Economic evaluations of interventions for acute ischemic stroke: a systematic review protocol

This systematic review will provide an overview of economic evaluation studies of interventions for acute ischemic stroke, including intravenous thrombolysis, endovascular thrombectomy, antiplatelet therapy, and emerging strategies such as mobile stroke units and remote robotic thrombectomy, across different health care settings and patient populations.

Acute ischemic stroke is a leading cause of disability and mortality, imposing significant economic burdens on health care systems. While various interventions improve clinical outcomes, their economic evidence remains uncertain.

Studies will be eligible if they include adult patients receiving any intervention for acute ischemic stroke. Eligible studies will report economic evaluations (full or partial) of the treatment of acute ischemic stroke.

A systematic search of academic, non-academic, and gray literature databases will be conducted. Two reviewers will independently screen studies and full texts against the eligibility criteria. Methodological quality will be assessed using the JBI Checklist for Economic Evaluations. Data will be extracted using a modified JBI data extraction form. For standardization across studies, cost data will be converted to a uniform base year and a single currency using the CCEMG-EPPI Centre Cost Converter. The JBI dominance ranking matrix will be used to summarize and compare the results of the different types of economic evaluations. Based on the incremental costs and effectiveness extracted from the studies, net monetary benefits will be calculated and, if feasible, explored in a meta-analysis. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach will be used to assess the certainty of economic evidence.

PROSPERO CRD420250651215.