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Record W4206167520 · doi:10.1017/cjn.2021.412

P.136 Evaluating outcome prediction models in endovascular treatment for acute ischemic stroke using baseline, treatment and post-treatment variables

2021· article· en· W4206167520 on OpenAlexaffvenue
JM Ospel, A Ganesh, Manon Kappelhof, Rosalie McDonough, R. G. Nogueira, Ryan McTaggart, Bijoy K. Menon, Andrew M. Demchuk, AY Poppe, Michael Tymianski, Michael D. Hill, Madhav Goyal

Bibliographic record

VenueCanadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques · 2021
Typearticle
Languageen
FieldMedicine
TopicAcute Ischemic Stroke Management
Canadian institutionsSystems, Applications & Products in Data Processing (Canada)Toronto Public HealthCalgary Laboratory Services
Fundersnot available
KeywordsModified Rankin ScaleMedicineLogistic regressionStroke (engine)Internal medicinePrognostic variableOutcome (game theory)Ischemic strokeMultivariate analysisIschemiaMathematics

Abstract

fetched live from OpenAlex

Background: Predicting outcomes after endovascular treatment (EVT) for acute ischemic stroke with baseline variables remains a challenge. We assessed the performance of stroke outcome prediction models for EVT in acute ischemic stroke in an iterative fashion using baseline, treatment-related and post-treatment variables. Methods: Data from the ESCAPE-NA1 trial were used to build 4 outcome prediction models using multi-variable logistic regression: Model 1 included baseline variables only that are available prior to treatment decision-making, model 2 included additional treatment-related variables, model 3 additional early post-treatment variables, and model 4 additional late post-treatment variables. The primary outcome was 90-day modified Rankin Scale score 0-2. Model performance was compared using the area under the curve (AUC). Results: Among 1,105 patients, good outcome was achieved by 666 (60.3%). When using baseline variables only (model 1), the AUC was 0.74 (95%CI:0.71-0.77); this iteratively improved when treatment and post-treatment variables were added to the models (model 2: AUC 0.77,95%CI: 0.74-0.80, model 3: AUC 0.80,95%CI:0.77-0.83, model 4: AUC 0.82, 95%CI:0.79-0.85). Conclusions: Predicting EVT outcomes using baseline variables alone is inaccurate in one in four patients, and may be inappropriate for patient selection. Even the most comprehensive models with treatment-related and post-treatment factors involve considerable uncertainty.

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 imitation

Not 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.

metaresearch head score (Codex)0.033
metaresearch head score (Gemma)0.092
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.033
Threshold uncertainty score0.176

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0330.092
Meta-epidemiology (narrow)0.0020.001
Meta-epidemiology (broad)0.0020.005
Bibliometrics0.0010.001
Science and technology studies0.0000.001
Scholarly communication0.0030.002
Open science0.0010.001
Research integrity0.0010.003
Insufficient payload (model declined to judge)0.0050.002

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.

Opus teacher head0.081
GPT teacher head0.331
Teacher spread0.250 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

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".

Quick stats

Citations0
Published2021
Admission routes2
Has abstractyes

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