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Related Experiment Videos

Interobserver variation of ASPECTS in real time.

Shelagh B Coutts1, Andrew M Demchuk, Philip A Barber

  • 1Seaman Family MR Centre, Calgary Health Region, Foothills Hospital, Calgary, Alberta, Canada. shelagh.coutts@calgaryhealthregion.ca

Stroke
|April 10, 2004
PubMed
Summary

The Alberta Stroke Program Early CT Score (ASPECTS) is reliable for assessing early ischemic changes on CT scans in acute stroke patients when performed in real time by treating physicians.

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Area of Science:

  • Neurology
  • Radiology
  • Emergency Medicine

Background:

  • The Alberta Stroke Program Early CT Score (ASPECTS) quantifies early ischemic changes on CT scans in acute stroke patients.
  • Assessing the reliability of real-time ASPECTS scoring is crucial for timely stroke management.

Purpose of the Study:

  • To evaluate the reliability of the ASPECTS score when applied prospectively by treating physicians compared to expert readings.
  • To determine interobserver agreement for real-time ASPECTS assessments.

Main Methods:

  • Prospective recruitment of 214 acute ischemic stroke or transient ischemic attack patients with CT scans within 12 hours of onset.
  • Independent ASPECTS scoring by treating physicians (real-time) and an expert reader (delayed).
  • Weighted kappa statistic used to assess interobserver agreement.

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Main Results:

  • Substantial interobserver agreement was found between real-time and expert ASPECTS (kappa(w)=0.69).
  • The mean difference between real-time and expert ASPECTS was minimal (0, SD: 1.1).
  • Study included patients with median NIHSS of 5 and median time to CT of 152 minutes.

Conclusions:

  • The ASPECTS score demonstrates reliability when used in real-time clinical practice for evaluating early ischemic changes.
  • Real-time ASPECTS assessment by treating physicians is a dependable method for acute stroke evaluation.