Diagnostic Accuracy of Glial Fibrillary Acidic Protein and Ubiquitin Carboxy-Terminal Hydrolase-L1 Serum Concentrations for Differentiating Acute Intracerebral Hemorrhage from Ischemic Stroke

Blood biomarkers for the diagnosis and differentiation of stroke: A systematic review and meta-analysis

“…Figure 1 depicts the PRISMA flow diagram for study inclusion in our meta-analysis. Eight studies were included from Germany, [11][12][13][14][15][16][17][18] seven were included from Spain, [19][20][21][22][23][24][25] four studies each from China, [26][27][28][29] Republic of Korea [30][31][32][33] and Italy, [34][35][36][37] two studies from India 38,39 and one study each from Greece, 40 Turkey, 41 Czech Republic, 42 United States of America, 43 Taiwan, 44 Sweden, 45 Israel, 46 Kuwait, 47 Croatia, 48 Norway, 49 and Japan 50 were included in our meta-analysis. The publication year of the included studies ranged from 1991 to 2020.…”

“…Four studies (10%) included in our meta-analysis had low quality of evidence, 33,38,41,46 27 studies (67.5%) had moderate quality of evidence, [14][15][16][17][20][21][22]24,25,[27][28][29]31,32,34,35,37,39,40,42,44,45,[47][48][49][50][51] and nine studies (22.5%) had high quality of evidence. [11][12][13]18,19,23,26,30,43 Only seven studies [12][13][14]23,32,45,47 used a previously established diagnostic threshold for selecting the appropriate cutoff points. Four studies 17,24,…”

“…Four studies 17,24,33,50 recruited IS cases which represented only a selected subgroup of patients. Only three studies 11,13,18 reported their results according to the Standards for Reporting Diagnostic accuracy studies (STARD) guidelines. 52 Only a single study 18 provided the rationale for sample size calculation.…”

“…Only three studies 11,13,18 reported their results according to the Standards for Reporting Diagnostic accuracy studies (STARD) guidelines. 52 Only a single study 18 provided the rationale for sample size calculation. The quality scale conducted for each study is attached, Suppl.…”

Serum Glial Fibrillary Acidic Protein in Acute Stroke

“…These are meaningful differences, though the authors are correct to point out various potential weaknesses-such as that patients with intraventricular hemorrhage may have normal GFAP levels (they had none in their cohort), and that small ICH had GFAP levels in the range of patients with ischemic stroke. Absolute separation between ICH and AIS was not present, but at the extremes of GFAP levels, the discrimination was excellent [6].…”