Agreement between core laboratory and study investigators for imaging scores in a thrombectomy trial

Journal of Neurointerventional Surgery
Robert FahedASTER Trial Investigators

Abstract

We aimed to assess the agreement between study investigators and the core laboratory (core lab) of a thrombectomy trial for imaging scores. The Alberta Stroke Program Early CT Score (ASPECTS), the European Collaborative Acute Stroke Study (ECASS) hemorrhagic transformation (HT) classification, and the Thrombolysis In Cerebral Infarction (TICI) scores as recorded by study investigators were compared with the core lab scores in order to assess interrater agreement, using Cohen's unweighted and weighted kappa statistics. There were frequent discrepancies between study sites and core lab for all the scores. Agreement for ASPECTS and ECASS HT classification was less than substantial, with disagreement occurring in more than one-third of cases. Agreement was higher on MRI-based scores than on CT, and was improved after dichotomization on both CT and MRI. Agreement for TICI scores was moderate (with disagreement occurring in more than 25% of patients), and went above the substantial level (less than 10% disagreement) after dichotomization (TICI 0/1/2a vs 2b/3). Discrepancies between scores assessed by the imaging core lab and those reported by study sites occurred in a significant proportion of patients. Disagreement in the assessment...Continue Reading

References

Jul 19, 2003·Stroke; a Journal of Cerebral Circulation·Randall T HigashidaUNKNOWN Technology Assessment Committee of the Society of Interventional Radiology
Oct 18, 2005·Journal of Neurology, Neurosurgery, and Psychiatry·P A BarberUNKNOWN ASPECTS Study Group
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Feb 12, 2015·The New England Journal of Medicine·Mayank GoyalUNKNOWN ESCAPE Trial Investigators

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Citations

Jul 25, 2019·Stroke; a Journal of Cerebral Circulation·Frank A WollenweberJens Fiehler
Feb 4, 2019·Journal of Neurointerventional Surgery·Naim KhouryRobert Fahed
Sep 1, 2019·Journal of Neurointerventional Surgery·Célina DucrouxUNKNOWN ASTER Trial investigators
Apr 18, 2020·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Jose Danilo B DiestroAditya Bharatha
Jul 29, 2020·AJNR. American Journal of Neuroradiology·D M HeifermanJ C Serrone
Mar 20, 2020·Scientific Reports·Takaya KitanoTakeshi Morimoto
Jul 2, 2020·Journal of Neurointerventional Surgery·Célina DucrouxUNKNOWN ETIS investigators
Sep 17, 2020·Stroke; a Journal of Cerebral Circulation·Johannes KaesmacherUNKNOWN BEYOND-SWIFT Investigators
Nov 27, 2020·Frontiers in Neurology·Katinka R van KranendonkUNKNOWN MR CLEAN investigators
Aug 15, 2021·Journal of Neurointerventional Surgery·Maxim MokinAshutosh P Jadhav

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