Transcranial doppler re-screening of subjects who participated in STOP and STOP II.
Transcranial doppler re-screening of subjects who participated in STOP and STOP II.
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经常参与Stop and Stop II的受试者的经颅多普勒重新筛选。
DOI：
10.1002/ajh.24551
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发表时间：
2016-12
影响因子：
12.8
通讯作者：
Kwiatkowski, Janet L.
中科院分区：
文献类型：
--
作者：
Adams, Robert J.;Lackland, Dan T.;Brown, Lynette;Brown, David;Voeks, Jenifer;Fullerton, Heather J.;Kanter, Julie;Kwiatkowski, Janet L.
在患有镰状细胞病的儿童中，经颅多普勒超声（TCD）和选择性慢性红细胞输注（CRCT-STOP方案）的风险分层相结合是医学上最有效的卒中预防策略之一。目前尚不清楚该计划的执行情况。进行两项关键临床试验（STOP和STOP II）的26家研究中心中有19家参与了STOP后，这是一项全面的病历审查，评估自试验结束后10-15年内的方案实施情况。专业摘要确定了2851 74%的3840名儿童谁参加了STOP和/或STOP II的STOP后时代的医疗记录，并记录TCD重新筛选，CRCT的风险，和中风的维护。在1896名有资格接受TCD再筛查的儿童（目标组）中，1090名（57%）儿童有再筛查的证据。TCD重新筛选的合格儿童的比例从18%到91%不等。年龄较小和STOP/II期间有条件性TCD与STOP后TCD的可能性较高相关。确定了68例新的异常高风险病例。尽管有明确的获益证据，但即使在有经验的研究中心，STOP方案也没有得到充分实施。研究中心的变化表明，系统的改进可能会消除实施的障碍，并导致更大的减少缺血性卒中的儿童SCD。
In children with Sickle Cell Disease, the combination of risk stratification with Transcranial Doppler Ultrasound (TCD) and selective chronic red cell transfusion (CRCT—the STOP Protocol) is one of the most effective stroke prevention strategies in medicine. How fully it is being implemented is unclear. Nineteen of 26 sites that conducted the two pivotal clinical trials (STOP and STOP II) participated in Post STOP, a comprehensive medical records review assessing protocol implementation in the 10-15 years since the trials ended. Professional abstractors identified medical records in the Post STOP era in 2851 74% of the 3840 children who took part in STOP and/or STOP II, and documented TCD rescreening, maintenance of CRCT in those at risk, and stroke. Among 1896 children eligible for TCD rescreening (target group), evidence of any rescreening was found in 1090 (57%). There was wide site variation in TCD rescreening ranging from 18% to 91% of eligible children. Both younger age and having a conditional TCD during STOP/II were associated with a higher likelihood of having a TCD in Post STOP. Sixty eight new abnormal, high risk cases were identified. Despite clear evidence of benefit the STOP protocol is not fully implemented even at experienced sites. Site variation suggests that system improvements might remove barriers to implementation and result in even greater reduction of ischemic stroke in children with SCD.
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影响因子：
3.2
作者：
Raphael, Jean L.;Shetty, Priya B.;Mueller, Brigitta U.
通讯作者：
Mueller, Brigitta U.
影响因子：
26.1
作者：
Lehman, Laura L.;Fullerton, Heather J.
通讯作者：
Fullerton, Heather J.
影响因子：
3.2
作者：
Eckrich, Michael J.;Wang, Winfred C.;Cooper, William O.
通讯作者：
Cooper, William O.
影响因子：
3.2
作者：
McCarville, M. Beth;Goodin, Geoffrey S.;Wang, Winfred
通讯作者：
Wang, Winfred
DOI：
10.1016/s0140-6736(15)01041-7
发表时间：
2016-02-13
期刊：
Lancet (London, England)
影响因子：
--
作者：
Ware RE;Davis BR;Schultz WH;Brown RC;Aygun B;Sarnaik S;Odame I;Fuh B;George A;Owen W;Luchtman-Jones L;Rogers ZR;Hilliard L;Gauger C;Piccone C;Lee MT;Kwiatkowski JL;Jackson S;Miller ST;Roberts C;Heeney MM;Kalfa TA;Nelson S;Imran H;Nottage K;Alvarez O;Rhodes M;Thompson AA;Rothman JA;Helton KJ;Roberts D;Coleman J;Bonner MJ;Kutlar A;Patel N;Wood J;Piller L;Wei P;Luden J;Mortier NA;Stuber SE;Luban NLC;Cohen AR;Pressel S;Adams RJ
通讯作者：
Adams RJ