Appendix Table 1. Literature Search and Inclusion and Exclusion Criteria^a

Key question 4: CEA complication rates

Literature search
  1. endarterectomy, carotid [mesh] AND outcome and process assessment (health care) [mesh]
    Yield: 690 items
      Limited to "usa [ad]0, which picks up the country designation "USA" in the author affiliation/address field
    Yield: 209 items
  2. Related article search through PubMed
    Articles related to Feasby TE, Quan H, Ghali WA. Hospital and surgeon determinants of carotid endarterectomy outcomes. Arch Neurol 2002;59:1877-81. [PMID: 12470174]
    Yield: 27 items
Study inclusion criteria
  Included complication rates related to CEA by 30-day rate of mortality or stroke for asymptomatic patients
  Evaluated differences in outcomes by technique, including:
    Different types of patches
    Shunting
    Eversion techniques
  Evaluated differences in outcomes by surgical specialty, including:
    Neurosurgery
    Vascular surgery
    General surgery
  Evaluated differences in outcomes by nonsurgical factors:
    Anesthesia type
    Intraoperative ultrasonography or other imaging
    Intraoperative angiography
   Evaluated differences in outcomes by patient factors:
   Age
     Sex
     Race
     Included >1 surgeon and >1 hospital
   Evaluated complication differences by surgical specialty, training, or experience
   Evaluated complication differences by surgeon or hospital volume and by setting
   Reported complication rates for asymptomatic patients
   Case series, RCTs, meta-analysis
Study exclusion criteria
   Evaluated only patients with combined CEA and coronary artery bypass graft surgery
   Included only patients receiving stenting, angioplasty, endovascular treatment
   Included only symptomatic patients or did not separate rates by symptom status
   Not done in the United States
   Review article without outcome data
   Included only patients with previous stroke
   Evaluated restenosis outcomes only
   Recurrent stenosis study
   Quality improvement study without complication rates listed
   Utilization study without complication rates
   Pseudoaneurysm study
   Bilateral CEA study
   Emergent CEA study
   Included outcomes for only 1 surgeon or only 1 clinical site
   ,50 participants
   Not on harms of CEA
   Lacked relevant or 30-day outcomes
   High-risk or special population
   Incorrect study type

Key questions 1, 2, and 3: inclusion criteria

Key question 1: benefits of screening
   RCT
   Compared screened versus nonscreened groups
   Outcomes of strokes or death
   Outcomes specific for asymptomatic persons
   Population generalizable to United States
   Published in English
Key question 2: accuracy and reliability of screening
   Ultrasonography, magnetic resonance angiography, or computed tomographic angiography screening
  Asymptomatic persons
   Systematic review of studies that compared screening test with gold standard of angiography
   Population-based prevalence study
   Population generalizable to United States
   Published in English
Key question 3: benefits of CEA
   RCTs of CEA comparing surgical treatment with medical treatment
   Reported 30-day complication rates of CEA
   Outcomes of stroke or death
   Outcomes specific for asymptomatic persons
   Population generalizable to United States
   Published in English

^a. CEA = carotid endarterectomy; KQ = key question.

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