Strengths Primary analysis restricted to RCTs; uniform 1-year follow-up; coverage of seven regimens; structured transferability assessment; multidimensional sensitivity analysis. Limitations (1) Regim

The gap

Consensus across the literature

Supporting evidence — 3 representative gaps

• Machine learning-based prediction of ischemic cardio-cerebrovascular events after endovascular or microsurgical treatment of unruptured intracranial aneurysms and risk stratification by the early post-treatment triglyceride-glucose index (2026) · doi

  Author contributions First, despite a registry-based design, data were collected mainly from two centers, which may limit generalizability and introduce selection bias. Second, the model was only validated internally; external validation is needed to confirm clinical appli- cability. Third, TyG was measured only at postoperative day 3 and may be affected by perioperative stress, so it should be inter- preted as a prognostic marker rather than a causal factor. Fourth, detailed information regarding antiplatelet therapy timing and adherence was incomplete, representing a potential confounder. Fifth, as an observational study, residual confounding and treat- ment-selection bias could not be fully eliminated. Although ACS and cerebral infarction represent distinct clinical entities, the consistent directionality and robust predictive performance observed in component-specific analyses support the clinical validity of the composite ICCE endpoint for capturing overall post-treatment vascular vulnerability. YH: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Visualization, Writing – original draft, Writing – review & editing, Software. SC: Data curation, Investigation, Writing  – review & editing. DL: Data curation, Investigation, Writing – review & editing. ZZ: Methodology, Validation, Writing – review & editing. YL: Methodology, Validation, Writing – review & editing. YW: Conceptualization, Funding acquisition, Project admin- istration, Supervision, Writing – review & editing.

  Keywords: writing review editing validation clinical curation investigation methodology selection bias conceptualization author contributions first despite
• Efficacy of dual antiplatelet therapy for three months versus 12 months after coronary artery bypass grafting: multicentre, double blinded, randomised controlled trial (2026) · doi

  international largely guide CABG surgical techniques, perioperative management, and postoperative antiplatelet strategies, the predominance of enrolment from one centre may still limit the generalisability to other healthcare settings with differing patient characteristics, surgical practices, and perioperative management patterns. Sixthly, the trial was powered for the primary endpoint of SVG patency and may have been underpowered to detect differences in secondary clinical endpoints, particularly MACCE. These findings should therefore be interpreted as exploratory. Seventhly, our trial was not designed to identify patients for whom aspirin monotherapy was preferable; comparing a shortened DAPT strategy with aspirin alone represented a logical next step. Eighthly, although the non-inferiority margin was determined based on statistical preservation of effect considerations and expert consensus, it was not informed by empirical data on patient preference or established thresholds for minimal clinically important differences. Therefore, the selected margin may not represent a validated clinical threshold. Ninthly, the data and safety monitoring board review was conducted every six months. While no major safety concerns were identified during the trial, we acknowledge that a more frequent monitoring schedule would have aligned better with evolving standards for high risk surgical interventions, and a more geographically diverse and multi-institutional committee structure would further enhance independence. Tenthly, our security protocol relied on two stage authentication involving a mandatory virtual private network gateway followed by application level credentials. Although this security measure provides robust network isolation, we acknowledge that it does not constitute formal two factor authentication as defined by modern cybersecurity standards, representing a technical limitation. Eleventhly, a higher rate of infection events was observed in the 12 month DAPT group. However, our trial did not systematically collect data on baseline infection risk factors, duration of antibiotic treatment, or details of prophylactic antibiotic use, which limited our ability to adjust for these factors.

  Keywords: trial surgical perioperative management patient differences clinical aspirin dapt margin safety monitoring acknowledge standards risk
• Time- and risk-dependent effects of dual antiplatelet therapy targeting the P2Y12 receptor after CABG: A network meta-analysis of graft permeability and clinical outcomes (2026) · doi

  Strengths Primary analysis restricted to RCTs; uniform 1-year follow-up; coverage of seven regimens; structured transferability assessment; multidimensional sensitivity analysis. Limitations (1) Regimens were not prospectively registered (PROSPERO), posing a risk of post-hoc analysis; (2) Sub- group analyses were exploratory (small sample size, sparse events) and serve only to generate hypotheses; (3) Mild heterogeneity in endpoint definitions (MACE components, bleeding criteria), but sensitivity analyses indicate robust conclusions; (4) A 1-year follow-up may be insufficient to capture the full potential benefit of DAPT on clinical hard endpoints; 5-year data from DACAB suggest a need for a longer observation window [35]; (5) The non-off-pump sub- group has an extremely small sample size, resulting in the highest uncertainty regarding related conclusions; interpre- tations should be most conservative.(6) Aspirin dose hetero- geneity. Aspirin doses varied across trials (75–300 mg/d), but formal dose-effect analysis was not feasible because dose variation was between-study (confounded with other study-level factors) and the number of trials using non-stan- dard doses was too small (n = 4) for meaningful subgroup or network analysis. All doses fell within guideline-recom- mended ranges (75–325 mg/d), and extensive sensitivity analyses confirmed the robustness of primary findings, indi- rectly indicating that dose heterogeneity did not introduce substantial bias.

  Keywords: dose year sensitivity analyses small doses primary follow regimens group sample size heterogeneity conclusions aspirin