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id="_NBK577867_"><span itemprop="name">Evidence review for very early mobilisation</span></h1><div class="subtitle">Stroke and transient ischaemic attack in over 16s: diagnosis and initial management</div><p><b>Evidence review F</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="ch6.s1"><h2 id="_ch6_s1_">1. Early mobilisation for people after acute stroke</h2><div id="ch6.s1.1"><h3>1.1. Review question: Does early mobilisation versus treatment as usual reduce mortality and morbidity in people with acute stroke?</h3></div><div id="ch6.s1.2"><h3>1.2. Introduction</h3><p>In recent years patients with acute stroke have been assessed and mobilised earlier as part of their rehabilitation programme. In practice, mobilisation refers to ‘out of bed’ activity such as sitting out of bed, standing and walking. Mobilisation is aimed at reducing the complications associated with immobility and promoting functional recovery. Previous NICE Guidance on stroke (CG68) suggests that people with acute stroke should be mobilised as soon as possible as part of an active management programme on a specialist stroke unit and that they should be helped to sit up as soon as possible. However, the impact of early mobilisation on mortality and morbidity is unclear. There has been limited evidence available to guide when and how early after stroke mobilisation should take place. In addition, the optimum frequency and duration of mobilisation is unknown. As a result clinical practice is variable and further guidance is required.</p><p>A large international randomised controlled trial was published since the previous version of this guideline was released. This trial tested a protocol of very early mobilisation, carried out more frequently and for longer than usual care. This has prompted a further review of the evidence in order to establish if early mobilisation versus usual care reduces mortality and morbidly in people with stroke.</p></div><div id="ch6.s1.3"><h3>1.3. PICO table</h3><p>For full details see the review protocol in <a href="#ch6.appa">appendix A</a>.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch6tab1"><a href="/books/NBK577867/table/ch6.tab1/?report=objectonly" target="object" title="Table 1" class="img_link icnblk_img figpopup" rid-figpopup="figch6tab1" rid-ob="figobch6tab1"><img class="small-thumb" src="/books/NBK577867/table/ch6.tab1/?report=thumb" src-large="/books/NBK577867/table/ch6.tab1/?report=previmg" alt="Table 1. PICO characteristics of review question." /></a><div class="icnblk_cntnt"><h4 id="ch6.tab1"><a href="/books/NBK577867/table/ch6.tab1/?report=objectonly" target="object" rid-ob="figobch6tab1">Table 1</a></h4><p class="float-caption no_bottom_margin">PICO characteristics of review question. </p></div></div></div><div id="ch6.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="#ch6.ref31" rid="ch6.ref31"><sup>31</sup></a> Methods specific to this review question are described in the review protocol in <a href="#ch6.appa">appendix A</a>.</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="ch6.s1.5"><h3>1.5. Clinical evidence</h3><div id="ch6.s1.5.1"><h4>1.5.1. Included studies</h4><p>Eight studies reported in 18 papers were included in the review.<a class="bibr" href="#ch6.ref83" rid="ch6.ref83"><sup>83</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref84" rid="ch6.ref84"><sup>84</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref15" rid="ch6.ref15"><sup>15</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref17" rid="ch6.ref17"><sup>17</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref18" rid="ch6.ref18"><sup>18</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref23" rid="ch6.ref23"><sup>23</sup></a><sup>–</sup><a class="bibr" href="#ch6.ref25" rid="ch6.ref25"><sup>25</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref30" rid="ch6.ref30"><sup>30</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref36" rid="ch6.ref36"><sup>36</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref37" rid="ch6.ref37"><sup>37</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref42" rid="ch6.ref42"><sup>42</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref47" rid="ch6.ref47"><sup>47</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref57" rid="ch6.ref57"><sup>57</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref58" rid="ch6.ref58"><sup>58</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref72" rid="ch6.ref72"><sup>72</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref79" rid="ch6.ref79"><sup>79</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref86" rid="ch6.ref86"><sup>86</sup></a> These are summarised in <a class="figpopup" href="/books/NBK577867/table/ch6.tab2/?report=objectonly" target="object" rid-figpopup="figch6tab2" rid-ob="figobch6tab2">Table 2</a> below; 6 used very early mobilisation and 2 used early mobilisation as the intervention. Two papers were Cochrane reports<a class="bibr" href="#ch6.ref24" rid="ch6.ref24"><sup>24</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref25" rid="ch6.ref25"><sup>25</sup></a> and they reported on one study that is included in the review.<a class="bibr" href="#ch6.ref36" rid="ch6.ref36"><sup>36</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref37" rid="ch6.ref37"><sup>37</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref79" rid="ch6.ref79"><sup>79</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref86" rid="ch6.ref86"><sup>86</sup></a> Evidence from all the studies is summarised in the clinical evidence summary below (<a class="figpopup" href="/books/NBK577867/table/ch6.tab3/?report=objectonly" target="object" rid-figpopup="figch6tab3" rid-ob="figobch6tab3">Table 3</a>). The intensity and timing of mobilisation varied across the studies for both the interventions and comparisons. Analyses according to stroke severity based on the NIHSS (mild, moderate and severe stroke) were not possible because the included studies did not stratify the results according to stroke severity.</p><p>See also the study selection flow chart in <a href="#ch6.appc">appendix C</a>, study evidence tables in <a href="#ch6.appd">appendix D</a>, forest plots in <a href="#ch6.appe">appendix E</a> and GRADE tables in <a href="#ch6.apph">appendix H</a>.</p></div><div id="ch6.s1.5.2"><h4>1.5.2. Excluded studies</h4><p>See the excluded studies list in <a href="#ch6.appi">appendix I</a>.</p></div><div id="ch6.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="figch6tab2"><a href="/books/NBK577867/table/ch6.tab2/?report=objectonly" target="object" title="Table 2" class="img_link icnblk_img figpopup" rid-figpopup="figch6tab2" rid-ob="figobch6tab2"><img class="small-thumb" src="/books/NBK577867/table/ch6.tab2/?report=thumb" src-large="/books/NBK577867/table/ch6.tab2/?report=previmg" alt="Table 2. Summary of studies included in the evidence review." /></a><div class="icnblk_cntnt"><h4 id="ch6.tab2"><a href="/books/NBK577867/table/ch6.tab2/?report=objectonly" target="object" rid-ob="figobch6tab2">Table 2</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the evidence review. </p></div></div><p>See <a href="#ch6.appd">appendix D</a> for full evidence tables.</p></div><div id="ch6.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="figch6tab3"><a href="/books/NBK577867/table/ch6.tab3/?report=objectonly" target="object" title="Table 3" class="img_link icnblk_img figpopup" rid-figpopup="figch6tab3" rid-ob="figobch6tab3"><img class="small-thumb" src="/books/NBK577867/table/ch6.tab3/?report=thumb" src-large="/books/NBK577867/table/ch6.tab3/?report=previmg" alt="Table 3. Clinical evidence summary: very early mobilisation versus usual care." /></a><div class="icnblk_cntnt"><h4 id="ch6.tab3"><a href="/books/NBK577867/table/ch6.tab3/?report=objectonly" target="object" rid-ob="figobch6tab3">Table 3</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: very early mobilisation versus usual care. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch6tab4"><a href="/books/NBK577867/table/ch6.tab4/?report=objectonly" target="object" title="Table 4" class="img_link icnblk_img figpopup" rid-figpopup="figch6tab4" rid-ob="figobch6tab4"><img class="small-thumb" src="/books/NBK577867/table/ch6.tab4/?report=thumb" src-large="/books/NBK577867/table/ch6.tab4/?report=previmg" alt="Table 4. Clinical evidence summary: early mobilisation versus usual care." /></a><div class="icnblk_cntnt"><h4 id="ch6.tab4"><a href="/books/NBK577867/table/ch6.tab4/?report=objectonly" target="object" rid-ob="figobch6tab4">Table 4</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: early mobilisation versus usual care. </p></div></div><p>See <a href="#ch6.appf">appendix F</a> for full GRADE tables.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch6tab5"><a href="/books/NBK577867/table/ch6.tab5/?report=objectonly" target="object" title="Table 5" class="img_link icnblk_img figpopup" rid-figpopup="figch6tab5" rid-ob="figobch6tab5"><img class="small-thumb" src="/books/NBK577867/table/ch6.tab5/?report=thumb" src-large="/books/NBK577867/table/ch6.tab5/?report=previmg" alt="Table 5. Data not suitable for meta-analysis." /></a><div class="icnblk_cntnt"><h4 id="ch6.tab5"><a href="/books/NBK577867/table/ch6.tab5/?report=objectonly" target="object" rid-ob="figobch6tab5">Table 5</a></h4><p class="float-caption no_bottom_margin">Data not suitable for meta-analysis. </p></div></div></div></div><div id="ch6.s1.6"><h3>1.6. Economic evidence</h3><div id="ch6.s1.6.1"><h4>1.6.1. Included studies</h4><p>One health economic study was identified with the relevant comparison and has been included in this review.<a class="bibr" href="#ch6.ref85" rid="ch6.ref85"><sup>85</sup></a> This is summarised in the health economic evidence profile below (<a class="figpopup" href="/books/NBK577867/table/ch6.tab6/?report=objectonly" target="object" rid-figpopup="figch6tab6" rid-ob="figobch6tab6">Table 6</a>) and the health economic evidence table in <a href="#ch6.apph">appendix H</a>.</p></div><div id="ch6.s1.6.2"><h4>1.6.2. Excluded studies</h4><p>No health economic studies that were relevant to this question were excluded due to assessment of limited applicability or methodological limitations.</p><p>See also the health economic study selection flow chart in <a href="#ch6.appg">appendix G</a>.</p></div><div id="ch6.s1.6.3"><h4>1.6.3. Summary of studies included in the economic evidence review</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch6tab6"><a href="/books/NBK577867/table/ch6.tab6/?report=objectonly" target="object" title="Table 6" class="img_link icnblk_img figpopup" rid-figpopup="figch6tab6" rid-ob="figobch6tab6"><img class="small-thumb" src="/books/NBK577867/table/ch6.tab6/?report=thumb" src-large="/books/NBK577867/table/ch6.tab6/?report=previmg" alt="Table 6. Health economic evidence profile: Very early mobilisation and standard care versus standard care." /></a><div class="icnblk_cntnt"><h4 id="ch6.tab6"><a href="/books/NBK577867/table/ch6.tab6/?report=objectonly" target="object" rid-ob="figobch6tab6">Table 6</a></h4><p class="float-caption no_bottom_margin">Health economic evidence profile: Very early mobilisation and standard care versus standard care. </p></div></div></div><div id="ch6.s1.6.4"><h4>1.6.4. Unit costs</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch6tab7"><a href="/books/NBK577867/table/ch6.tab7/?report=objectonly" target="object" title="Table 7" class="img_link icnblk_img figpopup" rid-figpopup="figch6tab7" rid-ob="figobch6tab7"><img class="small-thumb" src="/books/NBK577867/table/ch6.tab7/?report=thumb" src-large="/books/NBK577867/table/ch6.tab7/?report=previmg" alt="Table 7. UK costs of very early mobilisation." /></a><div class="icnblk_cntnt"><h4 id="ch6.tab7"><a href="/books/NBK577867/table/ch6.tab7/?report=objectonly" target="object" rid-ob="figobch6tab7">Table 7</a></h4><p class="float-caption no_bottom_margin">UK costs of very early mobilisation. </p></div></div></div></div><div id="ch6.s1.7"><h3>1.7. Resource costs</h3><p>The recommendations made by the committee based on this review (see section <b>Error! R eference source not found.</b>) are not expected to have a substantial impact on resources for the NHS in England.</p></div><div id="ch6.s1.8"><h3>1.8. Evidence statements</h3><div id="ch6.s1.8.1"><h4>1.8.1. Clinical evidence statements</h4><div id="ch6.s1.8.1.1"><h5>1.8.1.1. Very early mobilisation versus usual care</h5><ul id="l120"><li id="lt371" class="half_rhythm"><div>Evidence from 6 studies in 2475 people suggested that very early mobilisation may be associated with a clinical harm in terms of increased mortality at 7 days, 90 days and 12 months (Low and Moderate quality).</div></li><li id="lt372" class="half_rhythm"><div>There was also a suggestion of clinical harm from reduced numbers of people achieving mRS of 0-2 at 7 days with very early mobilisation compared to usual care in 2 studies with 191 participants (Low quality). However, no clinical difference in the numbers achieving mRS 0-2 was seen at 90 days (5 studies; n=2377; High quality) or 12 months (2 studies; n=2152; Moderate quality).</div></li><li id="lt373" class="half_rhythm"><div>No clinical difference was seen between very early mobilisation and usual care for recurrent stroke (1 study; n=71; Low quality), neurological deterioration (1 study; n=138; Very Low quality) or adverse events (2 studies; n=209; Moderate quality) or length of hospital stay (1 study; n=124; Low quality).</div></li><li id="lt374" class="half_rhythm"><div>Evidence from 1 study showed a clinical benefit of very early mobilisation for the Barthel index measured at discharge and at 90 days (1 study; n=90; Moderate quality).</div></li></ul></div><div id="ch6.s1.8.1.2"><h5>1.8.1.2. Early mobilisation versus usual care</h5><ul id="l121"><li id="lt375" class="half_rhythm"><div>Evidence from 2 studies in 75 people found clinical benefit of early mobilisation compared to usual care in terms of reduced mortality and fewer adverse events at 90 days (Very Low quality).</div></li><li id="lt376" class="half_rhythm"><div>No clinical difference was seen for the numbers achieving an mRS of 0-2 or experiencing neurological deterioration at 90 days (2 studies; n=75; Very Low quality).</div></li><li id="lt377" class="half_rhythm"><div>One study suggested that length of stay was longer in the early mobilisation group (n=42; Very Low quality).</div></li></ul></div></div><div id="ch6.s1.8.2"><h4>1.8.2. Health economic evidence statements</h4><p>One health economic analysis based on the AVERT II trial found that very early mobilisation with standard care was dominant (more effective and less costly) compared with standard care alone. The study was assessed as partially applicable with potentially serious limitations.</p></div></div><div id="ch6.s1.9"><h3>1.9. The committee’s discussion of the evidence</h3><div id="ch6.s1.9.1"><h4>1.9.1. Interpreting the evidence</h4><div id="ch6.s1.9.1.1"><h5>1.9.1.1. The outcomes that matter most</h5><p>The critical outcomes identified for this review were the mRS at 7 days, 90 days and 1 year, and mortality at 7 days, 90 days and 1 year. The committee considered both outcomes to be vital in decision making. Important outcomes included recurrent stroke, neurological deterioration, quality of life, length of hospital stay and adverse events (pulmonary embolism, deep vein thrombosis, pressure sores, pneumonia, and falls).</p></div><div id="ch6.s1.9.1.2"><h5>1.9.1.2. The quality of the evidence</h5><p>Eight studies were included in the review. Six studies compared very early (within 24 hours) mobilisation versus usual care and two compared early (within 48 hours) mobilisation versus usual care. Six studies were open blinded end-point (PROBE) trials. This meant that patient and care givers were not blinded to the intervention, but the outcome assessors were. Subjective outcomes in these six trials (mRS and quality of life) were therefore downgraded for risk of bias. Two studies ensured that the patients and care givers were blinded to the intervention, and one of these studies provided the majority of the body of evidence. Heterogeneity was found for the outcomes of mortality at 90 days and mRS at both 6 and 12 months for very early intervention versus usual care. One study dominated the evidence for these outcomes. It had the most intense mobilisation treatment and also had a control arm mobilising patients earlier than the intervention arm in other studies. Exclusion of this study did not explain the heterogeneity. It is possible that heterogeneity was a result of the varying types of mobilisation strategies used across the studies. Heterogeneity was also found for adverse events in early mobilisation versus usual care and this could not be explained by subgroup analysis. Outcomes such as renal failure, neurological deterioration and adverse events were rare, resulting in estimates of effect with wide confidence intervals, and therefore were downgraded for imprecision.</p><p>Evidence ranged from very low to high quality. For the very early mobilisation comparison the majority was moderate quality, while for the early mobilisation comparison the majority of the evidence was very low quality.</p></div><div id="ch6.s1.9.1.3"><h5>1.9.1.3. Benefits and harms</h5><p>The committee noted that the evidence was difficult to interpret due to the differences in intensity, timing and type of mobilisation used in the trials, as well as the unclear reporting of how mobilisation was defined in some cases.</p><div id="ch6.s1.9.1.3.1"><h5>Very early mobilisation (within 24 hours)</h5><p>There were 6 studies of very early (within 24 hours) mobilisation.</p><p>There was a suggestion of harm from very early mobilisation in terms of increased mortality and worse functional outcome on mRS. However, it was not possible to delineate the relationship between intensity of mobilisation and the timing of mobilisation. This is because the majority of the evidence was from the AVERT III 2016 trial in which the median time to first mobilisation was within 24 hours for both the intervention and comparison groups, but the intervention group received much more frequent mobilisation sessions and had a greater overall duration of mobilisation. Therefore, although the intervention group were mobilised a median of 3.9 hours earlier, they also received a greater intensity of mobilisation (frequency, duration of daily activity or total activity) and any combination of these factors could have influenced the outcome.</p><p>In the AVERT Trial the intention was to offer at least three additional out of bed sessions compared to usual care, with mobilisation to begin within the first 24 hours of stroke onset and to focus on sitting, standing and walking (i.e. out of bed) activity. The intervention summary for the trial shows that usual care consisted of a median of 3 (IQR: 2 - 4.5) mobilisation sessions per day compared with a median of 6.5 (IQR: 4.0 - 9.5) in the very early mobilisation group. Therefore, a median of 3.5 additional sessions were offered in the very early mobilisation group. This was based on both nursing and therapist data.</p><p>In the usual care group, the median time to first mobilisation (TTFM) was 22.4 (IQR: 16.5 - 29.3) hours of stroke onset compared with 18.5 hours (IQR: 12.8 - 22.3) in the very early mobilisation group. This this was only 3.9 hours earlier.</p><p>In the usual care group, the median daily amount of out of bed activity was 10 minutes (IQR 0 - 18) compared with 31 (IQR: 16.5 and 50.5) minutes in the very early mobilisation group. The median total amount of out of bed activity over the length of stay or until 14 days after stroke was 70 (IQR: 32 – 130) minutes in the usual care group compared with 201.5 (IQR: 108 – 340) minutes in the very early mobilisation group. It is important to note that the amount of minutes is derived only from physiotherapist data and does not include nursing time.</p><p>The committee discussed a published regression analysis of the results which suggested that increased frequency of mobilisation was associated with a good functional outcome and reduced odds of death, while increased total duration of mobilisation reduced the odds of a good outcome. However, this analysis was not robust enough to inform a recommendation.</p><p>The results for the outcome of Barthel Index showed some benefit of very early mobilisation but the committee did not consider this to be clinically meaningful. The committee noted that there was no clinical difference of very early intervention for the outcomes of recurrent stroke, neurological deterioration, adverse events and length of hospital stay.</p><p>The committee made a recommendation advising not to start intense mobilisation (more frequent mobilisations of a longer duration than ‘usual care’) within the first 24 hours of stroke onset because of the findings of the AVERT III 2016 study, which gave a signal for harm. This harm could be explained by the potential to reduce cerebral perfusion when mobilising very early at high intensity.</p><p>However, based on their clinical experience they discussed that this harm was most relevant to those who need help to sit out of bed, stand or walk, and so the recommendation is limited to this group. The committee acknowledged that approximately 40% of the AVERT trial participants were able to mobilise independently but that the results were not stratified according to this. Nevertheless, they did not want to prevent appropriate early mobilisation in people who are independently mobile after having a stroke. Where clinically appropriate people who are able to participate in out of bed activity with minimal or no assistance and have been mildly affected by their stroke, should not be discouraged from doing so within the first 24 hours. This was a consensus agreement.</p></div><div id="ch6.s1.9.1.3.2"><h5>Early mobilisation (within 48 hours)</h5><p>The committee noted that in two studies examining early (within 48 hours) mobilisation there was no clinically important difference for the outcomes of mortality, mRS, recurrent stroke, adverse events and length of hospital stay.</p><p>Early mobilisation may be appropriate in some cases where patients require minimal assistance to mobilise such as in those who have suffered a mild stroke, are experiencing language and/or upper limb dysfunction alone. These patients often require little or no assistance to mobilise. The committee therefore considered that people should be mobilised after having a stroke when their clinical condition permits and a consensus recommendation was made. This was an amendment of the 2008 recommendation: People with acute stroke should be mobilised as soon as possible (when their clinical condition permits) as part of an active management programme in a specialist stroke unit.</p></div></div></div><div id="ch6.s1.9.2"><h4>1.9.2. Cost effectiveness and resource use</h4><p>The results of a published within-trial cost effectiveness analysis of the AVERT phase II trial from the Australian hospital perspective estimated that very early mobilisation is dominant compared with standard care. However, the committee noted that the treatment effect for the health outcome mRS score 0-2 used in the economic analysis differs from the treatment effect calculated in the clinical review. The clinical review, incorporating the larger AVERT phase III trial, found no clear evidence for benefit or harm for this outcome. The committee thought that this difference in treatment effect would be likely to change the conclusions about cost effectiveness of very early and intense mobilisation. The committee therefore could not be confident in this economic evidence.</p><p>The committee therefore considered the clinical evidence. Notably, there was potential for clinical harm associated with very early and intense mobilisation for the outcome of mortality and no difference for other outcomes. The committee therefore chose to recommend that very early and intense mobilisation is not routinely offered.</p><p>The committee was confident that making this recommendation would not have a resource impact, as there was no indication that mobilising later leads to a longer length of stay. The committee noted that people will still be assessed and mobilised and there are not likely to be differences in staff costs. In current practice, mobilisation strategies differ according to stroke severity and the condition of the person with stroke. The strategy may also be impacted by the availability of different types of seating. The recommendation may change current practice in some patients and may mean ‘out of bed’ activities don’t commence until after 24 hours. This may lead to more need for in bed positioning, turning and pressure area care within this first 24 hour period.</p><p>In conclusion, the committee thought the cost effectiveness evidence was incongruous with the results of the clinical review which included a considerably larger phase III study. The committee therefore chose to make a recommendation in relation to very early and high intensity mobilisation based on the clinical evidence for mortality which was suggestive of clinical harm. This recommendation is not likely to have a resource impact.</p></div><div id="ch6.s1.9.3"><h4>1.9.3. Other factors the committee took into account</h4><p>The committee emphasised that although mobilisation may not be started very early after stroke, patient assessment should still be undertaken as soon as possible and a plan for mobilisation made.</p><p>Limitations of the AVERT study were discussed, including not measuring the duration of nursing input as part of the duration of mobilisation, but only basing this on physiotherapist time; the possible confounding effect from those who have had a more severe stroke receiving less frequent mobilisation per the trial protocol; and the complexity of the intervention protocol making it difficult to identify what caused the harm in the very early mobilisation group.</p></div></div></div><div id="ch6.rl.r1"><h2 id="_ch6_rl_r1_">References</h2><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1.</dt><dd><div class="bk_ref" id="ch6.ref1">Ada
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L, Dean
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C, Morris
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M. Establishing walking using treadmill training in non-ambulatory patients during inpatient stroke rehabilitation: the MOBILISE trial. Australian Journal of Physiotherapy. 2009; 55:(4 Suppl):2</div></dd></dl><dl class="bkr_refwrap"><dt>2.</dt><dd><div class="bk_ref" id="ch6.ref2">Ada
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L, Dean
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C, Morris
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M, Simpson
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J, Katrak
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P. Establishing walking using treadmill walking with body weight support in subacute non-ambulatory stroke: the MOBILISE trial I. International Journal of Stroke. 2010; 5:(Suppl 1):24–5</div></dd></dl><dl class="bkr_refwrap"><dt>3.</dt><dd><div class="bk_ref" id="ch6.ref3">Ada
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L, Dean
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CM, Morris
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ME, Simpson
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JM, Katrak
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P. Randomized trial of treadmill walking with body weight support to establish walking in subacute stroke: the MOBILISE trial. Stroke. 2010; 41(6):1237–42 [<a href="https://pubmed.ncbi.nlm.nih.gov/20413741" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20413741</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>4.</dt><dd><div class="bk_ref" id="ch6.ref4">Adeolu
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AA, Rabiu
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TB, Adeleye
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AO. Post-operative day two versus day seven mobilization after burr-hole drainage of subacute and chronic subdural haematoma in Nigerians. British Journal of Neurosurgery. 2012; 26(5):743–6 [<a href="https://pubmed.ncbi.nlm.nih.gov/22905886" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22905886</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>5.</dt><dd><div class="bk_ref" id="ch6.ref5">Aries
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MJ, Bakker
|
|
DC, Stewart
|
|
RE, De Keyser
|
|
J, Elting
|
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JW, Thien
|
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T
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et al. Exaggerated postural blood pressure rise is related to a favorable outcome in patients with acute ischemic stroke. Stroke. 2012; 43(1):92–6 [<a href="https://pubmed.ncbi.nlm.nih.gov/22052511" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22052511</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>6.</dt><dd><div class="bk_ref" id="ch6.ref6">Armstrong
|
|
RG, Ahmad
|
|
S, Seely
|
|
AJ, Kenny
|
|
GP. Heart rate variability and baroreceptor sensitivity following exercise-induced hyperthermia in endurance trained men. European Journal of Applied Physiology. 2012; 112(2):501–11 [<a href="https://pubmed.ncbi.nlm.nih.gov/21584685" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21584685</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>7.</dt><dd><div class="bk_ref" id="ch6.ref7">Arnold
|
|
SM, Dinkins
|
|
M, Mooney
|
|
LH, Freeman
|
|
WD, Rawal
|
|
B, Heckman
|
|
MG
|
|
et al. Very early mobilization in stroke patients treated with intravenous recombinant tissue plasminogen activator. Journal of Stroke and Cerebrovascular Diseases. 2015; 24(6):1168–73 [<a href="https://pubmed.ncbi.nlm.nih.gov/25869770" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25869770</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>8.</dt><dd><div class="bk_ref" id="ch6.ref8">Asberg
|
|
KH. Orthostatic tolerance training of stroke patients in general medical wards. An experimental study. Scandinavian Journal of Rehabilitation Medicine. 1989; 21(4):179–85 [<a href="https://pubmed.ncbi.nlm.nih.gov/2698505" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 2698505</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>9.</dt><dd><div class="bk_ref" id="ch6.ref9">Awad
|
|
AJ, Kellner
|
|
CP, Mascitelli
|
|
JR, Bederson
|
|
JB, Mocco
|
|
J. No early mobilization after stroke: Lessons learned from the AVERT trial. World Neurosurgery. 2016; 87:474 [<a href="https://pubmed.ncbi.nlm.nih.gov/26828459" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26828459</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>10.</dt><dd><div class="bk_ref" id="ch6.ref10">Bagley
|
|
P, Hudson
|
|
M, Forster
|
|
A, Smith
|
|
J, Young
|
|
J. A randomized trial evaluation of the Oswestry Standing Frame for patients after stroke. Clinical Rehabilitation. 2005; 19(4):354–64 [<a href="https://pubmed.ncbi.nlm.nih.gov/15929503" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15929503</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>11.</dt><dd><div class="bk_ref" id="ch6.ref11">Baltz
|
|
MJ, Lietz
|
|
HL, Sausser
|
|
IT, Kalpakjian
|
|
C, Brown
|
|
D. Tolerance of a standing tilt table protocol by patients an inpatient stroke unit setting: a pilot study. Journal of Neurologic Physical Therapy. 2013; 37(1):9–13 [<a href="/pmc/articles/PMC3767008/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3767008</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23399923" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23399923</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>12.</dt><dd><div class="bk_ref" id="ch6.ref12">Bayley
|
|
MT, Bowen
|
|
A, English
|
|
C, Teasell
|
|
R, Eng
|
|
JJ. Where to now? AVERT answered an important question, but raised many more. International Journal of Stroke. 2017; 12(7):683–6 [<a href="https://pubmed.ncbi.nlm.nih.gov/28820348" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28820348</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>13.</dt><dd><div class="bk_ref" id="ch6.ref13">Berhardt
|
|
J, Langhorne
|
|
P, Lindley
|
|
RI, Thrift
|
|
AG, Ellery
|
|
F, Collier
|
|
J. Exploring efficacy and safety of very early mobilization within 24 hours of stroke onset versus usual stroke unit care (A Very Early Rehabilitation Trial, AVERT): pre-specified subgroup analysis. Stroke. 2016; 47:(Suppl 1):A76</div></dd></dl><dl class="bkr_refwrap"><dt>14.</dt><dd><div class="bk_ref" id="ch6.ref14">Bernhardt
|
|
J. AVERT: an international clinical trial testing the efficacy and safety of early mobilisation within 24 hours of stroke onset - implications for clinical practice. APA 2015 Conference, 3rd- 6th October 2015, Gold Coast, Queensland. 2015;</div></dd></dl><dl class="bkr_refwrap"><dt>15.</dt><dd><div class="bk_ref" id="ch6.ref15">Bernhardt
|
|
J. Efficacy and safety of very early mobilisation within 24 h of stroke onset (AVERT): a randomised controlled trial. Lancet. 2015; 386(9988):46–55 [<a href="https://pubmed.ncbi.nlm.nih.gov/25892679" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25892679</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>16.</dt><dd><div class="bk_ref" id="ch6.ref16">Bernhardt
|
|
J. Very early mobilisation within 24 hours of stroke results in a less favourable outcome at 3 months. Journal of Physiotherapy. 2015; 61(4):220–1 [<a href="https://pubmed.ncbi.nlm.nih.gov/26365267" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26365267</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>17.</dt><dd><div class="bk_ref" id="ch6.ref17">Bernhardt
|
|
J, Churilov
|
|
L, Dewey
|
|
H, Lindley
|
|
RI, Moodie
|
|
M, Collier
|
|
J
|
|
et al. Statistical analysis plan (SAP) for A Very Early Rehabilitation Trial (AVERT): an international trial to determine the efficacy and safety of commencing out of bed standing and walking training (very early mobilization) within 24h of stroke onset vs. usual stroke unit care. International Journal of Stroke. 2015; 10(1):23–4 [<a href="https://pubmed.ncbi.nlm.nih.gov/25491547" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25491547</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>18.</dt><dd><div class="bk_ref" id="ch6.ref18">Bernhardt
|
|
J, Churilov
|
|
L, Ellery
|
|
F, Collier
|
|
J, Chamberlain
|
|
J, Langhorne
|
|
P
|
|
et al. Prespecified dose-response analysis for A Very Early Rehabilitation Trial (AVERT). Neurology. 2016; 86(23):2138–45 [<a href="/pmc/articles/PMC4898313/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4898313</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26888985" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26888985</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>19.</dt><dd><div class="bk_ref" id="ch6.ref19">Bernhardt
|
|
J, Cumming
|
|
T, Thrift
|
|
J, Leonid
|
|
C, Dewey
|
|
H, DonnanG. Very early mobilisation after stroke fast tracks returning to walk: further results from a phase II randomised controlled trial (AVERT). International Journal of Stroke. 2011; 6:(1 Suppl):27 [<a href="https://pubmed.ncbi.nlm.nih.gov/21148439" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21148439</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>20.</dt><dd><div class="bk_ref" id="ch6.ref20">Bernhardt
|
|
J, Dewey
|
|
H, Collier
|
|
J, Thrift
|
|
A, Donnan
|
|
G. A pilot randomized controlled trial to evaluate the safety and feasibility of very early mobilization in acute stroke units (AVERT). Physiotherapy. 2007; 93:(Suppl 1):S501</div></dd></dl><dl class="bkr_refwrap"><dt>21.</dt><dd><div class="bk_ref" id="ch6.ref21">Bernhardt
|
|
J, Dewey
|
|
H, Collier
|
|
J, Thrift
|
|
A, Lindley
|
|
R, Moodie
|
|
M
|
|
et al. A Very Early Rehabilitation Trial (AVERT): ongoing phase III trial testing efficacy & cost effectiveness of very early mobilisation after stroke. International Journal of Stroke. 2008; 3:(Suppl 1):257 [<a href="https://pubmed.ncbi.nlm.nih.gov/18706042" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18706042</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>22.</dt><dd><div class="bk_ref" id="ch6.ref22">Bernhardt
|
|
J, Dewey
|
|
H, Thrift
|
|
A, Collier
|
|
J, Donnan
|
|
G. A Very Early Rehabilitation Trial for stroke (AVERT): phase II safety and feasibility. Stroke. 2008; 39(2):390–6 [<a href="https://pubmed.ncbi.nlm.nih.gov/18174489" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18174489</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>23.</dt><dd><div class="bk_ref" id="ch6.ref23">Bernhardt
|
|
J, Raffelt
|
|
A, Churilov
|
|
L, Lindley
|
|
RI, Speare
|
|
S, Ancliffe
|
|
J
|
|
et al. Exploring threats to generalisability in a large international rehabilitation trial (AVERT). BMJ Open. 2015; 5:e008378 [<a href="/pmc/articles/PMC4550737/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4550737</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26283667" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26283667</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>24.</dt><dd><div class="bk_ref" id="ch6.ref24">Bernhardt
|
|
J, Thuy
|
|
MN, Collier
|
|
JM, Legg
|
|
LA. Very early versus delayed mobilisation after stroke. Cochrane Database of Systematic Reviews
|
|
2009, Issue 1. Art. No.: CD006187. DOI: 10.1002/14651858.CD006187.pub2. [<a href="/pmc/articles/PMC6465040/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6465040</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/19160268" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19160268</span></a>] [<a href="http://dx.crossref.org/10.1002/14651858.CD006187.pub2" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>25.</dt><dd><div class="bk_ref" id="ch6.ref25">Bernhardt
|
|
J, Thuy
|
|
MNT, Collier
|
|
JM, Legg
|
|
LA. Very early versus delayed mobilization after stroke. Stroke. 2009; 40(7):e489–90 [<a href="/pmc/articles/PMC6465040/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6465040</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/19160268" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19160268</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>26.</dt><dd><div class="bk_ref" id="ch6.ref26">Braun
|
|
T, Marks
|
|
D, Thiel
|
|
C, Zietz
|
|
D, Zutter
|
|
D, Grüneberg
|
|
C. Effects of additional, dynamic supported standing practice on functional recovery in patients with sub-acute stroke: a randomized pilot and feasibility trial. Clinical Rehabilitation. 2016; 30(4):374–82 [<a href="https://pubmed.ncbi.nlm.nih.gov/25952591" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25952591</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>27.</dt><dd><div class="bk_ref" id="ch6.ref27">Brauser
|
|
S. Very early mobilisation within 24 hours of stroke results in a less favourable outcome at 3 months. Journal of Physiotherapy. 2015; 64(5):220 [<a href="https://pubmed.ncbi.nlm.nih.gov/26364085" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26364085</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>28.</dt><dd><div class="bk_ref" id="ch6.ref28">Britton
|
|
E, Harris
|
|
N, Turton
|
|
A. An exploratory randomized controlled trial of assisted practice for improving sit-to-stand in stroke patients in the hospital setting. Clinical Rehabilitation. 2008; 22(5):458–68 [<a href="https://pubmed.ncbi.nlm.nih.gov/18441042" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18441042</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>29.</dt><dd><div class="bk_ref" id="ch6.ref29">Cabanas-Valdés
|
|
R, Bagur-Calafat
|
|
C, Girabent-Farrés
|
|
M, Caballero-Gómez
|
|
FM, Hernández-Valiño
|
|
M, Urrútia Cuchí
|
|
G. The effect of additional core stability exercises on improving dynamic sitting balance and trunk control for subacute stroke patients: a randomized controlled trial. Clinical Rehabilitation. 2016; 30(10):1024–33 [<a href="https://pubmed.ncbi.nlm.nih.gov/26451007" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26451007</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>30.</dt><dd><div class="bk_ref" id="ch6.ref30">Chippala
|
|
P, Sharma
|
|
R. Effect of very early mobilisation on functional status in patients with acute stroke: a single-blind, randomized controlled trail. Clinical Rehabilitation. 2016; 30(7):669–75 [<a href="https://pubmed.ncbi.nlm.nih.gov/26198890" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26198890</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>31.</dt><dd><div class="bk_ref" id="ch6.ref31">Chung
|
|
H, Refoios Camejo
|
|
R, Barnett
|
|
D. Alteplase for the treatment of acute ischaemic stroke: NICE technology appraisal guidance. Heart. 2007; 93(12):1616–7 [<a href="/pmc/articles/PMC2095758/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2095758</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/18003692" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18003692</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>32.</dt><dd><div class="bk_ref" id="ch6.ref32">Collier
|
|
J, Thrift
|
|
A, McQuinn
|
|
A, Fu
|
|
C, Grealy
|
|
S, Bernhardt
|
|
J. Implimentation of a randomized controlled trial of very early mobilization does not change standard stroke unit care. Physiotherapy. 2007; 93:(Suppl 1):S128</div></dd></dl><dl class="bkr_refwrap"><dt>33.</dt><dd><div class="bk_ref" id="ch6.ref33">Collier
|
|
JM, Cumming
|
|
TB, Thrift
|
|
AG, Bernhardt
|
|
J. The effect of very early mobilisation on mood after stroke. Cerebrovascular Diseases. 2008; 25:(Suppl 2):30–1</div></dd></dl><dl class="bkr_refwrap"><dt>34.</dt><dd><div class="bk_ref" id="ch6.ref34">Craig
|
|
LE, Bernhardt
|
|
J, Langhorne
|
|
P, Wu
|
|
O. Early mobilization after stroke: an example of an individual patient data meta-analysis of a complex intervention. Stroke. 2010; 41(11):2632–6 [<a href="https://pubmed.ncbi.nlm.nih.gov/20947855" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20947855</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>35.</dt><dd><div class="bk_ref" id="ch6.ref35">Cuesy
|
|
PG, Sotomayor
|
|
PL, Piña
|
|
JO. Reduction in the incidence of poststroke nosocomial pneumonia by using the “turn-mob" program. Journal of Stroke and Cerebrovascular Diseases. 2010; 19(1):23–8 [<a href="https://pubmed.ncbi.nlm.nih.gov/20123223" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20123223</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>36.</dt><dd><div class="bk_ref" id="ch6.ref36">Cumming
|
|
TB, Collier
|
|
J, Thrift
|
|
AG, Bernhardt
|
|
J. The effect of very early mobilisation after stroke on psychological well-being. Journal of Rehabilitation Medicine. 2008; 40(8):609–14 [<a href="https://pubmed.ncbi.nlm.nih.gov/19020693" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19020693</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>37.</dt><dd><div class="bk_ref" id="ch6.ref37">Cumming
|
|
TB, Thrift
|
|
AG, Collier
|
|
JM, Churilov
|
|
L, Dewey
|
|
HM, Donnan
|
|
GA
|
|
et al. Very early mobilization after stroke fast-tracks return to walking: further results from the phase II AVERT randomized controlled trial. Stroke. 2011; 42(1):153–8 [<a href="https://pubmed.ncbi.nlm.nih.gov/21148439" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21148439</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>38.</dt><dd><div class="bk_ref" id="ch6.ref38">Dagonnier
|
|
M, Muhl
|
|
L, Kulin
|
|
J, Churilov
|
|
L, Dewey
|
|
H, Linden
|
|
T. Early mobilization after thrombolysis (rt-PA) in acute stroke: are rt-PA treated patients enrolled in a trial of early mobilization (AVERT) different from those that are not?
|
|
Cerebrovascular Diseases. 2013; 35 (Suppl 3):764</div></dd></dl><dl class="bkr_refwrap"><dt>39.</dt><dd><div class="bk_ref" id="ch6.ref39">Dean
|
|
C, Ada
|
|
L, Bampton
|
|
J, Morris
|
|
M, Katrak
|
|
P, Potts
|
|
S. Improving walking speed and capacity using treadmill walking with body weight support in subacute non-ambulatory stroke: the mobilise trial II. International Journal of Stroke. 2010; 5:(Suppl 1):12–3</div></dd></dl><dl class="bkr_refwrap"><dt>40.</dt><dd><div class="bk_ref" id="ch6.ref40">Dean
|
|
C, Ada
|
|
L, Morris
|
|
M. Improving walking using treadmill training in non-ambulatory patients during inpatient stroke rehabilitation: the MOBILISE trial. Australian Journal of Physiotherapy. 2009; 55:(4 Suppl):8</div></dd></dl><dl class="bkr_refwrap"><dt>41.</dt><dd><div class="bk_ref" id="ch6.ref41">Dean
|
|
CM, Channon
|
|
EF, Hall
|
|
JM. Sitting training early after stroke improves sitting ability and quality and carries over to standing up but not to walking: a randomised trial. Australian Journal of Physiotherapy. 2007; 53(2):97–102 [<a href="https://pubmed.ncbi.nlm.nih.gov/17535145" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17535145</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>42.</dt><dd><div class="bk_ref" id="ch6.ref42">Diserens
|
|
K, Moreira
|
|
T, Hirt
|
|
L, Faouzi
|
|
M, Grujic
|
|
J, Bieler
|
|
G
|
|
et al. Early mobilization out of bed after ischaemic stroke reduces severe complications but not cerebral blood flow: a randomized controlled pilot trial. Clinical Rehabilitation. 2012; 26(5):451–9 [<a href="https://pubmed.ncbi.nlm.nih.gov/22144725" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22144725</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>43.</dt><dd><div class="bk_ref" id="ch6.ref43">Diserens
|
|
K, Moreira
|
|
T, Lorenz
|
|
H, Grujic
|
|
J, Bieler
|
|
G, Vaudens
|
|
P
|
|
et al. Early mobilisation out of bed after ischemic stroke reduces complications but not cerebral blood flow. Cerebrovascular Diseases. 2010; 29:(Suppl 2):246</div></dd></dl><dl class="bkr_refwrap"><dt>44.</dt><dd><div class="bk_ref" id="ch6.ref44">Forster
|
|
S. Very early mobilisation within 24 hours of stroke results in a less favourable outcome at 3 months. Journal of Physiotherapy. 2015; 61(4):219 [<a href="https://pubmed.ncbi.nlm.nih.gov/26365265" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26365265</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>45.</dt><dd><div class="bk_ref" id="ch6.ref45">Fuest
|
|
K, Schaller
|
|
SJ. Recent evidence on early mobilization in critical-Ill patients. Current Opinion in Anaesthesiology. 2018; 31(2):144–50 [<a href="https://pubmed.ncbi.nlm.nih.gov/29351145" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29351145</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>46.</dt><dd><div class="bk_ref" id="ch6.ref46">Hargroves
|
|
D, Tallis
|
|
R, Pomeroy
|
|
V, Bhalla
|
|
A. The influence of positioning upon cerebral oxygenation after acute stroke: a pilot study. Age and Ageing. 2008; 37(5):581–5 [<a href="https://pubmed.ncbi.nlm.nih.gov/18755785" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18755785</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>47.</dt><dd><div class="bk_ref" id="ch6.ref47">Herisson
|
|
F, Godard
|
|
S, Volteau
|
|
C, Blanc
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E, Guillon
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B, Gaudron
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M. Early sitting in ischemic stroke patients (SEVEL): a randomized controlled trial. PloS One. 2016; 11(3):e0149466 [<a href="/pmc/articles/PMC4811411/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4811411</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27023901" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27023901</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>48.</dt><dd><div class="bk_ref" id="ch6.ref48">Hokstad
|
|
A, Indredavik
|
|
B, Bernhardt
|
|
J, Langhammer
|
|
B, Gunnes
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M, Lundemo
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C
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et al. Upright activity within the first week after stroke is associated with better functional outcome and health-related quality of life: A Norwegian multi-site study. Journal of Rehabilitation Medicine. 2016; 48(3):280–6 [<a href="https://pubmed.ncbi.nlm.nih.gov/26843147" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26843147</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>49.</dt><dd><div class="bk_ref" id="ch6.ref49">Hunter
|
|
SM, Hammett
|
|
L, Ball
|
|
S, Smith
|
|
N, Anderson
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C, Clark
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A
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|
|
B, Bakke
|
|
F, Slordahl
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SA, Rokseth
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R, Hâheim
|
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LL. Treatment in a combined acute and rehabilitation stroke unit: which aspects are most important?
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Stroke. 1999; 30(5):917–23 [<a href="https://pubmed.ncbi.nlm.nih.gov/10229720" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10229720</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>51.</dt><dd><div class="bk_ref" id="ch6.ref51">Karic
|
|
T, Roe
|
|
C, Nordenmark
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TH, Becker
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F, Sorteberg
|
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A. Impact of early mobilization and rehabilitation on global functional outcome one year after aneurysmal subarachnoid hemorrhage. Journal of Rehabilitation Medicine. 2016; 48(8):676–82 [<a href="https://pubmed.ncbi.nlm.nih.gov/27494170" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27494170</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>52.</dt><dd><div class="bk_ref" id="ch6.ref52">Karic
|
|
T, Roe
|
|
C, Nordenmark
|
|
TH, Becker
|
|
F, Sorteberg
|
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W, Sorteberg
|
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A. Effect of early mobilization and rehabilitation on complications in aneurysmal subarachnoid hemorrhage. Journal of Neurosurgery. 2017; 126(2):518–26 [<a href="https://pubmed.ncbi.nlm.nih.gov/27058204" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27058204</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>53.</dt><dd><div class="bk_ref" id="ch6.ref53">Keating
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M, Penney
|
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M, Russell
|
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P, Bailey
|
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E. Positioning and early mobilisation in stroke. Nursing Times. 2012; 108(47):16–8 [<a href="https://pubmed.ncbi.nlm.nih.gov/23495578" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23495578</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>54.</dt><dd><div class="bk_ref" id="ch6.ref54">Kosak
|
|
M, Reding
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M. Early aggressive mobilization is as effective as treadmill training for ambulation recovery in patients with stroke. Journal of Stroke and Cerebrovascular Diseases. 1998; 7(5):372</div></dd></dl><dl class="bkr_refwrap"><dt>55.</dt><dd><div class="bk_ref" id="ch6.ref55">Kosak
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MC, Reding
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MJ. Comparison of partial body weight-supported treadmill gait training versus aggressive bracing assisted walking post stroke. Neurorehabilitation and Neural Repair. 2000; 14(1):13–9 [<a href="https://pubmed.ncbi.nlm.nih.gov/11228945" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11228945</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>56.</dt><dd><div class="bk_ref" id="ch6.ref56">Kurabe
|
|
S, Ozawa
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T, Watanabe
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|
T, Aiba
|
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T. Efficacy and safety of postoperative early mobilization for chronic subdural hematoma in elderly patients. Acta Neurochirurgica. 2010; 152(7):1171–4 [<a href="https://pubmed.ncbi.nlm.nih.gov/20336332" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20336332</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>57.</dt><dd><div class="bk_ref" id="ch6.ref57">Langhorne
|
|
P, Stott
|
|
D, Knight
|
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A, Bernhardt
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J, Barer
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D, Watkins
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C. Very early rehabilitation or intensive telemetry after stroke: a pilot randomised trial. Cerebrovascular Diseases. 2010; 29(4):352–60 [<a href="https://pubmed.ncbi.nlm.nih.gov/20130401" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20130401</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>58.</dt><dd><div class="bk_ref" id="ch6.ref58">Langhorne
|
|
P, Wu
|
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O, Rodgers
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H, Ashburn
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A, Bernhardt
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J. A Very Early Rehabilitation Trial after stroke (AVERT): a Phase III, multicentre, randomised controlled trial. Health Technology Assessment. 2017; 21(54) [<a href="/pmc/articles/PMC5641820/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5641820</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28967376" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28967376</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>59.</dt><dd><div class="bk_ref" id="ch6.ref59">Li
|
|
Z, Zhang
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X, Wang
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K, Wen
|
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J. Effects of early mobilization after acute stroke: A meta-analysis of randomized control trials. Journal of Stroke and Cerebrovascular Diseases. 2018; 27(5):1326–37 [<a href="https://pubmed.ncbi.nlm.nih.gov/29373228" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29373228</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>60.</dt><dd><div class="bk_ref" id="ch6.ref60">Liu
|
|
N, Cadilhac
|
|
DA, Andrew
|
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NE, Zeng
|
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L, Li
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Z, Li
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J
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et al. Randomized controlled trial of early rehabilitation after intracerebral hemorrhage stroke: difference in outcomes within 6 months of stroke. Stroke. 2014; 45(12):3502–7 [<a href="https://pubmed.ncbi.nlm.nih.gov/25336514" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25336514</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>61.</dt><dd><div class="bk_ref" id="ch6.ref61">Lynch
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E, Cumming
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T, Janssen
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H, Bernhardt
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J. The changing opinions of Australasian health professionals regarding early mobilisation after stroke. Cerebrovascular Diseases. 2016; 42:(Suppl 1):5</div></dd></dl><dl class="bkr_refwrap"><dt>62.</dt><dd><div class="bk_ref" id="ch6.ref62">Lynch
|
|
EA, Cumming
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T, Janssen
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H, Bernhardt
|
|
J. Early mobilization after stroke: Changes in clinical opinion despite an unchanging evidence base. Journal of Stroke and Cerebrovascular Diseases. 2017; 26(1):1–6 [<a href="https://pubmed.ncbi.nlm.nih.gov/27612626" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27612626</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>63.</dt><dd><div class="bk_ref" id="ch6.ref63">Ma
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Z, Wang
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Q, Liu
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M. Early versus delayed mobilisation for aneurysmal subarachnoid haemorrhage. Cochrane Database of Systematic Reviews
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2013, Issue 5. Art. No.: CD008346. DOI: 10.1002/14651858.CD008346.pub2. [<a href="https://pubmed.ncbi.nlm.nih.gov/23728673" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23728673</span></a>] [<a href="http://dx.crossref.org/10.1002/14651858.CD008346.pub2" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>64.</dt><dd><div class="bk_ref" id="ch6.ref64">Morreale
|
|
M, Marchione
|
|
P, Pili
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A, Lauta
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A, Castiglia
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SF, Spallone
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|
|
L, Kulin
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J, Daggonier
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M, Churilov
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L, Dewey
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H, Bernhardt
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J. Early mobilization after thrombolysis (rt-PA) in acute stroke: are rt-PA treated patients enrolled in a trial of early mobilization (AVERT) different from those who are not?
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International Journal of Stroke. 2013; 8(Suppl. 1):19</div></dd></dl><dl class="bkr_refwrap"><dt>66.</dt><dd><div class="bk_ref" id="ch6.ref66">Muhl
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L, Kulin
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J, Dagonnier
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M, Churilov
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|
L, Dewey
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H, Linden
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T. Early mobilization after thrombolysis (rt-PA) in acute stroke: are rt-PA treated patients enrolled in a trial of early mobilization (AVERT) different from those who are not?
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Stroke. 2014; 45:(Suppl 1):P104</div></dd></dl><dl class="bkr_refwrap"><dt>67.</dt><dd><div class="bk_ref" id="ch6.ref67">Muhl
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L, Kulin
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J, Dagonnier
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M, Churilov
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L, Dewey
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H, Linden
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T
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BMC Neurology. 2014; 14:163 [<a href="/pmc/articles/PMC4236653/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4236653</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25159047" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25159047</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>68.</dt><dd><div class="bk_ref" id="ch6.ref68">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>69.</dt><dd><div class="bk_ref" id="ch6.ref69">Olkowski
|
|
BF, Binning
|
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MJ, Sanfillippo
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G, Arcaro
|
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ML, Slotnick
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LE, Veznedaroglu
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E
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BF, Devine
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MA, Slotnick
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LE, Veznedaroglu
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E, Liebman
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KM, Arcaro
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ML
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|
|
SR, Rebello
|
|
LC, Valens
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|
MJM, Rossato
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D, Almeida
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AG, Brondani
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R
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et al. Early mobilization in ischemic stroke: a pilot randomized trial of safety and feasibility in a public hospital in Brazil. Cerebrovascular Diseases Extra. 2015; 5(1):31–40 [<a href="/pmc/articles/PMC4448047/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4448047</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26034487" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26034487</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>73.</dt><dd><div class="bk_ref" id="ch6.ref73">Pollock
|
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A, Baer
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G, Campbell
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P, Choo
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PL, Forster
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A, Morris
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J
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et al. Physical rehabilitation approaches for the recovery of function and mobility following stroke. Cochrane Database of Systematic Reviews
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2014, Issue 4. Art. No.: CD001920. DOI: 10.1002/14651858.CD001920.pub3. [<a href="/pmc/articles/PMC6465059/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6465059</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24756870" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24756870</span></a>] [<a href="http://dx.crossref.org/10.1002/14651858.CD001920.pub3" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>74.</dt><dd><div class="bk_ref" id="ch6.ref74">Rocca
|
|
A, Pignat
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JM, Berney
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L, Johr
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J, Ville
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D, Daniel
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RT
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et al. Sympathetic activity and early mobilization in patients in intensive and intermediate care with severe brain injuries: a preliminary prospective randomized study. BMC Neurology. 2016; 16:169 [<a href="/pmc/articles/PMC5020460/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5020460</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27619015" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27619015</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>75.</dt><dd><div class="bk_ref" id="ch6.ref75">Rønning
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OM. Akershus Early Mobilisation in Stroke Study (AKEMIS) [NCT00832351]. 2009. Available from: <a href="https://clinicaltrials.gov/ct2/show/NCT00832351" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://clinicaltrials.gov/ct2/show/NCT00832351</a> Last accessed: 14/8/2018.</div></dd></dl><dl class="bkr_refwrap"><dt>76.</dt><dd><div class="bk_ref" id="ch6.ref76">Sankara Kumaran
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P, Tamil Vanan
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M. Effect of early mobilisation training on gross motor function and functional outcome in hemi paretic stroke patients. International Journal of Pharmacy and Technology. 2013; 5(3):5637–50</div></dd></dl><dl class="bkr_refwrap"><dt>77.</dt><dd><div class="bk_ref" id="ch6.ref77">Silva
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DCS, Nascimento
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CF, Brito
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ES. Effects of early mobilization in clinical complications after stroke: Literature review. Revista Neurociencias. 2013; 21(4):620–7</div></dd></dl><dl class="bkr_refwrap"><dt>78.</dt><dd><div class="bk_ref" id="ch6.ref78">Sorbello
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D, Bernhardt
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J. The effect of very early mobilisation on the number and severity of complications experienced by stroke patients. Internal Medicine Journal. 2007; 37:(Suppl 4):A106</div></dd></dl><dl class="bkr_refwrap"><dt>79.</dt><dd><div class="bk_ref" id="ch6.ref79">Sorbello
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|
D, Dewey
|
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HM, Churilov
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|
L, Thrift
|
|
AG, Collier
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JM, Donnan
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G
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|
|
D, Ilbeh
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SM, Granato
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A, Servillo
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G, Pizzolato
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G, Grandi
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FC. Very early versus delayed mobilisation after stroke. Neuroepidemiology. 2010; 35(3):163–4 [<a href="https://pubmed.ncbi.nlm.nih.gov/20571285" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20571285</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>81.</dt><dd><div class="bk_ref" id="ch6.ref81">Sundseth
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A, Thommessen
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B, Rønning
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OM. Early mobilisation after stroke. Cerebrovascular Diseases. 2008; 25:(Suppl 2):179 [<a href="https://pubmed.ncbi.nlm.nih.gov/23680682" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23680682</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>82.</dt><dd><div class="bk_ref" id="ch6.ref82">Sundseth
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A, Thommessen
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B, Rønning
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OM. Mobilisation within 24 hours of acute stroke. A randomised controlled trial, Akerhus mobilisation in stroke study (AKEMIS). Cerebrovascular Diseases. 2012; 33:(Suppl 2):623–4</div></dd></dl><dl class="bkr_refwrap"><dt>83.</dt><dd><div class="bk_ref" id="ch6.ref83">Sundseth
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A, Thommessen
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B, Rønning
|
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OM. Outcome after mobilization within 24 hours of acute stroke: a randomized controlled trial. Stroke. 2012; 43(9):2389–94 [<a href="https://pubmed.ncbi.nlm.nih.gov/22700533" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22700533</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>84.</dt><dd><div class="bk_ref" id="ch6.ref84">Sundseth
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A, Thommessen
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B, Rønning
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OM. Early mobilization after acute stroke. Journal of Stroke and Cerebrovascular Diseases. 2014; 23(3):496–9 [<a href="https://pubmed.ncbi.nlm.nih.gov/23680682" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23680682</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>85.</dt><dd><div class="bk_ref" id="ch6.ref85">Tay-Teo
|
|
K, Moodie
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M, Bernhardt
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J, Thrift
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AG, Collier
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J, Donnan
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G
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K, Cumming
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TB, Bernhardt
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J. Quality of life: an important outcome measure in a trial of very early mobilisation after stroke. Disability and Rehabilitation. 2010; 32(11):875–84 [<a href="https://pubmed.ncbi.nlm.nih.gov/19852710" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19852710</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>87.</dt><dd><div class="bk_ref" id="ch6.ref87">Wijk
|
|
R, Cumming
|
|
T, Churilov
|
|
L, Donnan
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|
G, Bernhardt
|
|
J. An early mobilization protocol successfully delivers more and earlier therapy to acute stroke patients: further results from phase II of AVERT. Neurorehabilitation and Neural Repair. 2012; 26(1):20–6 [<a href="https://pubmed.ncbi.nlm.nih.gov/21807984" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21807984</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>88.</dt><dd><div class="bk_ref" id="ch6.ref88">Wijk
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RM, Churilov
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L, Bernhardt
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J. Intervention protocol increases frequency and amount of early mobilisation of acute stroke patients: results from a phase II RCT (AVERT). Cerebrovascular Diseases. 2009; 27:(Suppl 6):25</div></dd></dl><dl class="bkr_refwrap"><dt>89.</dt><dd><div class="bk_ref" id="ch6.ref89">Xu
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T, Yu
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X, Ou
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S, Liu
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X, Yuan
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J, Chen
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Y. Efficacy and safety of very early mobilization in patients with acute stroke: A systematic review and meta-analysis. Scientific Reports. 2017; 7(1):6550 [<a href="/pmc/articles/PMC5529532/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5529532</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28747763" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28747763</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>90.</dt><dd><div class="bk_ref" id="ch6.ref90">Zeng
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X. The effect of early mobilization for stroke patients [ChiCTR-TRC-08000201]. 2007. Available from: <a href="http://www.chictr.org.cn/showprojen.aspx?proj=9324" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.chictr.org<wbr style="display:inline-block"></wbr>​.cn/showprojen.aspx?proj=9324</a> Last accessed: 14/8/18.</div></dd></dl></dl></div><div id="appendixesappgroup6"><h2 id="_appendixesappgroup6_">Appendices</h2><div id="ch6.appa"><h3>Appendix A. Review protocols</h3><p id="ch6.appa.tab1"><a href="/books/NBK577867/table/ch6.appa.tab1/?report=objectonly" target="object" rid-ob="figobch6appatab1" class="figpopup">Table 8. Review protocol: Very early and early mobilisation</a></p><p id="ch6.appa.tab2"><a href="/books/NBK577867/table/ch6.appa.tab2/?report=objectonly" target="object" rid-ob="figobch6appatab2" class="figpopup">Table 9. Health economic review protocol</a></p></div><div id="ch6.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="ch6.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="ch6.appb.tab1"><a href="/books/NBK577867/table/ch6.appb.tab1/?report=objectonly" target="object" rid-ob="figobch6appbtab1" class="figpopup">Table 10. Database date parameters and filters used</a></p><p id="ch6.appb.tab2"><a href="/books/NBK577867/table/ch6.appb.tab2/?report=objectonly" target="object" rid-ob="figobch6appbtab2" class="figpopup">Medline (Ovid) search terms</a></p><p id="ch6.appb.tab3"><a href="/books/NBK577867/table/ch6.appb.tab3/?report=objectonly" target="object" rid-ob="figobch6appbtab3" class="figpopup">Embase (Ovid) search terms</a></p><p id="ch6.appb.tab4"><a href="/books/NBK577867/table/ch6.appb.tab4/?report=objectonly" target="object" rid-ob="figobch6appbtab4" class="figpopup">Cochrane Library (Wiley) search terms</a></p></div><div id="ch6.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.</p><p id="ch6.appb.tab5"><a href="/books/NBK577867/table/ch6.appb.tab5/?report=objectonly" target="object" rid-ob="figobch6appbtab5" class="figpopup">Table 11. Database date parameters and filters used</a></p><p id="ch6.appb.tab6"><a href="/books/NBK577867/table/ch6.appb.tab6/?report=objectonly" target="object" rid-ob="figobch6appbtab6" class="figpopup">Medline (Ovid) search terms</a></p><p id="ch6.appb.tab7"><a href="/books/NBK577867/table/ch6.appb.tab7/?report=objectonly" target="object" rid-ob="figobch6appbtab7" class="figpopup">Embase (Ovid) search terms</a></p><p id="ch6.appb.tab8"><a href="/books/NBK577867/table/ch6.appb.tab8/?report=objectonly" target="object" rid-ob="figobch6appbtab8" class="figpopup">NHS EED and HTA (CRD) search terms</a></p></div></div><div id="ch6.appc"><h3>Appendix C. Clinical evidence selection</h3><p id="ch6.appc.fig1"><a href="/books/NBK577867/figure/ch6.appc.fig1/?report=objectonly" target="object" rid-ob="figobch6appcfig1" class="figpopup">Figure 1. Flow chart of clinical study selection for the review of early mobilisation</a></p></div><div id="ch6.appd"><h3>Appendix D. Clinical evidence tables</h3><p id="ch6.appd.et1"><a href="/books/NBK577867/bin/ch6-appd-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (450K)</span></p></div><div id="ch6.appe"><h3>Appendix E. Forest plots</h3><div id="ch6.appe.s1"><h4>E.1. Very early mobilisation versus usual care</h4><p id="ch6.appe.fig1"><a href="/books/NBK577867/figure/ch6.appe.fig1/?report=objectonly" target="object" rid-ob="figobch6appefig1" class="figpopup">Figure 2. Mortality at 7 days</a></p><p id="ch6.appe.fig2"><a href="/books/NBK577867/figure/ch6.appe.fig2/?report=objectonly" target="object" rid-ob="figobch6appefig2" class="figpopup">Figure 3. Mortality at 90 days</a></p><p id="ch6.appe.fig3"><a href="/books/NBK577867/figure/ch6.appe.fig3/?report=objectonly" target="object" rid-ob="figobch6appefig3" class="figpopup">Figure 4. Mortality at 12 months</a></p><p id="ch6.appe.fig4"><a href="/books/NBK577867/figure/ch6.appe.fig4/?report=objectonly" target="object" rid-ob="figobch6appefig4" class="figpopup">Figure 5. Modified Rankin Scale 0 to 2 at 7 days</a></p><p id="ch6.appe.fig5"><a href="/books/NBK577867/figure/ch6.appe.fig5/?report=objectonly" target="object" rid-ob="figobch6appefig5" class="figpopup">Figure 6. Modified Rankin Scale 0 to 2 at 90 days</a></p><p id="ch6.appe.fig6"><a href="/books/NBK577867/figure/ch6.appe.fig6/?report=objectonly" target="object" rid-ob="figobch6appefig6" class="figpopup">Figure 7. Modified Rankin Scale 0 to 2 at 1 year</a></p><p id="ch6.appe.fig7"><a href="/books/NBK577867/figure/ch6.appe.fig7/?report=objectonly" target="object" rid-ob="figobch6appefig7" class="figpopup">Figure 8. Recurrent stroke at 90 days</a></p><p id="ch6.appe.fig8"><a href="/books/NBK577867/figure/ch6.appe.fig8/?report=objectonly" target="object" rid-ob="figobch6appefig8" class="figpopup">Figure 9. Neurological deterioration at 90 days</a></p><p id="ch6.appe.fig9"><a href="/books/NBK577867/figure/ch6.appe.fig9/?report=objectonly" target="object" rid-ob="figobch6appefig9" class="figpopup">Figure 10. Adverse events at 90 days</a></p><p id="ch6.appe.fig10"><a href="/books/NBK577867/figure/ch6.appe.fig10/?report=objectonly" target="object" rid-ob="figobch6appefig10" class="figpopup">Figure 11. Length of hospital stay</a></p><p id="ch6.appe.fig11"><a href="/books/NBK577867/figure/ch6.appe.fig11/?report=objectonly" target="object" rid-ob="figobch6appefig11" class="figpopup">Figure 12. Barthel index at discharge</a></p><p id="ch6.appe.fig12"><a href="/books/NBK577867/figure/ch6.appe.fig12/?report=objectonly" target="object" rid-ob="figobch6appefig12" class="figpopup">Figure 13. Barthel index at 90 days</a></p></div><div id="ch6.appe.s2"><h4>E.2. Early mobilisation versus usual care</h4><p id="ch6.appe.fig13"><a href="/books/NBK577867/figure/ch6.appe.fig13/?report=objectonly" target="object" rid-ob="figobch6appefig13" class="figpopup">Figure 14. Mortality at 90 days</a></p><p id="ch6.appe.fig14"><a href="/books/NBK577867/figure/ch6.appe.fig14/?report=objectonly" target="object" rid-ob="figobch6appefig14" class="figpopup">Figure 15. Modified Rankin Scale 0 to 2 at 90 days</a></p><p id="ch6.appe.fig15"><a href="/books/NBK577867/figure/ch6.appe.fig15/?report=objectonly" target="object" rid-ob="figobch6appefig15" class="figpopup">Figure 16. Neurological deterioration at 90 days</a></p><p id="ch6.appe.fig16"><a href="/books/NBK577867/figure/ch6.appe.fig16/?report=objectonly" target="object" rid-ob="figobch6appefig16" class="figpopup">Figure 17. Adverse events at 90 days</a></p><p id="ch6.appe.fig17"><a href="/books/NBK577867/figure/ch6.appe.fig17/?report=objectonly" target="object" rid-ob="figobch6appefig17" class="figpopup">Figure 18. Length of hospital stay</a></p><p id="ch6.appe.fig18"><a href="/books/NBK577867/figure/ch6.appe.fig18/?report=objectonly" target="object" rid-ob="figobch6appefig18" class="figpopup">Figure 19. Modified Rankin Scale at 7 and 90 days (ordinal shift graphs)</a></p></div></div><div id="ch6.appf"><h3>Appendix F. GRADE tables</h3><p id="ch6.appf.tab1"><a href="/books/NBK577867/table/ch6.appf.tab1/?report=objectonly" target="object" rid-ob="figobch6appftab1" class="figpopup">Table 12. Clinical evidence profile: very early mobilisation versus usual care</a></p><p id="ch6.appf.tab2"><a href="/books/NBK577867/table/ch6.appf.tab2/?report=objectonly" target="object" rid-ob="figobch6appftab2" class="figpopup">Table 13. Clinical evidence profile: early mobilisation versus usual care</a></p></div><div id="ch6.appg"><h3>Appendix G. Health economic evidence selection</h3><p id="ch6.appg.fig1"><a href="/books/NBK577867/figure/ch6.appg.fig1/?report=objectonly" target="object" rid-ob="figobch6appgfig1" class="figpopup">Figure 20. Flow chart of health economic study selection for the guideline</a></p></div><div id="ch6.apph"><h3>Appendix H. Health economic evidence tables</h3><p id="ch6.apph.et1"><a href="/books/NBK577867/bin/ch6-apph-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (179K)</span></p></div><div id="ch6.appi"><h3>Appendix I. Excluded studies</h3><div id="ch6.appi.s1"><h4>I.1. Excluded clinical studies</h4><p id="ch6.appi.tab1"><a href="/books/NBK577867/table/ch6.appi.tab1/?report=objectonly" target="object" rid-ob="figobch6appitab1" class="figpopup">Table 14. 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: NBK577867</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/35167209" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">35167209</a></span></div></div><div class="small-screen-prev"></div><div class="small-screen-next"></div></article><article data-type="table-wrap" id="figobch6tab1"><div id="ch6.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/NBK577867/table/ch6.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.tab1_lrgtbl__"><table><tbody><tr><th id="hd_b_ch6.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><td headers="hd_b_ch6.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">People aged over 16 with acute stroke</td></tr><tr><th id="hd_b_ch6.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interventions</th><td headers="hd_b_ch6.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Early mobilisation (within 72 hours)</p>
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<p>Very early mobilisation (within 24 hours)</p>
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<p>Mobilisation is defined as out of bed activity</p>
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</td></tr><tr><th id="hd_b_ch6.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparisons</th><td headers="hd_b_ch6.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Usual care (as defined by the studies, for example assessment within 24 hours and mobilisation as appropriate)</p>
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<p>Late mobilisation (first mobilisation after 72 hours)</p>
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<p>Different intensities of mobilisation (grouped as <3, 3 or >3 sessions per day)</p>
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<p>Interventions compared with each other</p>
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</td></tr><tr><th id="hd_b_ch6.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><td headers="hd_b_ch6.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>Modified Rankin scale (mRS) score at 7 days, 90 days and 1 year</p>
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<p>Barthel score if Modified Rankin Scale not reported</p>
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<p>Mortality at 7 days, 90 days and 1 year</p>
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<p>
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<u>Important</u>
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</p>
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<p>Recurrent stroke at 90 days</p>
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<p>Adverse events (pulmonary embolism [PE]/deep vein thrombosis [DVT]/pressure sores/pneumonia/falls) at 90 days</p>
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<p>Quality of life (both health- and social-related quality) at 90 days and 1 year Length of stay</p>
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<p>Acute neurological deterioration (worsening of National Institutes of Health Stroke Scale [NIHSS])</p>
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</td></tr><tr><th id="hd_b_ch6.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design</th><td headers="hd_b_ch6.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>Systematic reviews and meta-analyses of the above</p>
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</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch6tab2"><div id="ch6.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/NBK577867/table/ch6.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_ch6.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</th><th id="hd_h_ch6.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparison</th><th id="hd_h_ch6.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_ch6.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_ch6.tab2_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><th headers="hd_h_ch6.tab2_1_1_1_1 hd_h_ch6.tab2_1_1_1_2 hd_h_ch6.tab2_1_1_1_3 hd_h_ch6.tab2_1_1_1_4 hd_h_ch6.tab2_1_1_1_5 hd_h_ch6.tab2_1_1_1_6" id="hd_b_ch6.tab2_1_1_1_1" colspan="6" rowspan="1" style="text-align:left;vertical-align:top;">Very early mobilisation</th></tr><tr><td headers="hd_h_ch6.tab2_1_1_1_1 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>AKEMIS 2012<a class="bibr" href="#ch6.ref83" rid="ch6.ref83"><sup>83</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref84" rid="ch6.ref84"><sup>84</sup></a></p>
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<p>Norway</p>
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</td><td headers="hd_h_ch6.tab2_1_1_1_2 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Very early mobilisation</p>
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<p>First mobilisation within 24 hours of admission</p>
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<p>Out-of-bed activity performed by physiotherapists, nursing staff and occupational therapists until discharge, no strict protocol for the amount or type of exercise and patients’ needs and abilities were considered, all were mobilised out of bed several times a day</p>
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</td><td headers="hd_h_ch6.tab2_1_1_1_3 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>First mobilisation between 24 and 48 hours after admission.</p>
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<p>Out-of-bed activity performed by physiotherapists, nursing staff and occupational therapists until discharge, no strict protocol for the amount or type of exercise and patients’ needs and abilities were considered, all were mobilised out of bed several times a day</p>
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</td><td headers="hd_h_ch6.tab2_1_1_1_4 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Acute stroke (ischaemic and haemorrhagic) n=65</td><td headers="hd_h_ch6.tab2_1_1_1_5 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>90 day:</p>
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<p>Mortality</p>
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<p>Modified Rankin</p>
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<p>Scale 0 to 2</p>
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</td><td headers="hd_h_ch6.tab2_1_1_1_6 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Intervention:</p>
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<p>Median (IQR) time from stroke onset to first mobilisation was 13.1 (8.5-25.6) hours (5 patients were not mobilised within 24 hours; 3 within 48 hours and 2 within 72 hours).</p>
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<p>Comparison</p>
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<p>Median (IQR) time from stroke onset to first mobilisation was 33.3 (26.0-39.0) hours (1 patient was mobilised only 85 hours after admission).</p>
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</td></tr><tr><td headers="hd_h_ch6.tab2_1_1_1_1 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>AVERT II 2009<a class="bibr" href="#ch6.ref24" rid="ch6.ref24"><sup>24</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref25" rid="ch6.ref25"><sup>25</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref36" rid="ch6.ref36"><sup>36</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref37" rid="ch6.ref37"><sup>37</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref79" rid="ch6.ref79"><sup>79</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref86" rid="ch6.ref86"><sup>86</sup></a></p>
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<p>Australia</p>
|
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</td><td headers="hd_h_ch6.tab2_1_1_1_2 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>Very early mobilisation</p>
|
|
<p>First mobilisation within 24 hours of admission</p>
|
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<p>Upright and out of bed (sitting, standing or walking), at least twice/day, 6 days per week</p>
|
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<p>Mobilisation continued for 14 days</p>
|
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</td><td headers="hd_h_ch6.tab2_1_1_1_3 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conventional stroke care only which included a mobilisation component</td><td headers="hd_h_ch6.tab2_1_1_1_4 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Acute stroke (ischaemic and haemorrhagic) n=71</td><td headers="hd_h_ch6.tab2_1_1_1_5 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>7 day:</p>
|
|
<p>Mortality</p>
|
|
<p>90 day:</p>
|
|
<p>Mortality</p>
|
|
<p>Modified Rankin</p>
|
|
<p>Scale 0 to 2</p>
|
|
<p>Recurrent stroke</p>
|
|
<p>Adverse events (pressure sores, pneumonia, deep vein thrombosis, pulmonary embolism, falls)</p>
|
|
<p>12 month:</p>
|
|
<p>Mortality</p>
|
|
<p>Modified Rankin</p>
|
|
<p>Scale</p>
|
|
<p>Assessment of Quality of Life (AQoL) scale</p>
|
|
</td><td headers="hd_h_ch6.tab2_1_1_1_6 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Intervention:</p>
|
|
<p>First mobilisation at a median</p>
|
|
<p>(IQR): 18.1 (12.8 to 21.5) hours</p>
|
|
<p>Comparison:</p>
|
|
<p>First mobilisation at a median</p>
|
|
<p>(IQR): 30.8 (23.0 to 39.9) hours</p>
|
|
<p>Total amount per person (mins), median (IQR)</p>
|
|
<p>Intervention: 167 (63 to 305)</p>
|
|
<p>Comparison: 69 (31 to 115)</p>
|
|
</td></tr><tr><td headers="hd_h_ch6.tab2_1_1_1_1 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>AVERT III 2015<a class="bibr" href="#ch6.ref15" rid="ch6.ref15"><sup>15</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#ch6.ref17" rid="ch6.ref17"><sup>17</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#ch6.ref18" rid="ch6.ref18"><sup>18</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#ch6.ref23" rid="ch6.ref23"><sup>23</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#ch6.ref58" rid="ch6.ref58"><sup>58</sup></a></p>
|
|
<p>56 hospitals in five countries: UK (England, Scotland, Northern Ireland and Wales), Australia, New Zealand, Singapore and Malaysia</p>
|
|
</td><td headers="hd_h_ch6.tab2_1_1_1_2 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Very early mobilisation</p>
|
|
<p>First mobilisation within 24 hours of admission</p>
|
|
<p>Frequent out-of-bed activity (mobilisation), task specific out-of-bed activity, targeting recovery of active sitting, standing, and walking activity, only resting in bed for long periods if medically unstable, intensity and titration according to the patient’s level of functional ability</p>
|
|
<p>Mobilisation was delivered in at least 3 out of bed sessions</p>
|
|
<p>Sitting for more than 50 mins at one time was discouraged</p>
|
|
<p>Target was 5 hours less than usual care for first mobilisation</p>
|
|
</td><td headers="hd_h_ch6.tab2_1_1_1_3 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Usual post-stroke care, the number and type of mobilisations were not prescribed</td><td headers="hd_h_ch6.tab2_1_1_1_4 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Acute stroke (ischaemic and haemorrhagic) n=2104</td><td headers="hd_h_ch6.tab2_1_1_1_5 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>90 day:</p>
|
|
<p>Mortality</p>
|
|
<p>Modified Rankin</p>
|
|
<p>Scale 0 to 2</p>
|
|
<p>Length of hospital stay</p>
|
|
<p>12 month:</p>
|
|
<p>Mortality</p>
|
|
<p>AQoL scale</p>
|
|
</td><td headers="hd_h_ch6.tab2_1_1_1_6 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Intervention:</p>
|
|
<p>First mobilisation at a median</p>
|
|
<p>(IQR): 18.5 (12.8 to 22.3) hours</p>
|
|
<p>Comparison:</p>
|
|
<p>First mobilisation at a median</p>
|
|
<p>(IQR): 22.4 (16.5 to 29.3) hours</p>
|
|
<p>Note median is within 24 hours</p>
|
|
<p>Total amount per person (mins), median (IQR)</p>
|
|
<p>Intervention: 201 (108 to 340)</p>
|
|
<p>Comparison: 70 (32-130)</p>
|
|
</td></tr><tr><td headers="hd_h_ch6.tab2_1_1_1_1 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Chippala 2016<a class="bibr" href="#ch6.ref30" rid="ch6.ref30"><sup>30</sup></a></p>
|
|
<p>India</p>
|
|
</td><td headers="hd_h_ch6.tab2_1_1_1_2 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Very early mobilisation</p>
|
|
<p>First mobilisation within 24 hours of symptom onset</p>
|
|
<p>Mobilisation (upright and out of bed activities) duration of mobilisation was determined by patient tolerance (5-30 minutes) and frequency was at least twice a day, activities included sitting supported in bed, sitting unsupported out of bed, transfer along with assistance, roll and sit up, sitting without support, transfer feet to the floor, standing activities, walk-early gait and advanced gait activities</p>
|
|
</td><td headers="hd_h_ch6.tab2_1_1_1_3 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Routine stroke care including passive and, if possible, active mobilisation, correct positioning in bed, mobilisation in bed, sitting balance activities, facilitation of limb and trunk control activities, education of patient and caregiver</td><td headers="hd_h_ch6.tab2_1_1_1_4 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Acute stroke (ischaemic and haemorrhagic)</p>
|
|
<p>n=86</p>
|
|
</td><td headers="hd_h_ch6.tab2_1_1_1_5 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Discharge:</p>
|
|
<p>Length of hospital stay</p>
|
|
<p>Barthel index</p>
|
|
<p>90 day:</p>
|
|
<p>Mortality</p>
|
|
<p>Barthel index</p>
|
|
</td><td headers="hd_h_ch6.tab2_1_1_1_6 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Intervention:</p>
|
|
<p>First mobilisation at a median</p>
|
|
<p>(IQR): 18 (16.6-19.8) hours</p>
|
|
<p>Comparison:</p>
|
|
<p>First mobilisation at a median</p>
|
|
<p>(IQR): 30.5 (29-35) hours</p>
|
|
</td></tr><tr><td headers="hd_h_ch6.tab2_1_1_1_1 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SEVEL 2012<a class="bibr" href="#ch6.ref47" rid="ch6.ref47"><sup>47</sup></a></p>
|
|
<p>France</p>
|
|
</td><td headers="hd_h_ch6.tab2_1_1_1_2 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Very early mobilisation</p>
|
|
<p>First mobilisation within 24 hours of symptom onset</p>
|
|
<p>Seated out of bed as soon as possible, minimum duration of first sitting was 15 minutes, with duration determined by patient fatigue and tolerance (return to bed for any of the following: neurological worsening, vagal reaction >40 mmHg increase in blood pressure exceeding 180/100 mmHg, or symptomatic decrease in blood pressure)</p>
|
|
</td><td headers="hd_h_ch6.tab2_1_1_1_3 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Day 0: the patient would be positioned in bed at 30°; day 1: 45°; day 2: 60°; day 3: sitting out of bed, minimum duration 15 minutes</td><td headers="hd_h_ch6.tab2_1_1_1_4 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ischaemic stroke n=167</td><td headers="hd_h_ch6.tab2_1_1_1_5 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>7 day</p>
|
|
<p>Modified Rankin</p>
|
|
<p>Scale 0 to 2</p>
|
|
<p>90 day:</p>
|
|
<p>Mortality</p>
|
|
<p>Modified Rankin</p>
|
|
<p>Scale 0 to 2</p>
|
|
<p>Neurological deterioration</p>
|
|
<p>Adverse events (pneumonia, deep vein thrombosis, falls, pressure sores)</p>
|
|
</td><td headers="hd_h_ch6.tab2_1_1_1_6 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Length of fist sitting (mins), mean (SD)</p>
|
|
<p>Intervention 56.6 (41.7)</p>
|
|
<p>Comparison 83.7 (94.7)</p>
|
|
</td></tr><tr><td headers="hd_h_ch6.tab2_1_1_1_1 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>VERITAS 2010<a class="bibr" href="#ch6.ref57" rid="ch6.ref57"><sup>57</sup></a></p>
|
|
<p>Australia</p>
|
|
<p>UK</p>
|
|
</td><td headers="hd_h_ch6.tab2_1_1_1_2 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Very early mobilisation</p>
|
|
<p>First mobilisation within 24 hours of symptom onset</p>
|
|
<p>Standard care plus early mobilisation based on AVERT trial aim to get patients to sit stand and walk within 24 hours of stroke and continue this at least 4 times a day</p>
|
|
</td><td headers="hd_h_ch6.tab2_1_1_1_3 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Standard care: immediate transfer to a multidisciplinary stroke unit where the aim was to get patients to sit, stand and walk from the day of admission</td><td headers="hd_h_ch6.tab2_1_1_1_4 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Acute stroke (ischaemic and haemorrhagic) n=32</td><td headers="hd_h_ch6.tab2_1_1_1_5 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>90 day:</p>
|
|
<p>Mortality</p>
|
|
<p>Modified Rankin</p>
|
|
<p>Scale 0 to 2</p>
|
|
<p>Length of hospital stay</p>
|
|
</td><td headers="hd_h_ch6.tab2_1_1_1_6 hd_b_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Intervention:</p>
|
|
<p>First mobilisation at a median</p>
|
|
<p>(IQR): 27.3 (26.0 to 29.0) hours</p>
|
|
<p>Note longer than protocol aim</p>
|
|
<p>Comparison:</p>
|
|
<p>First mobilisation at a median</p>
|
|
<p>(IQR): 32.0 (22.5 to 47.3) hours</p>
|
|
</td></tr><tr><th headers="hd_h_ch6.tab2_1_1_1_1 hd_h_ch6.tab2_1_1_1_2 hd_h_ch6.tab2_1_1_1_3 hd_h_ch6.tab2_1_1_1_4 hd_h_ch6.tab2_1_1_1_5 hd_h_ch6.tab2_1_1_1_6" id="hd_b_ch6.tab2_1_1_8_1" colspan="6" rowspan="1" style="text-align:left;vertical-align:top;">Early mobilisation</th></tr><tr><td headers="hd_h_ch6.tab2_1_1_1_1 hd_b_ch6.tab2_1_1_8_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Diserens 2012<a class="bibr" href="#ch6.ref42" rid="ch6.ref42"><sup>42</sup></a></p>
|
|
<p>Switzerland</p>
|
|
</td><td headers="hd_h_ch6.tab2_1_1_1_2 hd_b_ch6.tab2_1_1_8_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Early mobilisation</p>
|
|
<p>Head laid flat for the first 24 hours, then raised to 45 for 24 hours and mobilisation out of bed to a sitting or standing position started at 52 hours by physiotherapist</p>
|
|
</td><td headers="hd_h_ch6.tab2_1_1_1_3 hd_b_ch6.tab2_1_1_8_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Head of bed progressively elevated over 6 days, and mobilised out of bed on day 7</td><td headers="hd_h_ch6.tab2_1_1_1_4 hd_b_ch6.tab2_1_1_8_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ischaemic stroke (NIHSS score >6) n=50</td><td headers="hd_h_ch6.tab2_1_1_1_5 hd_b_ch6.tab2_1_1_8_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>90 day:</p>
|
|
<p>Mortality</p>
|
|
<p>Modified Rankin</p>
|
|
<p>Scale 0 to 2</p>
|
|
<p>Worsening of NIHSS by >4 points</p>
|
|
<p>Adverse events (pneumonia)</p>
|
|
<p>Length of hospital stay</p>
|
|
</td><td headers="hd_h_ch6.tab2_1_1_1_6 hd_b_ch6.tab2_1_1_8_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_ch6.tab2_1_1_1_1 hd_b_ch6.tab2_1_1_8_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Poletto 2015<a class="bibr" href="#ch6.ref72" rid="ch6.ref72"><sup>72</sup></a></p>
|
|
<p>Brazil</p>
|
|
</td><td headers="hd_h_ch6.tab2_1_1_1_2 hd_b_ch6.tab2_1_1_8_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Early mobilisation</p>
|
|
<p>First mobilisation within 48 hours of symptom onset</p>
|
|
<p>Trained physical therapists focused on sitting out of bed in a chair or standing (whenever and as soon as possible) and conducting functional training and motor relearning (in line with the Bobath concept), exercises performed bilaterally with at least 5 repetitions for each joint and each exercise and emphasis on deficits in the impaired side</p>
|
|
</td><td headers="hd_h_ch6.tab2_1_1_1_3 hd_b_ch6.tab2_1_1_8_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conventional physical therapy performed when requested by the staff according to the patients’ needs and availability of physical therapists, included global motor exercises and respiratory therapy (ordinarily in bed), duration of standardcare therapy sessions was approximately 15 min and most did not leave their beds</td><td headers="hd_h_ch6.tab2_1_1_1_4 hd_b_ch6.tab2_1_1_8_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ischaemic stroke n=39</td><td headers="hd_h_ch6.tab2_1_1_1_5 hd_b_ch6.tab2_1_1_8_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>90 day:</p>
|
|
<p>Mortality</p>
|
|
<p>Modified Rankin</p>
|
|
<p>Scale 0 to 2</p>
|
|
<p>Neurological deterioration</p>
|
|
<p>Adverse events (pneumonia, deep vein thrombosis, falls, pressure sores)</p>
|
|
<p>Length of hospital stay</p>
|
|
</td><td headers="hd_h_ch6.tab2_1_1_1_6 hd_b_ch6.tab2_1_1_8_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Intervention:</p>
|
|
<p>First mobilisation at a median</p>
|
|
<p>(IQR): 43 (28 to 48) hours</p>
|
|
<p>Comparison:</p>
|
|
<p>First mobilisation at a median</p>
|
|
<p>(IQR): 72 (61 to 108) hours</p>
|
|
<p>Total amount per person (mins), median (IQR)</p>
|
|
<p>Intervention: 135 (85 to 313)</p>
|
|
<p>Comparison: 0 (0 to 50)</p>
|
|
</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch6tab3"><div id="ch6.tab3" class="table"><h3><span class="label">Table 3</span><span class="title">Clinical evidence summary: very early mobilisation versus usual care</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577867/table/ch6.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.tab3_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch6.tab3_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_ch6.tab3_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_ch6.tab3_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_ch6.tab3_1_1_1_2" style="text-align:left;vertical-align:bottom;">No of Participants (studies) Follow up</th><th id="hd_h_ch6.tab3_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_ch6.tab3_1_1_1_3" style="text-align:left;vertical-align:bottom;">Quality of the evidence (GRADE)</th><th id="hd_h_ch6.tab3_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch6.tab3_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_ch6.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_ch6.tab3_1_1_1_5" id="hd_h_ch6.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with Standard care - subgroups</th><th headers="hd_h_ch6.tab3_1_1_1_5" id="hd_h_ch6.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with Very early mobilisation (95% CI)</th></tr></thead><tbody><tr><td headers="hd_h_ch6.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mortality at 7 days</td><td headers="hd_h_ch6.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>71</p>
|
|
<p>(1 study)</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊝⊝</p>
|
|
<p>LOW<sup>a</sup></p>
|
|
<p>due to imprecision</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RR 3.47</p>
|
|
<p>(0.41 to 29.56)</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_5 hd_h_ch6.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30 per 1000</td><td headers="hd_h_ch6.tab3_1_1_1_5 hd_h_ch6.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>74 more per 1000</p>
|
|
<p>(from 18 fewer to 857 more)</p>
|
|
</td></tr><tr><td headers="hd_h_ch6.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mortality at 90 days</td><td headers="hd_h_ch6.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2475</p>
|
|
<p>(6 studies)</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊕⊝</p>
|
|
<p>MODERATE<sup>a</sup></p>
|
|
<p>due to imprecision</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RD 0.01</p>
|
|
<p>(−0.03 to 0.05)</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_5 hd_h_ch6.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">69 per 1000</td><td headers="hd_h_ch6.tab3_1_1_1_5 hd_h_ch6.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>11 more per 1000</p>
|
|
<p>(from 30 fewer to 51 more)<sup>b</sup></p>
|
|
</td></tr><tr><td headers="hd_h_ch6.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mortality at 12 months</td><td headers="hd_h_ch6.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2149</p>
|
|
<p>(2 studies)</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊕⊝</p>
|
|
<p>MODERATE<sup>a</sup></p>
|
|
<p>due to imprecision</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RR 1.21</p>
|
|
<p>(0.97 to 1.51)</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_5 hd_h_ch6.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">148 per 1000</td><td headers="hd_h_ch6.tab3_1_1_1_5 hd_h_ch6.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>31 more per 1000</p>
|
|
<p>(from 4 fewer to 75 more)</p>
|
|
</td></tr><tr><td headers="hd_h_ch6.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">mRS 0 to 2 at 7 days</td><td headers="hd_h_ch6.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>191</p>
|
|
<p>(2 studies)</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊝⊝</p>
|
|
<p>LOW<sup>a</sup><sup>,</sup><sup>c</sup></p>
|
|
<p>due to risk of bias, imprecision</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RR 0.82</p>
|
|
<p>(0.66 to 1.03)</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_5 hd_h_ch6.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">657 per 1000</td><td headers="hd_h_ch6.tab3_1_1_1_5 hd_h_ch6.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>118 fewer per 1000</p>
|
|
<p>(from 223 fewer to 20 more)</p>
|
|
</td></tr><tr><td headers="hd_h_ch6.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">mRS 0 to 2 at 90 days</td><td headers="hd_h_ch6.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2377</p>
|
|
<p>(5 studies)</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊕⊕</p>
|
|
<p>HIGH</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RR 0.94</p>
|
|
<p>(0.86 to 1.01)</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_5 hd_h_ch6.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">438 per 1000</td><td headers="hd_h_ch6.tab3_1_1_1_5 hd_h_ch6.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>26 fewer per 1000</p>
|
|
<p>(from 61 fewer to 4 more)</p>
|
|
</td></tr><tr><td headers="hd_h_ch6.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">mRS 0 to 2 at 12 months</td><td headers="hd_h_ch6.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2152</p>
|
|
<p>(2 studies)</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊕⊝</p>
|
|
<p>MODERATE<sup>d</sup></p>
|
|
<p>due to inconsistency</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RR 0.93</p>
|
|
<p>(0.85 to 1.02)</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_5 hd_h_ch6.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">372 per 1000</td><td headers="hd_h_ch6.tab3_1_1_1_5 hd_h_ch6.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>26 fewer per 1000</p>
|
|
<p>(from 56 fewer to 7 more)</p>
|
|
</td></tr><tr><td headers="hd_h_ch6.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Recurrent stroke at 90 days</td><td headers="hd_h_ch6.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>71</p>
|
|
<p>(1 study)</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊝⊝</p>
|
|
<p>LOW<sup>a</sup></p>
|
|
<p>due to imprecision</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>OR 6.48</p>
|
|
<p>(0.13 to 329.67)</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_5 hd_h_ch6.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0 per 1000</td><td headers="hd_h_ch6.tab3_1_1_1_5 hd_h_ch6.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>30 more per 1000</p>
|
|
<p>(from 50 fewer to 100 more)<sup>b</sup></p>
|
|
</td></tr><tr><td headers="hd_h_ch6.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Neurological deterioration (worsening NIHSS >4 points) at 90 days</td><td headers="hd_h_ch6.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>138</p>
|
|
<p>(1 study)</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊝⊝⊝</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>c</sup></p>
|
|
<p>due to risk of bias, imprecision</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>OR 8.94</p>
|
|
<p>(0.17 to 457.29)</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_5 hd_h_ch6.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0 per 1000</td><td headers="hd_h_ch6.tab3_1_1_1_5 hd_h_ch6.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>20 more per 1000</p>
|
|
<p>(from 30 fewer to 60 more)<sup>b</sup></p>
|
|
</td></tr><tr><td headers="hd_h_ch6.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adverse events at 90 days</td><td headers="hd_h_ch6.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>209</p>
|
|
<p>(2 studies)</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊕⊝</p>
|
|
<p>MODERATE<sup>a</sup></p>
|
|
<p>due to imprecision</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RR 0.88</p>
|
|
<p>(0.72 to 1.08)</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_5 hd_h_ch6.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">476 per 1000</td><td headers="hd_h_ch6.tab3_1_1_1_5 hd_h_ch6.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>57 fewer per 1000</p>
|
|
<p>(from 133 fewer to 38 more)</p>
|
|
</td></tr><tr><td headers="hd_h_ch6.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Barthel index at discharge</p>
|
|
<p>Scale: 0-100 (high is good outcome)</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>90</p>
|
|
<p>(1 study)</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊕⊝</p>
|
|
<p>MODERATE<sup>c</sup></p>
|
|
<p>due to risk of bias</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;"></td><td headers="hd_h_ch6.tab3_1_1_1_5 hd_h_ch6.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean Barthel index at discharge in the control group was 68.25</td><td headers="hd_h_ch6.tab3_1_1_1_5 hd_h_ch6.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean Barthel index at discharge in the intervention group was</p>
|
|
<p>8 higher</p>
|
|
<p>(1.61 to 14.39 higher)</p>
|
|
</td></tr><tr><td headers="hd_h_ch6.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Barthel index at 90 days</p>
|
|
<p>Scale: 0-100 (high is good outcome)</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>80</p>
|
|
<p>(1 study)</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊕⊝</p>
|
|
<p>MODERATE<sup>c</sup></p>
|
|
<p>due to risk of bias</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch6.tab3_1_1_1_5 hd_h_ch6.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean Barthel index at discharge in the control group was 75.25</td><td headers="hd_h_ch6.tab3_1_1_1_5 hd_h_ch6.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean Barthel index at 90 days in the intervention group was</p>
|
|
<p>13.12 higher</p>
|
|
<p>(8.37 to 17.87 higher)</p>
|
|
</td></tr><tr><td headers="hd_h_ch6.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Length of hospital stay</td><td headers="hd_h_ch6.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>124</p>
|
|
<p>(1 study)</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊝⊝</p>
|
|
<p>LOW<sup>a</sup><sup>,</sup><sup>c</sup></p>
|
|
<p>due to risk of bias, imprecision</p>
|
|
</td><td headers="hd_h_ch6.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch6.tab3_1_1_1_5 hd_h_ch6.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean length of hospital stay in the control groups was 10.53 days</td><td headers="hd_h_ch6.tab3_1_1_1_5 hd_h_ch6.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean length of hospital stay in the intervention groups was</p>
|
|
<p>0.75 days lower</p>
|
|
<p>(2.68 lower to 1.18 higher)</p>
|
|
</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="ch6.tab3_1"><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>b</dt><dd><div id="ch6.tab3_2"><p class="no_margin">Calculated from risk difference</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="ch6.tab3_3"><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>d</dt><dd><div id="ch6.tab3_4"><p class="no_margin">Heterogeneity, I<sup>2</sup>=55%, unexplained by subgroup analysis</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch6tab4"><div id="ch6.tab4" class="table"><h3><span class="label">Table 4</span><span class="title">Clinical evidence summary: early mobilisation versus usual care</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577867/table/ch6.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.tab4_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch6.tab4_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_ch6.tab4_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_ch6.tab4_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_ch6.tab4_1_1_1_2" style="text-align:left;vertical-align:bottom;">No of Participants (studies) Follow up</th><th id="hd_h_ch6.tab4_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_ch6.tab4_1_1_1_3" style="text-align:left;vertical-align:bottom;">Quality of the evidence (GRADE)</th><th id="hd_h_ch6.tab4_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch6.tab4_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_ch6.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_ch6.tab4_1_1_1_5" id="hd_h_ch6.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with Standard care</th><th headers="hd_h_ch6.tab4_1_1_1_5" id="hd_h_ch6.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with Early mobilisation (95% CI)</th></tr></thead><tbody><tr><td headers="hd_h_ch6.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mortality at 90 days</td><td headers="hd_h_ch6.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>75</p>
|
|
<p>(2 studies)</p>
|
|
</td><td headers="hd_h_ch6.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊝⊝⊝</p>
|
|
<p>LERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
<p>due to risk of bias, imprecision</p>
|
|
</td><td headers="hd_h_ch6.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RR 0.67</p>
|
|
<p>(0.15 to 2.98)</p>
|
|
</td><td headers="hd_h_ch6.tab4_1_1_1_5 hd_h_ch6.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">88 per 1000</td><td headers="hd_h_ch6.tab4_1_1_1_5 hd_h_ch6.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>29 fewer per 1000</p>
|
|
<p>(from 75 fewer to 174 more)</p>
|
|
</td></tr><tr><td headers="hd_h_ch6.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">mRS 0 to 2 at 90 days</td><td headers="hd_h_ch6.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>75</p>
|
|
<p>(2 studies)</p>
|
|
</td><td headers="hd_h_ch6.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊝⊝⊝</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
<p>due to risk of bias, imprecision</p>
|
|
</td><td headers="hd_h_ch6.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RR 1.03</p>
|
|
<p>(0.61 to 1.72)</p>
|
|
</td><td headers="hd_h_ch6.tab4_1_1_1_5 hd_h_ch6.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">441 per 1000</td><td headers="hd_h_ch6.tab4_1_1_1_5 hd_h_ch6.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>13 more per 1000</p>
|
|
<p>(from 172 fewer to 318 more)</p>
|
|
</td></tr><tr><td headers="hd_h_ch6.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Neurological deterioration (worsening NIHSS >4 points) at 90 days</td><td headers="hd_h_ch6.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>75</p>
|
|
<p>(2 studies)</p>
|
|
</td><td headers="hd_h_ch6.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊝⊝⊝</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
<p>due to risk of bias, imprecision</p>
|
|
</td><td headers="hd_h_ch6.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RD 0</p>
|
|
<p>(−0.14 to 0.09)</p>
|
|
</td><td headers="hd_h_ch6.tab4_1_1_1_5 hd_h_ch6.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">59 per 1000</td><td headers="hd_h_ch6.tab4_1_1_1_5 hd_h_ch6.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>21 fewer per 1000</p>
|
|
<p>(from 140 fewer to 90 more)<sup>c</sup></p>
|
|
</td></tr><tr><td headers="hd_h_ch6.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adverse events at 90 days</td><td headers="hd_h_ch6.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>75</p>
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<p>(2 studies)</p>
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</td><td headers="hd_h_ch6.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>a</sup><sup>,</sup><sup>b</sup><sup>,</sup><sup>d</sup></p>
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<p>due to risk of bias, ‘inconsistency, imprecision</p>
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</td><td headers="hd_h_ch6.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>RR 0.58</p>
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<p>(0.09 to 3.92)</p>
|
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</td><td headers="hd_h_ch6.tab4_1_1_1_5 hd_h_ch6.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">235 per 1000</td><td headers="hd_h_ch6.tab4_1_1_1_5 hd_h_ch6.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>99 fewer per 1000</p>
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<p>(from 214 fewer to 686 more)</p>
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</td></tr><tr><td headers="hd_h_ch6.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Length of hospital stay</td><td headers="hd_h_ch6.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>42</p>
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<p>(1 study)</p>
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</td><td headers="hd_h_ch6.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>a</sup><sup>,</sup><sup>b</sup></p>
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<p>due to risk of bias, imprecision</p>
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</td><td headers="hd_h_ch6.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch6.tab4_1_1_1_5 hd_h_ch6.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean length of hospital stay in the control groups was 11.7 days</td><td headers="hd_h_ch6.tab4_1_1_1_5 hd_h_ch6.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>The mean length of hospital stay in the intervention groups was 2 days higher</p>
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<p>(1.47 lower to 5.47 higher)</p>
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</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="ch6.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>b</dt><dd><div id="ch6.tab4_2"><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>c</dt><dd><div id="ch6.tab4_3"><p class="no_margin">Calculated from risk difference</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="ch6.tab4_4"><p class="no_margin">Heterogeneity, I<sup>2</sup>=66%, unexplained by subgroup analysis</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch6tab5"><div id="ch6.tab5" class="table"><h3><span class="label">Table 5</span><span class="title">Data not suitable for meta-analysis</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577867/table/ch6.tab5/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.tab5_lrgtbl__"><table><thead><tr><th id="hd_h_ch6.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_ch6.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Scale</th><th id="hd_h_ch6.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Early mobilisation</th><th id="hd_h_ch6.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">n</th><th id="hd_h_ch6.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Usual care</th><th id="hd_h_ch6.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">n</th><th id="hd_h_ch6.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk of bias</th></tr></thead><tbody><tr><td headers="hd_h_ch6.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">AVERT III 2015<a class="bibr" href="#ch6.ref15" rid="ch6.ref15"><sup>15</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref17" rid="ch6.ref17"><sup>17</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref18" rid="ch6.ref18"><sup>18</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref23" rid="ch6.ref23"><sup>23</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref58" rid="ch6.ref58"><sup>58</sup></a></td><td headers="hd_h_ch6.tab5_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Quality of life: Assessment of Quality of Life instrument at 12 months</p>
|
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<p>Median (IQR)</p>
|
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<p>Scale (−0.04-1.00)</p>
|
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<p>High is good outcome</p>
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</td><td headers="hd_h_ch6.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0.47 (0.07 to 0.81)</td><td headers="hd_h_ch6.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1048</td><td headers="hd_h_ch6.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0.49 (0.08 to 0.81))</td><td headers="hd_h_ch6.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1050</td><td headers="hd_h_ch6.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">AVERT II 2009<a class="bibr" href="#ch6.ref24" rid="ch6.ref24"><sup>24</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref25" rid="ch6.ref25"><sup>25</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref36" rid="ch6.ref36"><sup>36</sup></a><sup>,</sup>
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|
<a class="bibr" href="#ch6.ref37" rid="ch6.ref37"><sup>37</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#ch6.ref79" rid="ch6.ref79"><sup>79</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#ch6.ref86" rid="ch6.ref86"><sup>86</sup></a></td><td headers="hd_h_ch6.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0.32</td><td headers="hd_h_ch6.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38</td><td headers="hd_h_ch6.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0.24</td><td headers="hd_h_ch6.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33</td><td headers="hd_h_ch6.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">AVERT III<a class="bibr" href="#ch6.ref15" rid="ch6.ref15"><sup>15</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#ch6.ref17" rid="ch6.ref17"><sup>17</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#ch6.ref18" rid="ch6.ref18"><sup>18</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#ch6.ref23" rid="ch6.ref23"><sup>23</sup></a><sup>,</sup>
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|
<a class="bibr" href="#ch6.ref58" rid="ch6.ref58"><sup>58</sup></a></td><td headers="hd_h_ch6.tab5_1_1_1_2" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">Length of hospital stay (days), median (IQR)</td><td headers="hd_h_ch6.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16 (5 to 44)</td><td headers="hd_h_ch6.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1048</td><td headers="hd_h_ch6.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18 (6 to 43)</td><td headers="hd_h_ch6.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1050</td><td headers="hd_h_ch6.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Chippala 2016<a class="bibr" href="#ch6.ref30" rid="ch6.ref30"><sup>30</sup></a></td><td headers="hd_h_ch6.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8 (7 to 9)</td><td headers="hd_h_ch6.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40</td><td headers="hd_h_ch6.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10 (8 to 12.75)</td><td headers="hd_h_ch6.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40</td><td headers="hd_h_ch6.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">High</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Poletto 2015<a class="bibr" href="#ch6.ref72" rid="ch6.ref72"><sup>72</sup></a></td><td headers="hd_h_ch6.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8 (5 to 14)</td><td headers="hd_h_ch6.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16</td><td headers="hd_h_ch6.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10 (4 to 25)</td><td headers="hd_h_ch6.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17</td><td headers="hd_h_ch6.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">High</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERITAS 2010<a class="bibr" href="#ch6.ref57" rid="ch6.ref57"><sup>57</sup></a></td><td headers="hd_h_ch6.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10 (5 to 14)</td><td headers="hd_h_ch6.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16</td><td headers="hd_h_ch6.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12 (6 to 16)</td><td headers="hd_h_ch6.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16</td><td headers="hd_h_ch6.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">High</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch6tab6"><div id="ch6.tab6" class="table"><h3><span class="label">Table 6</span><span class="title">Health economic evidence profile: Very early mobilisation and standard care versus standard care</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577867/table/ch6.tab6/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.tab6_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch6.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Study</th><th id="hd_h_ch6.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Applicability</th><th id="hd_h_ch6.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Limitations</th><th id="hd_h_ch6.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Other comments</th><th id="hd_h_ch6.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Incremental cost</th><th id="hd_h_ch6.tab6_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Incremental effects</th><th id="hd_h_ch6.tab6_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Cost effectiveness</th><th id="hd_h_ch6.tab6_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Uncertainty</th></tr></thead><tbody><tr><td headers="hd_h_ch6.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Tay-Teo 2008<a class="bibr" href="#ch6.ref85" rid="ch6.ref85"><sup>85</sup></a></p>
|
|
<p>(Australia)</p>
|
|
</td><td headers="hd_h_ch6.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Partially applicable<sup>(a)</sup></td><td headers="hd_h_ch6.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Potentially serious limitations<sup>(b)</sup></td><td headers="hd_h_ch6.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Within-trial analysis of AVERT phase II RCT. Resource items for hospital perspective: Time cost for implementing very early mobilisation, acute-phase hospitalisation, interim care arrangement, emergency attendance, rehospitalisation, inpatient rehabilitation, and outpatient rehabilitation. Resource use data determined from medical records and patient/next-of-kin interviews. Unit costs applied to resource items.</td><td headers="hd_h_ch6.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Saves £2,659<sup>(c)</sup> (hospital perspective)</td><td headers="hd_h_ch6.tab6_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adjusted OR (mRS 0-2 at 90 days): 4.10 (95% CI: 0.99-16.88; p=0.051)</td><td headers="hd_h_ch6.tab6_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dominant<sup>(d)</sup> (da) (hospital perspective)</td><td headers="hd_h_ch6.tab6_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Probability very early mobilisation dominant (hospital perspective): NR</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">Abbreviations: da: deterministic analysis; ICER: incremental cost-effectiveness ratio; NR: not reported; OR: odds ratio; QALY: quality-adjusted life years; RCT: randomised controlled trial</p></div></dd></dl><dl class="bkr_refwrap"><dt>(a)</dt><dd><div id="ch6.tab6_1"><p class="no_margin">Australian societal perspective, recalculated as hospital perspective</p></div></dd></dl><dl class="bkr_refwrap"><dt>(b)</dt><dd><div id="ch6.tab6_2"><p class="no_margin">High recruitment of moderate to severe strokes to AVERT II could limit generalisability. Health outcomes and resource use are based on the AVERT phase II trial only. Health effects not expressed as QALYs, diverging from NICE reference case. mRS score is dichotomised; ordinal shift not used. Medications and diagnostic investigations not included in resource use. Aspects of resource use obtained through patient/next-of-kin interviews could be subject to recall bias. Potential conflicts of interest are not reported</p></div></dd></dl><dl class="bkr_refwrap"><dt>(c)</dt><dd><div id="ch6.tab6_3"><p class="no_margin">Converted using 2004 purchasing power parities<a class="bibr" href="#ch6.ref71" rid="ch6.ref71"><sup>71</sup></a></p></div></dd></dl><dl class="bkr_refwrap"><dt>(d)</dt><dd><div id="ch6.tab6_4"><p class="no_margin">A dominant treatment option is one that is both less costly and results in better health outcomes than the comparator treatment</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch6tab7"><div id="ch6.tab7" class="table"><h3><span class="label">Table 7</span><span class="title">UK costs of very early mobilisation</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577867/table/ch6.tab7/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.tab7_lrgtbl__"><table><thead><tr><th id="hd_h_ch6.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Currency Description</th><th id="hd_h_ch6.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Unit Cost</th><th id="hd_h_ch6.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Source</th></tr></thead><tbody><tr><td headers="hd_h_ch6.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">REHABL2 Specialist rehabilitation services level 2 (rehabilitation for stroke, admitted patient care)</td><td headers="hd_h_ch6.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£422</td><td headers="hd_h_ch6.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NHS Reference Costs 2016-2017</td></tr><tr><td headers="hd_h_ch6.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hospital-based nurse, cost per working hour (band 2-3)</td><td headers="hd_h_ch6.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£22 - £25</td><td headers="hd_h_ch6.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">PSSRU 2017</td></tr><tr><td headers="hd_h_ch6.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hospital-based scientific and professional staff, cost per working hour, band 5 – band 7(physiotherapist - physiotherapist advanced/specialist))</td><td headers="hd_h_ch6.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£34 - £55</td><td headers="hd_h_ch6.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">PSSRU 2017</td></tr><tr><td headers="hd_h_ch6.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hospital-based scientific and professional staff, cost per working hour, band 2- band 3 (clinical support worker - clinical support worker (higher level))</td><td headers="hd_h_ch6.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£24 - £27</td><td headers="hd_h_ch6.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">PSSRU 2016</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch6appatab1"><div id="ch6.appa.tab1" class="table"><h3><span class="label">Table 8</span><span class="title">Review protocol: Very early and early mobilisation</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577867/table/ch6.appa.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.appa.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_ch6.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Field</th><th id="hd_h_ch6.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_ch6.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Review question</td><td headers="hd_h_ch6.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Does early mobilisation versus treatment as usual reduce mortality and morbidity in people with acute stroke?</td></tr><tr><td headers="hd_h_ch6.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_ch6.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_ch6.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_ch6.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">To examine the effects of early mobilisation on recovery.</td></tr><tr><td headers="hd_h_ch6.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_ch6.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">People aged over 16 with acute stroke</td></tr><tr><td headers="hd_h_ch6.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_ch6.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>Early mobilisation (within 72 hours)</p>
|
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<p>Very early mobilisation (within 24 hours)</p>
|
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<p>Mobilisation is defined as out of bed activity</p>
|
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</td></tr><tr><td headers="hd_h_ch6.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_ch6.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Usual care (as defined by the studies, for example assessment within 24 hours and mobilisation as appropriate)</p>
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<p>Late mobilisation (first mobilisation after 72 hours)</p>
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<p>Different intensities of mobilisation (grouped as <3, 3 or >3 sessions per day)</p>
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<p>Interventions compared with each other</p>
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</td></tr><tr><td headers="hd_h_ch6.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_ch6.appa.tab1_1_1_1_2" 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>mRS score (or Barthel score if mRS not available) at 7 days, 90 days and 1 year</p>
|
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<p>Mortality at 7 days, 90 days and 1 year</p>
|
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<p>
|
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<u>Important</u>
|
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</p>
|
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<p>Recurrent stroke at 90 days</p>
|
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<p>Adverse events (PE/DVT/pressure sores/pneumonia/falls) at 90 days</p>
|
|
<p>Quality of life (both health- and social-related quality) at 90 days and 1 year</p>
|
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<p>Length of stay</p>
|
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<p>Acute neurological deterioration (worsening of NIHSS) at 90 days and 1 year</p>
|
|
</td></tr><tr><td headers="hd_h_ch6.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_ch6.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>Systematic reviews and meta-analyses of the above</p>
|
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</td></tr><tr><td headers="hd_h_ch6.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_ch6.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>
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<p>Settings: Hospital/stroke units</p>
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</td></tr><tr><td headers="hd_h_ch6.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Proposed sensitivity / subgroup analysis, or meta-regression</td><td headers="hd_h_ch6.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
|
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<u>Strata</u>
|
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</p>
|
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<p>Stroke severity (Mild/moderate or severe stroke according to NIHSS; or all severities if not reported separately)</p>
|
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<p>Rationale: Severity of stroke is highly likely to interact with the physiological tolerability and safety of early mobilisation</p>
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<p>
|
|
<u>Subgroups to be assessed if heterogeneity is present:</u>
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</p>
|
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<p>Intensity (< 3, 3 or >3 sessions a day)</p>
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<p>Ischaemic/haemorrhagic stroke</p>
|
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<p>Thrombolysis/no thrombolysis</p>
|
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<p>Usual care definition (first mobilisation unclear or at mean of <24 hours, <72 hours, or >72 hours)</p>
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</td></tr><tr><td headers="hd_h_ch6.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_ch6.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Studies are sifted by title and abstract. 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_ch6.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_ch6.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="l122"><li id="lt378" class="half_rhythm"><div>EndNote will be used for reference management, sifting, citations and bibliographies.</div></li><li id="lt379" class="half_rhythm"><div>EviBASE will be used for data extraction and quality assessment for clinical studies.</div></li><li id="lt380" class="half_rhythm"><div>Pairwise meta-analyses will be performed using Cochrane Review Manager (RevMan5).</div></li><li id="lt381" class="half_rhythm"><div>GRADEpro will be used to assess the quality of evidence for each outcome.</div></li></ul>
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</td></tr><tr><td headers="hd_h_ch6.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_ch6.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>
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<p>Language: Restrict to English only</p>
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<p>Date restriction: 2007</p>
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<p>Key papers
|
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<ol id="l123"><li id="lt382" class="half_rhythm"><div>Bernhardt J, Thuy MN, Collier JM et al. (2009) Very early versus delayed mobilisation after stroke. [Review] [56 refs]. Cochrane Database of Systematic Reviews CD006187.</div></li><li id="lt383" class="half_rhythm"><div>Bernhardt J, Dewey H, Thrift A et al. (2008) A very early rehabilitation trial for stroke (AVERT): phase II safety and feasibility. Stroke 39:390-396.</div></li><li id="lt384" class="half_rhythm"><div>Cumming TB, Thrift AG, Collier JM et al. (2011) Very early mobilization after stroke fast-tracks return to walking: further results from the phase II AVERT randomized controlled trial. Stroke 42:153-158.</div></li><li id="lt385" class="half_rhythm"><div>Sorbello D, Dewey HM, Churilov L et al. (2009) Very early mobilisation and complications in the first 3 months after stroke: further results from phase II of A Very Early Rehabilitation Trial (AVERT). Cerebrovascular Diseases 28:378-383.</div></li><li id="lt386" class="half_rhythm"><div>Tay-Teo K, Moodie M, Bernhardt J et al. (2008) Economic evaluation alongside a phase II, multi-centre, randomised controlled trial of very early rehabilitation after stroke (AVERT). Cerebrovascular Diseases 26:475-481.</div></li><li id="lt387" class="half_rhythm"><div>AVERT Trial Collaboration group, Bernhardt J, Langhorne P et al. (4-7-2015) Efficacy and safety of very early mobilisation within 24 h of stroke onset (AVERT): a randomised controlled trial. Lancet 386:46-55.</div></li><li id="lt388" class="half_rhythm"><div>Bernhardt J, Churilov L, Ellery F et al. (7-6-2016) Prespecified dose-response analysis for A Very Early Rehabilitation Trial (AVERT). Neurology 86:2138-2145.</div></li></ol>
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</p>
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</td></tr><tr><td headers="hd_h_ch6.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_ch6.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Yes. Cut off date 2007 in CG68</p>
|
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<p>Question in CG68: Does early mobilisation versus treatment as usual reduce mortality and morbidity in patients with acute stroke?</p>
|
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<p>Recommendations from CG68 2007</p>
|
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<p>1.7.1.1 People with acute stroke should be mobilised as soon as possible (when their clinical condition permits) as part of an active management programme in a specialist stroke unit.</p>
|
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</td></tr><tr><td headers="hd_h_ch6.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Author contacts</td><td headers="hd_h_ch6.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<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>
|
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</td></tr><tr><td headers="hd_h_ch6.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_ch6.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_ch6.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_ch6.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see <a href="#ch6.appb">appendix B</a></td></tr><tr><td headers="hd_h_ch6.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_ch6.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="#ch6.appd">appendix D</a> of the evidence report.</td></tr><tr><td headers="hd_h_ch6.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_ch6.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="#ch6.appd">Appendix D</a> (clinical evidence tables) or <a href="#ch6.apph">H</a> (health economic evidence tables).</td></tr><tr><td headers="hd_h_ch6.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_ch6.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></p>
|
|
<p>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>
|
|
</td></tr><tr><td headers="hd_h_ch6.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_ch6.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_ch6.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_ch6.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_ch6.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_ch6.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_ch6.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_ch6.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_ch6.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_ch6.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_ch6.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_ch6.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>
|
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</td></tr><tr><td headers="hd_h_ch6.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_ch6.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_ch6.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_ch6.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_ch6.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_ch6.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_ch6.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_ch6.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="figobch6appatab2"><div id="ch6.appa.tab2" class="table"><h3><span class="label">Table 9</span><span class="title">Health economic review protocol</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577867/table/ch6.appa.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.appa.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_ch6.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Review question</th><th id="hd_h_ch6.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_ch6.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_ch6.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_ch6.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_ch6.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="l124"><li id="lt389" class="half_rhythm"><div>Populations, interventions and comparators must be as specified in the clinical review protocol above.</div></li><li id="lt390" 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="lt391" 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="lt392" class="half_rhythm"><div>Unpublished reports will not be considered unless submitted as part of a call for evidence.</div></li><li id="lt393" class="half_rhythm"><div>Studies must be in English.</div></li></ul>
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</td></tr><tr><td headers="hd_h_ch6.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_ch6.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="#ch6.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_ch6.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_ch6.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<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>
|
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<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>
|
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<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="#ch6.apph">appendix H</a> of Developing NICE guidelines: the manual (2014).<a class="bibr" href="#ch6.ref68" rid="ch6.ref68"><sup>68</sup></a></p>
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<p><b>Inclusion and exclusion criteria</b>
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<ul id="l125"><li id="lt394" 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="lt395" 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="lt396" 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>
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<b>Where there is discretion</b></p>
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<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="#ch6.apph">appendix H</a>.</p>
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<p>The health economist will be guided by the following hierarchies.</p>
|
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<p><i>Setting:</i>
|
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<ul id="l126"><li id="lt397" class="half_rhythm"><div>UK NHS (most applicable).</div></li><li id="lt398" class="half_rhythm"><div>OECD countries with predominantly public health insurance systems (for example, France, Germany, Sweden).</div></li><li id="lt399" class="half_rhythm"><div>OECD countries with predominantly private health insurance systems (for example, Switzerland).</div></li><li id="lt400" 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>
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<ul id="l127"><li id="lt401" class="half_rhythm"><div>Cost–utility analysis (most applicable).</div></li><li id="lt402" class="half_rhythm"><div>Other type of full economic evaluation (cost–benefit analysis, cost-effectiveness analysis, cost–consequences analysis).</div></li><li id="lt403" class="half_rhythm"><div>Comparative cost analysis.</div></li><li id="lt404" 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>
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<ul id="l128"><li id="lt405" class="half_rhythm"><div>The more recent the study, the more applicable it will be.</div></li><li id="lt406" 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="lt407" 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="l129"><li id="lt408" 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>
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</p>
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</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch6appbtab1"><div id="ch6.appb.tab1" class="table"><h3><span class="label">Table 10</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/NBK577867/table/ch6.appb.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.appb.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_ch6.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Database</th><th id="hd_h_ch6.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dates searched</th><th id="hd_h_ch6.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_ch6.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Medline (OVID)</td><td headers="hd_h_ch6.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">01 January 2007 – 26 March 2018</td><td headers="hd_h_ch6.appb.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Exclusions</td></tr><tr><td headers="hd_h_ch6.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Embase (OVID)</td><td headers="hd_h_ch6.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">01 January 2007 – 26 March 2018</td><td headers="hd_h_ch6.appb.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Exclusions</td></tr><tr><td headers="hd_h_ch6.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_ch6.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Cochrane Reviews 2007 to 2018, Issue 3 of 12</p>
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<p>CENTRAL 2007 to 2018 Issue 2 of 12</p>
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<p>DARE, and NHSEED 2007 to 2015 Issue 2 of 4</p>
|
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<p>HTA to 2007 to 2016 Issue 2 of 4</p>
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</td><td headers="hd_h_ch6.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="figobch6appbtab2"><div id="ch6.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/NBK577867/table/ch6.appb.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.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;">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 “Intracranial Embolism and 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;">exp Carotid Artery Thrombosis/</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 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;">12.</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;">13.</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;">14.</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;">15.</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;">16.</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;">17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1-16</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;">letter/</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/</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;">news/</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 historical article/</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;">Anecdotes as Topic/</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;">comment/</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;">case report/</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;">(letter or comment*).ti.</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;">or/18-25</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;">randomized controlled trial/ or random*.ti,ab.</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;">26 not 27</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;">animals/ not humans/</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 Animals, Laboratory/</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 Animal Experimentation/</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 Models, Animal/</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;">exp Rodentia/</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;">(rat or rats or mouse or mice).ti.</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;">or/28-34</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;">17 not 35</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;">limit 36 to English language</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 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;">39.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37 not 38</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;">Patient Positioning/</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 Posture/</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;">(mobilis* or mobiliz*).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;">((head or patient or person or people or body or bodies) adj3 (supine or prone or position* or posture* or placing or place* or up*)).ti,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;">HeadPOST.ti,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;">or/40-44</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;">39 and 45</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch6appbtab3"><div id="ch6.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/NBK577867/table/ch6.appb.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.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;">*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;">*brain embolism/</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;">*Carotid Artery Thrombosis/</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 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;">12.</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;">13.</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;">14.</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;">15.</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;">16.</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;">17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1-16</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;">letter.pt. or letter/</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;">note.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;">editorial.pt.</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;">case report/ or case study/</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;">(letter or comment*).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/18-22</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;">randomized controlled trial/ or random*.ti,ab.</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;">23 not 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;">animal/ not human/</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;">nonhuman/</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 Animal Experiment/</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 Experimental Animal/</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;">animal model/</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 Rodent/</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;">(rat or rats or mouse or mice).ti.</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/25-32</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;">17 not 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;">limit 34 to English language</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;">(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;">37.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35 not 36</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;">*patient position support/ or *patient positioning/</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;">*body position/ or *prone position/ or *supine position/</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;">(mobilis* or mobiliz*).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;">((head or patient or person or people or body or bodies) adj3 (supine or prone or position* or posture* or placing or up*)).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;">HeadPOST.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/38-42</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;">37 and 43</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch6appbtab4"><div id="ch6.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/NBK577867/table/ch6.appb.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.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;">MeSH descriptor: [Stroke] explode all trees</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*) near/2 (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;">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 near/2 (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) near/3 (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;">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: [Intracranial Embolism and 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;">MeSH descriptor: [Carotid Artery Thrombosis] explode all trees</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 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) near/3 (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;">#12.</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;">#13.</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;">#14.</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;">#15.</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;">#16.</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;">#17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(or #1-#16)</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;">MeSH descriptor: [Patient Positioning] explode all trees</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;">MeSH descriptor: [Posture] explode all trees</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;">(mobilis* or mobiliz*):ti,ab</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;">((head or patient or person or people or body or bodies) near/3 (supine or prone or position* or posture* or placing or place* or up*)):ti,ab</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;">HeadPOST:ti,ab</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 #18-#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;">#17 and #23</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch6appbtab5"><div id="ch6.appb.tab5" class="table"><h3><span class="label">Table 11</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/NBK577867/table/ch6.appb.tab5/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.appb.tab5_lrgtbl__"><table><thead><tr><th id="hd_h_ch6.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Database</th><th id="hd_h_ch6.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dates searched</th><th id="hd_h_ch6.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_ch6.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Medline</td><td headers="hd_h_ch6.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_ch6.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_ch6.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Embase</td><td headers="hd_h_ch6.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_ch6.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_ch6.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_ch6.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_ch6.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="figobch6appbtab6"><div id="ch6.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/NBK577867/table/ch6.appb.tab6/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.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="figobch6appbtab7"><div id="ch6.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/NBK577867/table/ch6.appb.tab7/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.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="figobch6appbtab8"><div id="ch6.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/NBK577867/table/ch6.appb.tab8/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.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="figobch6appcfig1"><div id="ch6.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%20early%20mobilisation.&p=BOOKS&id=577867_ch6appcf1.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/NBK577867/bin/ch6appcf1.jpg" alt="Figure 1. Flow chart of clinical study selection for the review of early mobilisation." 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 early mobilisation</span></h3></div></article><article data-type="fig" id="figobch6appefig1"><div id="ch6.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.%20Mortality%20at%207%20days.&p=BOOKS&id=577867_ch6appef1.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/NBK577867/bin/ch6appef1.jpg" alt="Figure 2. Mortality at 7 days." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 2</span><span class="title">Mortality at 7 days</span></h3></div></article><article data-type="fig" id="figobch6appefig2"><div id="ch6.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.%20Mortality%20at%2090%20days.&p=BOOKS&id=577867_ch6appef2.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/NBK577867/bin/ch6appef2.jpg" alt="Figure 3. Mortality at 90 days." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 3</span><span class="title">Mortality at 90 days</span></h3></div></article><article data-type="fig" id="figobch6appefig3"><div id="ch6.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.%20Mortality%20at%2012%20months.&p=BOOKS&id=577867_ch6appef3.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/NBK577867/bin/ch6appef3.jpg" alt="Figure 4. Mortality at 12 months." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 4</span><span class="title">Mortality at 12 months</span></h3></div></article><article data-type="fig" id="figobch6appefig4"><div id="ch6.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.%20Modified%20Rankin%20Scale%200%20to%202%20at%207%20days.&p=BOOKS&id=577867_ch6appef4.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/NBK577867/bin/ch6appef4.jpg" alt="Figure 5. Modified Rankin Scale 0 to 2 at 7 days." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 5</span><span class="title">Modified Rankin Scale 0 to 2 at 7 days</span></h3></div></article><article data-type="fig" id="figobch6appefig5"><div id="ch6.appe.fig5" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%206.%20Modified%20Rankin%20Scale%200%20to%202%20at%2090%20days.&p=BOOKS&id=577867_ch6appef5.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/NBK577867/bin/ch6appef5.jpg" alt="Figure 6. Modified Rankin Scale 0 to 2 at 90 days." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 6</span><span class="title">Modified Rankin Scale 0 to 2 at 90 days</span></h3></div></article><article data-type="fig" id="figobch6appefig6"><div id="ch6.appe.fig6" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%207.%20Modified%20Rankin%20Scale%200%20to%202%20at%201%20year.&p=BOOKS&id=577867_ch6appef6.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/NBK577867/bin/ch6appef6.jpg" alt="Figure 7. Modified Rankin Scale 0 to 2 at 1 year." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 7</span><span class="title">Modified Rankin Scale 0 to 2 at 1 year</span></h3></div></article><article data-type="fig" id="figobch6appefig7"><div id="ch6.appe.fig7" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%208.%20Recurrent%20stroke%20at%2090%20days.&p=BOOKS&id=577867_ch6appef7.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/NBK577867/bin/ch6appef7.jpg" alt="Figure 8. Recurrent stroke at 90 days." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 8</span><span class="title">Recurrent stroke at 90 days</span></h3></div></article><article data-type="fig" id="figobch6appefig8"><div id="ch6.appe.fig8" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%209.%20Neurological%20deterioration%20at%2090%20days.&p=BOOKS&id=577867_ch6appef8.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/NBK577867/bin/ch6appef8.jpg" alt="Figure 9. Neurological deterioration at 90 days." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 9</span><span class="title">Neurological deterioration at 90 days</span></h3></div></article><article data-type="fig" id="figobch6appefig9"><div id="ch6.appe.fig9" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2010.%20Adverse%20events%20at%2090%20days.&p=BOOKS&id=577867_ch6appef9.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/NBK577867/bin/ch6appef9.jpg" alt="Figure 10. Adverse events at 90 days." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 10</span><span class="title">Adverse events at 90 days</span></h3></div></article><article data-type="fig" id="figobch6appefig10"><div id="ch6.appe.fig10" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2011.%20Length%20of%20hospital%20stay.&p=BOOKS&id=577867_ch6appef10.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/NBK577867/bin/ch6appef10.jpg" alt="Figure 11. Length of hospital stay." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 11</span><span class="title">Length of hospital stay</span></h3></div></article><article data-type="fig" id="figobch6appefig11"><div id="ch6.appe.fig11" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2012.%20Barthel%20index%20at%20discharge.&p=BOOKS&id=577867_ch6appef11.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/NBK577867/bin/ch6appef11.jpg" alt="Figure 12. Barthel index at discharge." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 12</span><span class="title">Barthel index at discharge</span></h3></div></article><article data-type="fig" id="figobch6appefig12"><div id="ch6.appe.fig12" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2013.%20Barthel%20index%20at%2090%20days.&p=BOOKS&id=577867_ch6appef12.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/NBK577867/bin/ch6appef12.jpg" alt="Figure 13. Barthel index at 90 days." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 13</span><span class="title">Barthel index at 90 days</span></h3></div></article><article data-type="fig" id="figobch6appefig13"><div id="ch6.appe.fig13" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2014.%20Mortality%20at%2090%20days.&p=BOOKS&id=577867_ch6appef13.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/NBK577867/bin/ch6appef13.jpg" alt="Figure 14. Mortality at 90 days." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 14</span><span class="title">Mortality at 90 days</span></h3></div></article><article data-type="fig" id="figobch6appefig14"><div id="ch6.appe.fig14" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2015.%20Modified%20Rankin%20Scale%200%20to%202%20at%2090%20days.&p=BOOKS&id=577867_ch6appef14.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/NBK577867/bin/ch6appef14.jpg" alt="Figure 15. Modified Rankin Scale 0 to 2 at 90 days." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 15</span><span class="title">Modified Rankin Scale 0 to 2 at 90 days</span></h3></div></article><article data-type="fig" id="figobch6appefig15"><div id="ch6.appe.fig15" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2016.%20Neurological%20deterioration%20at%2090%20days.&p=BOOKS&id=577867_ch6appef15.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/NBK577867/bin/ch6appef15.jpg" alt="Figure 16. Neurological deterioration at 90 days." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 16</span><span class="title">Neurological deterioration at 90 days</span></h3></div></article><article data-type="fig" id="figobch6appefig16"><div id="ch6.appe.fig16" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2017.%20Adverse%20events%20at%2090%20days.&p=BOOKS&id=577867_ch6appef16.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/NBK577867/bin/ch6appef16.jpg" alt="Figure 17. Adverse events at 90 days." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 17</span><span class="title">Adverse events at 90 days</span></h3></div></article><article data-type="fig" id="figobch6appefig17"><div id="ch6.appe.fig17" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2018.%20Length%20of%20hospital%20stay.&p=BOOKS&id=577867_ch6appef17.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/NBK577867/bin/ch6appef17.jpg" alt="Figure 18. Length of hospital stay." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 18</span><span class="title">Length of hospital stay</span></h3></div></article><article data-type="fig" id="figobch6appefig18"><div id="ch6.appe.fig18" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2019.%20Modified%20Rankin%20Scale%20at%207%20and%2090%20days%20(ordinal%20shift%20graphs).&p=BOOKS&id=577867_ch6appef18.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/NBK577867/bin/ch6appef18.jpg" alt="Figure 19. Modified Rankin Scale at 7 and 90 days (ordinal shift graphs)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 19</span><span class="title">Modified Rankin Scale at 7 and 90 days (ordinal shift graphs)</span></h3></div></article><article data-type="table-wrap" id="figobch6appftab1"><div id="ch6.appf.tab1" class="table"><h3><span class="label">Table 12</span><span class="title">Clinical evidence profile: very early mobilisation versus usual care</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577867/table/ch6.appf.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.appf.tab1_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch6.appf.tab1_1_1_1_1" colspan="7" rowspan="1" style="text-align:center;vertical-align:middle;">Quality assessment</th><th id="hd_h_ch6.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_ch6.appf.tab1_1_1_1_3" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">Effect</th><th id="hd_h_ch6.appf.tab1_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch6.appf.tab1_1_1_1_4" style="text-align:center;vertical-align:middle;">Quality</th><th id="hd_h_ch6.appf.tab1_1_1_1_5" rowspan="2" colspan="1" headers="hd_h_ch6.appf.tab1_1_1_1_5" style="text-align:center;vertical-align:middle;">Importance</th></tr><tr><th headers="hd_h_ch6.appf.tab1_1_1_1_1" id="hd_h_ch6.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_ch6.appf.tab1_1_1_1_1" id="hd_h_ch6.appf.tab1_1_1_2_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Design</th><th headers="hd_h_ch6.appf.tab1_1_1_1_1" id="hd_h_ch6.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_ch6.appf.tab1_1_1_1_1" id="hd_h_ch6.appf.tab1_1_1_2_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Inconsistency</th><th headers="hd_h_ch6.appf.tab1_1_1_1_1" id="hd_h_ch6.appf.tab1_1_1_2_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Indirectness</th><th headers="hd_h_ch6.appf.tab1_1_1_1_1" id="hd_h_ch6.appf.tab1_1_1_2_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Imprecision</th><th headers="hd_h_ch6.appf.tab1_1_1_1_1" id="hd_h_ch6.appf.tab1_1_1_2_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Other considerations</th><th headers="hd_h_ch6.appf.tab1_1_1_1_2" id="hd_h_ch6.appf.tab1_1_1_2_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Very early mobilisation</th><th headers="hd_h_ch6.appf.tab1_1_1_1_2" id="hd_h_ch6.appf.tab1_1_1_2_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Standard care - subgroups</th><th headers="hd_h_ch6.appf.tab1_1_1_1_3" id="hd_h_ch6.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_ch6.appf.tab1_1_1_1_3" id="hd_h_ch6.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_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_1 hd_h_ch6.appf.tab1_1_1_2_2 hd_h_ch6.appf.tab1_1_1_2_3 hd_h_ch6.appf.tab1_1_1_2_4 hd_h_ch6.appf.tab1_1_1_2_5 hd_h_ch6.appf.tab1_1_1_2_6 hd_h_ch6.appf.tab1_1_1_2_7 hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_8 hd_h_ch6.appf.tab1_1_1_2_9 hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_10 hd_h_ch6.appf.tab1_1_1_2_11 hd_h_ch6.appf.tab1_1_1_1_4 hd_h_ch6.appf.tab1_1_1_1_5" id="hd_b_ch6.appf.tab1_1_1_1_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Mortality at 7 days</th></tr><tr><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_1 hd_b_ch6.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_2 hd_b_ch6.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_3 hd_b_ch6.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious risk of bias</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_4 hd_b_ch6.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_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_5 hd_b_ch6.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_6 hd_b_ch6.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>1</sup></td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_7 hd_b_ch6.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_8 hd_b_ch6.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
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<p>4/38</p>
|
|
<p>(10.5%)</p>
|
|
</td><td headers="hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_9 hd_b_ch6.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">3%</td><td headers="hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_10 hd_b_ch6.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 3.47 (0.41 to 29.56)</td><td headers="hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_11 hd_b_ch6.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">74 more per 1000 (from 18 fewer to 857 more)</td><td headers="hd_h_ch6.appf.tab1_1_1_1_4 hd_b_ch6.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁⨁◯◯</p>
|
|
<p>LOW</p>
|
|
</td><td headers="hd_h_ch6.appf.tab1_1_1_1_5 hd_b_ch6.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_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_1 hd_h_ch6.appf.tab1_1_1_2_2 hd_h_ch6.appf.tab1_1_1_2_3 hd_h_ch6.appf.tab1_1_1_2_4 hd_h_ch6.appf.tab1_1_1_2_5 hd_h_ch6.appf.tab1_1_1_2_6 hd_h_ch6.appf.tab1_1_1_2_7 hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_8 hd_h_ch6.appf.tab1_1_1_2_9 hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_10 hd_h_ch6.appf.tab1_1_1_2_11 hd_h_ch6.appf.tab1_1_1_1_4 hd_h_ch6.appf.tab1_1_1_1_5" id="hd_b_ch6.appf.tab1_1_1_3_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Mortality at 90 days</th></tr><tr><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_1 hd_b_ch6.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_2 hd_b_ch6.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_3 hd_b_ch6.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious risk of bias</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_4 hd_b_ch6.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_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_5 hd_b_ch6.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_6 hd_b_ch6.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_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_7 hd_b_ch6.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_8 hd_b_ch6.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">106/1232 (8.6%)</td><td headers="hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_9 hd_b_ch6.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">6.9%</td><td headers="hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_10 hd_b_ch6.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RD 0.01 (−0.03 to 0.05)</td><td headers="hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_11 hd_b_ch6.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">11 more per 1000 (from 30 fewer to 51 more)<sup>2</sup></td><td headers="hd_h_ch6.appf.tab1_1_1_1_4 hd_b_ch6.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
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<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE</p>
|
|
</td><td headers="hd_h_ch6.appf.tab1_1_1_1_5 hd_b_ch6.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_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_1 hd_h_ch6.appf.tab1_1_1_2_2 hd_h_ch6.appf.tab1_1_1_2_3 hd_h_ch6.appf.tab1_1_1_2_4 hd_h_ch6.appf.tab1_1_1_2_5 hd_h_ch6.appf.tab1_1_1_2_6 hd_h_ch6.appf.tab1_1_1_2_7 hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_8 hd_h_ch6.appf.tab1_1_1_2_9 hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_10 hd_h_ch6.appf.tab1_1_1_2_11 hd_h_ch6.appf.tab1_1_1_1_4 hd_h_ch6.appf.tab1_1_1_1_5" id="hd_b_ch6.appf.tab1_1_1_5_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Mortality at 12 months</th></tr><tr><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_1 hd_b_ch6.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_2 hd_b_ch6.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_3 hd_b_ch6.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious risk of bias</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_4 hd_b_ch6.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_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_5 hd_b_ch6.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_6 hd_b_ch6.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_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_7 hd_b_ch6.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_8 hd_b_ch6.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">150/1074 (14%)</td><td headers="hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_9 hd_b_ch6.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">14.8%</td><td headers="hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_10 hd_b_ch6.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RD 1.21 (0.97 to 1.51)</td><td headers="hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_11 hd_b_ch6.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">31 more per 1000 (from 4 fewer to 75 more)</td><td headers="hd_h_ch6.appf.tab1_1_1_1_4 hd_b_ch6.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>MODERATE</p>
|
|
</td><td headers="hd_h_ch6.appf.tab1_1_1_1_5 hd_b_ch6.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_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_1 hd_h_ch6.appf.tab1_1_1_2_2 hd_h_ch6.appf.tab1_1_1_2_3 hd_h_ch6.appf.tab1_1_1_2_4 hd_h_ch6.appf.tab1_1_1_2_5 hd_h_ch6.appf.tab1_1_1_2_6 hd_h_ch6.appf.tab1_1_1_2_7 hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_8 hd_h_ch6.appf.tab1_1_1_2_9 hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_10 hd_h_ch6.appf.tab1_1_1_2_11 hd_h_ch6.appf.tab1_1_1_1_4 hd_h_ch6.appf.tab1_1_1_1_5" id="hd_b_ch6.appf.tab1_1_1_7_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">mRS at 0 to 2 at 7 days</th></tr><tr><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_1 hd_b_ch6.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_2 hd_b_ch6.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_3 hd_b_ch6.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>3</sup></td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_4 hd_b_ch6.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_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_5 hd_b_ch6.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_6 hd_b_ch6.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_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_7 hd_b_ch6.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_8 hd_b_ch6.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>49/88</p>
|
|
<p>(55.7%)</p>
|
|
</td><td headers="hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_9 hd_b_ch6.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">65.7%</td><td headers="hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_10 hd_b_ch6.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.82 (0.66 to 1.03)</td><td headers="hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_11 hd_b_ch6.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">118 fewer per 1000 (from 223 fewer to 20 more)</td><td headers="hd_h_ch6.appf.tab1_1_1_1_4 hd_b_ch6.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁⨁◯◯</p>
|
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<p>LOW</p>
|
|
</td><td headers="hd_h_ch6.appf.tab1_1_1_1_5 hd_b_ch6.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_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_1 hd_h_ch6.appf.tab1_1_1_2_2 hd_h_ch6.appf.tab1_1_1_2_3 hd_h_ch6.appf.tab1_1_1_2_4 hd_h_ch6.appf.tab1_1_1_2_5 hd_h_ch6.appf.tab1_1_1_2_6 hd_h_ch6.appf.tab1_1_1_2_7 hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_8 hd_h_ch6.appf.tab1_1_1_2_9 hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_10 hd_h_ch6.appf.tab1_1_1_2_11 hd_h_ch6.appf.tab1_1_1_1_4 hd_h_ch6.appf.tab1_1_1_1_5" id="hd_b_ch6.appf.tab1_1_1_9_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">mRS 0 to 2 at 90 days</th></tr><tr><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_1 hd_b_ch6.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_2 hd_b_ch6.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_3 hd_b_ch6.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious risk of bias</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_4 hd_b_ch6.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_5 hd_b_ch6.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_6 hd_b_ch6.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_7 hd_b_ch6.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_8 hd_b_ch6.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
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<p>565/1180</p>
|
|
<p>(47.9%)</p>
|
|
</td><td headers="hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_9 hd_b_ch6.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">43.8%</td><td headers="hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_10 hd_b_ch6.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.94 (0.86 to 1.01)</td><td headers="hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_11 hd_b_ch6.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">26 fewer per 1000 (from 61 fewer to 4 more)</td><td headers="hd_h_ch6.appf.tab1_1_1_1_4 hd_b_ch6.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁⨁⨁⨁</p>
|
|
<p>HIGH</p>
|
|
</td><td headers="hd_h_ch6.appf.tab1_1_1_1_5 hd_b_ch6.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_1 hd_h_ch6.appf.tab1_1_1_2_2 hd_h_ch6.appf.tab1_1_1_2_3 hd_h_ch6.appf.tab1_1_1_2_4 hd_h_ch6.appf.tab1_1_1_2_5 hd_h_ch6.appf.tab1_1_1_2_6 hd_h_ch6.appf.tab1_1_1_2_7 hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_8 hd_h_ch6.appf.tab1_1_1_2_9 hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_10 hd_h_ch6.appf.tab1_1_1_2_11 hd_h_ch6.appf.tab1_1_1_1_4 hd_h_ch6.appf.tab1_1_1_1_5" id="hd_b_ch6.appf.tab1_1_1_11_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">mRS 0 to 2 at 12 months</th></tr><tr><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_1 hd_b_ch6.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_2 hd_b_ch6.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_3 hd_b_ch6.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious risk of bias</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_4 hd_b_ch6.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>4</sup></td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_5 hd_b_ch6.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_6 hd_b_ch6.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_7 hd_b_ch6.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_8 hd_b_ch6.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
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<p>494/1074</p>
|
|
<p>(46%)</p>
|
|
</td><td headers="hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_9 hd_b_ch6.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">37.2%</td><td headers="hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_10 hd_b_ch6.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.93 (0.85 to 1.02)</td><td headers="hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_11 hd_b_ch6.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">26 fewer per 1000 (from 56 fewer to 7 more)</td><td headers="hd_h_ch6.appf.tab1_1_1_1_4 hd_b_ch6.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE</p>
|
|
</td><td headers="hd_h_ch6.appf.tab1_1_1_1_5 hd_b_ch6.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_1 hd_h_ch6.appf.tab1_1_1_2_2 hd_h_ch6.appf.tab1_1_1_2_3 hd_h_ch6.appf.tab1_1_1_2_4 hd_h_ch6.appf.tab1_1_1_2_5 hd_h_ch6.appf.tab1_1_1_2_6 hd_h_ch6.appf.tab1_1_1_2_7 hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_8 hd_h_ch6.appf.tab1_1_1_2_9 hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_10 hd_h_ch6.appf.tab1_1_1_2_11 hd_h_ch6.appf.tab1_1_1_1_4 hd_h_ch6.appf.tab1_1_1_1_5" id="hd_b_ch6.appf.tab1_1_1_13_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Recurrent stroke at 90 days</th></tr><tr><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_1 hd_b_ch6.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_2 hd_b_ch6.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_3 hd_b_ch6.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious risk of bias</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_4 hd_b_ch6.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_5 hd_b_ch6.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_6 hd_b_ch6.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>1</sup></td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_7 hd_b_ch6.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_8 hd_b_ch6.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>1/38</p>
|
|
<p>(2.6%)</p>
|
|
</td><td headers="hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_9 hd_b_ch6.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0%</td><td headers="hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_10 hd_b_ch6.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">OR 6.48 (0.13 to 329.67)</td><td headers="hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_11 hd_b_ch6.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">30 more per 1000 (from 50 fewer to 100 more)<sup>2</sup></td><td headers="hd_h_ch6.appf.tab1_1_1_1_4 hd_b_ch6.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
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<p>⨁⨁◯◯</p>
|
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<p>LOW</p>
|
|
</td><td headers="hd_h_ch6.appf.tab1_1_1_1_5 hd_b_ch6.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_1 hd_h_ch6.appf.tab1_1_1_2_2 hd_h_ch6.appf.tab1_1_1_2_3 hd_h_ch6.appf.tab1_1_1_2_4 hd_h_ch6.appf.tab1_1_1_2_5 hd_h_ch6.appf.tab1_1_1_2_6 hd_h_ch6.appf.tab1_1_1_2_7 hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_8 hd_h_ch6.appf.tab1_1_1_2_9 hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_10 hd_h_ch6.appf.tab1_1_1_2_11 hd_h_ch6.appf.tab1_1_1_1_4 hd_h_ch6.appf.tab1_1_1_1_5" id="hd_b_ch6.appf.tab1_1_1_15_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Neurological deterioration (worsening NIHSS >4 points) at 90 days</th></tr><tr><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_1 hd_b_ch6.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_2 hd_b_ch6.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_3 hd_b_ch6.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>3</sup></td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_4 hd_b_ch6.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_5 hd_b_ch6.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_6 hd_b_ch6.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>1</sup></td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_7 hd_b_ch6.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_8 hd_b_ch6.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>1/63</p>
|
|
<p>(1.6%)</p>
|
|
</td><td headers="hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_9 hd_b_ch6.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0%</td><td headers="hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_10 hd_b_ch6.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">OR 8.94 (0.17 to 457.29)</td><td headers="hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_11 hd_b_ch6.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">20 more per 1000 (from 30 fewer to 60 more)<sup>2</sup></td><td headers="hd_h_ch6.appf.tab1_1_1_1_4 hd_b_ch6.appf.tab1_1_1_15_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>
|
|
</td><td headers="hd_h_ch6.appf.tab1_1_1_1_5 hd_b_ch6.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_1 hd_h_ch6.appf.tab1_1_1_2_2 hd_h_ch6.appf.tab1_1_1_2_3 hd_h_ch6.appf.tab1_1_1_2_4 hd_h_ch6.appf.tab1_1_1_2_5 hd_h_ch6.appf.tab1_1_1_2_6 hd_h_ch6.appf.tab1_1_1_2_7 hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_8 hd_h_ch6.appf.tab1_1_1_2_9 hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_10 hd_h_ch6.appf.tab1_1_1_2_11 hd_h_ch6.appf.tab1_1_1_1_4 hd_h_ch6.appf.tab1_1_1_1_5" id="hd_b_ch6.appf.tab1_1_1_17_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Adverse events at 90 days</th></tr><tr><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_1 hd_b_ch6.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_2 hd_b_ch6.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_3 hd_b_ch6.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious risk of bias</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_4 hd_b_ch6.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_5 hd_b_ch6.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_6 hd_b_ch6.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_7 hd_b_ch6.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_8 hd_b_ch6.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>32/101</p>
|
|
<p>(31.7%)</p>
|
|
</td><td headers="hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_9 hd_b_ch6.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">47.6%</td><td headers="hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_10 hd_b_ch6.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.88 (0.72 to 1.08)</td><td headers="hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_11 hd_b_ch6.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">57 fewer per 1000 (from 133 fewer to 38 more)</td><td headers="hd_h_ch6.appf.tab1_1_1_1_4 hd_b_ch6.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
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<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE</p>
|
|
</td><td headers="hd_h_ch6.appf.tab1_1_1_1_5 hd_b_ch6.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_1 hd_h_ch6.appf.tab1_1_1_2_2 hd_h_ch6.appf.tab1_1_1_2_3 hd_h_ch6.appf.tab1_1_1_2_4 hd_h_ch6.appf.tab1_1_1_2_5 hd_h_ch6.appf.tab1_1_1_2_6 hd_h_ch6.appf.tab1_1_1_2_7 hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_8 hd_h_ch6.appf.tab1_1_1_2_9 hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_10 hd_h_ch6.appf.tab1_1_1_2_11 hd_h_ch6.appf.tab1_1_1_1_4 hd_h_ch6.appf.tab1_1_1_1_5" id="hd_b_ch6.appf.tab1_1_1_19_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Barthel index at discharge (Better indicated by higher values)</th></tr><tr><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_1 hd_b_ch6.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_2 hd_b_ch6.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_3 hd_b_ch6.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>3</sup></td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_4 hd_b_ch6.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_5 hd_b_ch6.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_6 hd_b_ch6.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_7 hd_b_ch6.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_8 hd_b_ch6.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">40</td><td headers="hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_9 hd_b_ch6.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">50</td><td headers="hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_10 hd_b_ch6.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_11 hd_b_ch6.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">MD 8 higher (1.61 to 14.39 higher)</td><td headers="hd_h_ch6.appf.tab1_1_1_1_4 hd_b_ch6.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE</p>
|
|
</td><td headers="hd_h_ch6.appf.tab1_1_1_1_5 hd_b_ch6.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_1 hd_h_ch6.appf.tab1_1_1_2_2 hd_h_ch6.appf.tab1_1_1_2_3 hd_h_ch6.appf.tab1_1_1_2_4 hd_h_ch6.appf.tab1_1_1_2_5 hd_h_ch6.appf.tab1_1_1_2_6 hd_h_ch6.appf.tab1_1_1_2_7 hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_8 hd_h_ch6.appf.tab1_1_1_2_9 hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_10 hd_h_ch6.appf.tab1_1_1_2_11 hd_h_ch6.appf.tab1_1_1_1_4 hd_h_ch6.appf.tab1_1_1_1_5" id="hd_b_ch6.appf.tab1_1_1_21_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Barthel index at 90 days (Better indicated by higher values)</th></tr><tr><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_1 hd_b_ch6.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_2 hd_b_ch6.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_3 hd_b_ch6.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>3</sup></td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_4 hd_b_ch6.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_5 hd_b_ch6.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_6 hd_b_ch6.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_7 hd_b_ch6.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_8 hd_b_ch6.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">40</td><td headers="hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_9 hd_b_ch6.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">40</td><td headers="hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_10 hd_b_ch6.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_11 hd_b_ch6.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">MD 13.12 higher (8.37 to 17.87 higher)</td><td headers="hd_h_ch6.appf.tab1_1_1_1_4 hd_b_ch6.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE</p>
|
|
</td><td headers="hd_h_ch6.appf.tab1_1_1_1_5 hd_b_ch6.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_1 hd_h_ch6.appf.tab1_1_1_2_2 hd_h_ch6.appf.tab1_1_1_2_3 hd_h_ch6.appf.tab1_1_1_2_4 hd_h_ch6.appf.tab1_1_1_2_5 hd_h_ch6.appf.tab1_1_1_2_6 hd_h_ch6.appf.tab1_1_1_2_7 hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_8 hd_h_ch6.appf.tab1_1_1_2_9 hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_10 hd_h_ch6.appf.tab1_1_1_2_11 hd_h_ch6.appf.tab1_1_1_1_4 hd_h_ch6.appf.tab1_1_1_1_5" id="hd_b_ch6.appf.tab1_1_1_23_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Length of hospital stay (Better indicated by lower values)</th></tr><tr><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_1 hd_b_ch6.appf.tab1_1_1_23_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_2 hd_b_ch6.appf.tab1_1_1_23_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_3 hd_b_ch6.appf.tab1_1_1_23_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>3</sup></td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_4 hd_b_ch6.appf.tab1_1_1_23_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_5 hd_b_ch6.appf.tab1_1_1_23_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_6 hd_b_ch6.appf.tab1_1_1_23_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_7 hd_b_ch6.appf.tab1_1_1_23_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_8 hd_b_ch6.appf.tab1_1_1_23_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">58</td><td headers="hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_9 hd_b_ch6.appf.tab1_1_1_23_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">66</td><td headers="hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_10 hd_b_ch6.appf.tab1_1_1_23_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_11 hd_b_ch6.appf.tab1_1_1_23_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">MD 0.75 lower (2.68 lower to 1.18 higher)</td><td headers="hd_h_ch6.appf.tab1_1_1_1_4 hd_b_ch6.appf.tab1_1_1_23_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁⨁◯◯</p>
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<p>LOW</p>
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</td><td headers="hd_h_ch6.appf.tab1_1_1_1_5 hd_b_ch6.appf.tab1_1_1_23_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</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="ch6.appf.tab1_1"><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>2</dt><dd><div id="ch6.appf.tab1_2"><p class="no_margin">Calculated from risk difference</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="ch6.appf.tab1_3"><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>4</dt><dd><div id="ch6.appf.tab1_4"><p class="no_margin">Heterogeneity, I2=55%, unexplained by subgroup analysis because only 2 studies were in the analysis</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch6appftab2"><div id="ch6.appf.tab2" class="table"><h3><span class="label">Table 13</span><span class="title">Clinical evidence profile: early mobilisation versus usual care</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577867/table/ch6.appf.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.appf.tab2_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch6.appf.tab2_1_1_1_1" colspan="7" rowspan="1" style="text-align:center;vertical-align:middle;">Quality assessment</th><th id="hd_h_ch6.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_ch6.appf.tab2_1_1_1_3" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">Effect</th><th id="hd_h_ch6.appf.tab2_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch6.appf.tab2_1_1_1_4" style="text-align:center;vertical-align:middle;">Quality</th><th id="hd_h_ch6.appf.tab2_1_1_1_5" rowspan="2" colspan="1" headers="hd_h_ch6.appf.tab2_1_1_1_5" style="text-align:center;vertical-align:middle;">Importance</th></tr><tr><th headers="hd_h_ch6.appf.tab2_1_1_1_1" id="hd_h_ch6.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_ch6.appf.tab2_1_1_1_1" id="hd_h_ch6.appf.tab2_1_1_2_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Design</th><th headers="hd_h_ch6.appf.tab2_1_1_1_1" id="hd_h_ch6.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_ch6.appf.tab2_1_1_1_1" id="hd_h_ch6.appf.tab2_1_1_2_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Inconsistency</th><th headers="hd_h_ch6.appf.tab2_1_1_1_1" id="hd_h_ch6.appf.tab2_1_1_2_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Indirectness</th><th headers="hd_h_ch6.appf.tab2_1_1_1_1" id="hd_h_ch6.appf.tab2_1_1_2_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Imprecision</th><th headers="hd_h_ch6.appf.tab2_1_1_1_1" id="hd_h_ch6.appf.tab2_1_1_2_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Other considerations</th><th headers="hd_h_ch6.appf.tab2_1_1_1_2" id="hd_h_ch6.appf.tab2_1_1_2_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Early mobilisation</th><th headers="hd_h_ch6.appf.tab2_1_1_1_2" id="hd_h_ch6.appf.tab2_1_1_2_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Standard care</th><th headers="hd_h_ch6.appf.tab2_1_1_1_3" id="hd_h_ch6.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_ch6.appf.tab2_1_1_1_3" id="hd_h_ch6.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_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_1 hd_h_ch6.appf.tab2_1_1_2_2 hd_h_ch6.appf.tab2_1_1_2_3 hd_h_ch6.appf.tab2_1_1_2_4 hd_h_ch6.appf.tab2_1_1_2_5 hd_h_ch6.appf.tab2_1_1_2_6 hd_h_ch6.appf.tab2_1_1_2_7 hd_h_ch6.appf.tab2_1_1_1_2 hd_h_ch6.appf.tab2_1_1_2_8 hd_h_ch6.appf.tab2_1_1_2_9 hd_h_ch6.appf.tab2_1_1_1_3 hd_h_ch6.appf.tab2_1_1_2_10 hd_h_ch6.appf.tab2_1_1_2_11 hd_h_ch6.appf.tab2_1_1_1_4 hd_h_ch6.appf.tab2_1_1_1_5" id="hd_b_ch6.appf.tab2_1_1_1_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Mortality at 90 days</th></tr><tr><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_1 hd_b_ch6.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_2 hd_b_ch6.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_3 hd_b_ch6.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_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_4 hd_b_ch6.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_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_5 hd_b_ch6.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_6 hd_b_ch6.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_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_7 hd_b_ch6.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch6.appf.tab2_1_1_1_2 hd_h_ch6.appf.tab2_1_1_2_8 hd_b_ch6.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>2/41</p>
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<p>(4.9%)</p>
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</td><td headers="hd_h_ch6.appf.tab2_1_1_1_2 hd_h_ch6.appf.tab2_1_1_2_9 hd_b_ch6.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">8.8%</td><td headers="hd_h_ch6.appf.tab2_1_1_1_3 hd_h_ch6.appf.tab2_1_1_2_10 hd_b_ch6.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.67 (0.15 to 2.98)</td><td headers="hd_h_ch6.appf.tab2_1_1_1_3 hd_h_ch6.appf.tab2_1_1_2_11 hd_b_ch6.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">29 fewer per 1000 (from 75 fewer to 174 more)</td><td headers="hd_h_ch6.appf.tab2_1_1_1_4 hd_b_ch6.appf.tab2_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_ch6.appf.tab2_1_1_1_5 hd_b_ch6.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_1 hd_h_ch6.appf.tab2_1_1_2_2 hd_h_ch6.appf.tab2_1_1_2_3 hd_h_ch6.appf.tab2_1_1_2_4 hd_h_ch6.appf.tab2_1_1_2_5 hd_h_ch6.appf.tab2_1_1_2_6 hd_h_ch6.appf.tab2_1_1_2_7 hd_h_ch6.appf.tab2_1_1_1_2 hd_h_ch6.appf.tab2_1_1_2_8 hd_h_ch6.appf.tab2_1_1_2_9 hd_h_ch6.appf.tab2_1_1_1_3 hd_h_ch6.appf.tab2_1_1_2_10 hd_h_ch6.appf.tab2_1_1_2_11 hd_h_ch6.appf.tab2_1_1_1_4 hd_h_ch6.appf.tab2_1_1_1_5" id="hd_b_ch6.appf.tab2_1_1_3_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">mRS 0 to 2 at 90 days</th></tr><tr><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_1 hd_b_ch6.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_2 hd_b_ch6.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_3 hd_b_ch6.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_4 hd_b_ch6.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_5 hd_b_ch6.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_6 hd_b_ch6.appf.tab2_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_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_7 hd_b_ch6.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch6.appf.tab2_1_1_1_2 hd_h_ch6.appf.tab2_1_1_2_8 hd_b_ch6.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>18/41</p>
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<p>(43.9%)</p>
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</td><td headers="hd_h_ch6.appf.tab2_1_1_1_2 hd_h_ch6.appf.tab2_1_1_2_9 hd_b_ch6.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">44.1%</td><td headers="hd_h_ch6.appf.tab2_1_1_1_3 hd_h_ch6.appf.tab2_1_1_2_10 hd_b_ch6.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 1.03 (0.61 to 1.72)</td><td headers="hd_h_ch6.appf.tab2_1_1_1_3 hd_h_ch6.appf.tab2_1_1_2_11 hd_b_ch6.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">13 more per 1000 (from 172 fewer to 318 more)</td><td headers="hd_h_ch6.appf.tab2_1_1_1_4 hd_b_ch6.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW</p>
|
|
</td><td headers="hd_h_ch6.appf.tab2_1_1_1_5 hd_b_ch6.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_1 hd_h_ch6.appf.tab2_1_1_2_2 hd_h_ch6.appf.tab2_1_1_2_3 hd_h_ch6.appf.tab2_1_1_2_4 hd_h_ch6.appf.tab2_1_1_2_5 hd_h_ch6.appf.tab2_1_1_2_6 hd_h_ch6.appf.tab2_1_1_2_7 hd_h_ch6.appf.tab2_1_1_1_2 hd_h_ch6.appf.tab2_1_1_2_8 hd_h_ch6.appf.tab2_1_1_2_9 hd_h_ch6.appf.tab2_1_1_1_3 hd_h_ch6.appf.tab2_1_1_2_10 hd_h_ch6.appf.tab2_1_1_2_11 hd_h_ch6.appf.tab2_1_1_1_4 hd_h_ch6.appf.tab2_1_1_1_5" id="hd_b_ch6.appf.tab2_1_1_5_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Neurological deterioration (worsening NIHSS >4 points) at 90 days</th></tr><tr><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_1 hd_b_ch6.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_2 hd_b_ch6.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_3 hd_b_ch6.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>1</sup></td><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_4 hd_b_ch6.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_5 hd_b_ch6.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_6 hd_b_ch6.appf.tab2_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_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_7 hd_b_ch6.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch6.appf.tab2_1_1_1_2 hd_h_ch6.appf.tab2_1_1_2_8 hd_b_ch6.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>2/41</p>
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|
<p>(4.9%)</p>
|
|
</td><td headers="hd_h_ch6.appf.tab2_1_1_1_2 hd_h_ch6.appf.tab2_1_1_2_9 hd_b_ch6.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">5.9%</td><td headers="hd_h_ch6.appf.tab2_1_1_1_3 hd_h_ch6.appf.tab2_1_1_2_10 hd_b_ch6.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RD 0 (−0.14 to 0.09)</td><td headers="hd_h_ch6.appf.tab2_1_1_1_3 hd_h_ch6.appf.tab2_1_1_2_11 hd_b_ch6.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">21 fewer per 1000 (from 140 fewer to 90 more)<sup>3</sup></td><td headers="hd_h_ch6.appf.tab2_1_1_1_4 hd_b_ch6.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW</p>
|
|
</td><td headers="hd_h_ch6.appf.tab2_1_1_1_5 hd_b_ch6.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_1 hd_h_ch6.appf.tab2_1_1_2_2 hd_h_ch6.appf.tab2_1_1_2_3 hd_h_ch6.appf.tab2_1_1_2_4 hd_h_ch6.appf.tab2_1_1_2_5 hd_h_ch6.appf.tab2_1_1_2_6 hd_h_ch6.appf.tab2_1_1_2_7 hd_h_ch6.appf.tab2_1_1_1_2 hd_h_ch6.appf.tab2_1_1_2_8 hd_h_ch6.appf.tab2_1_1_2_9 hd_h_ch6.appf.tab2_1_1_1_3 hd_h_ch6.appf.tab2_1_1_2_10 hd_h_ch6.appf.tab2_1_1_2_11 hd_h_ch6.appf.tab2_1_1_1_4 hd_h_ch6.appf.tab2_1_1_1_5" id="hd_b_ch6.appf.tab2_1_1_7_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Adverse events at 90 days</th></tr><tr><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_1 hd_b_ch6.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_2 hd_b_ch6.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_3 hd_b_ch6.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>1</sup></td><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_4 hd_b_ch6.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>4</sup></td><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_5 hd_b_ch6.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_6 hd_b_ch6.appf.tab2_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_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_7 hd_b_ch6.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch6.appf.tab2_1_1_1_2 hd_h_ch6.appf.tab2_1_1_2_8 hd_b_ch6.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>5/41</p>
|
|
<p>(12.2%)</p>
|
|
</td><td headers="hd_h_ch6.appf.tab2_1_1_1_2 hd_h_ch6.appf.tab2_1_1_2_9 hd_b_ch6.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">23.5%</td><td headers="hd_h_ch6.appf.tab2_1_1_1_3 hd_h_ch6.appf.tab2_1_1_2_10 hd_b_ch6.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.58 (0.09 to 3.92)</td><td headers="hd_h_ch6.appf.tab2_1_1_1_3 hd_h_ch6.appf.tab2_1_1_2_11 hd_b_ch6.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">99 fewer per 1000 (from 214 fewer to 686 more)</td><td headers="hd_h_ch6.appf.tab2_1_1_1_4 hd_b_ch6.appf.tab2_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_ch6.appf.tab2_1_1_1_5 hd_b_ch6.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_1 hd_h_ch6.appf.tab2_1_1_2_2 hd_h_ch6.appf.tab2_1_1_2_3 hd_h_ch6.appf.tab2_1_1_2_4 hd_h_ch6.appf.tab2_1_1_2_5 hd_h_ch6.appf.tab2_1_1_2_6 hd_h_ch6.appf.tab2_1_1_2_7 hd_h_ch6.appf.tab2_1_1_1_2 hd_h_ch6.appf.tab2_1_1_2_8 hd_h_ch6.appf.tab2_1_1_2_9 hd_h_ch6.appf.tab2_1_1_1_3 hd_h_ch6.appf.tab2_1_1_2_10 hd_h_ch6.appf.tab2_1_1_2_11 hd_h_ch6.appf.tab2_1_1_1_4 hd_h_ch6.appf.tab2_1_1_1_5" id="hd_b_ch6.appf.tab2_1_1_9_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Length of hospital stay (Better indicated by lower values)</th></tr><tr><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_1 hd_b_ch6.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_2 hd_b_ch6.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_3 hd_b_ch6.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>1</sup></td><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_4 hd_b_ch6.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_5 hd_b_ch6.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_6 hd_b_ch6.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>2</sup></td><td headers="hd_h_ch6.appf.tab2_1_1_1_1 hd_h_ch6.appf.tab2_1_1_2_7 hd_b_ch6.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch6.appf.tab2_1_1_1_2 hd_h_ch6.appf.tab2_1_1_2_8 hd_b_ch6.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">25</td><td headers="hd_h_ch6.appf.tab2_1_1_1_2 hd_h_ch6.appf.tab2_1_1_2_9 hd_b_ch6.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">17</td><td headers="hd_h_ch6.appf.tab2_1_1_1_3 hd_h_ch6.appf.tab2_1_1_2_10 hd_b_ch6.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch6.appf.tab2_1_1_1_3 hd_h_ch6.appf.tab2_1_1_2_11 hd_b_ch6.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">MD 2 higher (1.47 lower to 5.47 higher)</td><td headers="hd_h_ch6.appf.tab2_1_1_1_4 hd_b_ch6.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
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<p>⨁◯◯◯</p>
|
|
<p>VERY LOW</p>
|
|
</td><td headers="hd_h_ch6.appf.tab2_1_1_1_5 hd_b_ch6.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</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="ch6.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="ch6.appf.tab2_2"><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>3</dt><dd><div id="ch6.appf.tab2_3"><p class="no_margin">Calculated from risk difference</p></div></dd></dl><dl class="bkr_refwrap"><dt>4</dt><dd><div id="ch6.appf.tab2_4"><p class="no_margin">Heterogeneity, I2=66%, unexplained by subgroup analysis because only 2 studies were in the analysis</p></div></dd></dl></dl></div></div></div></article><article data-type="fig" id="figobch6appgfig1"><div id="ch6.appg.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2020.%20Flow%20chart%20of%20health%20economic%20study%20selection%20for%20the%20guideline.&p=BOOKS&id=577867_ch6appgf1.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/NBK577867/bin/ch6appgf1.jpg" alt="Figure 20. 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 20</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="figobch6appitab1"><div id="ch6.appi.tab1" class="table"><h3><span class="label">Table 14</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/NBK577867/table/ch6.appi.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.appi.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_ch6.appi.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_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ada 2009<a class="bibr" href="#ch6.ref1" rid="ch6.ref1"><sup>1</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract: unavailable</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ada 2010<a class="bibr" href="#ch6.ref2" rid="ch6.ref2"><sup>2</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ada 2010<a class="bibr" href="#ch6.ref3" rid="ch6.ref3"><sup>3</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adeolu 2012<a class="bibr" href="#ch6.ref4" rid="ch6.ref4"><sup>4</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Aries 2012<a class="bibr" href="#ch6.ref5" rid="ch6.ref5"><sup>5</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect study design</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Armstrong 2012<a class="bibr" href="#ch6.ref6" rid="ch6.ref6"><sup>6</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Arnold 2015<a class="bibr" href="#ch6.ref7" rid="ch6.ref7"><sup>7</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect study design</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Asberg 1989<a class="bibr" href="#ch6.ref8" rid="ch6.ref8"><sup>8</sup></a></td><td headers="hd_h_ch6.appi.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_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Awad 2016<a class="bibr" href="#ch6.ref9" rid="ch6.ref9"><sup>9</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Commentary</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bagley 2005<a class="bibr" href="#ch6.ref10" rid="ch6.ref10"><sup>10</sup></a></td><td headers="hd_h_ch6.appi.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_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Baltz 2013<a class="bibr" href="#ch6.ref11" rid="ch6.ref11"><sup>11</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect study design</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bayley 2017<a class="bibr" href="#ch6.ref12" rid="ch6.ref12"><sup>12</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Narrative review</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bernhardt 2016<a class="bibr" href="#ch6.ref13" rid="ch6.ref13"><sup>13</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bernhardt 2007<a class="bibr" href="#ch6.ref20" rid="ch6.ref20"><sup>20</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract: unavailable</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bernhardt 2008<a class="bibr" href="#ch6.ref21" rid="ch6.ref21"><sup>21</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">HE study</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bernhardt 2011<a class="bibr" href="#ch6.ref19" rid="ch6.ref19"><sup>19</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bernhardt 2015<a class="bibr" href="#ch6.ref16" rid="ch6.ref16"><sup>16</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Commentary</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bernhardt 2015<a class="bibr" href="#ch6.ref14" rid="ch6.ref14"><sup>14</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract: unavailable</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Braun 2016<a class="bibr" href="#ch6.ref26" rid="ch6.ref26"><sup>26</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Brauser 2015<a class="bibr" href="#ch6.ref27" rid="ch6.ref27"><sup>27</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Commentary</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Britton 2008<a class="bibr" href="#ch6.ref28" rid="ch6.ref28"><sup>28</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cabanas-Valdés 2016<a class="bibr" href="#ch6.ref29" rid="ch6.ref29"><sup>29</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Collier 2007<a class="bibr" href="#ch6.ref32" rid="ch6.ref32"><sup>32</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract: unavailable</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Collier 2008<a class="bibr" href="#ch6.ref33" rid="ch6.ref33"><sup>33</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract: unavailable</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Craig 2010<a class="bibr" href="#ch6.ref34" rid="ch6.ref34"><sup>34</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">IPD of only 2 RCTs</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cuesy 2010<a class="bibr" href="#ch6.ref35" rid="ch6.ref35"><sup>35</sup></a></td><td headers="hd_h_ch6.appi.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_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cumming 2011<a class="bibr" href="#ch6.ref37" rid="ch6.ref37"><sup>37</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No outcomes of interest</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dagonnier 2013<a class="bibr" href="#ch6.ref38" rid="ch6.ref38"><sup>38</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract: unavailable</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dean 2007<a class="bibr" href="#ch6.ref41" rid="ch6.ref41"><sup>41</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dean 2009<a class="bibr" href="#ch6.ref40" rid="ch6.ref40"><sup>40</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract: unavailable</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dean 2010<a class="bibr" href="#ch6.ref39" rid="ch6.ref39"><sup>39</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Diserens 2010<a class="bibr" href="#ch6.ref43" rid="ch6.ref43"><sup>43</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract: unavailable</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Forster 2015<a class="bibr" href="#ch6.ref44" rid="ch6.ref44"><sup>44</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Narrative review</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Fuest 2018<a class="bibr" href="#ch6.ref45" rid="ch6.ref45"><sup>45</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Narrative review</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hargroves 2008<a class="bibr" href="#ch6.ref46" rid="ch6.ref46"><sup>46</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect study design</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hokstad 2016<a class="bibr" href="#ch6.ref48" rid="ch6.ref48"><sup>48</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect study design</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hunter 2011<a class="bibr" href="#ch6.ref49" rid="ch6.ref49"><sup>49</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Indredavik 1999<a class="bibr" href="#ch6.ref50" rid="ch6.ref50"><sup>50</sup></a></td><td headers="hd_h_ch6.appi.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_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Karic 2016<a class="bibr" href="#ch6.ref51" rid="ch6.ref51"><sup>51</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect study design</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Karic 2017<a class="bibr" href="#ch6.ref52" rid="ch6.ref52"><sup>52</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect study design</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Keating 2012<a class="bibr" href="#ch6.ref53" rid="ch6.ref53"><sup>53</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Narrative review</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Kosak 1998<a class="bibr" href="#ch6.ref54" rid="ch6.ref54"><sup>54</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Kosak 2000<a class="bibr" href="#ch6.ref55" rid="ch6.ref55"><sup>55</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Kurabe 2010<a class="bibr" href="#ch6.ref56" rid="ch6.ref56"><sup>56</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect study design</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Li 2018<a class="bibr" href="#ch6.ref59" rid="ch6.ref59"><sup>59</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review: quality assessment is inadequate</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Liu 2014<a class="bibr" href="#ch6.ref60" rid="ch6.ref60"><sup>60</sup></a></td><td headers="hd_h_ch6.appi.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_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lynch 2016<a class="bibr" href="#ch6.ref61" rid="ch6.ref61"><sup>61</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract: unavailable</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lynch 2017<a class="bibr" href="#ch6.ref62" rid="ch6.ref62"><sup>62</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Commentary</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ma 2013<a class="bibr" href="#ch6.ref63" rid="ch6.ref63"><sup>63</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review: quality assessment is inadequate</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Morreale 2016<a class="bibr" href="#ch6.ref64" rid="ch6.ref64"><sup>64</sup></a></td><td headers="hd_h_ch6.appi.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_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Muhl 2013<a class="bibr" href="#ch6.ref65" rid="ch6.ref65"><sup>65</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Muhl 2014<a class="bibr" href="#ch6.ref66" rid="ch6.ref66"><sup>66</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract: unavailable</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Muhl 2014<a class="bibr" href="#ch6.ref67" rid="ch6.ref67"><sup>67</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect study design</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Olkowski 2013<a class="bibr" href="#ch6.ref70" rid="ch6.ref70"><sup>70</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect study design</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Olkowski 2015<a class="bibr" href="#ch6.ref69" rid="ch6.ref69"><sup>69</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect study design</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pollock 2014<a class="bibr" href="#ch6.ref73" rid="ch6.ref73"><sup>73</sup></a></td><td headers="hd_h_ch6.appi.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_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Rocca 2016<a class="bibr" href="#ch6.ref74" rid="ch6.ref74"><sup>74</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ronning 2009<a class="bibr" href="#ch6.ref75" rid="ch6.ref75"><sup>75</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Clinical trial webpage only</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sankara Kumaran 2013<a class="bibr" href="#ch6.ref76" rid="ch6.ref76"><sup>76</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect study design</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Silva 2013<a class="bibr" href="#ch6.ref77" rid="ch6.ref77"><sup>77</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Foreign language, Portuguese</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sorbello 2007<a class="bibr" href="#ch6.ref78" rid="ch6.ref78"><sup>78</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract: unavailable</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Stokelj 2010<a class="bibr" href="#ch6.ref80" rid="ch6.ref80"><sup>80</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review: quality assessment is inadequate</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sundseth 2008<a class="bibr" href="#ch6.ref81" rid="ch6.ref81"><sup>81</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract: unavailable</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sundseth 2012<a class="bibr" href="#ch6.ref82" rid="ch6.ref82"><sup>82</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract: unavailable</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Tay-teo 2008<a class="bibr" href="#ch6.ref85" rid="ch6.ref85"><sup>85</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No outcomes of interest</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Wijk 2009<a class="bibr" href="#ch6.ref88" rid="ch6.ref88"><sup>88</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract: unavailable</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Wijk 2012<a class="bibr" href="#ch6.ref87" rid="ch6.ref87"><sup>87</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No outcomes of interest</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Xu 2017<a class="bibr" href="#ch6.ref89" rid="ch6.ref89"><sup>89</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review: quality assessment is inadequate</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Zeng 2007<a class="bibr" href="#ch6.ref90" rid="ch6.ref90"><sup>90</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Clinical trial webpage only</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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