September 2022 PMID 35652287

Methodological survey of missing outcome data in an alteplase for ischemic stroke meta-analysis.

Ravi Garg

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Mentions

24
Peak: 4 in Aug 2022
across 4 sources since Aug 2022

Extended reach

454,372
potential audience

Total likes

12

Video views

41

Mentions per month

Aug 2022 – Oct 2025

Where it's discussed

  • X / Twitter17 posts
  • News3 articles
  • YouTube2 videos
  • Blogs2 articles

AI synopsis

What people are saying

The group actively discusses the potential biases introduced by missing outcome data, highlighting examples like @ravigarg415's work and the broader implications for stroke trial reliability. Their tone combines technical language and curiosity, reflecting a strong interest in understanding and addressing these methodological concerns, which supports their high interest and engagement scores.

AgreementModerate agreement

Most discussions acknowledge that missing outcome data could bias stroke trial results, showing a general consensus on its importance.

InterestHigh interest

The posts display high curiosity and concern about how missing data affects study validity, with multiple references to ongoing debates.

EngagementHigh engagement

Many posts delve into methodological details, referencing specific studies, alternative analyses, and upcoming discussions, indicating deep involvement.

ImpactModerate impact

While some posts suggest the issue raises awareness, the overall perceived impact on clinical practice or policy remains moderate, emphasizing research importance rather than immediate change.

Abstract in brief

  • This study conducted a methodological survey of a meta-analysis on alteplase treatment for ischemic stroke, specifically focusing on the issue of missing outcome data (MOD), which can occur when participants are lost to follow-up.
  • The survey found that all trials used a single imputation method to handle missing data, and the number of participants lost was often greater than the fragility index, indicating that MOD could potentially influence the reported effectiveness of the treatment.
  • The study emphasizes the importance of addressing MOD carefully, as it may introduce bias into study results, and recommends using more robust sensitivity analyses to improve the reliability of findings.

Top posts

Most liked on X and Bluesky
Ken Milne MD
@TheSGEM · X

@drjohnm @BrianAlperMD @BMJ_EBM @ravigarg415 More evidence from @ravigarg415 contributes to the uncertainty. "This methodological survey of an alteplase for ischemic stroke meta-analysis revealed MOD may be an important source of unrecognized bias." https://t.co/lDc3eukQP8

Jan 22, 2024 · 2 likes · 28,353 followers View post →
Ken Milne MD
@TheSGEM · X

Link to article by neurologist Dr. Garg. https://t.co/31hm0fAOcm

Aug 3, 2022 · 2 likes · 28,353 followers View post →
Ken Milne MD
@TheSGEM · X

@alandrummond2 @BrianAlperMD @BMJ_EBM @DrNancyOlivieri @ravigarg415 Another potential source of uncertainty comes from the missing outcome data in the tPA stroke studies. https://t.co/31hm0fAOcm @First10EM @DrHowieMell @MedFactChecks

Nov 12, 2023 · 2 likes · 28,353 followers View post →
Ken Milne MD
@TheSGEM · X

@OfficerCasualty @MicieliA_MD @KirstyChallen @ravigarg415 @StrokeAHA_ASA @First10EM @srrezaie @CCREM2 Another concern about lysis besides stroke mimics that @ravigarg415 has published about is the missing outcome data in alteplase studies. https://t.co/31hm0fAOcm @TheNewANA1

Feb 12, 2023 · 2 likes · 28,353 followers View post →
Ken Milne MD
@TheSGEM · X

If other experts have issues with @ravigarg415 publication on missing outcome data are encouraged to write a letter to the editor @BioMedCentral https://t.co/zr91qlwhwv

Sep 13, 2022 · 1 like · 28,353 followers View post →
Ken Milne MD
@TheSGEM · X

@syaddana_neuro @a_charidimou @ravigarg415 @EMNews @UofTNeurology @UCLAStrokeNeuro @First10EM @KirstyChallen @emlitofnote @DrHowieMell @TheStrokeAssoc @ZoiNetou @BMC_series He has also published a peer reviewed article on missing outcome data in the tPA literature. Do you have any specific issues with this analysis? https://t.co/31hm0fAOcm

Sep 4, 2022 · 1 like · 28,353 followers View post →

All mentions

Ken Milne MD
@TheSGEM · X

@drgt2010 @joshkimbre @drjohnm @First10EM @thenntgroup @BrianAlperMD Issues with how missing outcome data was handled in stroke trials. https://t.co/zr91qlwhwv

Oct 22, 2025 · 28,353 followers View post →
Ken Milne MD
@TheSGEM · X

@EpiEllie An example would be like in the alteplase literature for acute ischemic stroke identified by @ravigarg415 #EBM https://t.co/zr91qlwhwv

Apr 12, 2025 · 1 like · 28,353 followers View post →
Ken Milne MD
@TheSGEM · X

@armyemdoc @BrianAlperMD @BMJ_EBM @ravigarg415 My skepticism went even higher with @ravigarg415 's work on missing data in these stroke trials. https://t.co/zr91qlwPm3

Feb 3, 2025 · 28,353 followers View post →
Ken Milne MD
@TheSGEM · X

@drjohnm @BrianAlperMD @BMJ_EBM @ravigarg415 More evidence from @ravigarg415 contributes to the uncertainty. "This methodological survey of an alteplase for ischemic stroke meta-analysis revealed MOD may be an important source of unrecognized bias." https://t.co/lDc3eukQP8

Jan 22, 2024 · 2 likes · 28,353 followers View post →
Ken Milne MD
@TheSGEM · X

@alandrummond2 @BrianAlperMD @BMJ_EBM @DrNancyOlivieri @ravigarg415 Another potential source of uncertainty comes from the missing outcome data in the tPA stroke studies. https://t.co/31hm0fAOcm @First10EM @DrHowieMell @MedFactChecks

Nov 12, 2023 · 2 likes · 28,353 followers View post →
Ken Milne MD
@TheSGEM · X

@OfficerCasualty @KirstyChallen @ravigarg415 @StrokeAHA_ASA @First10EM @srrezaie @CCREM2 @TheNewANA1 The missing outcome data in these stroke trials may/may not be an important source of unrecognized bias. What this information does is increase my uncertainty about this therapy. https://t.co/zr91qlwhwv @ravigarg415 @BrianAlperMD https://t.co/NmCBe7DhNu

Feb 12, 2023 · 1 like · 28,353 followers View post →
Ken Milne MD
@TheSGEM · X

@OfficerCasualty @MicieliA_MD @KirstyChallen @ravigarg415 @StrokeAHA_ASA @First10EM @srrezaie @CCREM2 Another concern about lysis besides stroke mimics that @ravigarg415 has published about is the missing outcome data in alteplase studies. https://t.co/31hm0fAOcm @TheNewANA1

Feb 12, 2023 · 2 likes · 28,353 followers View post →
Ken Milne MD
@TheSGEM · X

@_dorandrew @First10EM @emergmedottawa @ravigarg415 Appreciate your response. How'd you think we interpret the potential biases that can be carried through in SRMAs? This includes but is not limited to: Lack of randomization (NINDS) Lack of blinding (IST-3 larges trial) Mission outcome Data (see attached) https://t.co/31hm0fAOcm

Feb 7, 2023 · 28,353 followers View post →
Josh Davis
@MedFactChecks · X

@4mmk36 @MicieliA_MD @TotoMynell @TheSGEM @stephanamayer @ravigarg415 @Hamishmcmack https://t.co/M0SVpCDK9X

Jan 12, 2023 · 684 followers View post →
Ken Milne MD
@TheSGEM · X

@TotoMynell @stephanamayer @AJWPharm @ravigarg415 Dr. Garg has also published an interesting study on missing outcome data from alteplase trials. https://t.co/zr91qlwPm3

Jan 9, 2023 · 28,353 followers View post →
Ken Milne MD
@TheSGEM · X

@PatientStormDoc @DrHowieMell @f2harrell @ADAlthousePhD @statsepi @ravigarg415 Neurologist @ravigarg415 has also published on the issue of missing data. https://t.co/31hm0fAOcm

Sep 17, 2022 · 28,353 followers View post →
Ken Milne MD
@TheSGEM · X

If other experts have issues with @ravigarg415 publication on missing outcome data are encouraged to write a letter to the editor @BioMedCentral https://t.co/zr91qlwhwv

Sep 13, 2022 · 1 like · 28,353 followers View post →
Ken Milne MD
@TheSGEM · X

@syaddana_neuro @a_charidimou @ravigarg415 @EMNews @UofTNeurology @UCLAStrokeNeuro @First10EM @KirstyChallen @emlitofnote @DrHowieMell @TheStrokeAssoc @ZoiNetou @BMC_series He has also published a peer reviewed article on missing outcome data in the tPA literature. Do you have any specific issues with this analysis? https://t.co/31hm0fAOcm

Sep 4, 2022 · 1 like · 28,353 followers View post →
Ken Milne MD
@TheSGEM · X

@DrHowieMell @aleksmineyko @Hamishmcmack @ravigarg415 @UCLAStrokeNeuro Dr. Garg will be back on the SGEM this fall to discuss his other peer reviewed study on missing outcome data & be given the opportunity to respond to Dr. Saver’s comments. @aleksmineyko Do you have any question you would like me to ask Dr. Garg. https://t.co/31hm0fAOcm

Aug 30, 2022 · 28,353 followers View post →
Ken Milne MD
@TheSGEM · X

@DrHowieMell @ravigarg415 @Hamishmcmack @aleksmineyko @UCLAStrokeNeuro There will be another SGEM Xtra with Dr. Garg discussing his missing outcome data paper. He will have an opportunity to comment on the poll and Dr. Saver’s comments. https://t.co/31hm0fSp3U

Aug 26, 2022 · 28,353 followers View post →
Ken Milne MD
@TheSGEM · X

Link to article by neurologist Dr. Garg. https://t.co/31hm0fAOcm

Aug 3, 2022 · 2 likes · 28,353 followers View post →
Ken Milne MD
@TheSGEM · X

@precordialthump @DocEd @ffolliet @ravigarg415 @PulmCrit @First10EM @WICSBottomLine Thank you for the helpful comments on the FI study by Dr. Saver. I’m also doing an SGEM Xtra on missing data that uses the FI with author @ravigarg415 who is tagged on this thread. Any feedback to help with this interview? I love talking nerdy. https://t.co/31hm0fAOcm

Aug 1, 2022 · 28,353 followers View post →