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ASPECTS Interobserver Agreement of 100 Investigators from the TENSION Study

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ASPECTS Interobserver Agreement of 100 Investigators from the TENSION Study. / van Horn, Noel; Kniep, Helge; Broocks, Gabriel; Meyer, Lukas; Flottmann, Fabian Alexander; Bechstein, Matthias; Götz, Julia; Thomalla, Götz; Bendszus, Martin; Bonekamp, Susanne; Pfaff, Johannes; Dellani, Paulo; Fiehler, Jens; Hanning, Uta.

In: CLIN NEURORADIOL, Vol. 31, No. 4, 18.12.2021, p. 1093-1100.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

van Horn, N, Kniep, H, Broocks, G, Meyer, L, Flottmann, FA, Bechstein, M, Götz, J, Thomalla, G, Bendszus, M, Bonekamp, S, Pfaff, J, Dellani, P, Fiehler, J & Hanning, U 2021, 'ASPECTS Interobserver Agreement of 100 Investigators from the TENSION Study', CLIN NEURORADIOL, vol. 31, no. 4, pp. 1093-1100. https://doi.org/10.1007/s00062-020-00988-x

APA

van Horn, N., Kniep, H., Broocks, G., Meyer, L., Flottmann, F. A., Bechstein, M., Götz, J., Thomalla, G., Bendszus, M., Bonekamp, S., Pfaff, J., Dellani, P., Fiehler, J., & Hanning, U. (2021). ASPECTS Interobserver Agreement of 100 Investigators from the TENSION Study. CLIN NEURORADIOL, 31(4), 1093-1100. https://doi.org/10.1007/s00062-020-00988-x

Vancouver

van Horn N, Kniep H, Broocks G, Meyer L, Flottmann FA, Bechstein M et al. ASPECTS Interobserver Agreement of 100 Investigators from the TENSION Study. CLIN NEURORADIOL. 2021 Dec 18;31(4):1093-1100. https://doi.org/10.1007/s00062-020-00988-x

Bibtex

@article{cce3a683566b42d3b6275a13d57d9e8f,
title = "ASPECTS Interobserver Agreement of 100 Investigators from the TENSION Study",
abstract = "PURPOSE: Evaluating the extent of cerebral ischemic infarction is essential for treatment decisions and assessment of possible complications in patients with acute ischemic stroke. Patients are often triaged according to image-based early signs of infarction, defined by Alberta Stroke Program Early CT Score (ASPECTS). Our aim was to evaluate interrater reliability in a large group of readers.METHODS: We retrospectively analyzed 100 investigators who independently evaluated 20 non-contrast computed tomography (NCCT) scans as part of their qualification program for the TENSION study. Test cases were chosen by four neuroradiologists who had previously scored NCCT scans with ASPECTS between 0 and 8 and high interrater agreement. Percent and interrater agreements were calculated for total ASPECTS, as well as for each ASPECTS region.RESULTS: Percent agreements for ASPECTS ratings was 28%, with interrater agreement of 0.13 (95% confidence interval, CI 0.09-0.16), at zero tolerance allowance and 66%, with interrater agreement of 0.32 (95% CI: 0.21-0.44), at tolerance allowance set by TENSION inclusion criteria. ASPECTS region with highest level of agreement was the insular cortex (percent agreement = 96%, interrater agreement = 0.96 (95% CI: 0.94-0.97)) and with lowest level of agreement the M3 region (percent agreement = 68%, interrater agreement = 0.39 [95% CI: 0.17-0.61]).CONCLUSION: Interrater agreement reliability for total ASPECTS and study enrollment was relatively low but seems sufficient for practical application. Individual region analysis suggests that some are particularly difficult to evaluate, with varying levels of reliability. Potential impairment of the supraganglionic region must be examined carefully, particularly with respect to the decision whether or not to perform mechanical thrombectomy.",
keywords = "Alberta, Brain Ischemia/diagnostic imaging, Humans, Insular Cortex, Observer Variation, Reproducibility of Results, Retrospective Studies, Stroke/diagnostic imaging",
author = "{van Horn}, Noel and Helge Kniep and Gabriel Broocks and Lukas Meyer and Flottmann, {Fabian Alexander} and Matthias Bechstein and Julia G{\"o}tz and G{\"o}tz Thomalla and Martin Bendszus and Susanne Bonekamp and Johannes Pfaff and Paulo Dellani and Jens Fiehler and Uta Hanning",
note = "{\textcopyright} 2021. The Author(s).",
year = "2021",
month = dec,
day = "18",
doi = "10.1007/s00062-020-00988-x",
language = "English",
volume = "31",
pages = "1093--1100",
journal = "CLIN NEURORADIOL",
issn = "1869-1439",
publisher = "Springer Heidelberg",
number = "4",

}

RIS

TY - JOUR

T1 - ASPECTS Interobserver Agreement of 100 Investigators from the TENSION Study

AU - van Horn, Noel

AU - Kniep, Helge

AU - Broocks, Gabriel

AU - Meyer, Lukas

AU - Flottmann, Fabian Alexander

AU - Bechstein, Matthias

AU - Götz, Julia

AU - Thomalla, Götz

AU - Bendszus, Martin

AU - Bonekamp, Susanne

AU - Pfaff, Johannes

AU - Dellani, Paulo

AU - Fiehler, Jens

AU - Hanning, Uta

N1 - © 2021. The Author(s).

PY - 2021/12/18

Y1 - 2021/12/18

N2 - PURPOSE: Evaluating the extent of cerebral ischemic infarction is essential for treatment decisions and assessment of possible complications in patients with acute ischemic stroke. Patients are often triaged according to image-based early signs of infarction, defined by Alberta Stroke Program Early CT Score (ASPECTS). Our aim was to evaluate interrater reliability in a large group of readers.METHODS: We retrospectively analyzed 100 investigators who independently evaluated 20 non-contrast computed tomography (NCCT) scans as part of their qualification program for the TENSION study. Test cases were chosen by four neuroradiologists who had previously scored NCCT scans with ASPECTS between 0 and 8 and high interrater agreement. Percent and interrater agreements were calculated for total ASPECTS, as well as for each ASPECTS region.RESULTS: Percent agreements for ASPECTS ratings was 28%, with interrater agreement of 0.13 (95% confidence interval, CI 0.09-0.16), at zero tolerance allowance and 66%, with interrater agreement of 0.32 (95% CI: 0.21-0.44), at tolerance allowance set by TENSION inclusion criteria. ASPECTS region with highest level of agreement was the insular cortex (percent agreement = 96%, interrater agreement = 0.96 (95% CI: 0.94-0.97)) and with lowest level of agreement the M3 region (percent agreement = 68%, interrater agreement = 0.39 [95% CI: 0.17-0.61]).CONCLUSION: Interrater agreement reliability for total ASPECTS and study enrollment was relatively low but seems sufficient for practical application. Individual region analysis suggests that some are particularly difficult to evaluate, with varying levels of reliability. Potential impairment of the supraganglionic region must be examined carefully, particularly with respect to the decision whether or not to perform mechanical thrombectomy.

AB - PURPOSE: Evaluating the extent of cerebral ischemic infarction is essential for treatment decisions and assessment of possible complications in patients with acute ischemic stroke. Patients are often triaged according to image-based early signs of infarction, defined by Alberta Stroke Program Early CT Score (ASPECTS). Our aim was to evaluate interrater reliability in a large group of readers.METHODS: We retrospectively analyzed 100 investigators who independently evaluated 20 non-contrast computed tomography (NCCT) scans as part of their qualification program for the TENSION study. Test cases were chosen by four neuroradiologists who had previously scored NCCT scans with ASPECTS between 0 and 8 and high interrater agreement. Percent and interrater agreements were calculated for total ASPECTS, as well as for each ASPECTS region.RESULTS: Percent agreements for ASPECTS ratings was 28%, with interrater agreement of 0.13 (95% confidence interval, CI 0.09-0.16), at zero tolerance allowance and 66%, with interrater agreement of 0.32 (95% CI: 0.21-0.44), at tolerance allowance set by TENSION inclusion criteria. ASPECTS region with highest level of agreement was the insular cortex (percent agreement = 96%, interrater agreement = 0.96 (95% CI: 0.94-0.97)) and with lowest level of agreement the M3 region (percent agreement = 68%, interrater agreement = 0.39 [95% CI: 0.17-0.61]).CONCLUSION: Interrater agreement reliability for total ASPECTS and study enrollment was relatively low but seems sufficient for practical application. Individual region analysis suggests that some are particularly difficult to evaluate, with varying levels of reliability. Potential impairment of the supraganglionic region must be examined carefully, particularly with respect to the decision whether or not to perform mechanical thrombectomy.

KW - Alberta

KW - Brain Ischemia/diagnostic imaging

KW - Humans

KW - Insular Cortex

KW - Observer Variation

KW - Reproducibility of Results

KW - Retrospective Studies

KW - Stroke/diagnostic imaging

U2 - 10.1007/s00062-020-00988-x

DO - 10.1007/s00062-020-00988-x

M3 - SCORING: Journal article

C2 - 33502563

VL - 31

SP - 1093

EP - 1100

JO - CLIN NEURORADIOL

JF - CLIN NEURORADIOL

SN - 1869-1439

IS - 4

ER -