Abstract TP260: <u>Utilization of Computed Tomography Perfusion in the Pediatric and Young Adult Population – A Nationwide Cohort Study</u>
Bibliographic record
Abstract
Introduction: Computer Tomography Perfusion (CTP) has become widely implemented into workflow models for adults presenting with acute stroke. However, its utilization in the pediatric/young adult population is not well characterized. Methods: We queried the RAPID Insights database from 10/05/2018-09/29/2023 for unique patients between 2-25 years with a CTP. Our inclusion criteria required a minimum ischemic core volume (defined as relative cerebral blood flow (rCBF) reduction of 30% less than normal) of >0 cc and a minimum mismatch volume of >/=0 cc. We analyzed age by pre-defined strata: 2-5, 6-11, 12-18, and 19-25 years. Utilization patterns were analyzed using descriptive statistics according to geographic region: Midwest, Northeast, Southeast, Southwest, and West, and by time epochs, defined as Day: 07:00h-14:59h, Evening: 15:00h-22:59h, and Night: 23:00h-06:59h. Results: There were 2492 unique CTP scans. There was a positive correlation between CTP usage with increasing age, with only 23/2492 (0.9%) of scans performed in the 2-5 year age group, and 1825/2492 (73.2%) scans performed in the 19-25 year age group. 307 (12.3%) cases had large vessel occlusions (LVOs) detected, and 77 (3.1%) had intracerebral hemorrhage (ICH). The ICH group was significantly younger than the total cohort: 18.8+/-5.1 vs 20.0+/-3.9 years (p=0.0085). There was a significantly higher proportion of ICHs detected on weekend days compared to LVOs: 59/77 (76.6%) vs 85/307 (27.7%), p<0.0001. Similar proportions of scans were done during the Day (37.5%) and Evening (43.1%), with only 19.4% of scans performed during the Night. The Northeast and Southeast had the highest number of scans performed per hospital (599/168 and 577/129, respectively) compared to the Southwest which had the lowest (156/49). Conclusion: This is the largest cohort of CTP studies done in the pediatric/ young adult population for suspected acute cerebral ischemia. Future studies should incorporate clinical indications and perfusion thresholds to advance our limited understanding of CTP use in the pediatric and young adult population.
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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".