Accuracy of the ABC/2 score for intracerebral hemorrhage: systematic review and analysis of MISTIE, CLEAR-IVH, and CLEAR III
<p><strong>Background and Purpose:</strong> The ABC/2 score estimates intracerebral hemorrhage (ICH) volume, yet validations have been limited by small samples and inappropriate outcome measures. We determined accuracy of the ABC/2 score calculated at a specialized reading center (...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
American Heart Association
2015
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| _version_ | 1797074351700312064 |
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| author | Webb, AJS Ullman, NL Morgan, TC Muschelli, J Kornbluth, J Awad, IA Mayo, S Rosenblum, M Ziai, W Zuccarrello, M Aldrich, F John, S Harnof, S Lopez, G Broaddus, WC Wijman, C Vespa, P Bullock, R Haines, SJ Cruz-Flores, S Tuhrim, S Hill, MD Narayan, R Hanley, DF MISTIE and CLEAR Investigators |
| author_facet | Webb, AJS Ullman, NL Morgan, TC Muschelli, J Kornbluth, J Awad, IA Mayo, S Rosenblum, M Ziai, W Zuccarrello, M Aldrich, F John, S Harnof, S Lopez, G Broaddus, WC Wijman, C Vespa, P Bullock, R Haines, SJ Cruz-Flores, S Tuhrim, S Hill, MD Narayan, R Hanley, DF MISTIE and CLEAR Investigators |
| author_sort | Webb, AJS |
| collection | OXFORD |
| description | <p><strong>Background and Purpose:</strong> The ABC/2 score estimates intracerebral hemorrhage (ICH) volume, yet validations have been limited by small samples and inappropriate outcome measures. We determined accuracy of the ABC/2 score calculated at a specialized reading center (RC-ABC) or local site (site-ABC) versus the reference-standard computed tomography–based planimetry (CTP).</p>
p><strong>Methods:</strong>In Minimally Invasive Surgery Plus Recombinant Tissue-Type Plasminogen Activator for Intracerebral Hemorrhage Evacuation-II (MISTIE-II), Clot Lysis Evaluation of Accelerated Resolution of Intraventricular Hemorrhage (CLEAR-IVH) and CLEAR-III trials. ICH volume was prospectively calculated by CTP, RC-ABC, and site-ABC. Agreement between CTP and ABC/2 was defined as an absolute difference up to 5 mL and relative difference within 20%. Determinants of ABC/2 accuracy were assessed by logistic regression.</p>
<p><strong>Results:</strong> In 4369 scans from 507 patients, CTP was more strongly correlated with RC-ABC (r2=0.93) than with site-ABC (r2=0.87). Although RC-ABC overestimated CTP-based volume on average (RC-ABC, 15.2 cm3; CTP, 12.7 cm3), agreement was reasonable when categorized into mild, moderate, and severe ICH (κ=0.75; P<0.001). This was consistent with overestimation of ICH volume in 6 of 8 previous studies. Agreement with CTP was greater for RC-ABC (84% within 5 mL; 48% of scans within 20%) than for site-ABC (81% within 5 mL; 41% within 20%). RC-ABC had moderate accuracy for detecting ≥5 mL change in CTP volume between consecutive scans (sensitivity, 0.76; specificity, 0.86) and was more accurate with smaller ICH, thalamic hemorrhage, and homogeneous clots.</p>
<p><strong>Conclusions:</strong> ABC/2 scores at local or central sites are sufficiently accurate to categorize ICH volume and assess eligibility for the CLEAR-III and MISTIE III studies and moderately accurate for change in ICH volume. However, accuracy decreases with large, irregular, or lobar clots.</p> |
| first_indexed | 2024-03-06T23:34:52Z |
| format | Journal article |
| id | oxford-uuid:6d51f298-2315-4973-925c-b4d5ac5fd95c |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T23:34:52Z |
| publishDate | 2015 |
| publisher | American Heart Association |
| record_format | dspace |
| spelling | oxford-uuid:6d51f298-2315-4973-925c-b4d5ac5fd95c2022-03-26T19:17:03ZAccuracy of the ABC/2 score for intracerebral hemorrhage: systematic review and analysis of MISTIE, CLEAR-IVH, and CLEAR IIIJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:6d51f298-2315-4973-925c-b4d5ac5fd95cEnglishSymplectic ElementsAmerican Heart Association2015Webb, AJSUllman, NLMorgan, TCMuschelli, JKornbluth, JAwad, IAMayo, SRosenblum, MZiai, WZuccarrello, MAldrich, FJohn, SHarnof, SLopez, GBroaddus, WCWijman, CVespa, PBullock, RHaines, SJCruz-Flores, STuhrim, SHill, MDNarayan, RHanley, DFMISTIE and CLEAR Investigators<p><strong>Background and Purpose:</strong> The ABC/2 score estimates intracerebral hemorrhage (ICH) volume, yet validations have been limited by small samples and inappropriate outcome measures. We determined accuracy of the ABC/2 score calculated at a specialized reading center (RC-ABC) or local site (site-ABC) versus the reference-standard computed tomography–based planimetry (CTP).</p> p><strong>Methods:</strong>In Minimally Invasive Surgery Plus Recombinant Tissue-Type Plasminogen Activator for Intracerebral Hemorrhage Evacuation-II (MISTIE-II), Clot Lysis Evaluation of Accelerated Resolution of Intraventricular Hemorrhage (CLEAR-IVH) and CLEAR-III trials. ICH volume was prospectively calculated by CTP, RC-ABC, and site-ABC. Agreement between CTP and ABC/2 was defined as an absolute difference up to 5 mL and relative difference within 20%. Determinants of ABC/2 accuracy were assessed by logistic regression.</p> <p><strong>Results:</strong> In 4369 scans from 507 patients, CTP was more strongly correlated with RC-ABC (r2=0.93) than with site-ABC (r2=0.87). Although RC-ABC overestimated CTP-based volume on average (RC-ABC, 15.2 cm3; CTP, 12.7 cm3), agreement was reasonable when categorized into mild, moderate, and severe ICH (κ=0.75; P<0.001). This was consistent with overestimation of ICH volume in 6 of 8 previous studies. Agreement with CTP was greater for RC-ABC (84% within 5 mL; 48% of scans within 20%) than for site-ABC (81% within 5 mL; 41% within 20%). RC-ABC had moderate accuracy for detecting ≥5 mL change in CTP volume between consecutive scans (sensitivity, 0.76; specificity, 0.86) and was more accurate with smaller ICH, thalamic hemorrhage, and homogeneous clots.</p> <p><strong>Conclusions:</strong> ABC/2 scores at local or central sites are sufficiently accurate to categorize ICH volume and assess eligibility for the CLEAR-III and MISTIE III studies and moderately accurate for change in ICH volume. However, accuracy decreases with large, irregular, or lobar clots.</p> |
| spellingShingle | Webb, AJS Ullman, NL Morgan, TC Muschelli, J Kornbluth, J Awad, IA Mayo, S Rosenblum, M Ziai, W Zuccarrello, M Aldrich, F John, S Harnof, S Lopez, G Broaddus, WC Wijman, C Vespa, P Bullock, R Haines, SJ Cruz-Flores, S Tuhrim, S Hill, MD Narayan, R Hanley, DF MISTIE and CLEAR Investigators Accuracy of the ABC/2 score for intracerebral hemorrhage: systematic review and analysis of MISTIE, CLEAR-IVH, and CLEAR III |
| title | Accuracy of the ABC/2 score for intracerebral hemorrhage: systematic review and analysis of MISTIE, CLEAR-IVH, and CLEAR III |
| title_full | Accuracy of the ABC/2 score for intracerebral hemorrhage: systematic review and analysis of MISTIE, CLEAR-IVH, and CLEAR III |
| title_fullStr | Accuracy of the ABC/2 score for intracerebral hemorrhage: systematic review and analysis of MISTIE, CLEAR-IVH, and CLEAR III |
| title_full_unstemmed | Accuracy of the ABC/2 score for intracerebral hemorrhage: systematic review and analysis of MISTIE, CLEAR-IVH, and CLEAR III |
| title_short | Accuracy of the ABC/2 score for intracerebral hemorrhage: systematic review and analysis of MISTIE, CLEAR-IVH, and CLEAR III |
| title_sort | accuracy of the abc 2 score for intracerebral hemorrhage systematic review and analysis of mistie clear ivh and clear iii |
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