Trial reportNeuroradiology2015
Observer reliability of CT angiography in the assessment of acute ischaemic stroke: data from the Third International Stroke Trial.
Trial report in Neuroradiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 51 citations in OpenAlex.
- Pooled it
- Effect of X-Ray Attenuation of Arterial Obstructions on Intravenous Thrombolysis and Outcome after Ischemic Stroke.PloS one · 2015Trial
- Comparison of AI-assisted quantitative collateral score and visual collateral score in stroke thrombectomy triage.Neuroradiology · 2026Article
- Development of a deep learning method to identify acute ischaemic stroke lesions on brain CT.Stroke and vascular neurology · 2025Article
- Automatic collateral quantification in acute ischemic stroke using UFrontiers in neurology · 2025Article
- Validation of CT perfusion-based vascular territory mapping: correlation to visual pial grading and outcome measures.BMJ neurology open · 2025Article
- Diagnostic accuracy of large and medium vessel occlusions in acute stroke imaging by neurology residents and stroke fellows: A comparison of CT angiography alone and CT angiography with CT perfusion.European stroke journal · 2024Article
- Intravenous Thrombolysis Before Thrombectomy Improves Functional Outcome After Stroke Independent of Reperfusion Grade.Journal of the American Heart Association · 2024Article
- Factors Associated With Fast Early Infarct Growth in Patients With Acute Ischemic Stroke With a Large Vessel Occlusion.Neurology · 2023Article
- Accuracy of artificial intelligence software for CT angiography in stroke.Annals of clinical and translational neurology · 2023Article
- Bifurcation occlusions and endovascular treatment outcome in acute ischemic stroke.Journal of neurointerventional surgery · 2023Article
- External Validation of e-ASPECTS Software for Interpreting Brain CT in Stroke.Annals of neurology · 2022Article
- FLAIR vascular hyperintensities predict functional outcome after endovascular thrombectomy in patients with large ischemic cores.European radiology · 2022Article
- Normal Appearing Ischaemic Brain Tissue on CT and Outcome After Intravenous Alteplase.Frontiers in radiology · 2022Article
- Accuracy of CTA evaluations in daily clinical practice for large and medium vessel occlusion detection in suspected stroke patients.European stroke journal · 2021Article
- COVID-19 pneumonia and its lookalikes: How radiologists perform in differentiating atypical pneumonias.European journal of radiology · 2021Article
- FLAIR vascular hyperintensities and functional outcome in nonagenarians with anterior circulation large-vessel ischemic stroke treated with endovascular thrombectomy.European radiology · 2021Article
- Reliability of Retinal Pathology Quantification in Age-Related Macular Degeneration: Implications for Clinical Trials and Machine Learning Applications.Translational vision science & technology · 2021Article
- Clot Burden Score and Collateral Status and Their Impact on Functional Outcome in Acute Ischemic Stroke.AJNR. American journal of neuroradiology · 2021Article
- Interrater variability for CT angiography evaluation between neurologists and neuroradiologist in acute stroke patients.The British journal of radiology · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
23 authors at 8 institutions in 3 countries.
Funding
Abstract
introductionCT angiography (CTA) is often used for assessing patients with acute ischaemic stroke. Only limited observer reliability data exist. We tested inter- and intra-observer reliability for the assessment of CTA in acute ischaemic stroke.
methodsWe selected 15 cases from the Third International Stroke Trial (IST-3, ISRCTN25765518) with various degrees of arterial obstruction in different intracranial locations on CTA. To assess inter-observer reliability, seven members of the IST-3 expert image reading panel (>5 years experience reading CTA) and seven radiology trainees (<2 years experience) rated all 15 scans independently and blind to clinical data for: presence (versus absence) of any intracranial arterial abnormality (stenosis or occlusion), severity of arterial abnormality using relevant scales (IST-3 angiography score, Thrombolysis in Cerebral Infarction (TICI) score, Clot Burden Score), collateral supply and visibility of a perfusion defect on CTA source images (CTA-SI). Intra-observer reliability was assessed using independently repeated expert panel scan ratings. We assessed observer agreement with Krippendorff's-alpha (K-alpha).
resultsAmong experienced observers, inter-observer agreement was substantial for the identification of any angiographic abnormality (K-alpha = 0.70) and with an angiography assessment scale (K-alpha = 0.60-0.66). There was less agreement for grades of collateral supply (K-alpha = 0.56) or for identification of a perfusion defect on CTA-SI (K-alpha = 0.32). Radiology trainees performed as well as expert readers when additional training was undertaken (neuroradiology specialist trainees). Intra-observer agreement among experts provided similar results (K-alpha = 0.33-0.72).
conclusionFor most imaging characteristics assessed, CTA has moderate to substantial observer agreement in acute ischaemic stroke. Experienced readers and those with specialist training perform best.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.