The unruptured intracranial aneurysm treatment score A multidisciplinary consensus

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Etminan , N , Brown , R D , Beseoglu , K , Juvela , S , Raymond , J , Morita , A , Torner , J C , Derdeyn , C P , Raabe , A , Mocco , J , Korja , M , Abdulazim , A , Amin-Hanjani , S , Salman , R A-S , Barrow , D L , Bederson , J , Bonafe , A , Dumont , A S , Fiorella , D J , Gruber , A , Hankey , G J , Hasan , D M , Hoh , B L , Jabbour , P , Kasuya , H , Kelly , M E , Kirkpatrick , P J , Knuckey , N , Koivisto , T , Krings , T , Lawton , M T , Marotta , T R , Mayer , S A , Mee , E , Pereira , V M , Molyneux , A , Morgan , M K , Mori , K , Murayama , Y , Nagahiro , S , Nakayama , N , Niemela , M , Ogilvy , C S , Pierot , L , Rabinstein , A A , Roos , Y B W E M , Rinne , J , Rosenwasser , R H , Ronkainen , A , Schaller , K , Seifert , V , Solomon , R A , Spears , J , Steiger , H-J , Vergouwen , M D I , Wanke , I , Wermer , M J H , Wong , G K C , Wong , J H , Zipfel , G J , Connolly , E S , Steinmetz , H , Lanzino , G , Pasqualin , A , Ruefenacht , D , Vajkoczy , P , McDougall , C , Haenggi , D , LeRoux , P , Rinkel , G J E & Macdonald , R L 2015 , ' The unruptured intracranial aneurysm treatment score A multidisciplinary consensus ' , Neurology , vol. 85 , no. 10 , pp. 881-889 . https://doi.org/10.1212/WNL.0000000000001891

Title: The unruptured intracranial aneurysm treatment score A multidisciplinary consensus
Author: Etminan, Nima; Brown, Robert D.; Beseoglu, Kerim; Juvela, Seppo; Raymond, Jean; Morita, Akio; Torner, James C.; Derdeyn, Colin P.; Raabe, Andreas; Mocco, J.; Korja, Miikka; Abdulazim, Amr; Amin-Hanjani, Sepideh; Salman, Rustam Al-Shahi; Barrow, Daniel L.; Bederson, Joshua; Bonafe, Alain; Dumont, Aaron S.; Fiorella, David J.; Gruber, Andreas; Hankey, Graeme J.; Hasan, David M.; Hoh, Brian L.; Jabbour, Pascal; Kasuya, Hidetoshi; Kelly, Michael E.; Kirkpatrick, Peter J.; Knuckey, Neville; Koivisto, Timo; Krings, Timo; Lawton, Michael T.; Marotta, Thomas R.; Mayer, Stephan A.; Mee, Edward; Pereira, Vitor Mendes; Molyneux, Andrew; Morgan, Michael K.; Mori, Kentaro; Murayama, Yuichi; Nagahiro, Shinji; Nakayama, Naoki; Niemela, Mika; Ogilvy, Christopher S.; Pierot, Laurent; Rabinstein, Alejandro A.; Roos, Yvo B. W. E. M.; Rinne, Jaakko; Rosenwasser, Robert H.; Ronkainen, Antti; Schaller, Karl; Seifert, Volker; Solomon, Robert A.; Spears, Julian; Steiger, Hans-Jakob; Vergouwen, Mervyn D. I.; Wanke, Isabel; Wermer, Marieke J. H.; Wong, George K. C.; Wong, John H.; Zipfel, Gregory J.; Connolly, E. Sander; Steinmetz, Helmuth; Lanzino, Giuseppe; Pasqualin, Alberto; Ruefenacht, Daniel; Vajkoczy, Peter; McDougall, Cameron; Haenggi, Daniel; LeRoux, Peter; Rinkel, Gabriel J. E.; Macdonald, R. Loch
Contributor: University of Helsinki, Clinicum
University of Helsinki, Neurokirurgian yksikkö
University of Helsinki, Clinicum
Date: 2015-09-08
Language: eng
Number of pages: 9
Belongs to series: Neurology
ISSN: 0028-3878
URI: http://hdl.handle.net/10138/197736
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 (v(r)*) (v(r)* 5 0 indicating excellent agreement and v(r)* = 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 (v(r)*) 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.
Subject: TERM-FOLLOW-UP
NATURAL-HISTORY
ENDOVASCULAR TREATMENT
CEREBRAL ANEURYSMS
SACCULAR ANEURYSMS
SURGICAL-TREATMENT
RUPTURE RISK
METAANALYSIS
COHORT
AGE
3124 Neurology and psychiatry
3126 Surgery, anesthesiology, intensive care, radiology
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