Armin Zarrintan, Mohamed K. Ibrahim, Noha Hamouda, Mohamed Sobhi Jabal, Zahra Beizavi, Sherief Ghozy, David F. Kallmes
{"title":"阿尔伯塔省卒中计划早期计算机断层扫描评分的地区性观察者间一致性:荟萃分析","authors":"Armin Zarrintan, Mohamed K. Ibrahim, Noha Hamouda, Mohamed Sobhi Jabal, Zahra Beizavi, Sherief Ghozy, David F. Kallmes","doi":"10.1111/jon.13184","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background and Purpose</h3>\n \n <p>The Alberta Stroke Program Early CT Score (ASPECTS) is a widely used scoring system for evaluating ischemic stroke to determine therapeutic strategy. However, there is variation in the interobserver agreement of ASPECTS. This systematic review and meta-analysis aimed to investigate the interobserver agreement of total and regional ASPECTS.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A comprehensive search was conducted in the Web of Sciences, PubMed, and Scopus databases to identify relevant studies. Inclusion criteria were studies of noncontrast CT performed within 24 hours of ischemic stroke in the middle cerebral artery territory.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 20 studies, with 3482 patients, reporting interobserver agreement of total and regional ASPECTS were included in the meta-analysis. The interobserver agreement for total ASPECTS in studies using Kappa coefficient (<i>κ</i>) analysis was substantial (<i>κ</i> = .67, 95% confidence interval [CI]: .57-.78). In studies using intraclass correlation coefficient (ICC) analysis, agreement was excellent (ICC = .84, 95% CI: .77-.90). Interobserver agreement was higher in studies in which the observer was unblinded to clinical scenario in both groups (<i>κ</i> = .74, 95% CI: .59-.89, and ICC = .82, 95% CI: .79-.85). Per-region analysis showed that the caudate nucleus had the highest agreement (<i>κ</i> = .68, 95% CI: .60-.76, and ICC = .84, 95% CI: .74-.93), while M2 and internal capsule in Kappa studies (<i>κ</i> = .45, 95% CI: .34-.55 and <i>κ</i> = .47, 95% CI: .28-.66), and M4 and internal capsule in ICC studies (ICC = .54, 95% CI: .43-.64 and ICC = .55, 95% CI: .18-.91) had the lowest agreement.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>This meta-analysis demonstrates substantial to excellent interobserver agreement for total ASPECTS, which supports using this method for stroke treatment. However, findings emphasize the need to consider interobserver agreement in specific regions of ASPECTS for treatment decisions.</p>\n </section>\n </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"34 2","pages":"195-204"},"PeriodicalIF":2.3000,"publicationDate":"2024-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Region-specific interobserver agreement of the Alberta Stroke Program Early Computed Tomography Score: A meta-analysis\",\"authors\":\"Armin Zarrintan, Mohamed K. Ibrahim, Noha Hamouda, Mohamed Sobhi Jabal, Zahra Beizavi, Sherief Ghozy, David F. Kallmes\",\"doi\":\"10.1111/jon.13184\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background and Purpose</h3>\\n \\n <p>The Alberta Stroke Program Early CT Score (ASPECTS) is a widely used scoring system for evaluating ischemic stroke to determine therapeutic strategy. However, there is variation in the interobserver agreement of ASPECTS. This systematic review and meta-analysis aimed to investigate the interobserver agreement of total and regional ASPECTS.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>A comprehensive search was conducted in the Web of Sciences, PubMed, and Scopus databases to identify relevant studies. Inclusion criteria were studies of noncontrast CT performed within 24 hours of ischemic stroke in the middle cerebral artery territory.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>A total of 20 studies, with 3482 patients, reporting interobserver agreement of total and regional ASPECTS were included in the meta-analysis. The interobserver agreement for total ASPECTS in studies using Kappa coefficient (<i>κ</i>) analysis was substantial (<i>κ</i> = .67, 95% confidence interval [CI]: .57-.78). In studies using intraclass correlation coefficient (ICC) analysis, agreement was excellent (ICC = .84, 95% CI: .77-.90). Interobserver agreement was higher in studies in which the observer was unblinded to clinical scenario in both groups (<i>κ</i> = .74, 95% CI: .59-.89, and ICC = .82, 95% CI: .79-.85). Per-region analysis showed that the caudate nucleus had the highest agreement (<i>κ</i> = .68, 95% CI: .60-.76, and ICC = .84, 95% CI: .74-.93), while M2 and internal capsule in Kappa studies (<i>κ</i> = .45, 95% CI: .34-.55 and <i>κ</i> = .47, 95% CI: .28-.66), and M4 and internal capsule in ICC studies (ICC = .54, 95% CI: .43-.64 and ICC = .55, 95% CI: .18-.91) had the lowest agreement.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>This meta-analysis demonstrates substantial to excellent interobserver agreement for total ASPECTS, which supports using this method for stroke treatment. 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Region-specific interobserver agreement of the Alberta Stroke Program Early Computed Tomography Score: A meta-analysis
Background and Purpose
The Alberta Stroke Program Early CT Score (ASPECTS) is a widely used scoring system for evaluating ischemic stroke to determine therapeutic strategy. However, there is variation in the interobserver agreement of ASPECTS. This systematic review and meta-analysis aimed to investigate the interobserver agreement of total and regional ASPECTS.
Methods
A comprehensive search was conducted in the Web of Sciences, PubMed, and Scopus databases to identify relevant studies. Inclusion criteria were studies of noncontrast CT performed within 24 hours of ischemic stroke in the middle cerebral artery territory.
Results
A total of 20 studies, with 3482 patients, reporting interobserver agreement of total and regional ASPECTS were included in the meta-analysis. The interobserver agreement for total ASPECTS in studies using Kappa coefficient (κ) analysis was substantial (κ = .67, 95% confidence interval [CI]: .57-.78). In studies using intraclass correlation coefficient (ICC) analysis, agreement was excellent (ICC = .84, 95% CI: .77-.90). Interobserver agreement was higher in studies in which the observer was unblinded to clinical scenario in both groups (κ = .74, 95% CI: .59-.89, and ICC = .82, 95% CI: .79-.85). Per-region analysis showed that the caudate nucleus had the highest agreement (κ = .68, 95% CI: .60-.76, and ICC = .84, 95% CI: .74-.93), while M2 and internal capsule in Kappa studies (κ = .45, 95% CI: .34-.55 and κ = .47, 95% CI: .28-.66), and M4 and internal capsule in ICC studies (ICC = .54, 95% CI: .43-.64 and ICC = .55, 95% CI: .18-.91) had the lowest agreement.
Conclusion
This meta-analysis demonstrates substantial to excellent interobserver agreement for total ASPECTS, which supports using this method for stroke treatment. However, findings emphasize the need to consider interobserver agreement in specific regions of ASPECTS for treatment decisions.
期刊介绍:
Start reading the Journal of Neuroimaging to learn the latest neurological imaging techniques. The peer-reviewed research is written in a practical clinical context, giving you the information you need on:
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and other new and upcoming neuroscientific modalities.The Journal of Neuroimaging addresses the full spectrum of human nervous system disease, including stroke, neoplasia, degenerating and demyelinating disease, epilepsy, tumors, lesions, infectious disease, cerebral vascular arterial diseases, toxic-metabolic disease, psychoses, dementias, heredo-familial disease, and trauma.Offering original research, review articles, case reports, neuroimaging CPCs, and evaluations of instruments and technology relevant to the nervous system, the Journal of Neuroimaging focuses on useful clinical developments and applications, tested techniques and interpretations, patient care, diagnostics, and therapeutics. Start reading today!