Hemorrhagic transformation after stroke: inter‐ and intrarater agreement
Background and purpose Hemorrhagic transformation (HT) is a complication of stroke that can occur spontaneously or after treatment. We aimed to assess the inter‐ and intrarater reliability of HT diagnosis. Methods Studies assessing the reliability of the European Cooperative Acute Stroke Study (ECAS...
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| Veröffentlicht in: | European journal of neurology 2019-03, Vol.26 (3), p.476-482 |
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| creator | Guenego, A. Lecler, A. Raymond, J. Sabben, C. Khoury, N. Premat, K. Botta, D. Boisseau, W. Maïer, B. Ciccio, G. Redjem, H. Smajda, S. Ducroux, C. Di Meglio, L. Davy, V. Olivot, J. M. Wang, A. Duplantier, J. Roques, M. Krystal, S. Koskas, P. Collin, A. Ben Maacha, M. Hamdani, M. Zuber, K. Blanc, R. Piotin, M. Fahed, R. |
| description | Background and purpose
Hemorrhagic transformation (HT) is a complication of stroke that can occur spontaneously or after treatment. We aimed to assess the inter‐ and intrarater reliability of HT diagnosis.
Methods
Studies assessing the reliability of the European Cooperative Acute Stroke Study (ECASS) classification of HT or of the presence (yes/no) of HT were systematically reviewed. A total of 18 raters independently examined 30 post‐thrombectomy computed tomography scans selected from the Aspiration versus STEnt‐Retriever (ASTER) trial. They were asked whether there was HT (yes/no), what the ECASS classification of the particular scan (0/HI1/HI2/PH1/PH2) (HI indicates hemorrhagic infarctions and PH indicates parenchymal hematomas) was and whether they would prescribe an antiplatelet agent if it was otherwise indicated. Agreement was measured with Fleiss’ and Cohen's κ statistics.
Results
The systematic review yielded four studies involving few (≤3) raters with heterogeneous results. In our 18‐rater study, agreement for the presence of HT was moderate [κ = 0.55; 95% confidence interval (CI), 0.41–0.68]. Agreement for ECASS classification was only fair for all five categories, but agreement improved to substantial (κ = 0.72; 95% CI, 0.69–0.75) after dichotomizing the ECASS classification into 0/HI1/HI2/PH1 versus PH2. The inter‐rater agreement for the decision to reintroduce antiplatelet therapy was moderate for all raters, but substantial among vascular neurologists (κ = 0.70; 95% CI, 0.57–0.84).
Conclusion
The ECASS classification may involve too many categories and the diagnosis of HT may not be easily replicable, except in the presence of a large parenchymal hematoma. |
| doi_str_mv | 10.1111/ene.13859 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_hal_p</sourceid><recordid>TN_cdi_hal_primary_oai_HAL_hal_03280064v1</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2132250490</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3879-fff33461c6f4272f841318b6fb6679c281d8bf9c8aa292367f713a71aa2d7d3</originalsourceid><addsrcrecordid>eNp1kc1OxCAUhYnR-L_wBUwTN7qocrkMUHfGjI5mogvdE6YFrbZFoaNx5yP4jD6JjONPYiKby7l8OVw4hGwB3Ye0Dmxn9wHVoFggq8CFygERFtMeB5APgMIKWYvxjlLKJKPLZAUpB46UrZLzkW19CLfmpi6zPpguOh9a09e-y4zrbchiH_y9PczqLqn317fMdNVMBBPM7NzcBGtb2_UbZMmZJtrNr7pOrk6G18ejfHx5enZ8NM5LVLLInXOIXEApHE_jOMUBQU2Emwghi5IpqNTEFaUyhhUMhXQS0EhIspIVrpO9ueutafRDqFsTXrQ3tR4djfWsR5EpSgV_gsTuztmH4B-nNva6rWNpm8Z01k-jZoCMDSgvaEJ3_qB3fhq69I5EScFQcuS_l5fBxxis-5kAqJ5FoVMU-jOKxG5_OU4nra1-yO-_T8DBHHiuG_vyv5MeXgznlh-CZJGF</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2176237434</pqid></control><display><type>article</type><title>Hemorrhagic transformation after stroke: inter‐ and intrarater agreement</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Guenego, A. ; Lecler, A. ; Raymond, J. ; Sabben, C. ; Khoury, N. ; Premat, K. ; Botta, D. ; Boisseau, W. ; Maïer, B. ; Ciccio, G. ; Redjem, H. ; Smajda, S. ; Ducroux, C. ; Di Meglio, L. ; Davy, V. ; Olivot, J. M. ; Wang, A. ; Duplantier, J. ; Roques, M. ; Krystal, S. ; Koskas, P. ; Collin, A. ; Ben Maacha, M. ; Hamdani, M. ; Zuber, K. ; Blanc, R. ; Piotin, M. ; Fahed, R.</creator><creatorcontrib>Guenego, A. ; Lecler, A. ; Raymond, J. ; Sabben, C. ; Khoury, N. ; Premat, K. ; Botta, D. ; Boisseau, W. ; Maïer, B. ; Ciccio, G. ; Redjem, H. ; Smajda, S. ; Ducroux, C. ; Di Meglio, L. ; Davy, V. ; Olivot, J. M. ; Wang, A. ; Duplantier, J. ; Roques, M. ; Krystal, S. ; Koskas, P. ; Collin, A. ; Ben Maacha, M. ; Hamdani, M. ; Zuber, K. ; Blanc, R. ; Piotin, M. ; Fahed, R. ; Aspiration versus STEnt-Retriever (ASTER) trial investigators ; the Aspiration versus STEnt‐Retriever (ASTER) trial investigators</creatorcontrib><description>Background and purpose
Hemorrhagic transformation (HT) is a complication of stroke that can occur spontaneously or after treatment. We aimed to assess the inter‐ and intrarater reliability of HT diagnosis.
Methods
Studies assessing the reliability of the European Cooperative Acute Stroke Study (ECASS) classification of HT or of the presence (yes/no) of HT were systematically reviewed. A total of 18 raters independently examined 30 post‐thrombectomy computed tomography scans selected from the Aspiration versus STEnt‐Retriever (ASTER) trial. They were asked whether there was HT (yes/no), what the ECASS classification of the particular scan (0/HI1/HI2/PH1/PH2) (HI indicates hemorrhagic infarctions and PH indicates parenchymal hematomas) was and whether they would prescribe an antiplatelet agent if it was otherwise indicated. Agreement was measured with Fleiss’ and Cohen's κ statistics.
Results
The systematic review yielded four studies involving few (≤3) raters with heterogeneous results. In our 18‐rater study, agreement for the presence of HT was moderate [κ = 0.55; 95% confidence interval (CI), 0.41–0.68]. Agreement for ECASS classification was only fair for all five categories, but agreement improved to substantial (κ = 0.72; 95% CI, 0.69–0.75) after dichotomizing the ECASS classification into 0/HI1/HI2/PH1 versus PH2. The inter‐rater agreement for the decision to reintroduce antiplatelet therapy was moderate for all raters, but substantial among vascular neurologists (κ = 0.70; 95% CI, 0.57–0.84).
Conclusion
The ECASS classification may involve too many categories and the diagnosis of HT may not be easily replicable, except in the presence of a large parenchymal hematoma.</description><identifier>ISSN: 1351-5101</identifier><identifier>EISSN: 1468-1331</identifier><identifier>DOI: 10.1111/ene.13859</identifier><identifier>PMID: 30414302</identifier><language>eng</language><publisher>England: John Wiley & Sons, Inc</publisher><subject>Bioengineering ; Classification ; Computed tomography ; Computer Science ; Confidence intervals ; Diagnosis ; Hematoma ; Hemorrhage ; Human health and pathology ; Implants ; Life Sciences ; Medical Imaging ; Nuclear medicine ; Reliability analysis ; Stroke ; Surgical implants</subject><ispartof>European journal of neurology, 2019-03, Vol.26 (3), p.476-482</ispartof><rights>2018 EAN</rights><rights>2018 EAN.</rights><rights>Copyright © 2019 European Academy of Neurology</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3879-fff33461c6f4272f841318b6fb6679c281d8bf9c8aa292367f713a71aa2d7d3</citedby><cites>FETCH-LOGICAL-c3879-fff33461c6f4272f841318b6fb6679c281d8bf9c8aa292367f713a71aa2d7d3</cites><orcidid>0000-0002-1887-5097</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fene.13859$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fene.13859$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30414302$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.univ-lorraine.fr/hal-03280064$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Guenego, A.</creatorcontrib><creatorcontrib>Lecler, A.</creatorcontrib><creatorcontrib>Raymond, J.</creatorcontrib><creatorcontrib>Sabben, C.</creatorcontrib><creatorcontrib>Khoury, N.</creatorcontrib><creatorcontrib>Premat, K.</creatorcontrib><creatorcontrib>Botta, D.</creatorcontrib><creatorcontrib>Boisseau, W.</creatorcontrib><creatorcontrib>Maïer, B.</creatorcontrib><creatorcontrib>Ciccio, G.</creatorcontrib><creatorcontrib>Redjem, H.</creatorcontrib><creatorcontrib>Smajda, S.</creatorcontrib><creatorcontrib>Ducroux, C.</creatorcontrib><creatorcontrib>Di Meglio, L.</creatorcontrib><creatorcontrib>Davy, V.</creatorcontrib><creatorcontrib>Olivot, J. M.</creatorcontrib><creatorcontrib>Wang, A.</creatorcontrib><creatorcontrib>Duplantier, J.</creatorcontrib><creatorcontrib>Roques, M.</creatorcontrib><creatorcontrib>Krystal, S.</creatorcontrib><creatorcontrib>Koskas, P.</creatorcontrib><creatorcontrib>Collin, A.</creatorcontrib><creatorcontrib>Ben Maacha, M.</creatorcontrib><creatorcontrib>Hamdani, M.</creatorcontrib><creatorcontrib>Zuber, K.</creatorcontrib><creatorcontrib>Blanc, R.</creatorcontrib><creatorcontrib>Piotin, M.</creatorcontrib><creatorcontrib>Fahed, R.</creatorcontrib><creatorcontrib>Aspiration versus STEnt-Retriever (ASTER) trial investigators</creatorcontrib><creatorcontrib>the Aspiration versus STEnt‐Retriever (ASTER) trial investigators</creatorcontrib><title>Hemorrhagic transformation after stroke: inter‐ and intrarater agreement</title><title>European journal of neurology</title><addtitle>Eur J Neurol</addtitle><description>Background and purpose
Hemorrhagic transformation (HT) is a complication of stroke that can occur spontaneously or after treatment. We aimed to assess the inter‐ and intrarater reliability of HT diagnosis.
Methods
Studies assessing the reliability of the European Cooperative Acute Stroke Study (ECASS) classification of HT or of the presence (yes/no) of HT were systematically reviewed. A total of 18 raters independently examined 30 post‐thrombectomy computed tomography scans selected from the Aspiration versus STEnt‐Retriever (ASTER) trial. They were asked whether there was HT (yes/no), what the ECASS classification of the particular scan (0/HI1/HI2/PH1/PH2) (HI indicates hemorrhagic infarctions and PH indicates parenchymal hematomas) was and whether they would prescribe an antiplatelet agent if it was otherwise indicated. Agreement was measured with Fleiss’ and Cohen's κ statistics.
Results
The systematic review yielded four studies involving few (≤3) raters with heterogeneous results. In our 18‐rater study, agreement for the presence of HT was moderate [κ = 0.55; 95% confidence interval (CI), 0.41–0.68]. Agreement for ECASS classification was only fair for all five categories, but agreement improved to substantial (κ = 0.72; 95% CI, 0.69–0.75) after dichotomizing the ECASS classification into 0/HI1/HI2/PH1 versus PH2. The inter‐rater agreement for the decision to reintroduce antiplatelet therapy was moderate for all raters, but substantial among vascular neurologists (κ = 0.70; 95% CI, 0.57–0.84).
Conclusion
The ECASS classification may involve too many categories and the diagnosis of HT may not be easily replicable, except in the presence of a large parenchymal hematoma.</description><subject>Bioengineering</subject><subject>Classification</subject><subject>Computed tomography</subject><subject>Computer Science</subject><subject>Confidence intervals</subject><subject>Diagnosis</subject><subject>Hematoma</subject><subject>Hemorrhage</subject><subject>Human health and pathology</subject><subject>Implants</subject><subject>Life Sciences</subject><subject>Medical Imaging</subject><subject>Nuclear medicine</subject><subject>Reliability analysis</subject><subject>Stroke</subject><subject>Surgical implants</subject><issn>1351-5101</issn><issn>1468-1331</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp1kc1OxCAUhYnR-L_wBUwTN7qocrkMUHfGjI5mogvdE6YFrbZFoaNx5yP4jD6JjONPYiKby7l8OVw4hGwB3Ye0Dmxn9wHVoFggq8CFygERFtMeB5APgMIKWYvxjlLKJKPLZAUpB46UrZLzkW19CLfmpi6zPpguOh9a09e-y4zrbchiH_y9PczqLqn317fMdNVMBBPM7NzcBGtb2_UbZMmZJtrNr7pOrk6G18ejfHx5enZ8NM5LVLLInXOIXEApHE_jOMUBQU2Emwghi5IpqNTEFaUyhhUMhXQS0EhIspIVrpO9ueutafRDqFsTXrQ3tR4djfWsR5EpSgV_gsTuztmH4B-nNva6rWNpm8Z01k-jZoCMDSgvaEJ3_qB3fhq69I5EScFQcuS_l5fBxxis-5kAqJ5FoVMU-jOKxG5_OU4nra1-yO-_T8DBHHiuG_vyv5MeXgznlh-CZJGF</recordid><startdate>201903</startdate><enddate>201903</enddate><creator>Guenego, A.</creator><creator>Lecler, A.</creator><creator>Raymond, J.</creator><creator>Sabben, C.</creator><creator>Khoury, N.</creator><creator>Premat, K.</creator><creator>Botta, D.</creator><creator>Boisseau, W.</creator><creator>Maïer, B.</creator><creator>Ciccio, G.</creator><creator>Redjem, H.</creator><creator>Smajda, S.</creator><creator>Ducroux, C.</creator><creator>Di Meglio, L.</creator><creator>Davy, V.</creator><creator>Olivot, J. M.</creator><creator>Wang, A.</creator><creator>Duplantier, J.</creator><creator>Roques, M.</creator><creator>Krystal, S.</creator><creator>Koskas, P.</creator><creator>Collin, A.</creator><creator>Ben Maacha, M.</creator><creator>Hamdani, M.</creator><creator>Zuber, K.</creator><creator>Blanc, R.</creator><creator>Piotin, M.</creator><creator>Fahed, R.</creator><general>John Wiley & Sons, Inc</general><general>Wiley</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U7</scope><scope>C1K</scope><scope>K9.</scope><scope>7X8</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0002-1887-5097</orcidid></search><sort><creationdate>201903</creationdate><title>Hemorrhagic transformation after stroke: inter‐ and intrarater agreement</title><author>Guenego, A. ; Lecler, A. ; Raymond, J. ; Sabben, C. ; Khoury, N. ; Premat, K. ; Botta, D. ; Boisseau, W. ; Maïer, B. ; Ciccio, G. ; Redjem, H. ; Smajda, S. ; Ducroux, C. ; Di Meglio, L. ; Davy, V. ; Olivot, J. M. ; Wang, A. ; Duplantier, J. ; Roques, M. ; Krystal, S. ; Koskas, P. ; Collin, A. ; Ben Maacha, M. ; Hamdani, M. ; Zuber, K. ; Blanc, R. ; Piotin, M. ; Fahed, R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3879-fff33461c6f4272f841318b6fb6679c281d8bf9c8aa292367f713a71aa2d7d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Bioengineering</topic><topic>Classification</topic><topic>Computed tomography</topic><topic>Computer Science</topic><topic>Confidence intervals</topic><topic>Diagnosis</topic><topic>Hematoma</topic><topic>Hemorrhage</topic><topic>Human health and pathology</topic><topic>Implants</topic><topic>Life Sciences</topic><topic>Medical Imaging</topic><topic>Nuclear medicine</topic><topic>Reliability analysis</topic><topic>Stroke</topic><topic>Surgical implants</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Guenego, A.</creatorcontrib><creatorcontrib>Lecler, A.</creatorcontrib><creatorcontrib>Raymond, J.</creatorcontrib><creatorcontrib>Sabben, C.</creatorcontrib><creatorcontrib>Khoury, N.</creatorcontrib><creatorcontrib>Premat, K.</creatorcontrib><creatorcontrib>Botta, D.</creatorcontrib><creatorcontrib>Boisseau, W.</creatorcontrib><creatorcontrib>Maïer, B.</creatorcontrib><creatorcontrib>Ciccio, G.</creatorcontrib><creatorcontrib>Redjem, H.</creatorcontrib><creatorcontrib>Smajda, S.</creatorcontrib><creatorcontrib>Ducroux, C.</creatorcontrib><creatorcontrib>Di Meglio, L.</creatorcontrib><creatorcontrib>Davy, V.</creatorcontrib><creatorcontrib>Olivot, J. M.</creatorcontrib><creatorcontrib>Wang, A.</creatorcontrib><creatorcontrib>Duplantier, J.</creatorcontrib><creatorcontrib>Roques, M.</creatorcontrib><creatorcontrib>Krystal, S.</creatorcontrib><creatorcontrib>Koskas, P.</creatorcontrib><creatorcontrib>Collin, A.</creatorcontrib><creatorcontrib>Ben Maacha, M.</creatorcontrib><creatorcontrib>Hamdani, M.</creatorcontrib><creatorcontrib>Zuber, K.</creatorcontrib><creatorcontrib>Blanc, R.</creatorcontrib><creatorcontrib>Piotin, M.</creatorcontrib><creatorcontrib>Fahed, R.</creatorcontrib><creatorcontrib>Aspiration versus STEnt-Retriever (ASTER) trial investigators</creatorcontrib><creatorcontrib>the Aspiration versus STEnt‐Retriever (ASTER) trial investigators</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>European journal of neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Guenego, A.</au><au>Lecler, A.</au><au>Raymond, J.</au><au>Sabben, C.</au><au>Khoury, N.</au><au>Premat, K.</au><au>Botta, D.</au><au>Boisseau, W.</au><au>Maïer, B.</au><au>Ciccio, G.</au><au>Redjem, H.</au><au>Smajda, S.</au><au>Ducroux, C.</au><au>Di Meglio, L.</au><au>Davy, V.</au><au>Olivot, J. M.</au><au>Wang, A.</au><au>Duplantier, J.</au><au>Roques, M.</au><au>Krystal, S.</au><au>Koskas, P.</au><au>Collin, A.</au><au>Ben Maacha, M.</au><au>Hamdani, M.</au><au>Zuber, K.</au><au>Blanc, R.</au><au>Piotin, M.</au><au>Fahed, R.</au><aucorp>Aspiration versus STEnt-Retriever (ASTER) trial investigators</aucorp><aucorp>the Aspiration versus STEnt‐Retriever (ASTER) trial investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hemorrhagic transformation after stroke: inter‐ and intrarater agreement</atitle><jtitle>European journal of neurology</jtitle><addtitle>Eur J Neurol</addtitle><date>2019-03</date><risdate>2019</risdate><volume>26</volume><issue>3</issue><spage>476</spage><epage>482</epage><pages>476-482</pages><issn>1351-5101</issn><eissn>1468-1331</eissn><abstract>Background and purpose
Hemorrhagic transformation (HT) is a complication of stroke that can occur spontaneously or after treatment. We aimed to assess the inter‐ and intrarater reliability of HT diagnosis.
Methods
Studies assessing the reliability of the European Cooperative Acute Stroke Study (ECASS) classification of HT or of the presence (yes/no) of HT were systematically reviewed. A total of 18 raters independently examined 30 post‐thrombectomy computed tomography scans selected from the Aspiration versus STEnt‐Retriever (ASTER) trial. They were asked whether there was HT (yes/no), what the ECASS classification of the particular scan (0/HI1/HI2/PH1/PH2) (HI indicates hemorrhagic infarctions and PH indicates parenchymal hematomas) was and whether they would prescribe an antiplatelet agent if it was otherwise indicated. Agreement was measured with Fleiss’ and Cohen's κ statistics.
Results
The systematic review yielded four studies involving few (≤3) raters with heterogeneous results. In our 18‐rater study, agreement for the presence of HT was moderate [κ = 0.55; 95% confidence interval (CI), 0.41–0.68]. Agreement for ECASS classification was only fair for all five categories, but agreement improved to substantial (κ = 0.72; 95% CI, 0.69–0.75) after dichotomizing the ECASS classification into 0/HI1/HI2/PH1 versus PH2. The inter‐rater agreement for the decision to reintroduce antiplatelet therapy was moderate for all raters, but substantial among vascular neurologists (κ = 0.70; 95% CI, 0.57–0.84).
Conclusion
The ECASS classification may involve too many categories and the diagnosis of HT may not be easily replicable, except in the presence of a large parenchymal hematoma.</abstract><cop>England</cop><pub>John Wiley & Sons, Inc</pub><pmid>30414302</pmid><doi>10.1111/ene.13859</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-1887-5097</orcidid></addata></record> |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Bioengineering Classification Computed tomography Computer Science Confidence intervals Diagnosis Hematoma Hemorrhage Human health and pathology Implants Life Sciences Medical Imaging Nuclear medicine Reliability analysis Stroke Surgical implants |
| title | Hemorrhagic transformation after stroke: inter‐ and intrarater agreement |
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