low, and very low quality.
Results Results of the systematic review
Our search strategy yielded 253 articles. Seventy-seven were judged by all reviewers to be non- relevant. Four articles were judged to be class III studies, and two were rated class II. There were no discrepancies between the independent ratings (i.e., kappa=1). Studies rated class III or higher are listed in Table 1 . Figure 1 outlines our process of selecting studies for inclusion in the meta-analysis.
Class II studies
Design
Patients
Number of dissections/VBA strokes
Smith et al., 2003
Case control
151
51
Dittrich et al., 2007
Case control
94
47
Class III studies
Rothwell et al., 2001*
Case control
2910
582
Cassidy et al., 2008
Case control
3982
818
Thomas et al., 2011
Case control
90
47
Engelter et al., 2013
Case control
1897
966
TABLE 1: Class II and III articles identified in the systematic review.
*Cases overlap with Cassidy et al., 2008. VBA = Vertebrobasilar accidents
2016 Church et al. Cureus 8(2): e498. DOI 10.7759/cureus.498
3 of 11
Made with FlippingBook HTML5