Abstract TP165: <u>Computed-Tomography (CT) Based Imaging Scores in Basilar Artery Occlusions – A Comparison of Predictive Abilities for Functional Outcomes</u>
Bibliographic record
Abstract
Background: Posterior circulation (PC) large-vessel occlusion (LVO) strokes have significant morbidity and mortality, but patient selection for acute interventions remains understudied. Multiple computed tomography (CT)-based scores exist, including the CT-perfusion-based CAPS score, CT-angiogram(CTA)-based BATMAN and PC-CTA scores, and CTA source image or non-contrast-CT-based PC-ASPECTS score, but their predictive values for long-term outcomes after thrombectomy have not been directly compared. Methods: We conducted a retrospective multicenter cohort study of patients with basilar artery occlusions treated with endovascular thrombectomy. Four CT-based scores were assessed: PC-ASPECTS, BATMAN, PC-CTA, and CAPS. The primary outcome of interest for the study was favourable functional outcome at 3 months (mRS of 0-3). We generated receiver operating characteristic curves measuring area under the curve (AUC) for poor functional outcomes and compared AUCs with non-parametric methods. Results: 98 patients were included for analysis, with an average age of 64.9±15.6 years. The median National Institute of Health Stroke Severity Score (NIHSS) was 13.5 (IQR 7.0 – 23.0). AUC values were highest for the CAPS score (AUC 0.72 (95%CI 0.63 – 82)), and lowest for the pc-CTA score (AUC 0.57 (95%CI 0.45 – 0.68)), p=0.019. There was a trend towards the CAPS score outperforming the BATMAN (AUC 0.66 (95%CI 0.55 – 0.77) and PC-ASPECTS scores (AUC 0.63 (95%CI 0.52 – 0.75)), though this difference was not statistically significant (p=0.29 and p=0.23, respectively). However, the CAPS score was the only score with 100% specificity for predicting inability to achieve good functional outcome after thrombectomy: 0/12 patients with CAPS score of 4-6 went on to have a good functional outcome at 3 months after thrombectomy. Conclusion: Our analysis demonstrated that the CT-perfusion-based CAPS score outperformed three other imaging-based scores for predicting outcomes after 3 months. The CAPS score could be implemented to inform patient selection for endovascular thrombectomy in basilar artery occlusions.
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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 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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 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".