To Use Perfusion Imaging or Not in Patient Selection for Late Window Endovascular Thrombectomy?
Bibliographic record
Abstract
The DAWN (Clinical Mismatch in the Triage of Wake up and Late Presenting Strokes Undergoing Neurointervention with Trevo Thrombectomy Procedure)1 and DEFUSE-3 (Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke 3)2 established the efficacy of endovascular thrombectomy (EVT) in selected patients presenting with a large vessel occlusion (LVO) in the anterior circulation and suspected symptom onset within the late window (last known well between 6 and 24 hours). Both trials selected candidates using CT perfusion (CTP) with eligibility confined to predefined core and penumbra thresholds quantified by an automated computer software. The results of DAWN and DEFUSE-3 have already been incorporated into the most recent guidelines from the American Heart Association/American Stroke Association3 and the European Stroke Organization,4 which strongly recommend EVT treatment up to 24 hours for patients with anterior circulation LVO if they satisfy either the DAWN or DEFUSE 3 eligibility criteria, inclusive of the respective core and penumbra thresholds on CTP.
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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 | 0.002 | 0.018 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.011 | 0.008 |
| Insufficient payload (model declined to judge) | 0.004 | 0.004 |
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".