{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T04:19:47Z","timestamp":1790914787374,"version":"4.1.0"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>\n            Brain arteriovenous malformations (bAVMs) are vascular lesions that carry significant morbidity and mortality risk upon rupture. bAVM rupture causes either intracerebral or intraventricular hemorrhage, or both. In 2014, the first results of the ARUBA trial (A Randomized Trial of Unruptured Brain Arteriovenous Malformations) were published in\n            <jats:italic>The Lancet<\/jats:italic>\n            , causing a paradigm shift in clinical practice and suggesting the superiority of medical treatment in terms of mortality or stroke compared with any intervention designed to obliterate the AVM. In 2020, the final results of the ARUBA trial were published. In this Viewpoint, we critically review the clinical equipoise behind the trial, highlight issues regarding external validity, and place the results of the trial in the context of other results in scientific literature of bAVMs using Bayesian inference. ARUBA is a trial of decision-making, and only proper knowledge of the nuances of its interpretation within the broader context of bAVM research can lead to proper decision-making when confronted with patients with unruptured bAVMs.\n          <\/jats:p>","DOI":"10.1161\/strokeaha.120.032429","type":"journal-article","created":{"date-parts":[[2021,1,26]],"date-time":"2021-01-26T10:00:21Z","timestamp":1611655221000},"page":"1143-1146","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Unruptured Arteriovenous Malformations"],"prefix":"10.1161","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5798-5360","authenticated-orcid":true,"given":"Victor","family":"Volovici","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Erasmus MC Stroke Center (V.V., J.W.S., R.D.), Erasmus MC Rotterdam, the Netherlands."},{"name":"Center for Medical Decision Making, Department of Public Health (V.V.), Erasmus MC Rotterdam, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joost W.","family":"Schouten","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Erasmus MC Stroke Center (V.V., J.W.S., R.D.), Erasmus MC Rotterdam, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Vajkoczy","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Charit\u00e9 University Hospital, Berlin, Germany (P.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7033-0644","authenticated-orcid":true,"given":"Ruben","family":"Dammers","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Erasmus MC Stroke Center (V.V., J.W.S., R.D.), Erasmus MC Rotterdam, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6595-0873","authenticated-orcid":true,"given":"Torstein R.","family":"Meling","sequence":"additional","affiliation":[{"name":"Neurosurgery Division, Department of Clinical Neurosciences, Faculty of Medicine, Geneva University Hospitals, Switzerland (T.R.M.)."},{"name":"Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway (T.R.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.73.5.547"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000069018.90456.C9"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1632"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.23736\/S0390-5616.18.04452-1"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62302-8"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.112.652032"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2015.8"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A4204"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.112.653584"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60786-8"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(20)30181-2"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.107.504605"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.wco.0000200546.14668.78"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.13.3.127"},{"key":"e_1_3_3_16_2","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1007\/978-1-4613-8674-2_10","volume-title":"Use and impact of computers in clinical medicine","author":"Banta HD","year":"1984","unstructured":"Banta, HD. Embracing or rejecting innovations: Clinical diffusion of health care technology. Use and impact of computers in clinical medicine. Springer; 1984:132\u2013160."},{"key":"e_1_3_3_17_2","unstructured":"Mohr JP. A randomized trial of unruptured brain AVMs (ARUBA) identifier NCT00389181. www.clinicaltrials.gov. Accessed August 18 2020."},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-4949.2009.00405.x"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-014-2140-7"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyaa448"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1986.65.4.0476"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000004532"},{"key":"e_1_3_3_23_2","first-page":"2","article-title":"The prospective application of a grading system for arteriovenous malformations.","volume":"34","author":"Hamilton MG","year":"1994","unstructured":"Hamilton, MG, Spetzler, RF. The prospective application of a grading system for arteriovenous malformations. Neurosurgery. 1994;34:2\u20136.","journal-title":"Neurosurgery"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/pst.1862"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.3171\/2019.8.JNS19998"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1159\/000502314"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.120.032429","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T14:55:53Z","timestamp":1715612153000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.120.032429"}},"subtitle":["Do We Have an Answer After the Final Follow-Up of ARUBA? A Bayesian Viewpoint"],"short-title":[],"issued":{"date-parts":[[2021,3]]},"references-count":25,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,3]]}},"alternative-id":["10.1161\/STROKEAHA.120.032429"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.120.032429","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3]]},"assertion":[{"value":"2021-01-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}