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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
The causative classification of stroke system: An international reliability and optimization study
Neurology, Volume 75, No. 14, Year 2010
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Description
Background: Valid and reliable ischemic stroke subtype determination is crucial for well-powered multicenter studies. The Causative Classification of Stroke System (CCS, available at http://ccs.mgh.harvard.edu) is a computerized, evidence-based algorithm that provides both causative and phenotypic stroke subtypes in a rule-based manner. We determined whether CCS demonstrates high interrater reliability in order to be useful for international multicenter studies. Methods: Twenty members of the International Stroke Genetics Consortium from 13 centers in 8 countries, who were not involved in the design and development of the CCS, independently assessed the same 50 consecutive patients with acute ischemic stroke through reviews of abstracted case summaries. Agreement among ratings was measured by kappa statistic. Results: The κ value for causative classification was 0.80 (95% confidence interval [CI] 0.78-0.81) for the 5-subtype, 0.79 (95% CI 0.77-0.80) for the 8-subtype, and 0.70 (95% CI 0.69-0.71) for the 16-subtype CCS. Correction of a software-related factor that generated ambiguity improved agreement: κ = 0.81 (95% CI 0.79-0.82) for the 5-subtype, 0.79 (95% CI 0.77-0.80) for the 8-subtype, and 0.79 (95% CI 0.78-0.80) for the 16-subtype CCS. The κ value for phenotypic classification was 0.79 (95% CI 0.77-0.82) for supra-aortic large artery atherosclerosis, 0.95 (95% CI 0.93-0.98) for cardioembolism, 0.88 (95% CI 0.85-0.91) for small artery occlusion, and 0.79 (0.76-0.82) for other uncommon causes. Conclusions: CCS allows classification of stroke subtypes by multiple investigators with high reliability, supporting its potential for improving stroke classification in multicenter studies and ensuring accurate means of communication among different researchers, institutions, and eras. © 2010 by AAN Enterprises, Inc. All rights reserved.
Authors & Co-Authors
Arsava, Ethem Murat
United States, Boston
Massachusetts General Hospital
Ballabio, Elena
Italy, Milan
National Neurological Institute
Benner, Thomas
United States, Boston
Massachusetts General Hospital
Cole, John W.
United States, Baltimore
University of Maryland, Baltimore Umb
Delgado, Pilar
Spain, Barcelona
Hospital Universitari Vall D'hebron
Dichgans, Martin
Germany, Munich
Ludwig-maximilians-universität München
Fazekas, Franz
Austria, Graz
Medizinische Universität Graz
Furie, Karen Lisa
United States, Boston
Massachusetts General Hospital
Illoh, Kachi O.
United States, Silver Spring
Food and Drug Administration
Jood, Katarina
Sweden, Gothenburg
Sahlgrenska Universitetssjukhuset
Kittner, Steven J.
United States, Baltimore
University of Maryland, Baltimore Umb
Lindgren, Arne G.
Sweden, Lund
Skånes Universitetssjukhus
Majersik, Jennifer Juhl
United States, Salt Lake City
The University of Utah
MacLeod, Mary Joan
Unknown Affiliation
Meurer, William J.
United States, Ann Arbor
University of Michigan, Ann Arbor
Montaner, J. M.
Spain, Barcelona
Hospital Universitari Vall D'hebron
Olugbodi, Akintomi A.
Nigeria, Ife
Obafemi Awolowo University
Pasdar, Alireza
United Kingdom, Aberdeen
University of Aberdeen
Redfors, Petra
Sweden, Gothenburg
Sahlgrenska Universitetssjukhuset
Schmidt, Reinhold T.
Austria, Graz
Medizinische Universität Graz
Sharma, Pankaj Kumar
United Kingdom, London
Hammersmith Hospital
Singhal, Aneesh Bhim
United States, Boston
Massachusetts General Hospital
Sorensen, Alma Gregory
United States, Boston
Massachusetts General Hospital
Sudlow, Cathie L.M.
United Kingdom, Edinburgh
The University of Edinburgh
Thijs, Vincent N.S.
Belgium, Leuven
Ku Leuven– University Hospital Leuven
Worrall, Bradford Burke
United States, Charlottesville
University of Virginia School of Medicine
Rosand, Jonathan
United States, Boston
Massachusetts General Hospital
United States, Cambridge
Broad Institute
Ay, Hakan
United States, Boston
Massachusetts General Hospital
Statistics
Citations: 164
Authors: 28
Affiliations: 19
Identifiers
Doi:
10.1212/WNL.0b013e3181f612ce
ISSN:
00283878
e-ISSN:
1526632X
Research Areas
Genetics And Genomics
Noncommunicable Diseases