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Building a European 'network of networks' for stroke clinical research - The European Stroke Organisation Trials Alliance (ESOTA).

ABSTRACT: Promoting research to improve stroke prevention, acute care, and recovery is a key mission of the European Stroke Organisation (ESO). Stroke research networks may increase efficiencies and reduce waste in randomised clinical trials of stroke treatments. Several European countries have established national or regional stroke research networks, or have informal groups or stroke registers which may serve as a foundation for establishing a research network. To increase international collaboration on randomised trials for stroke in Europe, the ESO Trials Network Committee is leading the development of an alliance of national networks, the ESO Trials Alliance (ESOTA). Following initial consultation work in 2017, this paper describes an overview of progress to date in the first year of ESOTA activity. Beginning with five founding networks in England, Ireland, Netherlands, Spain, and Switzerland, ESOTA aims to gradually grow, ultimately including several hundred stroke centres and affiliated investigators working collectively on randomised trials of new stroke treatments.

SUBMITTER: Kelly P

PROVIDER: S-EPMC6960687 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Building a European 'network of networks' for stroke clinical research - The European Stroke Organisation Trials Alliance (ESOTA).

Kelly Peter P Salman Rustam A RA Arsovska Anita A Dippel Diederik Wj DW Fischer Urs U Ford Gary A GA Fuentes Blanca B Lemmens Robin R Marshall John C JC Nederkoorn Paul J PJ Robinson Thompson T Weimar Christian C Berge Eivind E

European stroke journal 20190507 3

Promoting research to improve stroke prevention, acute care, and recovery is a key mission of the European Stroke Organisation (ESO). Stroke research networks may increase efficiencies and reduce waste in randomised clinical trials of stroke treatments. Several European countries have established national or regional stroke research networks, or have informal groups or stroke registers which may serve as a foundation for establishing a research network. To increase international collaboration on ...[more]

PMID: 31984229

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Project description:The optimal management of post-stroke cognitive impairment remains controversial. These joint European Stroke Organisation (ESO) and European Academy of Neurology (EAN) guidelines provide evidence-based recommendations to assist clinicians in decision making around prevention, diagnosis, treatment and prognosis. These guidelines were developed according to ESO standard operating procedure and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. The working group identified relevant clinical questions, performed systematic reviews and, where possible, meta-analyses of the literature, assessed the quality of the available evidence and made specific recommendations. Expert consensus statements were provided where insufficient evidence was available to provide recommendations based on the GRADE approach. There was limited randomised controlled trial evidence regarding single or multicomponent interventions to prevent post-stroke cognitive decline. Interventions to improve lifestyle and treat vascular risk factors may have many health benefits but a beneficial effect on cognition is not proven. We found no evidence around routine cognitive screening following stroke but recognise the importance of targeted cognitive assessment. We described the accuracy of various cognitive screening tests but found no clearly superior approach to testing. There was insufficient evidence to make a recommendation for use of cholinesterase inhibitors, memantine nootropics or cognitive rehabilitation. There was limited evidence on the use of prediction tools for post-stroke cognitive syndromes (cognitive impairment, dementia and delirium). The association between post-stroke cognitive impairment and most acute structural brain imaging features was unclear, although the presence of substantial white matter hyperintensities of presumed vascular origin on acute MRI brain may help predict cognitive outcomes. These guidelines have highlighted fundamental areas where robust evidence is lacking. Further, definitive randomised controlled trials are needed, and we suggest priority areas for future research.

Dataset Information

Building a European 'network of networks' for stroke clinical research - The European Stroke Organisation Trials Alliance (ESOTA).

Publications

Building a European 'network of networks' for stroke clinical research - The European Stroke Organisation Trials Alliance (ESOTA).

Similar Datasets

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