Multidimensional outcome after endovascular or microsurgical occlusion of ruptured intracranial aneurysms – Comparative analysis of a prospective Swiss multicenter study
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Introduction: Despite advances in cerebral aneurysm treatment, information on detailed outcomes remains limited. We compared complications and multidimensional outcomes in alert aneurysmal subarachnoid hemorrhage (aSAH) patients (GCS ≥13) who received clipping or coiling after individualized decisions were made through multidisciplinary board discussions. Research question: Are there significant differences in multidimensional outcomes between clipping and coiling treatments for alert aSAH patients when treatment selection is individualized? Material and methods: Within the prospective MoCA-DCI study (ClinicalTrials.gov identifier: NCT03032471), patients with a GCS of 13-15 72h post-aSAH in six neurovascular centers underwent neuropsychological (Montreal Cognitive Assessment; MoCA), neurological (National Institutes of Health Stroke Scale; NIHSS), headache (visual analog scale; VAS), disability (modified Rankin Scale; mRS) and health-related quality of life (EuroQol Five Dimensions; EQ5D) assessments within 72h, 14 days and three months after aSAH. We compared these multidimensional outcomes and complications for clipped and coiled patients. Results: Of 126 patients (mean age 53.8 years; 63.9 % female), 84 were coiled and 42 clipped. MoCA scores for clipped vs coiled patients were 23(7) vs 23(8; p = 0.250), 25(8) vs 28(5; p = 0.346), and 27(4) vs 28(5; p = 0.481). Normal cognition (MoCA ≥26) was achieved within 72h by 28.6 % of coiled and 40.5 % of clipped patients (p = 0.179). Complication rates were similar, though surgical patients had higher intraprocedural rupture rates (p = 0.027). Clipped patients reported higher headaches at three months (p = 0.013), while NIHSS, mRS and EQ5D showed no differences. Discussion and conclusion: After interdisciplinary selection of the most appropriate treatment, similar favorable outcomes can be achieved in alert aSAH patients.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| 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) | 0.000 | 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 it