Received: 9 November 2018
Accepted: 20 January 2019
First Online: 28 February 2019
Ethics approval and consent to participate
: Not applicable
: Not applicable
: Please refer to Additional file InternalRef removed for the full competing interest statement.
: Stephan Baldus, Director, Department of Cardiology, Angiology, Pneumology and Internal Intensive Medicine, Cardiac Centre at University Hospital Cologne, Kerpener Straße 62, 50937 Cologne, Representative of the DGK.Hans-Christoph Diener, Senior Professor for Clinical Neuroscience, Department of Neurology and Stroke Centre, University Hospital Essen, Hufelandstraße 55, 45147 Essen, ExternalRef removed, Representative of the DGN.Alexander Ghanem, Head of Department, Department of Cardiology, Asklepios Hospital St Georg, Lohmuhlenstrasse 5, 20099 Hamburg, Representative of the DGK.Armin J. Grau, Director of the Neurology Department, Hospital of the City of Ludwigshafen a. Rh., Bremserstrasse 79, 67063 Ludwigshafen a. Rh., ExternalRef removed, Representative of the DSG.Klaus Gröschel, Department and Outpatient Department of Neurology, University Hospital Mainz, Langenbeckstrasse 1, 55131 Mainz, ExternalRef removed, Representative of the DSG.Christoph Liebetrau, Executive Director of Cardiology, Head of Unit, Cardiac Catheter Laboratory Kerckhoff-Klinik Gmbh Cardiology Department, Benekestraße 2–8, 61231 Bad Nauheim, Representative of DGK.Steffen Massberg, Medical Department and Outpatient Department I, University Hospital Munich, Ludwig Maximilian University of Munich, Marchioninistrasse 15, 81377 Munich, ExternalRef removed, Representative of the DGK.Helge Möllmann, Senior Consultant of the Department of Internal Medicine, St Johannes Hospital, Johannesstraße 9–13, 44137 Dortmund, Representative of the DGK.Holger Nef, Medical Department I, Internal Medicine/Cardiology, Klinikstraße 33, 35392 Gießen, Representative of the DGK.Dirk Sander, Senior Consultant of the Neurology Department, Benedictus Krankenhaus Tutzing Gmbh & Co. KG, Academic Teaching Hospital of the TU Munich, Bahnhofstraße 5, 82327 Tutzing, ExternalRef removed, Representative of the DSG.Christian Weimar, Department of Neurology, University Hospital Essen, Hufelandstraße 55, 45147 Essen, ExternalRef removed, Representative of the DGN.Jochen Wöhrle, Department of Internal Medicine II, University Hospital Ulm, Albert-Einstein-Allee 23, 89073 Ulm, ExternalRef removed, Representative of the DGK.<b>For the Swiss expert association:</b>Heinrich Mattle, Senior Consultant, Univ. Dept. of Neurology, Inselspital, CH-3010 Bern, Meisenweg 18, CH-3014 Bern, ExternalRef removed, Representative of the Swiss Neurological Society.
: The boards of the three participating scientific societies nominated authors to prepare the recommendations. Each of the five key questions was assigned to a team of authors comprising neurologists and cardiologists to create the text. The authors initially conducted a systematic literature search in Medline with the terms “stroke”, “cryptogenic stroke”, “patent foramen ovale”, “closure” and “randomised trial”. The search identified 32 hits in which 7 randomised studies were identified (Tables InternalRef removed and InternalRef removed). This search was aligned with the published meta-analyses and guidelines (Table InternalRef removed). The risk of bias was investigated in 3 meta-analyses [CitationRef removed, CitationRef removed, CitationRef removed] and due to the fact that the studies were not blinded (which was technically not possible) this was classified as minimal or not present. Endpoint adjudication was blinded in all studies. The meta-analysis of Mir et al. included the evaluation of studies according to GRADE criteria [CitationRef removed]. The referenced meta-analyses were published with one exception in peer-reviewed journals, which included methodologists competent in the review process. This was not the case in the meta-analysis of Wang et al. [CitationRef removed]. Therefore, this meta-analysis was not taken into account. The authors followed this assessment. The author groups then created the text sections and wrote the recommendations. The draft text was then proofread and corrected by three lead authors. Thereafter, the recommendations were read and corrected in three iterations from all members of the author group. Finally, the total text was signed off by a written Delphi procedure.
: Date of last content revision and status: 13 June 2018.Valid until: 12 June 2021.
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