ArticleClinical neuroradiology2021
ASPECTS Interobserver Agreement of 100 Investigators from the TENSION Study.
Article in Clinical neuroradiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03094715 (Efficacy and Safety of Thrombectomy in Stroke With Extended Lesion and Extended Time Window), which is not on this map. Cited by 32 papers, 1 of them a synthesis that pooled 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.
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.
Efficacy and Safety of Thrombectomy in Stroke With Extended Lesion and Extended Time Window: a Randomized, Controlled Trial
Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effect of endovascular therapy in large anterior circulation ischaemic strokes: A systematic review and meta-analysis of randomised controlled trials.European stroke journal · 2023Pooled it
- Tmax 10 Volume Is Independently Associated with NWU Delta in Large Core Stroke.Clinical neuroradiology · 2026Observational
- Influence of deep learning image reconstruction and adaptive statistical iterative reconstruction-V on automated Alberta stroke program early CT score- evaluation.Neuroradiology · 2026Article
- Reliability of radiotherapist assessment for radiation induced skin-toxicity: investigational study.Frontiers in oncology · 2026Article
- Large Core Trial.AJNR. American journal of neuroradiology · 2025Review
- Hypodensity Beyond the Ischemic Core: Penumbral Changes Detected With Relative Noncontrast Computed Tomography.Stroke · 2025Observational
- Prospective Evaluation of Artificial Intelligence Imaging Support Software for Acute Ischemic Stroke in the Mayo Clinic Telestroke Network.Mayo Clinic proceedings. Innovations, quality & outcomes · 2025Article
- Validation of the Charlotte large artery occlusion endovascular therapy outcome score using Viz.ai-derived cerebral blood volume index.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Article
- Automated ischemic stroke lesion detection on non-contrast brain CT: a large-scale clinical feasibility test AI stroke lesion detection on NCCT.Frontiers in neuroscience · 2025Article
- Baseline clinical and neuroradiological predictors of outcome in patients with large ischemic core undergoing mechanical thrombectomy: A retrospective multicenter study.International journal of stroke : official journal of the International Stroke Society · 2024Article
- Clinical Applications of Dual-Energy Computed Tomography for Acute Ischemic Stroke.Stroke (Hoboken, N.J.) · 2024Review
- Article
- The lesion core extent modulates the impact of early perfusion mismatch imaging on outcome variability after thrombectomy in stroke.Frontiers in neurology · 2024Article
- Application of imaging modalities for endovascular thrombectomy of large core infarcts in clinical practice.Frontiers in neurology · 2024Review
- Performance of Automated ASPECTS Software and Value as a Computer-Aided Detection Tool.AJNR. American journal of neuroradiology · 2023Article
- Nomogram to predict unfavorable outcome of endovascular thrombectomy for large ischemic core.Annals of clinical and translational neurology · 2023Article
- Impact of e-ASPECTS software on the performance of physicians compared to a consensus ground truth: a multi-reader, multi-case study.Frontiers in neurology · 2023Article
- Association of Thrombectomy With Functional Outcome for Patients With Ischemic Stroke Who Presented in the Extended Time Window With Extensive Signs of Infarction.JAMA network open · 2022Article
- How Machine Learning is Powering Neuroimaging to Improve Brain Health.Neuroinformatics · 2022Review
- Review of Current Large Core Volume Stroke Thrombectomy Clinical Trials: Controversies and Progress.Stroke (Hoboken, N.J.) · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
Abstract
purposeEvaluating the extent of cerebral ischemic infarction is essential for treatment decisions and assessment of possible complications in patients with acute ischemic stroke. Patients are often triaged according to image-based early signs of infarction, defined by Alberta Stroke Program Early CT Score (ASPECTS). Our aim was to evaluate interrater reliability in a large group of readers.
methodsWe retrospectively analyzed 100 investigators who independently evaluated 20 non-contrast computed tomography (NCCT) scans as part of their qualification program for the TENSION study. Test cases were chosen by four neuroradiologists who had previously scored NCCT scans with ASPECTS between 0 and 8 and high interrater agreement. Percent and interrater agreements were calculated for total ASPECTS, as well as for each ASPECTS region.
resultsPercent agreements for ASPECTS ratings was 28%, with interrater agreement of 0.13 (95% confidence interval, CI 0.09-0.16), at zero tolerance allowance and 66%, with interrater agreement of 0.32 (95% CI: 0.21-0.44), at tolerance allowance set by TENSION inclusion criteria. ASPECTS region with highest level of agreement was the insular cortex (percent agreement = 96%, interrater agreement = 0.96 (95% CI: 0.94-0.97)) and with lowest level of agreement the M3 region (percent agreement = 68%, interrater agreement = 0.39 [95% CI: 0.17-0.61]).
conclusionInterrater agreement reliability for total ASPECTS and study enrollment was relatively low but seems sufficient for practical application. Individual region analysis suggests that some are particularly difficult to evaluate, with varying levels of reliability. Potential impairment of the supraganglionic region must be examined carefully, particularly with respect to the decision whether or not to perform mechanical thrombectomy.
Indexed as
Identifiers
What OpenQuestion holds
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.