Google
Trusted Resources: Evidence & Education
Scientific literature and patient education texts
Transcranial Doppler screening for stroke risk in children with sickle cell disease: a systematic review
source: International Journal of Stroke
year: 2017
authors: Mazzucco S, Diomedi M, Qureshi A, Sainati L, Padayachee ST
summary/abstract:Background Sickle cell disease (SCD) is one of the most common causes of stroke in children worldwide. Based on the results of the Stroke Prevention Trial in Sickle Cell Anemia (STOP), annual transcranial Doppler ultrasound (TCD) screening for affected children is standard practice. However, the need for TCD surveillance programs could override the accuracy of the screening, affecting the correct stratification of stroke risk and subsequent clinical management of the target population. Aims To shed light on this issue, a systematic review of the literature on TCD screening for children and adolescents with SCD was carried out (CRD42016050549), according to a list of clinically relevant questions, with a particular focus on screening practices in European countries. Quality of the evidence was rated using the grading of recommendations assessment, development and evaluation. Summary of review Thirty-three studies published in English or French were included (5 randomized controlled trials, 8 experimental non-randomized, and 20 observational studies). The quality of the retrieved evidence ranged between low and high, but was rated as moderate or high most of the times. TCD is effective as a screening tool for the primary prevention of stroke in SCD children. There is no high-quality evidence on the effectiveness of alternative screening methods, such as imaging-TCD with or without angle correction or magnetic resonance angiography. No evidence was found on effectiveness of the screening on children on hydroxyurea and with genotypes other than HbSS and HbS/β0. No European data were found on screening rates or adherence of screening practices to the STOP protocol. Conclusions High-quality studies on alternative screening methods that are currently used in real-world practice, and on screening applicability to specific subgroups of patients are urgently needed. Considering the low awareness of the disease in European countries and the lack of data on screening practices and adherence, clinicians need up-to-date guidelines for more uniform and evidence-based surveillance of children with SCD.
organization: University of Oxford; University of Verona; University of Rome Tor Vergata; Children's Hospital-Oxford University Hospital Foundation Trust; Padua University, Padova; Guy's & St Thomas' NHS Foundation Trust, LondonDOI: 10.1177/1747493017706189
read more full text
+myBinderRelated Content
-
Social-Environmental Factors and Cognitive and Behavioral Functioning in Pediatric Sickle Cell DiseaseSickle cell disease (SCD), an inherited ...
-
Regional- and Age-Related Differences in Pain in Children with Sickle Cell Anemia: Results from the Multinational DO...Background: Determining Effects of Plate...
-
Fighting Through Our Pain TV with Thomas J. Harrington MDhttps://www.youtube.com/watch?time_conti...
-
Safety and early hints of benefit seen in phase 1b trial of PF-04447943Sickle cell disease (SCD) patients were ...
-
The Ways I Made Hydration a HabitWhen I was younger and didn’t have a f...
-
First systemic evidence for safety of tPA in stroke patients with sickle cell diseaseIn the largest report on acute stroke in...
-
Living With Unpredictable Pain: A Sickle Cell Disease StoryGrowing up, Vismel Marquez wanted to joi...
To improve your experience on this site, we use cookies. This includes cookies essential for the basic functioning of our website, cookies for analytics purposes, and cookies enabling us to personalize site content. By clicking on 'Accept' or any content on this site, you agree that cookies can be placed. You may adjust your browser's cookie settings to suit your preferences. More Information
The cookie settings on this website are set to "allow cookies" to give you the best browsing experience possible. If you continue to use this website without changing your cookie settings or you click "Accept" below then you are consenting to this.
Powered by
Support for this site is provided by
This platform is made possible through a partnership with the Sickle Cell Disease Association of America, Inc. (SCDAA) and its member organizations. SCDAA's mission is to advocate for people affected by sickle cell conditions and empower community-based organizations to maximize quality of life and raise public consciousness while advancing the search for a universal cure.