Impact of e-ASPECTS software on the performance of physicians compared to a consensus ground truth: a multi-reader, multi-case study

Frontiers in Neurology

Neurology

Olivier Joly¹  Zoe Victoria Joan Woodhead¹  George Harston²  James Briggs³  Stephen Gerry⁴  Eugene L. Scharf⁵  James Klaas⁵  Deena M. Nasr⁵  Sherri Braksick⁵  Kambiz Nael⁶  Mohamad AbdalKader⁷  Ajay Madhavan⁸  David F. Kallmes⁸  Alex Nagelschneider⁸  Kara Schwartz⁸  Norbert Campeau⁸  John Benson⁸  Carrie M. Carr⁸  Hassan Kobeissi⁸  Steven A. Messina⁸  Ramanathan Kadirvel⁹  Waleed Brinjikji⁹  Anna L. Kuhn^1,10  Angelos A. Kostas^1,11 

[1] Brainomix Limited, Oxford, United Kingdom;Brainomix Limited, Oxford, United Kingdom;Acute Stroke Service, Oxford University Hospitals NHSFT, Oxford, United Kingdom;Brainomix Limited, Oxford, United Kingdom;Royal Berkshire NHS Foundation Trust, Reading, United Kingdom;Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom;Department of Neurology, Mayo Clinic, Rochester, MN, United States;Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, United States;Department of Radiology, Boston Medical Center, Boston, MA, United States;Department of Radiology, Mayo Clinic, Rochester, MN, United States;Department of Radiology, Mayo Clinic, Rochester, MN, United States;Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States;Division of Neurointerventional Radiology, Department of Radiology, UMass Medical Center, Worcester, MA, United States;Huntington Hospital and Hill Medical Imaging, Pasadena, CA, United States;

关键词: imaging;    stroke;    ASPECTS;    neuroradiology;    thrombectomy;   

DOI  :  10.3389/fneur.2023.1221255

 received in 2023-05-12, accepted in 2023-08-14,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundThe Alberta Stroke Program Early CT Score (ASPECTS) is used to quantify the extent of injury to the brain following acute ischemic stroke (AIS) and to inform treatment decisions. The e-ASPECTS software uses artificial intelligence methods to automatically process non-contrast CT (NCCT) brain scans from patients with AIS affecting the middle cerebral artery (MCA) territory and generate an ASPECTS. This study aimed to evaluate the impact of e-ASPECTS (Brainomix, Oxford, UK) on the performance of US physicians compared to a consensus ground truth.MethodsThe study used a multi-reader, multi-case design. A total of 10 US board-certified physicians (neurologists and neuroradiologists) scored 54 NCCT brain scans of patients with AIS affecting the MCA territory. Each reader scored each scan on two occasions: once with and once without reference to the e-ASPECTS software, in random order. Agreement with a reference standard (expert consensus read with reference to follow-up imaging) was evaluated with and without software support.ResultsA comparison of the area under the curve (AUC) for each reader showed a significant improvement from 0.81 to 0.83 (p = 0.028) with the support of the e-ASPECTS tool. The agreement of reader ASPECTS scoring with the reference standard was improved with e-ASPECTS compared to unassisted reading of scans: Cohen's kappa improved from 0.60 to 0.65, and the case-based weighted Kappa improved from 0.70 to 0.81.ConclusionDecision support with the e-ASPECTS software significantly improves the accuracy of ASPECTS scoring, even by expert US neurologists and neuroradiologists.

【 授权许可】

Unknown   
Copyright © 2023 Kobeissi, Kallmes, Benson, Nagelschneider, Madhavan, Messina, Schwartz, Campeau, Carr, Nasr, Braksick, Scharf, Klaas, Woodhead, Harston, Briggs, Joly, Gerry, Kuhn, Kostas, Nael, AbdalKader, Kadirvel and Brinjikji.