| Level I | Good quality evidence |
Systematic review of RCTs with consistent findings High quality individual RCT |
| Level II |
Limited quality patient orientated evidence |
Systematic review of lower quality studies or studies with inconsistent findings Low quality clinical trial Cohort studies Case-control studies |
| Level III | Other |
Consensus guidelines, extrapolations from bench research, usual practice, opinion, disease-oriented evidence (intermediate or physiologic outcomes only), or case series |
[1] Tissue plasminogen activator: Emberson J, Lees KR, Lyden P, Blackwell L, Albers G, Bluhmki E, et al.; Stroke Thrombolysis Trialists' Collaborative Group. Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials. Lancet. 2014 Nov 29;384(9958):1929-35. https://www.ncbi.nlm.nih.gov/pubmed/25106063
Tissue plasminogen activator: Wardlaw JM, Murray V, Berge E, del Zoppo GJ. Thrombolysis for acute ischaemic stroke. Cochrane Database Syst Rev. 2014 Jul 29;(7):CD000213. https://www.ncbi.nlm.nih.gov/pubmed/25072528
Tissue plasminogen activator: Alteplase (window period 3 hours versus 4.5 hours): National Department of Health: Affordable Medicines, EDP-Adult Hospital level. Medicine Review: Alteplase – Window period for treating hyper acute ischaemic stroke, February 2018. http://www.health.gov.za/
Tissue plasminogen activator: National Department of Health. Essential Drugs Programme - Tertiary and Quaternary EML, December 2019. http://www.health.gov.za/
Tissue plasminogen activator (Alteplase, IV – window period): National Department of Health: Affordable Medicines, EDP-Adult Hospital level. Medicine Review: Alteplase for hyper acute ischaemic stroke, January 2018. http://www.health.gov.za/
Tissue plasminogen activator (Alteplase, IV – window period): Emberson J, Lees KR, Lyden P, Blackwell L, Albers G, Bluhmki E, et al.; Stroke Thrombolysis Trialists' Collaborative Group. Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials. Lancet. 2014 Nov 29;384(9958):1929-35 https://www.ncbi.nlm.nih.gov/pubmed/25106063
Tissue plasminogen activator: Nicola Logallo, Vojtech Novotny, Jörg Assmus, Christopher E Kvistad, Lars Alteheld, Ole Morten Rønning, Bente Thommessen,Karl-Friedrich Amthor, Hege Ihle-Hansen, Martin Kurz, Håkon Tobro, Kamaljit Kaur, Magdalena Stankiewicz, Maria Carlsson, Åse Morsund,Titto Idicula, Anne Hege Aamodt, Christian Lund, Halvor Næss, Ulrike Waje-Andreassen, Lars Thomassen. Tenecteplase versus alteplase for management of acute ischaemic stroke (NOR-TEST): a phase 3, randomised, open-label, blinded endpoint trial. Lancet Neurology 2017; 16: 781–88. https://www.ncbi.nlm.nih.gov/pubmed/28780236