (including any such studies included in the previous guideline) will be excluded before being assessed for applicability and methodological limitations.</div></li></ul>
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<i>Quality and relevance of effectiveness data used in the health economic analysis:</i>
|
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<ul id="l65"><li id="lt173" class="half_rhythm"><div>The more closely the clinical effectiveness data used in the health economic analysis match with the outcomes of the studies included in the clinical review the more useful the analysis will be for decision-making in the guideline.</div></li></ul></p></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch1appbtab1"><div id="ch1.appb.tab1" class="table"><h3><span class="label">Table 8</span><span class="title">Database date parameters and filters used</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577863/table/ch1.appb.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch1.appb.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_ch1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Database</th><th id="hd_h_ch1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dates searched</th><th id="hd_h_ch1.appb.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Search filter used</th></tr></thead><tbody><tr><td headers="hd_h_ch1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Medline (OVID)</td><td headers="hd_h_ch1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1946 – 09 February 2018</td><td headers="hd_h_ch1.appb.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Exclusions</p>
|
|
<p>Randomised controlled trials</p>
|
|
<p>Systematic review studies</p>
|
|
<p>Observational studies</p>
|
|
</td></tr><tr><td headers="hd_h_ch1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Embase (OVID)</td><td headers="hd_h_ch1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1974 – 09 February 2018</td><td headers="hd_h_ch1.appb.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Exclusions</p>
|
|
<p>Randomised controlled trials</p>
|
|
<p>Systematic review studies</p>
|
|
<p>Observational studies</p>
|
|
</td></tr><tr><td headers="hd_h_ch1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The Cochrane Library (Wiley)</td><td headers="hd_h_ch1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Cochrane Reviews to 2018</p>
|
|
<p>Issue 2 of 12</p>
|
|
<p>CENTRAL to 2018 Issue 1 of 12</p>
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|
<p>DARE, and NHSEED to 2015 Issue 2 of 4</p>
|
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<p>HTA to 2016 Issue 4 of 4</p>
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</td><td headers="hd_h_ch1.appb.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch1appbtab2"><div id="ch1.appb.tab2" class="table"><h3><span class="title">Medline (Ovid) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577863/table/ch1.appb.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch1.appb.tab2_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((mini or minor or mild or acute) adj2 (stroke or strokes)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Brain Ischemia/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((brain or brainstem or cerebr* or cerebell* or vertebrobasil* or verte brobasil* or hemisphere* or intracran* or intracerebral or infratentorial or supratentorial or mca*1 or anterior circulation or carotid or crescendo or transient or lacunar) adj3 isch?emi*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ischemic Attack, Transient/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(isch?emi* adj2 attack*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">TIA*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1-6</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">news/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp historical article/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Anecdotes as Topic/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">comment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case report/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or comment*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/8-15</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial/ or random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16 not 17</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animals/ not humans/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animals, Laboratory/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animal Experimentation/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Models, Animal/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Rodentia/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or mice).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/18-24</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7 not 25</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 26 to English language</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(exp child/ or exp pediatrics/ or exp infant/) not (exp adolescent/ or exp adult/ or exp middle age/ or exp aged/)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27 not 28</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Aspirin/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(aspirin or caprin or disprin or aspro or acetylsaliclyic acid or 2-acetoxybenzoic acid or acetylsalicylate or solprin).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">ASA.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/30-32</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29 and 33</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">trial.ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">clinical trials as topic.sh.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">trial.ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Meta-Analysis/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Meta-Analysis as Topic/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(meta analy* or metanaly* or metaanaly* or meta regression).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((systematic* or evidence*) adj2 (review* or overview*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(reference list* or bibliograph* or hand search* or manual search* or relevant journals).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(search strategy or search criteria or systematic search or study selection or data extraction).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(search* adj4 literature).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(medline or pubmed or cochrane or embase or psychlit or psyclit or psychinfo or psycinfo or cinahl or science citation index or bids or cancerlit).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cochrane.jw.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((multiple treatment* or indirect or mixed) adj2 comparison*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">48.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/38-47</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Epidemiologic studies/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Observational study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">51.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Cohort studies/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">52.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(cohort adj (study or studies or analys* or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((follow up or observational or uncontrolled or non randomi#ed or epidemiologic*) adj (study or studies or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((longitudinal or retrospective or prospective or cross sectional) and (study or studies or review or analys* or cohort* or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Controlled Before-After Studies/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">56.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Historically Controlled Study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">57.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interrupted Time Series Analysis/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">58.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(before adj2 after adj2 (study or studies or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">59.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/49-58</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">60.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp case control study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">61.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case control*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">62.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/60-61</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">63.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">59 or 62</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">64.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cross-sectional studies/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">65.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(cross sectional and (study or studies or review or analys* or cohort* or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">66.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/64-65</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">67.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">59 or 66</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">68.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">59 or 62 or 66</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">69.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">70.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">controlled clinical trial.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">71.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomi#ed.ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">72.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">placebo.ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">73.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomly.ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">74.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">clinical trials as topic.sh.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">75.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">trial.ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">76.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/69-75</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">77.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">59 or 68 or 76</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">78.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34 and 77</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch1appbtab3"><div id="ch1.appb.tab3" class="table"><h3><span class="title">Embase (Ovid) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577863/table/ch1.appb.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch1.appb.tab3_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((mini or minor or mild or acute) adj2 (stroke or strokes)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*brain ischemia/ or *hypoxic ischemic encephalopathy/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((brain or brainstem or cerebr* or cerebell* or vertebrobasil* or verte brobasil* or hemisphere* or intracran* or intracerebral or infratentorial or supratentorial or mca*1 or anterior circulation or carotid or crescendo or transient or lacunar) adj3 isch?emi*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*Transient ischemic attack/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(isch?emi* adj2 attack*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">TIA*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1-6</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter.pt. or letter/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">note.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case report/ or case study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or comment*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/8-12</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial/ or random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13 not 14</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animal/ not human/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">nonhuman/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animal Experiment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Experimental Animal/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animal model/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Rodent/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or mice).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/15-22</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7 not 23</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 24 to English language</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(exp child/ or exp pediatrics/) not (exp adult/ or exp adolescent/)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25 not 26</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Aspirin/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(aspirin or caprin or disprin or aspro or acetylsaliclyic acid or 2-acetoxybenzoic acid or acetylsalicylate or solprin).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">ASA.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28 or 30</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27 and 31</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">systematic review/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Meta-Analysis/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(meta analy* or metanaly* or metaanaly* or meta regression).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((systematic* or evidence*) adj2 (review* or overview*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(reference list* or bibliograph* or hand search* or manual search* or relevant journals).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(search strategy or search criteria or systematic search or study selection or data extraction).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(search* adj4 literature).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(medline or pubmed or cochrane or embase or psychlit or psyclit or psychinfo or psycinfo or cinahl or science citation index or bids or cancerlit).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cochrane.jw.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((multiple treatment* or indirect or mixed) adj2 comparison*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/33-42</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Epidemiologic studies/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Observational study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Cohort studies/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(cohort adj (study or studies or analys* or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">48.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((follow up or observational or uncontrolled or non randomi#ed or epidemiologic*) adj (study or studies or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((longitudinal or retrospective or prospective or cross sectional) and (study or studies or review or analys* or cohort* or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Controlled Before-After Studies/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">51.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Historically Controlled Study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">52.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interrupted Time Series Analysis/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(before adj2 after adj2 (study or studies or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/44-53</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp case control study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">56.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case control*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">57.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/55-56</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">58.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54 or 57</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">59.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cross-sectional studies/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">60.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(cross sectional and (study or studies or review or analys* or cohort* or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">61.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/59-60</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">62.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54 or 61</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">63.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54 or 57 or 61</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">64.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">65.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">factorial*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">66.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(crossover* or cross over*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">67.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((doubl* or singl*) adj blind*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">68.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(assign* or allocat* or volunteer* or placebo*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">69.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">crossover procedure/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">70.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">single blind procedure/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">71.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">72.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">double blind procedure/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">73.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/64-72</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">74.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43 or 58 or 73</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">75.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32 and 74</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch1appbtab4"><div id="ch1.appb.tab4" class="table"><h3><span class="title">Cochrane Library (Wiley) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577863/table/ch1.appb.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch1.appb.tab4_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(mini or minor or mild or acute) near/2 (stroke or strokes):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Brain Ischemia] explode all trees</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((brain or brainstem or cerebr* or cerebell* or vertebrobasil* or verte brobasil* or hemisphere* or intracran* or intracerebral or infratentorial or supratentorial or mca*1 or anterior circulation or carotid or crescendo or transient or lacunar) near/3 isch?emi*):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Ischemic Attack, Transient] explode all trees</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(isch?emi* near/2 attack*):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">TIA*:ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(or #1-#6)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Aspirin] explode all trees</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(aspirin or caprin or disprin or aspro or acetylsaliclyic acid or 2-acetoxybenzoic acid or acetylsalicylate solprin):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">ASA:ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#8 or #9 or #10</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#7 and #11</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch1appbtab5"><div id="ch1.appb.tab5" class="table"><h3><span class="label">Table 9</span><span class="title">Database data parameters and filters used</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577863/table/ch1.appb.tab5/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch1.appb.tab5_lrgtbl__"><table><thead><tr><th id="hd_h_ch1.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Database</th><th id="hd_h_ch1.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dates searched</th><th id="hd_h_ch1.appb.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Search filter used</th></tr></thead><tbody><tr><td headers="hd_h_ch1.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Medline</td><td headers="hd_h_ch1.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">01 January 2007 – 06 August 2018</td><td headers="hd_h_ch1.appb.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Exclusions</p>
|
|
<p>Health economics studies</p>
|
|
</td></tr><tr><td headers="hd_h_ch1.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Embase</td><td headers="hd_h_ch1.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">01 January 2007 – 06 August 2018</td><td headers="hd_h_ch1.appb.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Exclusions</p>
|
|
<p>Health economics studies</p>
|
|
</td></tr><tr><td headers="hd_h_ch1.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Centre for Research and Dissemination (CRD)</td><td headers="hd_h_ch1.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>HTA - 01 January 2007 – 10 November 2017</p>
|
|
<p>NHSEED - 01 January 2007 – March 2015</p>
|
|
</td><td headers="hd_h_ch1.appb.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch1appbtab6"><div id="ch1.appb.tab6" class="table"><h3><span class="title">Medline (Ovid) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577863/table/ch1.appb.tab6/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch1.appb.tab6_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Stroke/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(stroke or strokes).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((cerebro* or cerebral*) adj2 (accident* or apoplexy)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(CVA or poststroke or poststrokes).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Intracranial Hemorrhages/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(brain adj2 (attack*1 or hemorrhag* or haemorrhag* or bleed* or infarct*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((intracerebral or intracranial or cerebral* or cerebro* or cerebrum or cerebellum or subarachnoid* or choroidal or basal ganglia or subdural) adj3 (hemorrhag* or haemorrhag* or bleed*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Brain infarction/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Carotid Artery Thrombosis/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((brain or brainstem or cerebr* or cerebell* or vertebrobasil* or verte brobasil* or hemisphere* or intracran* or intracerebral or infratentorial or supratentorial or mca*1 or anterior circulation or carotid or transient or lacunar) adj3 (infarct* or thrombo* or emboli* or occlus* or hypoxi*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Brain Ischemia/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((brain or brainstem or cerebr* or cerebell* or vertebrobasil* or verte brobasil* or hemisphere* or intracran* or intracerebral or infratentorial or supratentorial or mca*1 or anterior circulation or carotid or crescendo or transient or lacunar) adj3 isch?emi*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ischemic Attack, Transient/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(isch?emi* adj2 attack*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">TIA.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1-15</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">news/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp historical article/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Anecdotes as Topic/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">comment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case report/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or comment*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/17-24</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial/ or random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25 not 26</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animals/ not humans/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animals, Laboratory/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animal Experimentation/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Models, Animal/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Rodentia/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or mice).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/27-33</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16 not 34</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 35 to english language</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(exp child/ or exp pediatrics/ or exp infant/) not (exp adolescent/ or exp adult/ or exp middle age/ or exp aged/)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36 not 37</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">economics/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">value of life/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp “costs and cost analysis”/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Economics, Hospital/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Economics, medical/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Economics, nursing/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">economics, pharmaceutical/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp “Fees and Charges”/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp budgets/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">48.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">budget*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cost*.ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(economic* or pharmaco?economic*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">51.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(price* or pricing*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">52.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(cost* adj2 (effectiv* or utilit* or benefit* or minimi* or unit* or estimat* or variable*)).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(financ* or fee or fees).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(value adj2 (money or monetary)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/39-54</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">56.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38 and 55</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch1appbtab7"><div id="ch1.appb.tab7" class="table"><h3><span class="title">Embase (Ovid) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577863/table/ch1.appb.tab7/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch1.appb.tab7_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*cerebrovascular accident/ or cardioembolic stroke/ or exp experimental stroke/ or lacunar stroke/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(stroke or strokes).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((cerebro* or cerebral*) adj2 (accident* or apoplexy)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(CVA or poststroke or poststrokes).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*brain hemorrhage/ or *brain ventricle hemorrhage/ or *cerebellum hemorrhage/ or *subarachnoid hemorrhage/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(brain adj2 (attack*1 or hemorrhag* or haemorrhag* or bleed* or infarct*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((intracerebral or intracranial or cerebral* or cerebro* or cerebrum or cerebellum or subarachnoid* or choroidal or basal ganglia or subdural) adj3 (hemorrhag* or haemorrhag* or bleed*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*brain infarction/ or *brain infarction size/ or *brain stem infarction/ or *cerebellum infarction/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*Carotid Artery Thrombosis/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((brain or brainstem or cerebr* or cerebell* or vertebrobasil* or verte brobasil* or hemisphere* or intracran* or intracerebral or infratentorial or supratentorial or mca*1 or anterior circulation or carotid or transient or lacunar) adj3 (infarct* or thrombo* or emboli* or occlus* or hypoxi*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*brain ischemia/ or *hypoxic ischemic encephalopathy/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((brain or brainstem or cerebr* or cerebell* or vertebrobasil* or verte brobasil* or hemisphere* or intracran* or intracerebral or infratentorial or supratentorial or mca*1 or anterior circulation or carotid or crescendo or transient or lacunar) adj3 isch?emi*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*Transient ischemic attack/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(isch?emi* adj2 attack*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">TIA.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1-15</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter.pt. or letter/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">note.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case report/ or case study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or comment*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/17-21</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial/ or random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22 not 23</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animal/ not human/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">nonhuman/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animal Experiment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Experimental Animal/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animal model/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Rodent/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or mice).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/24-31</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16 not 32</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(exp child/ or exp pediatrics/) not (exp adult/ or exp adolescent/)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33 not 34</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">health economics/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp economic evaluation/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp health care cost/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp fee/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">budget/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">funding/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">budget*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cost*.ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(economic* or pharmaco?economic*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(price* or pricing*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(cost* adj2 (effectiv* or utilit* or benefit* or minimi* or unit* or estimat* or variable*)).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(finance* or fee or fees).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">48.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(value adj2 (money or monetary)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/36-48</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35 and 49</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch1appbtab8"><div id="ch1.appb.tab8" class="table"><h3><span class="title">NHS EED and HTA (CRD) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577863/table/ch1.appb.tab8/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch1.appb.tab8_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH DESCRIPTOR Stroke EXPLODE 1 2</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((stroke or strokes))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(((cerebro* or cerebral*) adj2 (accident* or apoplexy)))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((CVA or poststroke or poststrokes))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH DESCRIPTOR Intracranial Hemorrhages EXPLODE ALL TREES</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((brain adj2 (attack*1 or hemorrhag* or haemorrhag* or bleed* or infarct*)))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(((intracerebral or intracranial or cerebral* or cerebro* or cerebrum or cerebellum or subarachnoid* or choroidal or basal ganglia or subdural) adj3 (hemorrhag* or haemorrhag* or bleed*)))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH DESCRIPTOR Brain Infarction EXPLODE ALL TREES</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH DESCRIPTOR Carotid Artery Thrombosis EXPLODE ALL TREES</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(((brain or brainstem or cerebr* or cerebell* or vertebrobasil* or verte brobasil* or hemisphere* or intracran* or intracerebral or infratentorial or supratentorial or mca*1 or anterior circulation or carotid or transient or lacunar) adj3 (infarct* or thrombo* or emboli* or occlus* or hypoxi*)))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH DESCRIPTOR Brain Ischemia EXPLODE ALL TREES</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(((brain or brainstem or cerebr* or cerebell* or vertebrobasil* or verte brobasil* or hemisphere* or intracran* or intracerebral or infratentorial or supratentorial or mca*1 or anterior circulation or carotid or crescendo or transient or lacunar) adj3 isch?emi*))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH DESCRIPTOR Ischemic Attack, Transient EXPLODE ALL TREES</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#14.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((isch?emi* adj2 attack*))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#15.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8 OR #9 OR #10 OR #11 OR #12 OR #13 OR #14</td></tr></tbody></table></div></div></article><article data-type="fig" id="figobch1appcfig1"><div id="ch1.appc.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%201.%20Flow%20chart%20of%20clinical%20study%20selection%20for%20the%20review%20of%20aspirin.&p=BOOKS&id=577863_ch1appcf1.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577863/bin/ch1appcf1.jpg" alt="Figure 1. Flow chart of clinical study selection for the review of aspirin." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 1</span><span class="title">Flow chart of clinical study selection for the review of aspirin</span></h3></div></article><article data-type="fig" id="figobch1appefig1"><div id="ch1.appe.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%202.%20Risk%20of%20recurrent%20stroke%20(hazard%20ratios).&p=BOOKS&id=577863_ch1appef1.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577863/bin/ch1appef1.jpg" alt="Figure 2. Risk of recurrent stroke (hazard ratios)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 2</span><span class="title">Risk of recurrent stroke (hazard ratios)</span></h3></div></article><article data-type="fig" id="figobch1appefig2"><div id="ch1.appe.fig2" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%203.%20Risk%20of%20recurrent%20stroke%20at%2014%20days%20%02013%20mild%20initial%20neurological%20deficit.&p=BOOKS&id=577863_ch1appef2.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577863/bin/ch1appef2.jpg" alt="Figure 3. Risk of recurrent stroke at 14 days – mild initial neurological deficit." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 3</span><span class="title">Risk of recurrent stroke at 14 days – mild initial neurological deficit</span></h3></div></article><article data-type="fig" id="figobch1appefig3"><div id="ch1.appe.fig3" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%204.%20Risk%20of%20recurrent%20stroke%20at%2014%20days%20%02013%20moderate%20initial%20neurological%20deficit.&p=BOOKS&id=577863_ch1appef3.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577863/bin/ch1appef3.jpg" alt="Figure 4. Risk of recurrent stroke at 14 days – moderate initial neurological deficit." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 4</span><span class="title">Risk of recurrent stroke at 14 days – moderate initial neurological deficit</span></h3></div></article><article data-type="fig" id="figobch1appefig4"><div id="ch1.appe.fig4" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%205.%20Risk%20of%20Recurrent%20Stroke%20(hazard%20ratios).&p=BOOKS&id=577863_ch1appef4.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577863/bin/ch1appef4.jpg" alt="Figure 5. Risk of Recurrent Stroke (hazard ratios)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 5</span><span class="title">Risk of Recurrent Stroke (hazard ratios)</span></h3></div></article><article data-type="table-wrap" id="figobch1appftab1"><div id="ch1.appf.tab1" class="table"><h3><span class="label">Table 10</span><span class="title">Clinical evidence profile: Aspirin versus placebo</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577863/table/ch1.appf.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch1.appf.tab1_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch1.appf.tab1_1_1_1_1" colspan="7" rowspan="1" style="text-align:center;vertical-align:middle;">Quality assessment</th><th id="hd_h_ch1.appf.tab1_1_1_1_2" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">No of patients</th><th id="hd_h_ch1.appf.tab1_1_1_1_3" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">Effect</th><th id="hd_h_ch1.appf.tab1_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch1.appf.tab1_1_1_1_4" style="text-align:center;vertical-align:middle;">Quality</th><th id="hd_h_ch1.appf.tab1_1_1_1_5" rowspan="2" colspan="1" headers="hd_h_ch1.appf.tab1_1_1_1_5" style="text-align:center;vertical-align:middle;">Importance</th></tr><tr><th headers="hd_h_ch1.appf.tab1_1_1_1_1" id="hd_h_ch1.appf.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No of studies</th><th headers="hd_h_ch1.appf.tab1_1_1_1_1" id="hd_h_ch1.appf.tab1_1_1_2_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Design</th><th headers="hd_h_ch1.appf.tab1_1_1_1_1" id="hd_h_ch1.appf.tab1_1_1_2_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Risk of bias</th><th headers="hd_h_ch1.appf.tab1_1_1_1_1" id="hd_h_ch1.appf.tab1_1_1_2_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Inconsistency</th><th headers="hd_h_ch1.appf.tab1_1_1_1_1" id="hd_h_ch1.appf.tab1_1_1_2_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Indirectness</th><th headers="hd_h_ch1.appf.tab1_1_1_1_1" id="hd_h_ch1.appf.tab1_1_1_2_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Imprecision</th><th headers="hd_h_ch1.appf.tab1_1_1_1_1" id="hd_h_ch1.appf.tab1_1_1_2_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Other considerations</th><th headers="hd_h_ch1.appf.tab1_1_1_1_2" id="hd_h_ch1.appf.tab1_1_1_2_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Aspirin</th><th headers="hd_h_ch1.appf.tab1_1_1_1_2" id="hd_h_ch1.appf.tab1_1_1_2_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Placebo</th><th headers="hd_h_ch1.appf.tab1_1_1_1_3" id="hd_h_ch1.appf.tab1_1_1_2_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Relative (95% CI)</th><th headers="hd_h_ch1.appf.tab1_1_1_1_3" id="hd_h_ch1.appf.tab1_1_1_2_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Absolute</th></tr></thead><tbody><tr><th headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_1 hd_h_ch1.appf.tab1_1_1_2_2 hd_h_ch1.appf.tab1_1_1_2_3 hd_h_ch1.appf.tab1_1_1_2_4 hd_h_ch1.appf.tab1_1_1_2_5 hd_h_ch1.appf.tab1_1_1_2_6 hd_h_ch1.appf.tab1_1_1_2_7 hd_h_ch1.appf.tab1_1_1_1_2 hd_h_ch1.appf.tab1_1_1_2_8 hd_h_ch1.appf.tab1_1_1_2_9 hd_h_ch1.appf.tab1_1_1_1_3 hd_h_ch1.appf.tab1_1_1_2_10 hd_h_ch1.appf.tab1_1_1_2_11 hd_h_ch1.appf.tab1_1_1_1_4 hd_h_ch1.appf.tab1_1_1_1_5" id="hd_b_ch1.appf.tab1_1_1_1_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Risk of Recurrent Stroke - 24 hours</th></tr><tr><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_1 hd_b_ch1.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_2 hd_b_ch1.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_3 hd_b_ch1.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_4 hd_b_ch1.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_5 hd_b_ch1.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_6 hd_b_ch1.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>3</sup></td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_7 hd_b_ch1.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch1.appf.tab1_1_1_1_2 hd_h_ch1.appf.tab1_1_1_2_8 hd_b_ch1.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">15961</td><td headers="hd_h_ch1.appf.tab1_1_1_1_2 hd_h_ch1.appf.tab1_1_1_2_9 hd_b_ch1.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">15883</td><td headers="hd_h_ch1.appf.tab1_1_1_1_3 hd_h_ch1.appf.tab1_1_1_2_10 hd_b_ch1.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">HR 0.94 (0.67 to 1.32)</td><td headers="hd_h_ch1.appf.tab1_1_1_1_3 hd_h_ch1.appf.tab1_1_1_2_11 hd_b_ch1.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;"></td><td headers="hd_h_ch1.appf.tab1_1_1_1_4 hd_b_ch1.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
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<p>⊕⊝⊝⊝</p>
|
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<p>VERY LOW</p>
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</td><td headers="hd_h_ch1.appf.tab1_1_1_1_5 hd_b_ch1.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_1 hd_h_ch1.appf.tab1_1_1_2_2 hd_h_ch1.appf.tab1_1_1_2_3 hd_h_ch1.appf.tab1_1_1_2_4 hd_h_ch1.appf.tab1_1_1_2_5 hd_h_ch1.appf.tab1_1_1_2_6 hd_h_ch1.appf.tab1_1_1_2_7 hd_h_ch1.appf.tab1_1_1_1_2 hd_h_ch1.appf.tab1_1_1_2_8 hd_h_ch1.appf.tab1_1_1_2_9 hd_h_ch1.appf.tab1_1_1_1_3 hd_h_ch1.appf.tab1_1_1_2_10 hd_h_ch1.appf.tab1_1_1_2_11 hd_h_ch1.appf.tab1_1_1_1_4 hd_h_ch1.appf.tab1_1_1_1_5" id="hd_b_ch1.appf.tab1_1_1_3_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Risk of Recurrent Stroke - 3 days</th></tr><tr><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_1 hd_b_ch1.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_2 hd_b_ch1.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_3 hd_b_ch1.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_4 hd_b_ch1.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_5 hd_b_ch1.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_6 hd_b_ch1.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_7 hd_b_ch1.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch1.appf.tab1_1_1_1_2 hd_h_ch1.appf.tab1_1_1_2_8 hd_b_ch1.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">15961</td><td headers="hd_h_ch1.appf.tab1_1_1_1_2 hd_h_ch1.appf.tab1_1_1_2_9 hd_b_ch1.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">15883</td><td headers="hd_h_ch1.appf.tab1_1_1_1_3 hd_h_ch1.appf.tab1_1_1_2_10 hd_b_ch1.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">HR 0.31 (0.16 to 0.6)</td><td headers="hd_h_ch1.appf.tab1_1_1_1_3 hd_h_ch1.appf.tab1_1_1_2_11 hd_b_ch1.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;"></td><td headers="hd_h_ch1.appf.tab1_1_1_1_4 hd_b_ch1.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⊕⊝⊝⊝</p>
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<p>VERY LOW</p>
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</td><td headers="hd_h_ch1.appf.tab1_1_1_1_5 hd_b_ch1.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_1 hd_h_ch1.appf.tab1_1_1_2_2 hd_h_ch1.appf.tab1_1_1_2_3 hd_h_ch1.appf.tab1_1_1_2_4 hd_h_ch1.appf.tab1_1_1_2_5 hd_h_ch1.appf.tab1_1_1_2_6 hd_h_ch1.appf.tab1_1_1_2_7 hd_h_ch1.appf.tab1_1_1_1_2 hd_h_ch1.appf.tab1_1_1_2_8 hd_h_ch1.appf.tab1_1_1_2_9 hd_h_ch1.appf.tab1_1_1_1_3 hd_h_ch1.appf.tab1_1_1_2_10 hd_h_ch1.appf.tab1_1_1_2_11 hd_h_ch1.appf.tab1_1_1_1_4 hd_h_ch1.appf.tab1_1_1_1_5" id="hd_b_ch1.appf.tab1_1_1_5_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Risk of Recurrent Stroke - 7-14 days</th></tr><tr><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_1 hd_b_ch1.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_2 hd_b_ch1.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_3 hd_b_ch1.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_4 hd_b_ch1.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_5 hd_b_ch1.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_6 hd_b_ch1.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>3</sup></td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_7 hd_b_ch1.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch1.appf.tab1_1_1_1_2 hd_h_ch1.appf.tab1_1_1_2_8 hd_b_ch1.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">15961</td><td headers="hd_h_ch1.appf.tab1_1_1_1_2 hd_h_ch1.appf.tab1_1_1_2_9 hd_b_ch1.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">15883</td><td headers="hd_h_ch1.appf.tab1_1_1_1_3 hd_h_ch1.appf.tab1_1_1_2_10 hd_b_ch1.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">HR 0.64 (0.45 to 0.91)</td><td headers="hd_h_ch1.appf.tab1_1_1_1_3 hd_h_ch1.appf.tab1_1_1_2_11 hd_b_ch1.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;"></td><td headers="hd_h_ch1.appf.tab1_1_1_1_4 hd_b_ch1.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⊕⊝⊝⊝</p>
|
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<p>VERY LOW</p>
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</td><td headers="hd_h_ch1.appf.tab1_1_1_1_5 hd_b_ch1.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_1 hd_h_ch1.appf.tab1_1_1_2_2 hd_h_ch1.appf.tab1_1_1_2_3 hd_h_ch1.appf.tab1_1_1_2_4 hd_h_ch1.appf.tab1_1_1_2_5 hd_h_ch1.appf.tab1_1_1_2_6 hd_h_ch1.appf.tab1_1_1_2_7 hd_h_ch1.appf.tab1_1_1_1_2 hd_h_ch1.appf.tab1_1_1_2_8 hd_h_ch1.appf.tab1_1_1_2_9 hd_h_ch1.appf.tab1_1_1_1_3 hd_h_ch1.appf.tab1_1_1_2_10 hd_h_ch1.appf.tab1_1_1_2_11 hd_h_ch1.appf.tab1_1_1_1_4 hd_h_ch1.appf.tab1_1_1_1_5" id="hd_b_ch1.appf.tab1_1_1_7_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">14-day risk of recurrent ischaemic stroke - Mild initial neurological deficit</th></tr><tr><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_1 hd_b_ch1.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_2 hd_b_ch1.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_3 hd_b_ch1.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_4 hd_b_ch1.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_5 hd_b_ch1.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_6 hd_b_ch1.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_7 hd_b_ch1.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch1.appf.tab1_1_1_1_2 hd_h_ch1.appf.tab1_1_1_2_8 hd_b_ch1.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
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<p>34/4207</p>
|
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<p>(0.81%)</p>
|
|
</td><td headers="hd_h_ch1.appf.tab1_1_1_1_2 hd_h_ch1.appf.tab1_1_1_2_9 hd_b_ch1.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">1.6%</td><td headers="hd_h_ch1.appf.tab1_1_1_1_3 hd_h_ch1.appf.tab1_1_1_2_10 hd_b_ch1.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.5 (0.33 to 0.76)</td><td headers="hd_h_ch1.appf.tab1_1_1_1_3 hd_h_ch1.appf.tab1_1_1_2_11 hd_b_ch1.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">8 fewer per 1000 (from 4 fewer to 11 fewer)</td><td headers="hd_h_ch1.appf.tab1_1_1_1_4 hd_b_ch1.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⊕⊝⊝⊝</p>
|
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<p>VERY LOW</p>
|
|
</td><td headers="hd_h_ch1.appf.tab1_1_1_1_5 hd_b_ch1.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_1 hd_h_ch1.appf.tab1_1_1_2_2 hd_h_ch1.appf.tab1_1_1_2_3 hd_h_ch1.appf.tab1_1_1_2_4 hd_h_ch1.appf.tab1_1_1_2_5 hd_h_ch1.appf.tab1_1_1_2_6 hd_h_ch1.appf.tab1_1_1_2_7 hd_h_ch1.appf.tab1_1_1_1_2 hd_h_ch1.appf.tab1_1_1_2_8 hd_h_ch1.appf.tab1_1_1_2_9 hd_h_ch1.appf.tab1_1_1_1_3 hd_h_ch1.appf.tab1_1_1_2_10 hd_h_ch1.appf.tab1_1_1_2_11 hd_h_ch1.appf.tab1_1_1_1_4 hd_h_ch1.appf.tab1_1_1_1_5" id="hd_b_ch1.appf.tab1_1_1_9_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">14-day risk of recurrent ischaemic stroke - Moderate initial neurological deficit</th></tr><tr><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_1 hd_b_ch1.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_2 hd_b_ch1.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_3 hd_b_ch1.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_4 hd_b_ch1.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>4</sup></td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_5 hd_b_ch1.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_6 hd_b_ch1.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>3</sup></td><td headers="hd_h_ch1.appf.tab1_1_1_1_1 hd_h_ch1.appf.tab1_1_1_2_7 hd_b_ch1.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch1.appf.tab1_1_1_1_2 hd_h_ch1.appf.tab1_1_1_2_8 hd_b_ch1.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>149/11754</p>
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<p>(1.3%)</p>
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|
</td><td headers="hd_h_ch1.appf.tab1_1_1_1_2 hd_h_ch1.appf.tab1_1_1_2_9 hd_b_ch1.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">2.2%</td><td headers="hd_h_ch1.appf.tab1_1_1_1_3 hd_h_ch1.appf.tab1_1_1_2_10 hd_b_ch1.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.61 (0.38 to 0.97)</td><td headers="hd_h_ch1.appf.tab1_1_1_1_3 hd_h_ch1.appf.tab1_1_1_2_11 hd_b_ch1.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">9 fewer per 1000 (from 1 fewer to 14 fewer)</td><td headers="hd_h_ch1.appf.tab1_1_1_1_4 hd_b_ch1.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⊕⊝⊝⊝</p>
|
|
<p>VERY LOW</p>
|
|
</td><td headers="hd_h_ch1.appf.tab1_1_1_1_5 hd_b_ch1.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">CRITICAL</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch1.appf.tab1_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias.</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="ch1.appf.tab1_2"><p class="no_margin">Downgraded by 1 or 2 increments because the majority of the evidence included an indirect or very indirect population respectively.</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="ch1.appf.tab1_3"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs.</p></div></dd></dl><dl class="bkr_refwrap"><dt>4</dt><dd><div id="ch1.appf.tab1_4"><p class="no_margin">Downgraded by 2 increments because of heterogeneity, with I2=81%, p=0.02, unexplained by subgroup analysis</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch1appftab2"><div id="ch1.appf.tab2" class="table"><h3><span class="label">Table 11</span><span class="title">Clinical evidence profile: Continued aspirin versus placebo in those with prior aspirin use</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577863/table/ch1.appf.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch1.appf.tab2_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch1.appf.tab2_1_1_1_1" colspan="7" rowspan="1" style="text-align:center;vertical-align:middle;">Quality assessment</th><th id="hd_h_ch1.appf.tab2_1_1_1_2" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">No of patients</th><th id="hd_h_ch1.appf.tab2_1_1_1_3" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">Effect</th><th id="hd_h_ch1.appf.tab2_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch1.appf.tab2_1_1_1_4" style="text-align:center;vertical-align:middle;">Quality</th><th id="hd_h_ch1.appf.tab2_1_1_1_5" rowspan="2" colspan="1" headers="hd_h_ch1.appf.tab2_1_1_1_5" style="text-align:center;vertical-align:middle;">Importance</th></tr><tr><th headers="hd_h_ch1.appf.tab2_1_1_1_1" id="hd_h_ch1.appf.tab2_1_1_2_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No of studies</th><th headers="hd_h_ch1.appf.tab2_1_1_1_1" id="hd_h_ch1.appf.tab2_1_1_2_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Design</th><th headers="hd_h_ch1.appf.tab2_1_1_1_1" id="hd_h_ch1.appf.tab2_1_1_2_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Risk of bias</th><th headers="hd_h_ch1.appf.tab2_1_1_1_1" id="hd_h_ch1.appf.tab2_1_1_2_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Inconsistency</th><th headers="hd_h_ch1.appf.tab2_1_1_1_1" id="hd_h_ch1.appf.tab2_1_1_2_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Indirectness</th><th headers="hd_h_ch1.appf.tab2_1_1_1_1" id="hd_h_ch1.appf.tab2_1_1_2_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Imprecision</th><th headers="hd_h_ch1.appf.tab2_1_1_1_1" id="hd_h_ch1.appf.tab2_1_1_2_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Other considerations</th><th headers="hd_h_ch1.appf.tab2_1_1_1_2" id="hd_h_ch1.appf.tab2_1_1_2_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Aspirin</th><th headers="hd_h_ch1.appf.tab2_1_1_1_2" id="hd_h_ch1.appf.tab2_1_1_2_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Placebo</th><th headers="hd_h_ch1.appf.tab2_1_1_1_3" id="hd_h_ch1.appf.tab2_1_1_2_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Relative (95% CI)</th><th headers="hd_h_ch1.appf.tab2_1_1_1_3" id="hd_h_ch1.appf.tab2_1_1_2_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Absolute</th></tr></thead><tbody><tr><th headers="hd_h_ch1.appf.tab2_1_1_1_1 hd_h_ch1.appf.tab2_1_1_2_1 hd_h_ch1.appf.tab2_1_1_2_2 hd_h_ch1.appf.tab2_1_1_2_3 hd_h_ch1.appf.tab2_1_1_2_4 hd_h_ch1.appf.tab2_1_1_2_5 hd_h_ch1.appf.tab2_1_1_2_6 hd_h_ch1.appf.tab2_1_1_2_7 hd_h_ch1.appf.tab2_1_1_1_2 hd_h_ch1.appf.tab2_1_1_2_8 hd_h_ch1.appf.tab2_1_1_2_9 hd_h_ch1.appf.tab2_1_1_1_3 hd_h_ch1.appf.tab2_1_1_2_10 hd_h_ch1.appf.tab2_1_1_2_11 hd_h_ch1.appf.tab2_1_1_1_4 hd_h_ch1.appf.tab2_1_1_1_5" id="hd_b_ch1.appf.tab2_1_1_1_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Risk of Recurrent Stroke at 24 hrs (prior aspirin) (follow-up 24 hours)</th></tr><tr><td headers="hd_h_ch1.appf.tab2_1_1_1_1 hd_h_ch1.appf.tab2_1_1_2_1 hd_b_ch1.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch1.appf.tab2_1_1_1_1 hd_h_ch1.appf.tab2_1_1_2_2 hd_b_ch1.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch1.appf.tab2_1_1_1_1 hd_h_ch1.appf.tab2_1_1_2_3 hd_b_ch1.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch1.appf.tab2_1_1_1_1 hd_h_ch1.appf.tab2_1_1_2_4 hd_b_ch1.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch1.appf.tab2_1_1_1_1 hd_h_ch1.appf.tab2_1_1_2_5 hd_b_ch1.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_ch1.appf.tab2_1_1_1_1 hd_h_ch1.appf.tab2_1_1_2_6 hd_b_ch1.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>3</sup></td><td headers="hd_h_ch1.appf.tab2_1_1_1_1 hd_h_ch1.appf.tab2_1_1_2_7 hd_b_ch1.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch1.appf.tab2_1_1_1_2 hd_h_ch1.appf.tab2_1_1_2_8 hd_b_ch1.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch1.appf.tab2_1_1_1_2 hd_h_ch1.appf.tab2_1_1_2_9 hd_b_ch1.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch1.appf.tab2_1_1_1_3 hd_h_ch1.appf.tab2_1_1_2_10 hd_b_ch1.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">HR 0.31 (0.11 to 0.87)</td><td headers="hd_h_ch1.appf.tab2_1_1_1_3 hd_h_ch1.appf.tab2_1_1_2_11 hd_b_ch1.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch1.appf.tab2_1_1_1_4 hd_b_ch1.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⊕⊝⊝⊝</p>
|
|
<p>VERY LOW</p>
|
|
</td><td headers="hd_h_ch1.appf.tab2_1_1_1_5 hd_b_ch1.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">CRITICAL</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch1.appf.tab2_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias.</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="ch1.appf.tab2_2"><p class="no_margin">Downgraded by 1 or 2 increments because the majority of the evidence included an indirect or very indirect population respectively.</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="ch1.appf.tab2_3"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs.</p></div></dd></dl></dl></div></div></div></article><article data-type="fig" id="figobch1appgfig1"><div id="ch1.appg.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%206.%20Flow%20chart%20of%20health%20economic%20study%20selection%20for%20the%20guideline.&p=BOOKS&id=577863_ch1appgf1.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577863/bin/ch1appgf1.jpg" alt="Figure 6. Flow chart of health economic study selection for the guideline." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 6</span><span class="title">Flow chart of health economic study selection for the guideline</span></h3><div class="caption"><p>* Non-relevant population, intervention, comparison, design or setting; non-English language</p></div></div></article><article data-type="table-wrap" id="figobch1apphtab1"><div id="ch1.apph.tab1" class="table"><h3><span class="label">Table 12</span><span class="title">Studies excluded from the clinical review</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577863/table/ch1.apph.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch1.apph.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Exclusion reason</th></tr></thead><tbody><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Aglua 2017<a class="bibr" href="#ch1.ref1" rid="ch1.ref1"><sup>1</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review; results are unclear</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Amarenco 2017<a class="bibr" href="#ch1.ref2" rid="ch1.ref2"><sup>2</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population or time point</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Amarenco 2017<a class="bibr" href="#ch1.ref3" rid="ch1.ref3"><sup>3</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population or time point</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Anon 1978<a class="bibr" href="#ch1.ref25" rid="ch1.ref25"><sup>25</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population or time point</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Anon 1991<a class="bibr" href="#ch1.ref38" rid="ch1.ref38"><sup>38</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population or time point</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Anon 1991<a class="bibr" href="#ch1.ref33" rid="ch1.ref33"><sup>33</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population or time point</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Anon 1996<a class="bibr" href="#ch1.ref32" rid="ch1.ref32"><sup>32</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population or time point</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Biller 1989<a class="bibr" href="#ch1.ref4" rid="ch1.ref4"><sup>4</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population or time point</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bousser 1983<a class="bibr" href="#ch1.ref6" rid="ch1.ref6"><sup>6</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population or time point</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bousser 2011<a class="bibr" href="#ch1.ref5" rid="ch1.ref5"><sup>5</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population or time point</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Boysen 1988<a class="bibr" href="#ch1.ref7" rid="ch1.ref7"><sup>7</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population or time point</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Britton 1987<a class="bibr" href="#ch1.ref8" rid="ch1.ref8"><sup>8</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population or time point</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Candelise 1982<a class="bibr" href="#ch1.ref9" rid="ch1.ref9"><sup>9</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Inappropriate comparison</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Chen 1997<a class="bibr" href="#ch1.ref11" rid="ch1.ref11"><sup>11</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Included in Rothwell IPD meta-analysis. Abstract only</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Chen 2000<a class="bibr" href="#ch1.ref10" rid="ch1.ref10"><sup>10</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population or time point</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">De Schryver 2012<a class="bibr" href="#ch1.ref13" rid="ch1.ref13"><sup>13</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect interventions. Inappropriate comparison</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Diener 1996<a class="bibr" href="#ch1.ref14" rid="ch1.ref14"><sup>14</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population or time point</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Easton 2017<a class="bibr" href="#ch1.ref15" rid="ch1.ref15"><sup>15</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population or time point</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">ESPS Group 1997<a class="bibr" href="#ch1.ref16" rid="ch1.ref16"><sup>16</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population. Included in Rothwell IPD meta-analysis</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Fields 1977<a class="bibr" href="#ch1.ref17" rid="ch1.ref17"><sup>17</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population. Included in Rothwell IPD meta-analysis</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Huang 2017<a class="bibr" href="#ch1.ref18" rid="ch1.ref18"><sup>18</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population or time point</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Johnston 2015<a class="bibr" href="#ch1.ref21" rid="ch1.ref21"><sup>21</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population or time point</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Johnston 2016<a class="bibr" href="#ch1.ref20" rid="ch1.ref20"><sup>20</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population or time point</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Johnston 2016<a class="bibr" href="#ch1.ref19" rid="ch1.ref19"><sup>19</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Abstract only</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lavallee 2007<a class="bibr" href="#ch1.ref22" rid="ch1.ref22"><sup>22</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect interventions</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Murakami 1983<a class="bibr" href="#ch1.ref23" rid="ch1.ref23"><sup>23</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not in the English language</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Redman 2001<a class="bibr" href="#ch1.ref26" rid="ch1.ref26"><sup>26</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review is not relevant to review question or unclear PICO</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Rothwell 2007<a class="bibr" href="#ch1.ref28" rid="ch1.ref28"><sup>28</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population or time point</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sandercock 2014<a class="bibr" href="#ch1.ref29" rid="ch1.ref29"><sup>29</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review is not relevant to review question or unclear PICO</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sorensen 1983<a class="bibr" href="#ch1.ref30" rid="ch1.ref30"><sup>30</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population. Included in Rothwell IPD meta-analysis</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Stachenko 1991<a class="bibr" href="#ch1.ref31" rid="ch1.ref31"><sup>31</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review is not relevant to review question or unclear PICO</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sze 1988<a class="bibr" href="#ch1.ref34" rid="ch1.ref34"><sup>34</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review is not relevant to review question or unclear PICO</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Takahashi 2014<a class="bibr" href="#ch1.ref35" rid="ch1.ref35"><sup>35</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population or time point</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Thijs 2008<a class="bibr" href="#ch1.ref36" rid="ch1.ref36"><sup>36</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review is not relevant to review question or unclear PICO</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Tohgi 1987<a class="bibr" href="#ch1.ref37" rid="ch1.ref37"><sup>37</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population or time point</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Wa 2017<a class="bibr" href="#ch1.ref39" rid="ch1.ref39"><sup>39</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review is not relevant to review question or unclear PICO</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Wang 2016<a class="bibr" href="#ch1.ref40" rid="ch1.ref40"><sup>40</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review is not relevant to review question or unclear PICO. Not review population</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Wang 2017<a class="bibr" href="#ch1.ref41" rid="ch1.ref41"><sup>41</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population or time point</td></tr><tr><td headers="hd_h_ch1.apph.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Weinberger 2005<a class="bibr" href="#ch1.ref42" rid="ch1.ref42"><sup>42</sup></a></td><td headers="hd_h_ch1.apph.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population or time point</td></tr></tbody></table></div></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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