The Causative Classification of Stroke system An international reliability and optimization study
The Causative Classification of Stroke system An international reliability and optimization study
复制标题
DOI：
10.1212/wnl.0b013e3181f612ce
复制
发表时间：
2010-10-05
期刊：
影响因子：
9.9
通讯作者：
Ay, H.
中科院分区：
文献类型：
--
作者：
Arsava, E. M.;Ballabio, E.;Ay, H.
背景：有效和可靠的缺血性卒中亚型确定对于有效的多中心研究至关重要。中风病因分类系统（CCS，可在http://ccs.mgh.harvard.edu获得）是一种计算机化的循证算法，以基于规则的方式提供病因和表型中风亚型。我们确定CCS是否表现出较高的评价者间的可靠性，以是有用的国际多中心studies.Methods：20名成员的国际中风遗传学联盟从13个中心在8个国家，谁没有参与的CCS的设计和开发，独立评估了相同的50例连续急性缺血性中风患者通过审查的摘要摘要。结果：5种亚型、8种亚型和16种亚型CCS病因分类的Kappa值分别为0.80（95%CI 0.78-0.81）、0.79（95%CI 0.77-0.80）和0.70（95%CI 0.69-0.71）。校正产生模糊性的软件相关因素改善了一致性：5亚型的kappa = 0.81（95% CI 0.79-0.82），8亚型的kappa = 0.79（95% CI 0.77-0.80），16亚型CCS的kappa = 0.79（95% CI 0.78-0.80）。表型分类的Kappa值为0.79（95% CI 0.77-0.82）对于主动脉上大动脉粥样硬化，0.95（95% CI 0.93-0.98）心源性栓塞，0.88（95% CI 0.85-0.91）小动脉闭塞，0.79（0.76-0.82）其他不常见的原因。CCS允许多名研究者对卒中亚型进行高可靠性分类，支持其在多中心研究中改善卒中分类的潜力，并确保不同研究人员之间的准确沟通，制度和时代。神经病学（R）2010;75：1277-1284
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 kappa 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: kappa = 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 kappa 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. Neurology (R) 2010;75:1277-1284