Title |
e-ASPECTS software is non-inferior to neuroradiologists in applying the ASPECT score to computed tomography scans of acute ischemic stroke patients
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Published in |
International Journal of Stroke, December 2016
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DOI | 10.1177/1747493016681020 |
Pubmed ID | |
Authors |
Simon Nagel, Devesh Sinha, Diana Day, Wolfgang Reith, René Chapot, Panagiotis Papanagiotou, Elizabeth A Warburton, Paul Guyler, Sharon Tysoe, Klaus Fassbender, Silke Walter, Marco Essig, Jens Heidenrich, Angelos A Konstas, Michael Harrison, Michalis Papadakis, Eric Greveson, Olivier Joly, Stephen Gerry, Holly Maguire, Christine Roffe, James Hampton-Till, Alastair M Buchan, Iris Q Grunwald |
Abstract |
The Alberta Stroke Program Early Computed Tomography Score (ASPECTS) is an established 10-point quantitative topographic computed tomography scan score to assess early ischemic changes. We performed a non-inferiority trial between the e-ASPECTS software and neuroradiologists in scoring ASPECTS on non-contrast enhanced computed tomography images of acute ischemic stroke patients. In this multicenter study, e-ASPECTS and three independent neuroradiologists retrospectively and blindly assessed baseline non-contrast enhanced computed tomography images of 132 patients with acute anterior circulation ischemic stroke. Follow-up scans served as ground truth to determine the definite area of infarction. Sensitivity, specificity, and accuracy for region- and score-based analysis, receiver-operating characteristic curves, Bland-Altman plots and Matthews correlation coefficients relative to the ground truth were calculated and comparisons were made between neuroradiologists and different pre-specified e-ASPECTS operating points. The non-inferiority margin was set to 10% for both sensitivity and specificity on region-based analysis. In total 2640 (132 patients × 20 regions per patient) ASPECTS regions were scored. Mean time from onset to baseline computed tomography was 146 ± 124 min and median NIH Stroke Scale (NIHSS) was 11 (6-17, interquartile range). Median ASPECTS for ground truth on follow-up imaging was 8 (6.5-9, interquartile range). In the region-based analysis, two e-ASPECTS operating points (sensitivity, specificity, and accuracy of 44%, 93%, 87% and 44%, 91%, 85%) were statistically non-inferior to all three neuroradiologists (all p-values <0.003). Both Matthews correlation coefficients for e-ASPECTS were higher (0.36 and 0.34) than those of all neuroradiologists (0.32, 0.31, and 0.3). e-ASPECTS was non-inferior to three neuroradiologists in scoring ASPECTS on non-contrast enhanced computed tomography images of acute stroke patients. |
X Demographics
Geographical breakdown
Country | Count | As % |
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United Kingdom | 2 | 50% |
Hungary | 1 | 25% |
Unknown | 1 | 25% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 2 | 50% |
Practitioners (doctors, other healthcare professionals) | 2 | 50% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Unknown | 178 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Researcher | 34 | 19% |
Student > Ph. D. Student | 20 | 11% |
Student > Master | 20 | 11% |
Other | 14 | 8% |
Student > Postgraduate | 11 | 6% |
Other | 29 | 16% |
Unknown | 50 | 28% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 59 | 33% |
Neuroscience | 13 | 7% |
Computer Science | 11 | 6% |
Engineering | 10 | 6% |
Biochemistry, Genetics and Molecular Biology | 4 | 2% |
Other | 17 | 10% |
Unknown | 64 | 36% |