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Article: Per-region interobserver agreement of Alberta stroke program early CT scores (ASPECTS)

TitlePer-region interobserver agreement of Alberta stroke program early CT scores (ASPECTS)
Authors
KeywordsCT
stroke
Issue Date2020
PublisherBMJ Group. The Journal's web site is located at http://jnis.bmj.com
Citation
Journal of NeuroInterventional Surgery, 2020, Epub 2020-02-05 How to Cite?
AbstractBackground and purpose: The Alberta Stroke Program Early CT Score (ASPECTS) is a commonly used scoring system to select patients with stroke for endovascular treatment (EVT). However, the inter- and intra-reader variability is high. Objective: To determine whether the inter- and intra-reader variability is different for various regions of the ASPECTS scoring system by evaluating the interobserver variability of ASPECTS between different readers in a per-region analysis. Materials and methods: All patients with acute ischemic stroke who proceeded to EVT in our institutions over a 4-year period were retrospectively identified from a prospectively maintained database. Images were reviewed by two experienced neuroradiologists, who recalculated the ASPECTS independently. We examined each region of the ASPECTS system to evaluate agreement between the raters in each area. Results: 375 patients were included. The median total ASPECTS was 9 (IQR 8–9). The most common region showing ischemic change was the insula, with the M6 region being least commonly affected. Overall interobserver agreement for ASPECTS using Cohen’s κ was 0.56 (95% CI 0.51 to 0.61). The region with the highest agreement was the insula (κ=0.56; 0.48 to 0.64). The region with the lowest agreement was M3 (κ=0.34; 0.12 to 0.56). Agreement was relatively good when ASPECTS were dichotomized into 0–5 versus 6–10 (κ=0.66; 0.49 to 0.84). Conclusions: Substantial interobserver variability is found when calculating ASPECTS. This variability is region dependent, and practitioners should take this into account when using ASPECTS for treatment decisions in patients with acute stroke.
Persistent Identifierhttp://hdl.handle.net/10722/280985
ISSN
2020 Impact Factor: 5.836
2020 SCImago Journal Rankings: 2.652
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorNicholson, P-
dc.contributor.authorHilditch, CA-
dc.contributor.authorNeuhaus, A-
dc.contributor.authorSeyedsaadat, SM-
dc.contributor.authorBenson, JC-
dc.contributor.authorMark, I-
dc.contributor.authorTsang, COA-
dc.contributor.authorSchaafsma, J-
dc.contributor.authorKallmes, DF-
dc.contributor.authorKrings, T-
dc.contributor.authorBrinjikji, W-
dc.date.accessioned2020-02-25T07:43:37Z-
dc.date.available2020-02-25T07:43:37Z-
dc.date.issued2020-
dc.identifier.citationJournal of NeuroInterventional Surgery, 2020, Epub 2020-02-05-
dc.identifier.issn1759-8478-
dc.identifier.urihttp://hdl.handle.net/10722/280985-
dc.description.abstractBackground and purpose: The Alberta Stroke Program Early CT Score (ASPECTS) is a commonly used scoring system to select patients with stroke for endovascular treatment (EVT). However, the inter- and intra-reader variability is high. Objective: To determine whether the inter- and intra-reader variability is different for various regions of the ASPECTS scoring system by evaluating the interobserver variability of ASPECTS between different readers in a per-region analysis. Materials and methods: All patients with acute ischemic stroke who proceeded to EVT in our institutions over a 4-year period were retrospectively identified from a prospectively maintained database. Images were reviewed by two experienced neuroradiologists, who recalculated the ASPECTS independently. We examined each region of the ASPECTS system to evaluate agreement between the raters in each area. Results: 375 patients were included. The median total ASPECTS was 9 (IQR 8–9). The most common region showing ischemic change was the insula, with the M6 region being least commonly affected. Overall interobserver agreement for ASPECTS using Cohen’s κ was 0.56 (95% CI 0.51 to 0.61). The region with the highest agreement was the insula (κ=0.56; 0.48 to 0.64). The region with the lowest agreement was M3 (κ=0.34; 0.12 to 0.56). Agreement was relatively good when ASPECTS were dichotomized into 0–5 versus 6–10 (κ=0.66; 0.49 to 0.84). Conclusions: Substantial interobserver variability is found when calculating ASPECTS. This variability is region dependent, and practitioners should take this into account when using ASPECTS for treatment decisions in patients with acute stroke.-
dc.languageeng-
dc.publisherBMJ Group. The Journal's web site is located at http://jnis.bmj.com-
dc.relation.ispartofJournal of NeuroInterventional Surgery-
dc.rightsJournal of NeuroInterventional Surgery. Copyright © BMJ Group.-
dc.rightsThis article has been accepted for publication in [Journal, Year] following peer review, and the Version of Record can be accessed online at [insert full DOI eg. http://dx.doi.org/10.1136/xxxxx]. [© Authors (or their employer(s)) OR © BMJ Publishing Group Ltd ( for assignments of BMJ Case Reports)] <year>-
dc.subjectCT-
dc.subjectstroke-
dc.titlePer-region interobserver agreement of Alberta stroke program early CT scores (ASPECTS)-
dc.typeArticle-
dc.identifier.emailNicholson, P: paddynicholson@gmail.com-
dc.identifier.emailTsang, COA: acotsang@hku.hk-
dc.identifier.authorityTsang, COA=rp01519-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1136/neurintsurg-2019-015473-
dc.identifier.pmid32024784-
dc.identifier.scopuseid_2-s2.0-85079157643-
dc.identifier.hkuros309219-
dc.identifier.volumeEpub 2020-02-05-
dc.identifier.isiWOS:000580458200010-
dc.publisher.placeUnited Kingdom-
dc.identifier.issnl1759-8478-

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