Abstract WP180: Recanalization Predicts Prognosis After Cerebral Venous Thrombosis: A Systematic Review and Meta-analysis
Bibliographic record
Abstract
Background: Guidelines recommend a 3-12 month duration of anticoagulation for cerebral venous thrombosis (CVT) and a repeat venogram at 3-6 months to assess recanalization. However, the relationship between recanalization and prognosis is not well defined. We performed a systematic review and meta-analysis to clarify the association between venous recanalization and prognosis in CVT. Methods: We performed a literature search to identify all published studies that evaluated recanalization and prognosis in adult patients with a diagnosis of CVT treated with anticoagulation. Studies were identified using MEDLINE and EMBASE databases (1946 - 2017). Recanalization was ascertained by repeat venogram (CT, MR or conventional) and degree of recanalization was characterized as complete, partial or absent. Prognosis was defined using the modified Rankin Scale (mRS, 0-1 = excellent outcome). Results: We found 675 articles and conference abstracts. Thirty-five were appropriate for full-text review and 11 had information regarding recanalization and clinical outcome, accounting for 450 subjects in total. All but one study had clinical and neuro-imaging reassessments within 12 months. Eighty-five percent had complete or partial recanalization within one year. Eighty-seven percent had an excellent outcome (mRS 0-1). As compared with complete or partial recanalization, those with no recanalization had a significantly increased odds of an mRS of 2-6 (OR 3.3, 95% CI 1.5 - 7.2, p=0.003). There was no significant difference in odds of worse prognosis for those with partial recanalization versus full recanaliation. No recanalization also carried a higher odds of CVT recurrence (OR 7.2, 95% CI 1.5 - 33, p=0.01) and chronic headache (OR 3.8, 95% CI 1.6 - 9.0, p=0.002). Conclusion: Absence of recanalization is associated with a poorer prognosis in CVT patients. There does not appear to be a dose-response relationship with regards to degree of recanalization (partial versus complete) and prognosis.
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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 | 0.009 | 0.031 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.012 | 0.024 |
| Bibliometrics | 0.006 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 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".