Appendix Table 1.
Fifteen Questions to Assess the Quality of Included Studies
| Question | Possible Answers (Score) | |
|---|---|---|
| 1. | Was AF the primary exposure of interest? | Yes (1) or no (0) |
| 2. | What was the reported temporal relationship between AF and SCI? | Prospective (1), not prospective (0), or both (1) |
| 3. | Were the inclusion and exclusion criteria adequately described? | Yes (1) or no (0) |
| 4. | Was the history of symptomatic stroke confirmed by detailed neurologic examination? | Yes (1) or no (0) |
| 5. | Were autopsies, MRI, and CT done for the purpose of research (as opposed to clinical care)? | Yes (1) or no (0) |
| 6. | What was the method of SCI diagnosis? | MRI (3), CT (2), or autopsy (1) |
| 7. | Were the investigators blinded to the clinical history of patients during the ascertainment of SCIs? | Yes (1) or no (0) |
| 8. | Were the SCIs ascertained by ≥1 investigator? | Yes (1) or no (0) |
| 9. | Did the investigators attempt to distinguish SCIs from dilated perivascular spaces? | Yes (1) or no (0) |
| 10. | Did the authors acknowledge whether they excluded leukoaraiosis from SCIs in their analysis? | Yes (1) or no (0) |
| 11. | Did the investigators use diffusion-weighted imaging to distinguish acute SCIs from leukoaraiosis? | Yes (1) or no (0) |
| 12. | Did the investigators distinguish chronic SCIs from leukoaraiosis by colocalizing the hyperintense lesions on T2-weighted images to nonterritorial FLAIR hyperdensity or prominent hypointense lesions (CSF intensity) on T1-weighted images? | Yes (1 or no (0) |
| 13. | Was AF documented on ≥1 electrocardiography? | Yes (1) or no (0) |
| 14. | Did the investigators assess or report carotid stenosis in study patients? | Yes (1) or no (0) |
| 15. | Risk of confounding bias? | Minimal (2) if studies controlled for ≥5 of following 6 potential confounders: age, sex, hypertension (or blood pressure measurements), DM, hyperlipidemia (or lipid profile measurements), and CAS (or carotid intima-media thickness) either by including these variables in the multivariate model or by ensuring that patients with and without AF were similar or matched on these variables; moderate (1) if studies did not control for ≥2 of these variables; or high (0) if studies did not control for any potential confounders. |
AF = atrial fibrillation; CAS = carotid artery stenosis; CT = computed tomography; CSF = cerebrospinal fluid; DM = diabetes mellitus; FLAIR = fluid-attenuated inversion recovery; MRI = magnetic resonance imaging; SCI = silent cerebral infarction.