Embolization of middle meningeal artery for chronic subdural hematoma: Do we have sufficient evidence?
Bibliographic record
Abstract
Embolization of middle meningeal artery (EMMA) for chronic subdural hematoma (cSDH) is growing in popularity over the last two decade. Several randomized control trials are underway across the world. Indeed, the recent presentation of results from the EMBOLISE (embolization of the middle meningeal artery with onyx liquid embolic system in the treatment of subacute and chronic subdural hematoma), MAGIC-MT (middle meningeal artery treatment) and STEM (squid trial for the embolization of the MMA for the treatment of cSDH) trials at the International Stroke Congress marks a significant development in the field of neurointerventional radiology. The absence of level 1 evidence for EMMA in cSDH underscores the importance of these trials and the need for rigorous evaluation of their results. While the initial findings are promising, further analysis and interpretation are necessary to inform clinical decision-making effectively. We conclude that there may be evidence supporting EMMA for non-surgical cSDH patients, but the evidence for surgical patients is questionable and requires further study. More studies are underway, and hopefully, there will be more evidence on this topic in the coming years.
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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 | 0.010 | 0.034 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.005 | 0.006 |
| Open science | 0.004 | 0.001 |
| Research integrity | 0.012 | 0.019 |
| Insufficient payload (model declined to judge) | 0.006 | 0.005 |
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".