Evidence map›Paper›PMID 40481318›Full record

ArticleNPJ digital medicine2025

Machine learning to predict penumbra core mismatch in acute ischemic stroke using clinical note data.

Shaun Kohli, Parul Agarwal, Andy Ho Wing Chan, Asala Erekat, Girish Nadkarni, Benjamin Kummer

Abstract read
In one paragraph

Article in NPJ digital medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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. Article
  2. Article
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.

Shaun KohliIcahn School of Medicine at Mount Sinai, New York, NY, USA.
Parul AgarwalDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Andy Ho Wing ChanDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Asala ErekatDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Girish NadkarniWindreich Department of Artificial Intelligence and Human Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Benjamin KummerDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA. benjamin.kummer@mountsinai.org.

Funding

Conduits: Mount Sinai Health System Translational Science HubUL1TR004419 · NCATS · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI Rosalind J Wright · 2022 to 2026
$46.4M
Elucidating hereditary transthyretin-mediated heart failure risk using machine learning, polygenic risk and recall by genotype approaches in African ancestry individualsR01HL155915 · NHLBI · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI DO, RON, NADKARNI, GIRISH NITIN · 2021 to 2024
$3.4M
Deep learning on ECGs to improve outcomes in patients on dialysisR01HL167050 · NHLBI · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI David M Charytan, Jasmin Divers · 2023 to 2026
$2.9M
NCATS NIH HHS UL1 TR004419NCATS NIH HHS UL1TR004419NHLBI NIH HHS R01 HL155915NHLBI NIH HHS R01 HL167050NIH HHS R01HL155915
6 · The paper itself

Abstract

In acute ischemic stroke due to large-vessel occlusion (AIS-LVO), late-window endovascular thrombectomy (EVT) decisions depend on penumbra-to-core (P:C) mismatch from computed tomographic perfusion (CTP). We developed multiple machine learning (ML) models to predict P:C ratios from a retrospectively-identified cohort of AIS-LVO patients who underwent CTP within 30 min of initial neuroimaging, using non-imaging electronic health record (EHR) data available prior to CTP evaluation. We extracted structured data and free-text clinical notes from the EHR, generating document embeddings as sums of BioWordVec vectors weighted by term-frequency-inverse-document-frequency scores. We identified 120 patients; an extreme-gradient-boosting model classified P:C ratios as ≥ or <1.8, achieving an AUROC of 0.80 (95% CI 0.57-0.92) with optimal performance using text limited to 500 characters. Sensitivity was 0.80, specificity 0.66, and F1 score 0.86. Our findings suggest that ML models leveraging real-world non-imaging data can potentially aid LVO-AIS triage, though further validation is needed.

Identifiers

PMID40481318
PMCPMC12144192

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LicenceCC BY-NC-ND
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Registered trials

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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.