Interobserver Agreement on Intracranial Hemorrhage on Magnetic Resonance Imaging in Patients With Ischemic Stroke
BACKGROUND: The Heidelberg Bleeding Classification, developed for computed tomography, is also frequently used to classify intracranial hemorrhage (ICH) on magnetic resonance imaging. Additionally, the presence of any ICH is frequently used as (safety) outcome measure in clinical stroke trials that evaluate acute interventions. We assessed the interobserver agreement on the presence of any ICH and the type of ICH according to the Heidelberg Bleeding Classification on magnetic resonance imaging in patients treated with reperfusion therapy.
METHODS: We used 300 magnetic resonance imaging scans including susceptibility-weighted imaging or T2*-weighted gradient echo imaging of ischemic stroke patients within 1 week after reperfusion therapy. Six observers, blinded to clinical characteristics except for suspected location of the infarction, independently rated ICH according to the Heidelberg Bleeding Classification in random pairs. Percent agreement and Cohen's kappa (κ) were estimated for the presence of any ICH (yes/no), and for agreement on the Heidelberg Bleeding Classification class 1 and 2. For the Heidelberg Bleeding Classification class 1 and 2, weighted κ was estimated to take the degree of disagreement into account.
RESULTS: In 297 of 300 scans, the quality of scans was sufficient to score ICH. Observers agreed on the presence or absence of any ICH in 264 of 297 scans (88.9%; κ 0.78 [95% CI, 0.71-0.85]). There was agreement on the Heidelberg Bleeding Classification class 1 and 2 and no ICH in class 1 and 2 in 226 of 297 scans (76.1%; κ 0.63 [95% CI, 0.56-0.69]; weighted κ 0.90 [95% CI, 0.87-0.93]).
CONCLUSIONS: The presence of any ICH can be reliably scored on magnetic resonance imaging and can, therefore, be used as (safety) outcome measure in clinical stroke trials that evaluate acute interventions. Agreement of ICH types according to the Heidelberg Bleeding Classification is substantial and disagreements are small.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:54 |
|---|---|
| Enthalten in: |
Stroke - 54(2023), 6 vom: 04. Juni, Seite 1587-1592 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
van der Ende, Nadinda A M [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Interobserver agreement |
|---|
| Anmerkungen: |
Date Completed 24.05.2023 Date Revised 02.06.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1161/STROKEAHA.122.042145 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM356571963 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM356571963 | ||
| 003 | DE-627 | ||
| 005 | 20231226070740.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1161/STROKEAHA.122.042145 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1188.xml |
| 035 | |a (DE-627)NLM356571963 | ||
| 035 | |a (NLM)37154054 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a van der Ende, Nadinda A M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Interobserver Agreement on Intracranial Hemorrhage on Magnetic Resonance Imaging in Patients With Ischemic Stroke |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 24.05.2023 | ||
| 500 | |a Date Revised 02.06.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: The Heidelberg Bleeding Classification, developed for computed tomography, is also frequently used to classify intracranial hemorrhage (ICH) on magnetic resonance imaging. Additionally, the presence of any ICH is frequently used as (safety) outcome measure in clinical stroke trials that evaluate acute interventions. We assessed the interobserver agreement on the presence of any ICH and the type of ICH according to the Heidelberg Bleeding Classification on magnetic resonance imaging in patients treated with reperfusion therapy | ||
| 520 | |a METHODS: We used 300 magnetic resonance imaging scans including susceptibility-weighted imaging or T2*-weighted gradient echo imaging of ischemic stroke patients within 1 week after reperfusion therapy. Six observers, blinded to clinical characteristics except for suspected location of the infarction, independently rated ICH according to the Heidelberg Bleeding Classification in random pairs. Percent agreement and Cohen's kappa (κ) were estimated for the presence of any ICH (yes/no), and for agreement on the Heidelberg Bleeding Classification class 1 and 2. For the Heidelberg Bleeding Classification class 1 and 2, weighted κ was estimated to take the degree of disagreement into account | ||
| 520 | |a RESULTS: In 297 of 300 scans, the quality of scans was sufficient to score ICH. Observers agreed on the presence or absence of any ICH in 264 of 297 scans (88.9%; κ 0.78 [95% CI, 0.71-0.85]). There was agreement on the Heidelberg Bleeding Classification class 1 and 2 and no ICH in class 1 and 2 in 226 of 297 scans (76.1%; κ 0.63 [95% CI, 0.56-0.69]; weighted κ 0.90 [95% CI, 0.87-0.93]) | ||
| 520 | |a CONCLUSIONS: The presence of any ICH can be reliably scored on magnetic resonance imaging and can, therefore, be used as (safety) outcome measure in clinical stroke trials that evaluate acute interventions. Agreement of ICH types according to the Heidelberg Bleeding Classification is substantial and disagreements are small | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a interobserver agreement | |
| 650 | 4 | |a intracranial hemorrhage | |
| 650 | 4 | |a ischemic stroke | |
| 650 | 4 | |a magnetic resonance imaging | |
| 700 | 1 | |a Luijten, Sven P R |e verfasserin |4 aut | |
| 700 | 1 | |a Kluijtmans, Leo |e verfasserin |4 aut | |
| 700 | 1 | |a Postma, Alida A |e verfasserin |4 aut | |
| 700 | 1 | |a Cornelissen, Sandra A |e verfasserin |4 aut | |
| 700 | 1 | |a van Hattem, Antonius M G |e verfasserin |4 aut | |
| 700 | 1 | |a Lycklama À Nijeholt, Geert J |e verfasserin |4 aut | |
| 700 | 1 | |a Bokkers, Reinoud P H |e verfasserin |4 aut | |
| 700 | 1 | |a Thomassen, Lars |e verfasserin |4 aut | |
| 700 | 1 | |a Waje-Andreassen, Ulrike |e verfasserin |4 aut | |
| 700 | 1 | |a Logallo, Nicola |e verfasserin |4 aut | |
| 700 | 1 | |a Bracard, Serge |e verfasserin |4 aut | |
| 700 | 1 | |a Gory, Benjamin |e verfasserin |4 aut | |
| 700 | 1 | |a Roozenbeek, Bob |e verfasserin |4 aut | |
| 700 | 1 | |a Dippel, Diederik W J |e verfasserin |4 aut | |
| 700 | 1 | |a van der Lugt, Aad |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Stroke |d 1970 |g 54(2023), 6 vom: 04. Juni, Seite 1587-1592 |w (DE-627)NLM000010995 |x 1524-4628 |7 nnns |
| 773 | 1 | 8 | |g volume:54 |g year:2023 |g number:6 |g day:04 |g month:06 |g pages:1587-1592 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1161/STROKEAHA.122.042145 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 54 |j 2023 |e 6 |b 04 |c 06 |h 1587-1592 | ||