ASPECTS Interobserver Agreement of 100 Investigators from the
TENSION Study

J 2021

ASPECTS Interobserver Agreement of 100 Investigators from the TENSION Study

HORN, van N., H. KNIEP, G. BROOCKS, L. MEYER, F. FLOTTMANN et. al.

Basic information

Original name

ASPECTS Interobserver Agreement of 100 Investigators from the TENSION Study

Authors

HORN, van N. (guarantor), H. KNIEP, G. BROOCKS, L. MEYER, F. FLOTTMANN, M. BECHSTEIN, J. GOTZ, G. THOMALLA, M. BENDSZUS, S. BONEKAMP, JAR. PFAFF, PR. DELLANI, J. FIEHLER and U. HANNING

Edition

CLINICAL NEURORADIOLOGY, HEIDELBERG, SPRINGER HEIDELBERG, 2021, 1869-1439

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30230 Other clinical medicine subjects

Country of publisher

Germany

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 3.156

RIV identification code

RIV/00216224:14110/21:00124106

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1007/s00062-020-00988-x

UT WoS

000612304600001

Keywords (in Czech)

Acute stroke therapy; Brain; Endovascular treatment; Interrater reliability; Ischemic stroke; Krippendorff's alpha

Keywords in English

Acute stroke therapy; Brain; Endovascular treatment; Interrater reliability; Ischemic stroke; Krippendorff's alpha

Abstract

V originále

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.

Links

90128, large research infrastructures

Name: CZECRIN III

Citovat

HORN, van N., H. KNIEP, G. BROOCKS, L. MEYER, F. FLOTTMANN, M. BECHSTEIN, J. GOTZ, G. THOMALLA, M. BENDSZUS, S. BONEKAMP, JAR. PFAFF, PR. DELLANI, J. FIEHLER and U. HANNING. ASPECTS Interobserver Agreement of 100 Investigators from the TENSION Study. CLINICAL NEURORADIOLOGY. HEIDELBERG: SPRINGER HEIDELBERG, 2021, vol. 31, No 4, p. 1093-1100. ISSN 1869-1439. Available from: https://dx.doi.org/10.1007/s00062-020-00988-x.

@article{1832869,
   author = {Horn, van N. and Kniep, H. and Broocks, G. and Meyer, L. and Flottmann, F. and Bechstein, M. and Gotz, J. and Thomalla, G. and Bendszus, M. and Bonekamp, S. and Pfaff, JAR. and Dellani, PR. and Fiehler, J. and Hanning, U.},
   article_location = {HEIDELBERG},
   article_number = {4},
   doi = {http://dx.doi.org/10.1007/s00062-020-00988-x},
   keywords = {Acute stroke therapy; Brain; Endovascular treatment; Interrater reliability; Ischemic stroke; Krippendorff's alpha},
   language = {eng},
   issn = {1869-1439},
   journal = {CLINICAL NEURORADIOLOGY},
   note = {TENSION},
   title = {ASPECTS Interobserver Agreement of 100 Investigators from the TENSION Study},
   url = {https://link.springer.com/article/10.1007/s00062-020-00988-x},
   volume = {31},
   year = {2021}
}

TY  - JOUR
ID  - 1832869
AU  - Horn, van N. - Kniep, H. - Broocks, G. - Meyer, L. - Flottmann, F. - Bechstein, M. - Gotz, J. - Thomalla, G. - Bendszus, M. - Bonekamp, S. - Pfaff, JAR. - Dellani, PR. - Fiehler, J. - Hanning, U.
PY  - 2021
TI  - ASPECTS Interobserver Agreement of 100 Investigators from the TENSION Study
JF  - CLINICAL NEURORADIOLOGY
VL  - 31
IS  - 4
SP  - 1093-1100
EP  - 1093-1100
PB  - SPRINGER HEIDELBERG
SN  - 18691439
N1  - TENSION
KW  - Acute stroke therapy
KW  - Brain
KW  - Endovascular treatment
KW  - Interrater reliability
KW  - Ischemic stroke
KW  - Krippendorff's alpha
UR  - https://link.springer.com/article/10.1007/s00062-020-00988-x
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.
ER  -

HORN, van N., H. KNIEP, G. BROOCKS, L. MEYER, F. FLOTTMANN, M. BECHSTEIN, J. GOTZ, G. THOMALLA, M. BENDSZUS, S. BONEKAMP, JAR. PFAFF, PR. DELLANI, J. FIEHLER and U. HANNING. ASPECTS Interobserver Agreement of 100 Investigators from the TENSION Study. \textit{CLINICAL NEURORADIOLOGY}. HEIDELBERG: SPRINGER HEIDELBERG, 2021, vol.~31, No~4, p.~1093-1100. ISSN~1869-1439. Available from: https://dx.doi.org/10.1007/s00062-020-00988-x.

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