Evidence map›Paper›PMID 26243227›Full record

SynthesisStroke2015

Accuracy of the ABC/2 Score for Intracerebral Hemorrhage: Systematic Review and Analysis of MISTIE, CLEAR-IVH, and CLEAR III.

Alastair J S Webb, Natalie L Ullman, Tim C Morgan, John Muschelli, Joshua Kornbluth, Issam A Awad, Stephen Mayo, Michael Rosenblum, Wendy Ziai, Mario Zuccarrello and 15 more

2 registry-linked trialsOpen access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Stroke, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 90 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
90citing papers in PubMed, 1 pooled it
6.0field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT00224770 phase2completednot on this map

Minimally Invasive Surgery and rtPA for Intracerebral Hemorrhage Evacuation

TypeinterventionalSponsorDaniel HanleyRan2005 to 2013Enrolled141ConditionsIntracerebral HemorrhageArmsMIS+Cathflo Activase (drug), Intraoperative stereotactic CT-Guided Endoscopic Surgery
NCT00784134 phase3completednot on this map

Clot Lysis: Evaluating Accelerated Resolution of Intraventricular Hemorrhage Phase III

TypeinterventionalSponsorJohns Hopkins UniversityRan2009 to 2016Enrolled500ConditionsIntraventricular HemorrhageArmsAlteplase, Normal saline
3 · Its place in the literature

Who cites it

90 citing papers in PubMed, 1 synthesis or guideline pooled it, 168 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. [Hematoma Segmentation of Spontaneous Intracerebral Hemorrhage Based on Watershed and Region-Growing Algorithm].Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition · 2022
    Trial
  4. Trial
  5. Trial
  6. Trial
  7. Trial
  8. Trial
  9. Article
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  12. Observational
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  16. Comparison of ischemic and hemorrhagic stroke in the thalamus.Quantitative imaging in medicine and surgery · 2026
    Article
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  18. Article
  19. Article
  20. Review

30 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors at 20 institutions in 13 countries.

Alastair J S WebbFrom the Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom (A.J.S.W.); Division of Brain Injury Outcomes, Johns Hopkins Medical Institutions, Baltimore, MD (N.L.U., T.C.M., J.K., W.Z., D.F.H.); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.M., M.R.); Department of Neurosurgery, University of Chicago, IL (I.A.A.); Emissary International, LLC, Austin, TX (S.M.); Department of Neurosurgery, University of Cincinnati, OH (M.Z.); Department of Neurosurgery, University of Maryland, Baltimore (F.A.); Department of Neurology, Rush University Medical Center, Chicago, IL (S.J., G.L.); Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel (S.H.); Department of Neurosurgery, Medical College of Virginia, Richmond (W.C.B., R.B.); Department of Neurology and Neurological Sciences, Stanford Medicine, CA (C.W.); Department of Neurosurgery, University of California, Los Angeles (P.V.); Department of Neurological Surgery, Medical University of South Carolina, Charleston (S.J.H.); St. Louis University, MO (S.C.-F.); Department of Neurology, Mount Sinai School of Medicine, New York, NY (S.T.); Department of Clinical Neurosciences, University of Calgary, Alberta, Canada (M.D.H.); and Department of Neurosurgery, Wayne State University, Detroit, MI (R.N.).
Natalie L UllmanFrom the Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom (A.J.S.W.); Division of Brain Injury Outcomes, Johns Hopkins Medical Institutions, Baltimore, MD (N.L.U., T.C.M., J.K., W.Z., D.F.H.); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.M., M.R.); Department of Neurosurgery, University of Chicago, IL (I.A.A.); Emissary International, LLC, Austin, TX (S.M.); Department of Neurosurgery, University of Cincinnati, OH (M.Z.); Department of Neurosurgery, University of Maryland, Baltimore (F.A.); Department of Neurology, Rush University Medical Center, Chicago, IL (S.J., G.L.); Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel (S.H.); Department of Neurosurgery, Medical College of Virginia, Richmond (W.C.B., R.B.); Department of Neurology and Neurological Sciences, Stanford Medicine, CA (C.W.); Department of Neurosurgery, University of California, Los Angeles (P.V.); Department of Neurological Surgery, Medical University of South Carolina, Charleston (S.J.H.); St. Louis University, MO (S.C.-F.); Department of Neurology, Mount Sinai School of Medicine, New York, NY (S.T.); Department of Clinical Neurosciences, University of Calgary, Alberta, Canada (M.D.H.); and Department of Neurosurgery, Wayne State University, Detroit, MI (R.N.).
Tim C MorganFrom the Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom (A.J.S.W.); Division of Brain Injury Outcomes, Johns Hopkins Medical Institutions, Baltimore, MD (N.L.U., T.C.M., J.K., W.Z., D.F.H.); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.M., M.R.); Department of Neurosurgery, University of Chicago, IL (I.A.A.); Emissary International, LLC, Austin, TX (S.M.); Department of Neurosurgery, University of Cincinnati, OH (M.Z.); Department of Neurosurgery, University of Maryland, Baltimore (F.A.); Department of Neurology, Rush University Medical Center, Chicago, IL (S.J., G.L.); Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel (S.H.); Department of Neurosurgery, Medical College of Virginia, Richmond (W.C.B., R.B.); Department of Neurology and Neurological Sciences, Stanford Medicine, CA (C.W.); Department of Neurosurgery, University of California, Los Angeles (P.V.); Department of Neurological Surgery, Medical University of South Carolina, Charleston (S.J.H.); St. Louis University, MO (S.C.-F.); Department of Neurology, Mount Sinai School of Medicine, New York, NY (S.T.); Department of Clinical Neurosciences, University of Calgary, Alberta, Canada (M.D.H.); and Department of Neurosurgery, Wayne State University, Detroit, MI (R.N.).
John MuschelliFrom the Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom (A.J.S.W.); Division of Brain Injury Outcomes, Johns Hopkins Medical Institutions, Baltimore, MD (N.L.U., T.C.M., J.K., W.Z., D.F.H.); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.M., M.R.); Department of Neurosurgery, University of Chicago, IL (I.A.A.); Emissary International, LLC, Austin, TX (S.M.); Department of Neurosurgery, University of Cincinnati, OH (M.Z.); Department of Neurosurgery, University of Maryland, Baltimore (F.A.); Department of Neurology, Rush University Medical Center, Chicago, IL (S.J., G.L.); Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel (S.H.); Department of Neurosurgery, Medical College of Virginia, Richmond (W.C.B., R.B.); Department of Neurology and Neurological Sciences, Stanford Medicine, CA (C.W.); Department of Neurosurgery, University of California, Los Angeles (P.V.); Department of Neurological Surgery, Medical University of South Carolina, Charleston (S.J.H.); St. Louis University, MO (S.C.-F.); Department of Neurology, Mount Sinai School of Medicine, New York, NY (S.T.); Department of Clinical Neurosciences, University of Calgary, Alberta, Canada (M.D.H.); and Department of Neurosurgery, Wayne State University, Detroit, MI (R.N.).
Joshua KornbluthFrom the Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom (A.J.S.W.); Division of Brain Injury Outcomes, Johns Hopkins Medical Institutions, Baltimore, MD (N.L.U., T.C.M., J.K., W.Z., D.F.H.); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.M., M.R.); Department of Neurosurgery, University of Chicago, IL (I.A.A.); Emissary International, LLC, Austin, TX (S.M.); Department of Neurosurgery, University of Cincinnati, OH (M.Z.); Department of Neurosurgery, University of Maryland, Baltimore (F.A.); Department of Neurology, Rush University Medical Center, Chicago, IL (S.J., G.L.); Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel (S.H.); Department of Neurosurgery, Medical College of Virginia, Richmond (W.C.B., R.B.); Department of Neurology and Neurological Sciences, Stanford Medicine, CA (C.W.); Department of Neurosurgery, University of California, Los Angeles (P.V.); Department of Neurological Surgery, Medical University of South Carolina, Charleston (S.J.H.); St. Louis University, MO (S.C.-F.); Department of Neurology, Mount Sinai School of Medicine, New York, NY (S.T.); Department of Clinical Neurosciences, University of Calgary, Alberta, Canada (M.D.H.); and Department of Neurosurgery, Wayne State University, Detroit, MI (R.N.).
Issam A AwadFrom the Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom (A.J.S.W.); Division of Brain Injury Outcomes, Johns Hopkins Medical Institutions, Baltimore, MD (N.L.U., T.C.M., J.K., W.Z., D.F.H.); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.M., M.R.); Department of Neurosurgery, University of Chicago, IL (I.A.A.); Emissary International, LLC, Austin, TX (S.M.); Department of Neurosurgery, University of Cincinnati, OH (M.Z.); Department of Neurosurgery, University of Maryland, Baltimore (F.A.); Department of Neurology, Rush University Medical Center, Chicago, IL (S.J., G.L.); Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel (S.H.); Department of Neurosurgery, Medical College of Virginia, Richmond (W.C.B., R.B.); Department of Neurology and Neurological Sciences, Stanford Medicine, CA (C.W.); Department of Neurosurgery, University of California, Los Angeles (P.V.); Department of Neurological Surgery, Medical University of South Carolina, Charleston (S.J.H.); St. Louis University, MO (S.C.-F.); Department of Neurology, Mount Sinai School of Medicine, New York, NY (S.T.); Department of Clinical Neurosciences, University of Calgary, Alberta, Canada (M.D.H.); and Department of Neurosurgery, Wayne State University, Detroit, MI (R.N.).
Stephen MayoFrom the Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom (A.J.S.W.); Division of Brain Injury Outcomes, Johns Hopkins Medical Institutions, Baltimore, MD (N.L.U., T.C.M., J.K., W.Z., D.F.H.); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.M., M.R.); Department of Neurosurgery, University of Chicago, IL (I.A.A.); Emissary International, LLC, Austin, TX (S.M.); Department of Neurosurgery, University of Cincinnati, OH (M.Z.); Department of Neurosurgery, University of Maryland, Baltimore (F.A.); Department of Neurology, Rush University Medical Center, Chicago, IL (S.J., G.L.); Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel (S.H.); Department of Neurosurgery, Medical College of Virginia, Richmond (W.C.B., R.B.); Department of Neurology and Neurological Sciences, Stanford Medicine, CA (C.W.); Department of Neurosurgery, University of California, Los Angeles (P.V.); Department of Neurological Surgery, Medical University of South Carolina, Charleston (S.J.H.); St. Louis University, MO (S.C.-F.); Department of Neurology, Mount Sinai School of Medicine, New York, NY (S.T.); Department of Clinical Neurosciences, University of Calgary, Alberta, Canada (M.D.H.); and Department of Neurosurgery, Wayne State University, Detroit, MI (R.N.).
Michael RosenblumFrom the Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom (A.J.S.W.); Division of Brain Injury Outcomes, Johns Hopkins Medical Institutions, Baltimore, MD (N.L.U., T.C.M., J.K., W.Z., D.F.H.); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.M., M.R.); Department of Neurosurgery, University of Chicago, IL (I.A.A.); Emissary International, LLC, Austin, TX (S.M.); Department of Neurosurgery, University of Cincinnati, OH (M.Z.); Department of Neurosurgery, University of Maryland, Baltimore (F.A.); Department of Neurology, Rush University Medical Center, Chicago, IL (S.J., G.L.); Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel (S.H.); Department of Neurosurgery, Medical College of Virginia, Richmond (W.C.B., R.B.); Department of Neurology and Neurological Sciences, Stanford Medicine, CA (C.W.); Department of Neurosurgery, University of California, Los Angeles (P.V.); Department of Neurological Surgery, Medical University of South Carolina, Charleston (S.J.H.); St. Louis University, MO (S.C.-F.); Department of Neurology, Mount Sinai School of Medicine, New York, NY (S.T.); Department of Clinical Neurosciences, University of Calgary, Alberta, Canada (M.D.H.); and Department of Neurosurgery, Wayne State University, Detroit, MI (R.N.).
Wendy ZiaiFrom the Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom (A.J.S.W.); Division of Brain Injury Outcomes, Johns Hopkins Medical Institutions, Baltimore, MD (N.L.U., T.C.M., J.K., W.Z., D.F.H.); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.M., M.R.); Department of Neurosurgery, University of Chicago, IL (I.A.A.); Emissary International, LLC, Austin, TX (S.M.); Department of Neurosurgery, University of Cincinnati, OH (M.Z.); Department of Neurosurgery, University of Maryland, Baltimore (F.A.); Department of Neurology, Rush University Medical Center, Chicago, IL (S.J., G.L.); Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel (S.H.); Department of Neurosurgery, Medical College of Virginia, Richmond (W.C.B., R.B.); Department of Neurology and Neurological Sciences, Stanford Medicine, CA (C.W.); Department of Neurosurgery, University of California, Los Angeles (P.V.); Department of Neurological Surgery, Medical University of South Carolina, Charleston (S.J.H.); St. Louis University, MO (S.C.-F.); Department of Neurology, Mount Sinai School of Medicine, New York, NY (S.T.); Department of Clinical Neurosciences, University of Calgary, Alberta, Canada (M.D.H.); and Department of Neurosurgery, Wayne State University, Detroit, MI (R.N.).
Mario ZuccarrelloFrom the Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom (A.J.S.W.); Division of Brain Injury Outcomes, Johns Hopkins Medical Institutions, Baltimore, MD (N.L.U., T.C.M., J.K., W.Z., D.F.H.); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.M., M.R.); Department of Neurosurgery, University of Chicago, IL (I.A.A.); Emissary International, LLC, Austin, TX (S.M.); Department of Neurosurgery, University of Cincinnati, OH (M.Z.); Department of Neurosurgery, University of Maryland, Baltimore (F.A.); Department of Neurology, Rush University Medical Center, Chicago, IL (S.J., G.L.); Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel (S.H.); Department of Neurosurgery, Medical College of Virginia, Richmond (W.C.B., R.B.); Department of Neurology and Neurological Sciences, Stanford Medicine, CA (C.W.); Department of Neurosurgery, University of California, Los Angeles (P.V.); Department of Neurological Surgery, Medical University of South Carolina, Charleston (S.J.H.); St. Louis University, MO (S.C.-F.); Department of Neurology, Mount Sinai School of Medicine, New York, NY (S.T.); Department of Clinical Neurosciences, University of Calgary, Alberta, Canada (M.D.H.); and Department of Neurosurgery, Wayne State University, Detroit, MI (R.N.).
Francois AldrichFrom the Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom (A.J.S.W.); Division of Brain Injury Outcomes, Johns Hopkins Medical Institutions, Baltimore, MD (N.L.U., T.C.M., J.K., W.Z., D.F.H.); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.M., M.R.); Department of Neurosurgery, University of Chicago, IL (I.A.A.); Emissary International, LLC, Austin, TX (S.M.); Department of Neurosurgery, University of Cincinnati, OH (M.Z.); Department of Neurosurgery, University of Maryland, Baltimore (F.A.); Department of Neurology, Rush University Medical Center, Chicago, IL (S.J., G.L.); Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel (S.H.); Department of Neurosurgery, Medical College of Virginia, Richmond (W.C.B., R.B.); Department of Neurology and Neurological Sciences, Stanford Medicine, CA (C.W.); Department of Neurosurgery, University of California, Los Angeles (P.V.); Department of Neurological Surgery, Medical University of South Carolina, Charleston (S.J.H.); St. Louis University, MO (S.C.-F.); Department of Neurology, Mount Sinai School of Medicine, New York, NY (S.T.); Department of Clinical Neurosciences, University of Calgary, Alberta, Canada (M.D.H.); and Department of Neurosurgery, Wayne State University, Detroit, MI (R.N.).
Sayona JohnFrom the Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom (A.J.S.W.); Division of Brain Injury Outcomes, Johns Hopkins Medical Institutions, Baltimore, MD (N.L.U., T.C.M., J.K., W.Z., D.F.H.); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.M., M.R.); Department of Neurosurgery, University of Chicago, IL (I.A.A.); Emissary International, LLC, Austin, TX (S.M.); Department of Neurosurgery, University of Cincinnati, OH (M.Z.); Department of Neurosurgery, University of Maryland, Baltimore (F.A.); Department of Neurology, Rush University Medical Center, Chicago, IL (S.J., G.L.); Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel (S.H.); Department of Neurosurgery, Medical College of Virginia, Richmond (W.C.B., R.B.); Department of Neurology and Neurological Sciences, Stanford Medicine, CA (C.W.); Department of Neurosurgery, University of California, Los Angeles (P.V.); Department of Neurological Surgery, Medical University of South Carolina, Charleston (S.J.H.); St. Louis University, MO (S.C.-F.); Department of Neurology, Mount Sinai School of Medicine, New York, NY (S.T.); Department of Clinical Neurosciences, University of Calgary, Alberta, Canada (M.D.H.); and Department of Neurosurgery, Wayne State University, Detroit, MI (R.N.).
Sagi HarnofFrom the Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom (A.J.S.W.); Division of Brain Injury Outcomes, Johns Hopkins Medical Institutions, Baltimore, MD (N.L.U., T.C.M., J.K., W.Z., D.F.H.); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.M., M.R.); Department of Neurosurgery, University of Chicago, IL (I.A.A.); Emissary International, LLC, Austin, TX (S.M.); Department of Neurosurgery, University of Cincinnati, OH (M.Z.); Department of Neurosurgery, University of Maryland, Baltimore (F.A.); Department of Neurology, Rush University Medical Center, Chicago, IL (S.J., G.L.); Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel (S.H.); Department of Neurosurgery, Medical College of Virginia, Richmond (W.C.B., R.B.); Department of Neurology and Neurological Sciences, Stanford Medicine, CA (C.W.); Department of Neurosurgery, University of California, Los Angeles (P.V.); Department of Neurological Surgery, Medical University of South Carolina, Charleston (S.J.H.); St. Louis University, MO (S.C.-F.); Department of Neurology, Mount Sinai School of Medicine, New York, NY (S.T.); Department of Clinical Neurosciences, University of Calgary, Alberta, Canada (M.D.H.); and Department of Neurosurgery, Wayne State University, Detroit, MI (R.N.).
George LopezFrom the Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom (A.J.S.W.); Division of Brain Injury Outcomes, Johns Hopkins Medical Institutions, Baltimore, MD (N.L.U., T.C.M., J.K., W.Z., D.F.H.); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.M., M.R.); Department of Neurosurgery, University of Chicago, IL (I.A.A.); Emissary International, LLC, Austin, TX (S.M.); Department of Neurosurgery, University of Cincinnati, OH (M.Z.); Department of Neurosurgery, University of Maryland, Baltimore (F.A.); Department of Neurology, Rush University Medical Center, Chicago, IL (S.J., G.L.); Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel (S.H.); Department of Neurosurgery, Medical College of Virginia, Richmond (W.C.B., R.B.); Department of Neurology and Neurological Sciences, Stanford Medicine, CA (C.W.); Department of Neurosurgery, University of California, Los Angeles (P.V.); Department of Neurological Surgery, Medical University of South Carolina, Charleston (S.J.H.); St. Louis University, MO (S.C.-F.); Department of Neurology, Mount Sinai School of Medicine, New York, NY (S.T.); Department of Clinical Neurosciences, University of Calgary, Alberta, Canada (M.D.H.); and Department of Neurosurgery, Wayne State University, Detroit, MI (R.N.).
William C BroaddusFrom the Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom (A.J.S.W.); Division of Brain Injury Outcomes, Johns Hopkins Medical Institutions, Baltimore, MD (N.L.U., T.C.M., J.K., W.Z., D.F.H.); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.M., M.R.); Department of Neurosurgery, University of Chicago, IL (I.A.A.); Emissary International, LLC, Austin, TX (S.M.); Department of Neurosurgery, University of Cincinnati, OH (M.Z.); Department of Neurosurgery, University of Maryland, Baltimore (F.A.); Department of Neurology, Rush University Medical Center, Chicago, IL (S.J., G.L.); Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel (S.H.); Department of Neurosurgery, Medical College of Virginia, Richmond (W.C.B., R.B.); Department of Neurology and Neurological Sciences, Stanford Medicine, CA (C.W.); Department of Neurosurgery, University of California, Los Angeles (P.V.); Department of Neurological Surgery, Medical University of South Carolina, Charleston (S.J.H.); St. Louis University, MO (S.C.-F.); Department of Neurology, Mount Sinai School of Medicine, New York, NY (S.T.); Department of Clinical Neurosciences, University of Calgary, Alberta, Canada (M.D.H.); and Department of Neurosurgery, Wayne State University, Detroit, MI (R.N.).
Christine WijmanFrom the Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom (A.J.S.W.); Division of Brain Injury Outcomes, Johns Hopkins Medical Institutions, Baltimore, MD (N.L.U., T.C.M., J.K., W.Z., D.F.H.); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.M., M.R.); Department of Neurosurgery, University of Chicago, IL (I.A.A.); Emissary International, LLC, Austin, TX (S.M.); Department of Neurosurgery, University of Cincinnati, OH (M.Z.); Department of Neurosurgery, University of Maryland, Baltimore (F.A.); Department of Neurology, Rush University Medical Center, Chicago, IL (S.J., G.L.); Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel (S.H.); Department of Neurosurgery, Medical College of Virginia, Richmond (W.C.B., R.B.); Department of Neurology and Neurological Sciences, Stanford Medicine, CA (C.W.); Department of Neurosurgery, University of California, Los Angeles (P.V.); Department of Neurological Surgery, Medical University of South Carolina, Charleston (S.J.H.); St. Louis University, MO (S.C.-F.); Department of Neurology, Mount Sinai School of Medicine, New York, NY (S.T.); Department of Clinical Neurosciences, University of Calgary, Alberta, Canada (M.D.H.); and Department of Neurosurgery, Wayne State University, Detroit, MI (R.N.).
Paul VespaFrom the Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom (A.J.S.W.); Division of Brain Injury Outcomes, Johns Hopkins Medical Institutions, Baltimore, MD (N.L.U., T.C.M., J.K., W.Z., D.F.H.); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.M., M.R.); Department of Neurosurgery, University of Chicago, IL (I.A.A.); Emissary International, LLC, Austin, TX (S.M.); Department of Neurosurgery, University of Cincinnati, OH (M.Z.); Department of Neurosurgery, University of Maryland, Baltimore (F.A.); Department of Neurology, Rush University Medical Center, Chicago, IL (S.J., G.L.); Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel (S.H.); Department of Neurosurgery, Medical College of Virginia, Richmond (W.C.B., R.B.); Department of Neurology and Neurological Sciences, Stanford Medicine, CA (C.W.); Department of Neurosurgery, University of California, Los Angeles (P.V.); Department of Neurological Surgery, Medical University of South Carolina, Charleston (S.J.H.); St. Louis University, MO (S.C.-F.); Department of Neurology, Mount Sinai School of Medicine, New York, NY (S.T.); Department of Clinical Neurosciences, University of Calgary, Alberta, Canada (M.D.H.); and Department of Neurosurgery, Wayne State University, Detroit, MI (R.N.).
Ross BullockFrom the Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom (A.J.S.W.); Division of Brain Injury Outcomes, Johns Hopkins Medical Institutions, Baltimore, MD (N.L.U., T.C.M., J.K., W.Z., D.F.H.); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.M., M.R.); Department of Neurosurgery, University of Chicago, IL (I.A.A.); Emissary International, LLC, Austin, TX (S.M.); Department of Neurosurgery, University of Cincinnati, OH (M.Z.); Department of Neurosurgery, University of Maryland, Baltimore (F.A.); Department of Neurology, Rush University Medical Center, Chicago, IL (S.J., G.L.); Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel (S.H.); Department of Neurosurgery, Medical College of Virginia, Richmond (W.C.B., R.B.); Department of Neurology and Neurological Sciences, Stanford Medicine, CA (C.W.); Department of Neurosurgery, University of California, Los Angeles (P.V.); Department of Neurological Surgery, Medical University of South Carolina, Charleston (S.J.H.); St. Louis University, MO (S.C.-F.); Department of Neurology, Mount Sinai School of Medicine, New York, NY (S.T.); Department of Clinical Neurosciences, University of Calgary, Alberta, Canada (M.D.H.); and Department of Neurosurgery, Wayne State University, Detroit, MI (R.N.).
Stephen J HainesFrom the Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom (A.J.S.W.); Division of Brain Injury Outcomes, Johns Hopkins Medical Institutions, Baltimore, MD (N.L.U., T.C.M., J.K., W.Z., D.F.H.); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.M., M.R.); Department of Neurosurgery, University of Chicago, IL (I.A.A.); Emissary International, LLC, Austin, TX (S.M.); Department of Neurosurgery, University of Cincinnati, OH (M.Z.); Department of Neurosurgery, University of Maryland, Baltimore (F.A.); Department of Neurology, Rush University Medical Center, Chicago, IL (S.J., G.L.); Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel (S.H.); Department of Neurosurgery, Medical College of Virginia, Richmond (W.C.B., R.B.); Department of Neurology and Neurological Sciences, Stanford Medicine, CA (C.W.); Department of Neurosurgery, University of California, Los Angeles (P.V.); Department of Neurological Surgery, Medical University of South Carolina, Charleston (S.J.H.); St. Louis University, MO (S.C.-F.); Department of Neurology, Mount Sinai School of Medicine, New York, NY (S.T.); Department of Clinical Neurosciences, University of Calgary, Alberta, Canada (M.D.H.); and Department of Neurosurgery, Wayne State University, Detroit, MI (R.N.).
Salvador Cruz-FloresFrom the Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom (A.J.S.W.); Division of Brain Injury Outcomes, Johns Hopkins Medical Institutions, Baltimore, MD (N.L.U., T.C.M., J.K., W.Z., D.F.H.); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.M., M.R.); Department of Neurosurgery, University of Chicago, IL (I.A.A.); Emissary International, LLC, Austin, TX (S.M.); Department of Neurosurgery, University of Cincinnati, OH (M.Z.); Department of Neurosurgery, University of Maryland, Baltimore (F.A.); Department of Neurology, Rush University Medical Center, Chicago, IL (S.J., G.L.); Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel (S.H.); Department of Neurosurgery, Medical College of Virginia, Richmond (W.C.B., R.B.); Department of Neurology and Neurological Sciences, Stanford Medicine, CA (C.W.); Department of Neurosurgery, University of California, Los Angeles (P.V.); Department of Neurological Surgery, Medical University of South Carolina, Charleston (S.J.H.); St. Louis University, MO (S.C.-F.); Department of Neurology, Mount Sinai School of Medicine, New York, NY (S.T.); Department of Clinical Neurosciences, University of Calgary, Alberta, Canada (M.D.H.); and Department of Neurosurgery, Wayne State University, Detroit, MI (R.N.).
Stan TuhrimFrom the Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom (A.J.S.W.); Division of Brain Injury Outcomes, Johns Hopkins Medical Institutions, Baltimore, MD (N.L.U., T.C.M., J.K., W.Z., D.F.H.); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.M., M.R.); Department of Neurosurgery, University of Chicago, IL (I.A.A.); Emissary International, LLC, Austin, TX (S.M.); Department of Neurosurgery, University of Cincinnati, OH (M.Z.); Department of Neurosurgery, University of Maryland, Baltimore (F.A.); Department of Neurology, Rush University Medical Center, Chicago, IL (S.J., G.L.); Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel (S.H.); Department of Neurosurgery, Medical College of Virginia, Richmond (W.C.B., R.B.); Department of Neurology and Neurological Sciences, Stanford Medicine, CA (C.W.); Department of Neurosurgery, University of California, Los Angeles (P.V.); Department of Neurological Surgery, Medical University of South Carolina, Charleston (S.J.H.); St. Louis University, MO (S.C.-F.); Department of Neurology, Mount Sinai School of Medicine, New York, NY (S.T.); Department of Clinical Neurosciences, University of Calgary, Alberta, Canada (M.D.H.); and Department of Neurosurgery, Wayne State University, Detroit, MI (R.N.).
Michael D HillFrom the Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom (A.J.S.W.); Division of Brain Injury Outcomes, Johns Hopkins Medical Institutions, Baltimore, MD (N.L.U., T.C.M., J.K., W.Z., D.F.H.); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.M., M.R.); Department of Neurosurgery, University of Chicago, IL (I.A.A.); Emissary International, LLC, Austin, TX (S.M.); Department of Neurosurgery, University of Cincinnati, OH (M.Z.); Department of Neurosurgery, University of Maryland, Baltimore (F.A.); Department of Neurology, Rush University Medical Center, Chicago, IL (S.J., G.L.); Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel (S.H.); Department of Neurosurgery, Medical College of Virginia, Richmond (W.C.B., R.B.); Department of Neurology and Neurological Sciences, Stanford Medicine, CA (C.W.); Department of Neurosurgery, University of California, Los Angeles (P.V.); Department of Neurological Surgery, Medical University of South Carolina, Charleston (S.J.H.); St. Louis University, MO (S.C.-F.); Department of Neurology, Mount Sinai School of Medicine, New York, NY (S.T.); Department of Clinical Neurosciences, University of Calgary, Alberta, Canada (M.D.H.); and Department of Neurosurgery, Wayne State University, Detroit, MI (R.N.).
Raj NarayanFrom the Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom (A.J.S.W.); Division of Brain Injury Outcomes, Johns Hopkins Medical Institutions, Baltimore, MD (N.L.U., T.C.M., J.K., W.Z., D.F.H.); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.M., M.R.); Department of Neurosurgery, University of Chicago, IL (I.A.A.); Emissary International, LLC, Austin, TX (S.M.); Department of Neurosurgery, University of Cincinnati, OH (M.Z.); Department of Neurosurgery, University of Maryland, Baltimore (F.A.); Department of Neurology, Rush University Medical Center, Chicago, IL (S.J., G.L.); Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel (S.H.); Department of Neurosurgery, Medical College of Virginia, Richmond (W.C.B., R.B.); Department of Neurology and Neurological Sciences, Stanford Medicine, CA (C.W.); Department of Neurosurgery, University of California, Los Angeles (P.V.); Department of Neurological Surgery, Medical University of South Carolina, Charleston (S.J.H.); St. Louis University, MO (S.C.-F.); Department of Neurology, Mount Sinai School of Medicine, New York, NY (S.T.); Department of Clinical Neurosciences, University of Calgary, Alberta, Canada (M.D.H.); and Department of Neurosurgery, Wayne State University, Detroit, MI (R.N.).
Daniel F HanleyFrom the Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom (A.J.S.W.); Division of Brain Injury Outcomes, Johns Hopkins Medical Institutions, Baltimore, MD (N.L.U., T.C.M., J.K., W.Z., D.F.H.); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.M., M.R.); Department of Neurosurgery, University of Chicago, IL (I.A.A.); Emissary International, LLC, Austin, TX (S.M.); Department of Neurosurgery, University of Cincinnati, OH (M.Z.); Department of Neurosurgery, University of Maryland, Baltimore (F.A.); Department of Neurology, Rush University Medical Center, Chicago, IL (S.J., G.L.); Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel (S.H.); Department of Neurosurgery, Medical College of Virginia, Richmond (W.C.B., R.B.); Department of Neurology and Neurological Sciences, Stanford Medicine, CA (C.W.); Department of Neurosurgery, University of California, Los Angeles (P.V.); Department of Neurological Surgery, Medical University of South Carolina, Charleston (S.J.H.); St. Louis University, MO (S.C.-F.); Department of Neurology, Mount Sinai School of Medicine, New York, NY (S.T.); Department of Clinical Neurosciences, University of Calgary, Alberta, Canada (M.D.H.); and Department of Neurosurgery, Wayne State University, Detroit, MI (R.N.). dhanley@jhmi.edu.
MISTIE and CLEAR Investigators
University of Pittsburgh Medical Center · USAllegheny General Hospital · USBellvitge University Hospital · ESBose (United States) · USCase Western Reserve University · USCedars-Sinai Medical Center · USChrist University · INClinics Hospital of Ribeirão Preto · BRCrabtree (United States) · USDr. Agarwal's Eye Hospital · INHartford Hospital · USHenry Ford Health System · USHospital de Sant Pau · ESIDEO (United States) · USJacksonville College · USJohannes Gutenberg University Mainz · DEJohn F. Kennedy Medical Center · USKinetic Art & Technology (United States) · USLeipzig University · DELeonardo (United Kingdom) · GB

Funding

MISTIE III_ Lead Grant_ Cluster Application for the Clinical Coordinating CenterU01NS080824 · NINDS · JOHNS HOPKINS UNIVERSITY · PI HANLEY, DANIEL F · 2013 to 2017
$23.2M
Clot Lysis: Evaluating Accelerated Resolution of IVH Phase III (CLEAR III)U01NS062851 · NINDS · JOHNS HOPKINS UNIVERSITY · PI HANLEY, DANIEL F · 2009 to 2013
$21.6M
ICH Removal: Minimally Invasive Surgery + rt-PAR01NS046309 · NINDS · JOHNS HOPKINS UNIVERSITY · PI HANLEY, DANIEL F · 2005 to 2011
$9.1M
CLEAR IVH Phase III Planning GrantR34NS056638 · NINDS · JOHNS HOPKINS UNIVERSITY · PI HANLEY, DANIEL F · 2008 to 2008
$164k
NINDS NIH HHS 1U01NS080824NINDS NIH HHS 5U01NS062851NINDS NIH HHS R01 NS046309NINDS NIH HHS R01NS046309NINDS NIH HHS R34 NS056638NINDS NIH HHS U01 NS062851NINDS NIH HHS U01 NS080824
6 · The paper itself

Abstract

background and purposeThe ABC/2 score estimates intracerebral hemorrhage (ICH) volume, yet validations have been limited by small samples and inappropriate outcome measures. We determined accuracy of the ABC/2 score calculated at a specialized reading center (RC-ABC) or local site (site-ABC) versus the reference-standard computed tomography-based planimetry (CTP).

methodsIn Minimally Invasive Surgery Plus Recombinant Tissue-Type Plasminogen Activator for Intracerebral Hemorrhage Evacuation-II (MISTIE-II), Clot Lysis Evaluation of Accelerated Resolution of Intraventricular Hemorrhage (CLEAR-IVH) and CLEAR-III trials. ICH volume was prospectively calculated by CTP, RC-ABC, and site-ABC. Agreement between CTP and ABC/2 was defined as an absolute difference up to 5 mL and relative difference within 20%. Determinants of ABC/2 accuracy were assessed by logistic regression.

resultsIn 4369 scans from 507 patients, CTP was more strongly correlated with RC-ABC (r(2)=0.93) than with site-ABC (r(2)=0.87). Although RC-ABC overestimated CTP-based volume on average (RC-ABC, 15.2 cm(3); CTP, 12.7 cm3), agreement was reasonable when categorized into mild, moderate, and severe ICH (κ=0.75; P<0.001). This was consistent with overestimation of ICH volume in 6 of 8 previous studies. Agreement with CTP was greater for RC-ABC (84% within 5 mL; 48% of scans within 20%) than for site-ABC (81% within 5 mL; 41% within 20%). RC-ABC had moderate accuracy for detecting ≥5 mL change in CTP volume between consecutive scans (sensitivity, 0.76; specificity, 0.86) and was more accurate with smaller ICH, thalamic hemorrhage, and homogeneous clots.

conclusionsABC/2 scores at local or central sites are sufficiently accurate to categorize ICH volume and assess eligibility for the CLEAR-III and MISTIE III studies and moderately accurate for change in ICH volume. However, accuracy decreases with large, irregular, or lobar clots. CLINICAL

trial registrationURL: http://www.clinicaltrials.gov. Unique identifier: MISTIE-II NCT00224770; CLEAR-III NCT00784134.

Indexed as

Severity of Illness IndexCerebral HemorrhageHumanscerebral hemorrhagecontrolled clinical trials, randomizedreview, systematicsensitivity and specificitytissue-type plasminogen activator

Identifiers

PMID26243227
PMCPMC4550520
OpenAlexW1956771503

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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.