Evidence map›Paper›PMID 32700160›Full record

ArticleNeurosurgical review2021

Management of unruptured intracranial aneurysms: correlation of UIATS, ELAPSS, and PHASES with referral center practice.

James Feghali, Abhishek Gami, Justin M Caplan, Rafael J Tamargo, Cameron G McDougall, Judy Huang

Abstract read
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Article in Neurosurgical review, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.3field-weighted citation impact, top 15% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 19 citations in OpenAlex.

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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

6 authors at 1 institution in 1 country.

James Feghali *Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Abhishek Gami *Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Justin M CaplanDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Rafael J TamargoDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Cameron G McDougallDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Judy HuangDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. jhuang24@jhmi.edu.ORCID http://orcid.org/0000-0002-0675-1935
Johns Hopkins University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Concordance between the Unruptured Intracranial Aneurysm Treatment Score (UIATS), Earlier Subarachnoid Hemorrhage, Location, Age, Population, Size, Shape (ELAPSS) score, and Population, Hypertension, Age, Size, Earlier Subarachnoid Hemorrhage, Site (PHASES) score with real-world management decisions in unruptured intracranial aneurysms (UIAs) remains unclear, especially in current practice. This study aimed to investigate this concordance, while developing an optimal model predictive of recent decision practices at a quaternary referral center. A prospective database of patients presenting with UIAs to our institution from January 1 to December 31, 2018, was used. Concordance between the scores and real-world management decisions on every UIA was assessed. Complications and length of stay (LOS) were compared between aneurysms in the UIATS-recommended treatment and observation groups. A subgroup analysis of concordance was also conducted among junior and senior surgeons. An optimal logistic regression model predictive of real-world decisions was also derived. The cohort consisted of 198 patients with 271 UIAs, of which 42% were treated. The UIATS demonstrated good concordance with an AUC of 0.765. Of the aneurysms in the UIATS-recommended "observation" group, 22% were discordantly treated. The ELAPSS score demonstrated good discrimination (AUC = 0.793), unlike the PHASES score (AUC = 0.579). Endovascular treatment rates, complications, and LOS were similar between aneurysms in the UIATS-recommended treatment and observation groups. Similar concordance was obtained among junior and senior surgeons. The optimal predictive model consisted of several significantly associated variables and had an AUC of 0.942. Cerebrovascular specialists may be treating aneurysms slightly more than these scores would recommend, independently of years in practice. Wide variation still exists in management practices of UIAs.

Indexed as

Disease ManagementTertiary Care CentersAdultAgedCohort StudiesEndovascular ProceduresFemaleHumansHypertensionIntracranial AneurysmMaleMiddle AgedNeurosurgical ProceduresProspective StudiesReferral and ConsultationSubarachnoid HemorrhageDecision makingEndovascular surgeryIntracranial aneurysmTreatment

Identifiers

PMID32700160
OpenAlexW3045141861

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.