Supplemental material for: Validation of intraluminal filling defect length to identify carotid free-floating thrombus in patients with stroke/TIA
Why this work is in the frame
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Bibliographic record
Abstract
Objective: To validate a previously proposed filling defect length threshold of >3.8 mm on CT-angiography (CTA) to discriminate between free-floating thrombus (FFT) and plaque of atheroma. Materials and Methods: Prospective multicenter observational study of 100 participants presenting with TIA/stroke symptoms and a carotid intraluminal filling defect on initial CTA. Follow-up CTA was obtained within one week, and at weeks 2 and 4 if the intraluminal filling defect was unchanged in length. Resolution or decreased length was diagnostic of FFT, whereas its static appearance after 4 weeks was indicative of plaque. Diagnostic accuracy of FFT length was assessed by receiver operating characteristic analysis. Results: Ninety-five participants (mean age [standard deviation], 68 [13] years; 61 men; 83 participants with FFT; 12 participants with a plaque) were evaluated. The >3.8 mm threshold had a sensitivity of 88% (73/83) (95% confidence interval {CI}: 78%, 94%) and specificity of 83% (10/12) (95% CI, 51%, 97%) (area under the curve [AUC], 0.91, p<.001) for the diagnosis of FFT. The optimal length threshold was >3.64 mm with a sensitivity of 89%( 74/83) (95% CI, 80%, 95%) and specificity of 83% (10/12) (95% CI, 51%, 97%). Adjusted logistic regression showed that every 1 mm increase in intraluminal filling defect length is associated with an increase in odds of FFT of 4.6 ([95% CI] 1.9-11.1; p=.01). Conclusion: CTA enables accurate differentiation of FFT versus plaque using craniocaudal length thresholds. Clinical Trial Identifier: www.clinicaltrials.gov NCT02405845. Classification of Evidence: This study provides Class I evidence that in patients with TIA/stroke symptoms, the presence of a carotid intraluminal filling defect with length > 3.8 mm on CTA accurately discriminates free-floating thrombus from atheromatous plaque.
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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 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.007 | 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