Abstract 143: Evaluation of Interval Times from Onset to Recanalization in Patients Undergoing Endovascular Therapy in the IMS III Trial
Bibliographic record
Abstract
Background: There were significant delays in achieving recanalization observed in the IA arm of IMS III. A detailed analysis of the workflow helps to identify factors contributing to overall delay. Methods: In 418 subjects randomized to the IA arm, the following time intervals were calculated: stroke onset to ED arrival; ED to CT; CT to start of IV tPA; IV tPA to randomization; randomization to groin puncture; groin puncture to thrombus identification; thrombus identification to start of IA therapy; start of IA therapy to reperfusion. The effects of time of day and general anesthesia (GA) on workflow were evaluated. The change of ED to reperfusion and groin puncture to reperfusion over the study period were also evaluated. All times are reported as medians (with IQR).Kruskal-Wallis test was applied. Results: Time intervals are shown in figure 1. Intubation had no significant effect on the overall workflow time. The time from CT to groin puncture during business hours (Mon-Fri; 0800-1700) was 119 min (n=201; IQR 49 min) and after hours was 141 min (n=203; IQR 54 min, p <0.0001). The time from CT to groin puncture during day time (0800-2100) was 127 min (n=341; IQR: 51 min) and during night time was 142 min (n=63; IQR 60 min, p=0.0012). After adjusting for multiple comparisons (Bonferroni method), the times from ED to reperfusion (316 min in 1st quartile to 246 min in last quartile,p<0.0001), and groin puncture to reperfusion (145 min in 1st quartile to 120 min in last quartile;p=0.0005) decreased over the trial duration. Conclusion: In the endovascular arm of the IMS III trial there were significant delays from start of IV tPA to groin puncture. Endovascular techniques used in the trial were quite inefficient in achieving recanalization. Use of GA did not result in additional delays. Endovascular treatment outside of daytime hours did result in slight additional delays. These data may help in designing, optimizing and documenting workflow in current and future endovascular trials.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".