Abstract 070: Thrombectomy for Acute Ischemic Stroke with Large Infarct in a Randomized Trial versus Routine Clinical Practice ‐ A Comparison of the TENSION Trial and the German Stroke Registry
Bibliographic record
Abstract
Introduction Randomized trials have shown that endovascular thrombectomy improves functional outcomes in patients with acute ischemic stroke and large infarct. This study assesses the replicability of the functional outcomes observed in the TENSION trial within routine clinical practice. Materials and Methods TENSION was a prospective, multicenter, randomized trial that enrolled patients with acute ischemic stroke and large infarct at 41 centers across Europe and Canada. Patients were randomized to endovascular thrombectomy or medical treatment. The main inclusion criteria of TENSION were defined as a pre‐stroke mRS score 0‐2, a randomization within 11 hours of symptom onset, an occlusion of the intracranial ICA or M1 segment of the MCA, an ASPECTS 3‐5, and a NIHSS score 0‐25. Patients from the thrombectomy arm of TENSION (TENSION‐RCT) were compared to patients from the German Stroke Registry meeting the main inclusion criteria of TENSION (TENSION‐GSR) using 1:1 propensity score matching. Primary outcome was the 90‐day mRS score (shift analysis). Results Of 308 patients who met the inclusion criteria, 198 patients were matched (median age, 74 [IQR, 64‐81]; 98 [49.5%] female, median 90‐day mRS, 5 [IQR, 3‐6]). There was no significant shift in the distribution of 90‐day mRS scores between TENSION‐RCT and TENSION‐GSR (acOR, 1.19; 95% CI, 0.70‐2.02; P=.52). The proportions of favorable 90‐day mRS scores 0‐3 (33.3% vs. 31.3%, P=.76) and 90‐day mortality (38.4% vs. 45.5%, P=.31) did not differ between TENSION‐RCT and TENSION‐GSR. Conclusion Functional outcomes from the thrombectomy arm of TENSION can be replicated within the German healthcare system. These findings support the benefit of endovascular thrombectomy for acute ischemic stroke with large infarct and its broad adoption in routine clinical practice. image
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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 | 0.013 | 0.018 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".