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Adapting to Evolving Technologies and Treatment Guidelines in a Procedural Trial: A Qualitative Review of the CREST-2 Experience.
Meschia, James F; Lal, Brajesh; Roubin, Gary; Turan, Tanya N; Howard, Virginia J; Benson, Richard T; Carman, Kaley; Howard, George; Brott, Thomas G.
Affiliation
  • Meschia JF; From the Mayo Clinic (J.F.M., K.C., T.G.B.), Jacksonville, FL; University of Maryland School of Medicine (B.L.), Baltimore; CREST-2 Executive Committee (G.R.), Jackson, WY; Medical University of South Carolina (T.N.T.), Charleston; University of Alabama at Birmingham (V.J.H., G.H.); and National Ins
  • Lal B; From the Mayo Clinic (J.F.M., K.C., T.G.B.), Jacksonville, FL; University of Maryland School of Medicine (B.L.), Baltimore; CREST-2 Executive Committee (G.R.), Jackson, WY; Medical University of South Carolina (T.N.T.), Charleston; University of Alabama at Birmingham (V.J.H., G.H.); and National Ins
  • Roubin G; From the Mayo Clinic (J.F.M., K.C., T.G.B.), Jacksonville, FL; University of Maryland School of Medicine (B.L.), Baltimore; CREST-2 Executive Committee (G.R.), Jackson, WY; Medical University of South Carolina (T.N.T.), Charleston; University of Alabama at Birmingham (V.J.H., G.H.); and National Ins
  • Turan TN; From the Mayo Clinic (J.F.M., K.C., T.G.B.), Jacksonville, FL; University of Maryland School of Medicine (B.L.), Baltimore; CREST-2 Executive Committee (G.R.), Jackson, WY; Medical University of South Carolina (T.N.T.), Charleston; University of Alabama at Birmingham (V.J.H., G.H.); and National Ins
  • Howard VJ; From the Mayo Clinic (J.F.M., K.C., T.G.B.), Jacksonville, FL; University of Maryland School of Medicine (B.L.), Baltimore; CREST-2 Executive Committee (G.R.), Jackson, WY; Medical University of South Carolina (T.N.T.), Charleston; University of Alabama at Birmingham (V.J.H., G.H.); and National Ins
  • Benson RT; From the Mayo Clinic (J.F.M., K.C., T.G.B.), Jacksonville, FL; University of Maryland School of Medicine (B.L.), Baltimore; CREST-2 Executive Committee (G.R.), Jackson, WY; Medical University of South Carolina (T.N.T.), Charleston; University of Alabama at Birmingham (V.J.H., G.H.); and National Ins
  • Carman K; From the Mayo Clinic (J.F.M., K.C., T.G.B.), Jacksonville, FL; University of Maryland School of Medicine (B.L.), Baltimore; CREST-2 Executive Committee (G.R.), Jackson, WY; Medical University of South Carolina (T.N.T.), Charleston; University of Alabama at Birmingham (V.J.H., G.H.); and National Ins
  • Howard G; From the Mayo Clinic (J.F.M., K.C., T.G.B.), Jacksonville, FL; University of Maryland School of Medicine (B.L.), Baltimore; CREST-2 Executive Committee (G.R.), Jackson, WY; Medical University of South Carolina (T.N.T.), Charleston; University of Alabama at Birmingham (V.J.H., G.H.); and National Ins
  • Brott TG; From the Mayo Clinic (J.F.M., K.C., T.G.B.), Jacksonville, FL; University of Maryland School of Medicine (B.L.), Baltimore; CREST-2 Executive Committee (G.R.), Jackson, WY; Medical University of South Carolina (T.N.T.), Charleston; University of Alabama at Birmingham (V.J.H., G.H.); and National Ins
Neurology ; 100(22): 1060-1066, 2023 05 30.
Article in En | MEDLINE | ID: mdl-36746636
Multiple challenges confront procedural trials, including slow enrollment, lack of equipoise among patients and physicians, and failure to achieve adequate masking. Nonetheless, randomized clinical trials provide the best evidence of efficacy. The evolution of technology, techniques, and standards of care during the conduct of procedural trials challenges external validity. In this study, we review how a multicenter trial of revascularization of asymptomatic carotid arteries for stroke prevention has managed changes in treating carotid stenosis and medical management of atherothrombotic disease. TRIAL REGISTRATION INFORMATION: ClinicalTrials.gov number: NCT02089217.
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Full text: 1 Database: MEDLINE Main subject: Endarterectomy, Carotid / Carotid Stenosis / Stroke Type of study: Clinical_trials / Guideline / Qualitative_research Limits: Humans Language: En Year: 2023 Type: Article
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Full text: 1 Database: MEDLINE Main subject: Endarterectomy, Carotid / Carotid Stenosis / Stroke Type of study: Clinical_trials / Guideline / Qualitative_research Limits: Humans Language: En Year: 2023 Type: Article