{"type":"rich","version":"1.0","provider_name":"Transistor","provider_url":"https://transistor.fm","author_name":"In the Interim...","title":"A Visit with Stroke Neurologist Dr. Jeff Saver","html":"","width":"100%","height":180,"duration":2219,"description":"In episode 37 of \"In the Interim…\", Dr. Jeff Saver, Director of the UCLA Comprehensive Stroke and Vascular Neurology Program, details his shift from behavioral neurology to clinical stroke research after early engagement with multicenter trials like TOAST. The discussion covers the biology of acute ischemic stroke, quantifying neuronal loss, and the scientific underpinnings of “time is brain.” Dr. Saver outlines the evolution of endovascular therapy, from early device challenges to current reperfusion success rates exceeding 85%. Key methodological issues in stroke trial analyses are presented, including debate over endpoint selection—dichotomous versus ordinal approaches and the limitations therein. Special focus is placed on the utility-weighted modified Rankin Scale, which assigns empirically derived, patient-centered health values to each disability state, providing a comprehensive measure that captures both benefit and harm. The episode explores regulatory hesitancy, differing analytic preferences within the field, and the design prospects for neuroprotectant interventions. Heterogeneity in patient outcomes and implications for public health and trial methodology are addressed. The episode provides an empirical account of clinical trial endpoint selection, interpretation, and future directions in cerebrovascular research.\nKey Highlights\nEarly career influences and pivotal trial participation.\nPathophysiology and quantification of acute stroke injury.\nEndovascular device development and clinical impact.\nComparative analysis of endpoint methods: dichotomous, ordinal, and utility-weighted approaches.\nTechnical derivation and application of utility-weighted mRS.\nOngoing regulatory and methodological debate.\nHeterogeneity in ischemic vulnerability and future trial directions.\nFor more, visit us at https://www.berryconsultants.com/","thumbnail_url":"https://img.transistorcdn.com/toFATB0JXvqQXRqzUqrK1EWCJCLOA_Qvjkb5ml3q-s8/rs:fill:0:0:1/w:400/h:400/q:60/mb:500000/aHR0cHM6Ly9pbWct/dXBsb2FkLXByb2R1/Y3Rpb24udHJhbnNp/c3Rvci5mbS9jM2M0/ZDE2YzA1N2FhNjkx/NDk1NDczNjYzM2E5/NjlmYS5wbmc.webp","thumbnail_width":300,"thumbnail_height":300}