Journal article
The unruptured intracranial aneurysm treatment score: a multidisciplinary consensus
Neurology, Vol.85(10), pp.881-889
2015
DOI: 10.1212/wnl.0000000000001891
PMID: 26276380
Abstract
Abstract
Objective: We endeavored to develop an unruptured intracranial aneurysm (UIA) treatment score (UIATS) model that includes and quantifies key factors involved in clinical decision-making in the management of UIAs and to assess agreement for this model among specialists in UIA management and research.
Methods: An international multidisciplinary (neurosurgery, neuroradiology, neurology, clinical epidemiology) group of 69 specialists was convened to develop and validate the UIATS model using a Delphi consensus. For internal (39 panel members involved in identification of relevant features) and external validation (30 independent external reviewers), 30 selected UIA cases were used to analyze agreement with UIATS management recommendations based on a 5-point Likert scale (5 indicating strong agreement). Interrater agreement (IRA) was assessed with standardized coefficients of dispersion (vr*) (vr* = 0 indicating excellent agreement and vr* = 1 indicating poor agreement).
Results: The UIATS accounts for 29 key factors in UIA management. Agreement with UIATS (mean Likert scores) was 4.2 (95% confidence interval [CI] 4.1–4.3) per reviewer for both reviewer cohorts; agreement per case was 4.3 (95% CI 4.1–4.4) for panel members and 4.5 (95% CI 4.3–4.6) for external reviewers (p = 0.017). Mean Likert scores were 4.2 (95% CI 4.1–4.3) for interventional reviewers (n = 56) and 4.1 (95% CI 3.9–4.4) for noninterventional reviewers (n = 12) (p = 0.290). Overall IRA (vr*) for both cohorts was 0.026 (95% CI 0.019–0.033).
Conclusions: This novel UIA decision guidance study captures an excellent consensus among highly informed individuals on UIA management, irrespective of their underlying specialty. Clinicians can use the UIATS as a comprehensive mechanism for indicating how a large group of specialists might manage an individual patient with a UIA.
Details
- Title: Subtitle
- The unruptured intracranial aneurysm treatment score: a multidisciplinary consensus
- Creators
- James C TornerNima EtminanColin P DerdeynRobert D BrownDavid M HasanKerim BeseogluSeppo JuvelaMichael E KellyJean RaymondAkio MoritaAndreas RaabeJ MoccoMiikka KorjaAmr AbdulazimSepideh Amin-HanjaniRustam Al-Shahi SalmanDaniel L BarrowJoshua BedersonAlain BonafeAaron S DumontDavid J FiorellaAndreas GruberGraeme J HankeyBrian L HohPascal JabbourHidetoshi KasuyaPeter J KirkpatrickNeville KnuckeyTimo KoivistoTimo KringsMichael T LawtonThomas R MarottaStephan A MayerEdward MeeVitor Mendes PereiraAndrew MolyneuxMichael K MorganKentaro MoriYuichi MurayamaShinji NagahiroNaoki NakayamaMika NiemeläChristopher S OgilvyLaurent PierotAlejandro A RabinsteinYvo B.W.E.M RoosJaakko RinneRobert H RosenwasserAntti RonkainenKarl SchallerVolker SeifertRobert A SolomonJulian SpearsHans-Jakob SteigerMervyn D.I VergouwenIsabel WankeMarieke J.H WermerGeorge K.C WongJohn H WongGregory J ZipfelE. Sander ConnollyHelmuth SteinmetzGiuseppe LanzinoAlberto PasqualinDaniel RüfenachtPeter VajkoczyCameron McDougallDaniel HänggiPeter LeRouxGabriel J.E RinkelR. Loch Macdonald
- Resource Type
- Journal article
- Publication Details
- Neurology, Vol.85(10), pp.881-889
- DOI
- 10.1212/wnl.0000000000001891
- PMID
- 26276380
- NLM abbreviation
- Neurology
- ISSN
- 0028-3878
- eISSN
- 1526-632X
- Publisher
- Ovid Technologies (Wolters Kluwer Health)
- Language
- English
- Date published
- 2015
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Neurology; Radiology; Epidemiology; Iowa Neuroscience Institute; Surgery; Injury Prevention Research Center; Neurosurgery; Otolaryngology
- Record Identifier
- 9983995172002771
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