Risk assessment of symptomatic intracerebral hemorrhage after thrombolysis using the Alberta Stroke Programme Early CT Score applied to diffusion weighted imaging
Why this work is in the frame
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Bibliographic record
Abstract
Objective To investigate whether the Alberta Stroke Programme Early CT Score applied to diffusion weighted imaging (DWI-ASPECTS) predicts symptomatic intracerebral hemorrhage (sICH) risk accurately. Methods In this retrospective study, continuously collected data of 53 patients at Department of Neurology, Baotou Central Hospital from 2010 to 2013 with anterior circulation stroke treated with standard intravenous tissue plasminogen activator (tPA; 0.6 mg/kg) therapy within 4.5 hours after symptom onset were analyzed. All patients had completed the MRI scan and DWI at the time of admission. Patients age, NIHSS score on admission, time between symptom onset and thrombolytic treatment and other information were recorded. DWI-ASPECTS scores were calculated by the 10 regional diffusion image of anterior circulation marked, a total of 10 points, each involving a region minus 1 point. The patients were divided into 3 groups of 0-5 (n=16), 6-7 (n=17), 8-10 (n=20) based on DWI-ASPECTS scores. sICH was defined as CT- (or MRI-) documented hemorrhage that occurred within 36 hours after treatment onset and an elevated NIHSS score more than 4 points. Results Ten (18.8%) patients developed sICH. DWI-ASPECTS scores were 0-5 in 6 patients (37.5%), 6-7 in 3 (17.6%) and 8-10 in 1(5.0%), respectively. The sICH rate was significantly higher in patients with DWI-ASPECTS scores 0 to 5 as compared to patients with DWI-ASPECTS scores 6 to 7 and 8 to 10 (χ2=7.861, P=0.005). DWI- ASPECTS score and sICH had good correlation. Logistic regression analysis showed DWI-ASPECTS score was an independent prognostic factor of sICH when controlling for age and time to thrombolytic treatment. Conclusion DWI-ASPECTS can predict sICH risk after thrombolysis and may be helpful to quick sICH risk assessment before thrombolytic therapy. Key words: Intracranial hemorrhages; Brain ischemia; Stroke; Thrombolytic therapy; Diffusion magnetic resonance imaging; Tomography, X-ray computed; Forecasting
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 it