Evidence map›Paper›PMID 38711044›Full record

ArticleThe journal of headache and pain2024

The additive value of complementing diagnostic idiopathic intracranial hypertension criteria by MRI - an external validation study.

Stefan Macher, Wolfgang Marik, Nik Krajnc, Christoph Mitsch, Martin Michl, Nina Mueller, Klaus Novak, Sina Zaic, Christian Woeber, Berthold Pemp and 1 more

Abstract readValidation Study
In one paragraph

Article in The journal of headache and pain, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

11 authors.

Stefan MacherDepartment of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, 1090, Austria.
Wolfgang MarikComprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria.
Nik KrajncDepartment of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, 1090, Austria.
Christoph MitschDepartment of Ophthalmology, Medical University of Vienna, Vienna, Austria.
Martin MichlDepartment of Ophthalmology, Medical University of Vienna, Vienna, Austria.
Nina MuellerDepartment of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, 1090, Austria.
Klaus NovakDepartment of Neurosurgery, Medical University of Vienna, Vienna, Austria.
Sina ZaicDepartment of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, 1090, Austria.
Christian WoeberDepartment of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, 1090, Austria.
Berthold PempDepartment of Ophthalmology, Medical University of Vienna, Vienna, Austria.
Gabriel BstehDepartment of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, 1090, Austria. gabriel.bsteh@meduniwien.ac.at.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecently, diagnostic criteria including a standardized MRI criterion were presented to identify patients suffering from idiopathic intracranial hypertension (IIH) proposing that IIH might be defined by two out of three objective findings (papilledema, ≥ 25 cm cerebrospinal fluid opening pressure (CSF-OP) and ≥ 3/4 neuroimaging signs).

methodsTo provide independent external validation, we retrospectively applied the proposed diagnostic criteria to our cohort of patients with clinical suspicion of IIH from the Vienna IIH database. Neuroimaging was reevaluated for IIH signs according to standardized definitions by a blinded expert neuroradiologist. We determined isolated diagnostic accuracy of the neuroimaging criterion (≥ 3/4 signs) as well as overall accuracy of the new proposed criteria.

resultsWe included patients with IIH (n = 102) and patients without IIH (no-IIH, n = 23). Baseline characteristics were balanced between IIH and no-IIH groups, but papilledema and CSF-OP were significantly higher in IIH. For the presence of ≥ 3/4 MRI signs, sensitivity was 39.2% and specificity was 91.3% with positive predictive value (PPV) of 95.2% and negative predictive value (NPV) 25.3%. Reclassifying our cohort according to the 2/3 IIH definition correctly identified 100% of patients without IIH, with definite IIH and suggested to have IIH without papilledema by Friedman criteria, respectively.

conclusionThe standardized neuroimaging criteria are easily applicable in clinical routine and provide moderate sensitivity and excellent specificity to identify patients with IIH. Defining IIH by 2/3 criteria significantly simplifies diagnosis without compromising accuracy.

Indexed as

Magnetic Resonance ImagingPseudotumor CerebriAdultFemaleHumansMaleMiddle AgedPapilledemaRetrospective StudiesSensitivity and SpecificityCriteriaDiagnosisIdiopathic intracranial hypertensionMagnetic resonance imagingNeuroimaging signsValidation

Identifiers

PMID38711044
PMCPMC11071194

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