O-052 Middle meningeal artery embolization for subdural hematoma: meta-analysis of randomized controlled trials
Bibliographic record
Abstract
<h3>Background</h3> Embolization of the middle meningeal artery embolization is a novel neuroendovascular therapy for chronic subdural hematoma. Recently, a number of randomized control trials were conducted to its efficacy in reducing the recurrence or progression rate of chronic subdural hematoma. <h3>Methods</h3> Preliminary data were reviewed from three randomized control trials (MAGIC-MT, EMBOLISE, STEM: SQUID) presented at the International Stroke Conference 2024. Meta-analysis was undertaken to compare patients undergoing middle meningeal artery embolization and standard care (intervention group) compared to standard care alone (control group); primary endpoints from each study (symptomatic recurrence, symptomatic progression, major adverse event, neurologic deterioration, stroke, MI, and/or death) were analyzed. <h3>Results</h3> A total of 1432 patients (712 intervention group, 720 control group) were included among the three trials. Heterogeneity was low (I<sup>2</sup> = 5%, τ = 0.0133, p = 0.35), therefore a common-effect model was used. The primary endpoint was met in 58 patients (8.1%) in the intervention group compared to 128 patients (17.8%) in the control group. MMA embolization combined with standard management was associated a significantly lower rate of the primary outcome when compared to standard management alone (8.1% vs 17.8%; RR 0.46, 95% CI, 0.34–0.61; <i>p</i> < 0.001; NNT 10.3). <h3>Conclusion</h3> This preliminary meta-analysis demonstrates that middle meningeal artery embolization is effective in reducing symptomatic recurrence, symptomatic progression, major adverse event, neurologic deterioration, stroke, MI, and/or death among patients with chronic subdural hematoma. Further analysis will be performed once the trials are published in peer-reviewed journals. <h3>Disclosures</h3> <b>A. Wang:</b> None. <b>H. Shakil:</b> None. <b>B. Drake:</b> None.
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How this classification was reachedexpand
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 | 0.003 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.007 | 0.008 |
| Bibliometrics | 0.000 | 0.001 |
| 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) | 0.001 | 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 teacher head, 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".