Evidence map›Paper›PMID 33200331›Full record

ArticleNeurocritical care2021

The Modified Fisher Scale Lacks Interrater Reliability.

Christopher Melinosky, Hope Kincaid, Jan Claassen, Gunjan Parikh, Neeraj Badjatia, Nicholas A Morris

Abstract read
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Article in Neurocritical care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 1 pooled it
2.8field-weighted citation impact, top 9% 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

25 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 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 3 institutions in 1 country.

Christopher MelinoskyDepartment of Neurology, Lehigh Valley Health Network, 1250 S Cedar Crest Blvd, Suite 405, Allentown, PA, USA. christopher.melinosky@lvhn.org.ORCID http://orcid.org/0000-0002-0277-8508
Hope KincaidNetwork Office of Research and Innovation (NORI), Lehigh Valley Health Network, Allentown, PA, USA.
Jan ClaassenDepartment of Neurology, Neurological Institute, New York Presbyterian Hospital, Columbia University, New York, NY, USA.
Gunjan ParikhDepartment of Neurology, Program in Trauma, University of Maryland School of Medicine, Baltimore, MD, USA.
Neeraj BadjatiaDepartment of Neurology, Program in Trauma, University of Maryland School of Medicine, Baltimore, MD, USA.
Nicholas A MorrisDepartment of Neurology, Program in Trauma, University of Maryland School of Medicine, Baltimore, MD, USA.
University of Maryland, Baltimore · USLehigh Valley Hospital-Pocono · USNewYork–Presbyterian Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe modified Fisher scale (mFS) is a critical clinical and research tool for risk stratification of cerebral vasospasm. As such, the mFS is included as a common data element by the National Institute of Neurological Disorders and Stroke SAH Working Group. There are few studies assessing the interrater reliability of the mFS.

methodsWe distributed a survey to a convenience sample with snowball sampling of practicing neurointensivists and through the research survey portion of the Neurocritical Care Society Web site. The survey consisted of 15 scrollable CT scans of patients with SAH for mFS grading, two questions regarding the definitions of the scale criteria and demographics of the responding physician. Kendall's coefficient of concordance was used to determine the interrater reliability of mFS grading.

resultsForty-six participants (97.8% neurocritical care fellowship trained, 78% UCNS-certified in neurocritical care, median 5 years (IQR 3-6.3) in practice, treating median of 80 patients (IQR 50-100) with SAH annually from 32 institutions) completed the survey. By mFS criteria, 30% correctly identified that there is no clear measurement of thin versus thick blood, and 42% correctly identified that blood in any ventricle is scored as "intraventricular blood." The overall interrater reliability by Kendall's coefficient of concordance for the mFS was moderate (W = 0.586, p < 0.0005).

conclusionsAgreement among raters in grading the mFS is only moderate. Online training tools could be developed to improve mFS reliability and standardize research in SAH.

Indexed as

Subarachnoid HemorrhageVasospasm, IntracranialHumansReproducibility of ResultsTomography, X-Ray ComputedAneurysmal subarachnoid hemorrhageCerebral aneurysmCerebral ischemiaCerebral vasospasmComputed tomographyComputerized tomography (CT)Intracranial hemorrhageIntracranial vasospasmNeuroimagingReproducibility of results

Identifiers

PMID33200331
OpenAlexW2984312108

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.