{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T07:23:07Z","timestamp":1787728987524,"version":"build-2784847793"},"reference-count":46,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100011963","name":"European Academy of Neurology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011963","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute ischemic stroke is a leading cause of death and disability. Despite strong evidence supporting reperfusion therapies and Stroke Unit care, access and quality of stroke services remain heterogeneous across Europe. Although national stroke registries provide valuable real\u2010world data, fragmentation, limited interoperability, and data protection constraints have restricted multinational analyses and benchmarking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Federating European REgistries for Stroke (FERES) initiative establishes a GDPR\u2010compliant federated framework for secondary use of stroke registry data. FERES harmonizes heterogeneous datasets through a stroke\u2010specific Common Data Elements (CDE) model and performs analyses locally within each registry using the Medical Informatics Platform, sharing only aggregated, non\u2010identifiable outputs. To validate the framework, a predefined showcase analysis comparing anterior versus posterior circulation acute ischemic stroke was executed in both centralized and federated modes using an identical harmonized dataset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>FERES connected five national registries from Austria, Greece, Ireland, Italy, and Switzerland within a unified federated infrastructure. At the time of analysis, 149,772 patient events from two registries were accessible for federated querying, with three additional registries technically integrated and in advanced onboarding. The harmonized ontology comprised 945 standardized variables spanning the stroke care pathway. Federated execution reproduced centralized pooled\u2010data results across descriptive statistics, hypothesis testing, effect sizes, and multivariable regression models with only minimal numerical discrepancies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>FERES demonstrates that large\u2010scale, multinational stroke research and benchmarking can be conducted in Europe using a privacy\u2010preserving federated approach, providing a scalable foundation for cross\u2010border real\u2010world evidence generation and quality improvement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70715","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T13:59:05Z","timestamp":1785851945000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Federating European\n                    <scp>REgistries<\/scp>\n                    for Stroke: Principles, Data Model and Future Perspectives for a Federated Analysis of Multiple Prospective Stroke Registries"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8494-5527","authenticated-orcid":false,"given":"Alexander","family":"Salerno","sequence":"first","affiliation":[{"name":"Stroke Center, Department of Clinical Neurosciences Lausanne University Hospital and University of Lausanne  Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6924-2390","authenticated-orcid":false,"given":"Georges","family":"Melissargos","sequence":"additional","affiliation":[{"name":"NeuroDigital@NeuroTech Lab, Department of Clinical Neurosciences Lausanne University Hospital and University of Lausanne  Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9265-8066","authenticated-orcid":false,"given":"Mira","family":"Katan","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital Basel and University of Basel  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5576-6562","authenticated-orcid":false,"given":"Michael","family":"Knoflach","sequence":"additional","affiliation":[{"name":"Department of Neurology Medical University of Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Kiechl","sequence":"additional","affiliation":[{"name":"Department of Neurology Medical University of Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Harbison","sequence":"additional","affiliation":[{"name":"Department of Medical Gerontology Trinity College Dublin  Dublin 2 Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Renieri","sequence":"additional","affiliation":[{"name":"Interventional Neurovascular Unit Azienda Ospedaliero Universitaria Careggi  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2735-8427","authenticated-orcid":false,"given":"Danilo","family":"Toni","sequence":"additional","affiliation":[{"name":"Department of Human Neurosciences Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7757-609X","authenticated-orcid":false,"given":"Lina","family":"Palaiodimou","sequence":"additional","affiliation":[{"name":"Second Department of Neurology \u201cAttikon\u201d University Hospital, School of Medicine, National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0640-3797","authenticated-orcid":false,"given":"Georgios","family":"Tsivigoulis","sequence":"additional","affiliation":[{"name":"Second Department of Neurology \u201cAttikon\u201d University Hospital, School of Medicine, National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7110-5147","authenticated-orcid":false,"given":"Andreas","family":"Ktenidis","sequence":"additional","affiliation":[{"name":"Athena Research &amp; Innovation Center in Information Communication &amp; Knowledge Technologies  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theofilos","family":"Mailis","sequence":"additional","affiliation":[{"name":"Athena Research &amp; Innovation Center in Information Communication &amp; Knowledge Technologies  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1705-8247","authenticated-orcid":false,"given":"Yannis","family":"Ioannidis","sequence":"additional","affiliation":[{"name":"Athena Research &amp; Innovation Center in Information Communication &amp; Knowledge Technologies  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrik","family":"Michel","sequence":"additional","affiliation":[{"name":"Stroke Center, Department of Clinical Neurosciences Lausanne University Hospital and University of Lausanne  Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7775-6576","authenticated-orcid":false,"given":"Philippe","family":"Ryvlin","sequence":"additional","affiliation":[{"name":"Stroke Center, Department of Clinical Neurosciences Lausanne University Hospital and University of Lausanne  Lausanne Switzerland"},{"name":"NeuroDigital@NeuroTech Lab, Department of Clinical Neurosciences Lausanne University Hospital and University of Lausanne  Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the FERES collaborators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(24)00369-7"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.122.040073"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.123.064053"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/2396987321989865"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2018-014569"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.15415"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.15480"},{"issue":"4","key":"e_1_2_11_9_1","article-title":"Organised Inpatient (Stroke Unit) Care for Stroke: Network Meta\u2010Analysis","volume":"4","author":"Langhorne P.","year":"2020","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00642-1"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000357"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31363-5"},{"key":"e_1_2_11_13_1","volume-title":"Inequity in Access to Stroke Care in Europe: Overlook Based on Mappings","author":"Fischer U.","year":"2022"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/17474930251364082"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.70050"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40263-025-01161-z"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30802-X"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/14737175.2025.2490538"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.121.037687"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/17474930251314395"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.031027"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/2396987318786023"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/2396987318808719"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/2396987318816136"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/esj\/aakaf026"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.628396"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.008811"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1614394"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/eci.70153"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.4221"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.12869"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/bmb\/ldy038"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezad289"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.2196\/41588"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-genom-110122-084756"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-021-00489-2"},{"key":"e_1_2_11_37_1","unstructured":"K.Filippopolitis Y.Foufoulas M.Garofalakis et\u00a0al. \u201cMIP: Advanced Data Processing and Analytics for Science and Medicine. Proceedings of the 27th International Conference on Extending Database Technology (EDBT) \u201d(2024)."},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1523\/ENEURO.0316-21.2022"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.3389\/femer.2026.1748193"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-1331.2003.00609.x"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1177\/23969873221103474"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2025-102789"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-014-2053-5"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000008362"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.124.047805"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.124.045889"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1093\/esj\/aakag041"}],"container-title":["European Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.70715","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ene.70715","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.70715","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T06:31:08Z","timestamp":1787725868000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ene.70715"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":46,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1111\/ene.70715"],"URL":"https:\/\/doi.org\/10.1111\/ene.70715","archive":["Portico"],"relation":{},"ISSN":["1351-5101","1468-1331"],"issn-type":[{"value":"1351-5101","type":"print"},{"value":"1468-1331","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"2026-04-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70715"}}