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Journal article

Statistical analysis plan for the Head Position in Stroke Trial (HeadPoST): an international cluster cross-over randomised trial

Abstract:

Background

There is evidence to indicate that the lying flat head position increases cerebral blood flow and oxygenation in patients with acute ischemic stroke, but how these physiological effects translate into clinical outcomes is uncertain. The Head Position in Stroke Trial (HeadPoST) aims to determine the comparative effectiveness of lying flat (0°) compared to sitting up (≥30°) head positioning, initiated within 24 hours of hospital admission for patients with acute stroke.

Design

An international, pragmatic, cluster randomised, crossover, open, blinded outcome assessed clinical trial. Each hospital with an established acute stroke unit (cluster) site was required to recruit up to 140 consecutive cases of acute stroke (one phase of head positioning before immediately crossing over to the other phase of head positioning), including both acute ischaemic stroke and intracerebral haemorrhage, in each randomised head position as a ‘business as usual’ policy.

Objective

To outline in detail the predetermined statistical analysis plan (SAP) for the study.

Methods

All accumulated data will be reviewed and formally assessed. Information regarding baseline characteristics of patients, their process of care and management will be outlined, and for each item, statistically relevant descriptive elements will be described. For the trial outcomes, the most appropriate statistical comparisons are described.

Results

A SAP was developed that is transparent, verifiable, and predetermined before completion of data collection.

Conclusions

We developed a predetermined SAP for HeadPoST to avoid analysis bias arising from prior knowledge of the findings, in order to reliably quantify the benefits and harms of lying flat versus sitting up early after the onset of acute stroke.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1177/1747493017701943

Authors

More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Women's and Reproductive Health
Role:
Author



Publisher:
SAGE Publications
Journal:
International Journal of Stroke More from this journal
Volume:
12
Issue:
6
Pages:
667-670
Publication date:
2017-03-01
Acceptance date:
2017-01-12
DOI:
EISSN:
1747-4949
ISSN:
1747-4930


Keywords:
Pubs id:
pubs:675360
UUID:
uuid:0b855661-012c-44b1-861b-c0bbff10a5ee
Local pid:
pubs:675360
Source identifiers:
675360
Deposit date:
2017-02-02
ARK identifier:

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