Intravenous thrombolysis and thrombectomy decisions in acute ischemic stroke: An interrater and intrarater agreement study

Célina Ducroux; Robert Fahed; Naim Khoury; Guylaine Gevry; Erwah Kalsoum; Marc-Antoine Labeyrie; Daniela Ziegler; Caroline Sauvé; Miguel Chagnon; Tim Darsaut; Jean Raymond; Philippe Niclot; Alain Ameri; Jerome Hodel; Jean-Christophe Gentric; Francois-Mathias Merrien; Aurore Jourdain; Francois Rouhart; Irina Viakhireva; Serge Timsit; Frederic Clarencon; Silvia Pistocchi; Charlotte Rosso; Chiara Zavanone; Emmanuel Houdart; Peggy Reiner; Benjamin Gory; Roberto Riva; Norbert Nighoghossian; Tae-Hee Cho; Laurent Derex; Francois Eugene; Jean-Christophe Ferré; Anthony Le Bras; Stephane Vannier; Maria Lassalle; Cyril Chivot; Audrey Arnoux; Philippe Alla; Jean-Brice Veyrieres; Gaultier Marnat; Jerome Berge; Stephane Olindo; Igor Sibon; Bertrand Lapergue; Adrien Wang; Arturo Consoli; Federico Di Maria; Michael Obadia; Candice Sabben; Mikael Mazighi; Hocine Redjem; Michel Piotin; William Boisseau; Lilia Razlog; Raoul Pop; Remy Beaujeux; Dan Mihoc; Sebastian Richter; Monica Manisor; Valerie Wolff; Veronique Quenardelle; Lisa Zinchenko; Mihaela Diaconu; Marion Yger; Stephen Delorme; Christina Iosif; Thierry Moulin; Hatem Zekri; Francois Lallement; Olivier Vercruysse; Christanthi Papagiannaki; Ozlem Ozkul-Wermester; Cyril Dargazanli; Vincent Costalat; Nicolas Gaillard; Caroline Arquizan; Mireille Cayrecastel; Serge Bracard; Anne-Laure Derelle; Sebastien Richard; Lisa Humbertjean; Yann Herve; Pascal Favrole; Patrick Le Coz; Thomas de Brouker; Marie-Isabelle Force; Serge Akono; Serkan Cakmak; Alexandru Florea; Thibault Lalu; Gregory Taurin; Duc Long Duong; Marie-Laure Chadenat; Fernando Pico; Remi Allibert; Sarah Evain; Philippe Tassan; Eric Berthier; Xavier Ducrocq; Matthieu Rigal; Marion Boulanger

doi:10.1016/j.neurol.2018.10.005

Back

Intravenous thrombolysis and thrombectomy decisions in acute ischemic stroke: An interrater and intrarater agreement study

Journal article

Open access

Peer reviewed

Intravenous thrombolysis and thrombectomy decisions in acute ischemic stroke: An interrater and intrarater agreement study

Célina Ducroux, Robert Fahed, Naim Khoury, Guylaine Gevry, Erwah Kalsoum, Marc-Antoine Labeyrie, Daniela Ziegler, Caroline Sauvé, Miguel Chagnon, Tim Darsaut, …

Revue Neurologique, Vol.175(6), pp.380-389

2019

DOI: https://doi.org/10.1016/j.neurol.2018.10.005

PMID: 31047687

Abstract

Purpose. - We aimed to assess agreement on intravenous tissue-plasminogen activator (IV tPA) and mechanical thrombectomy (MT) management decisions in acute ischemic stroke (AIS) patients. Secondary objectives were to assess agreement on Diffusion-Weighted-Imaging-Alberta-Stroke-Program-EArly-CT-Score (DWI-ASPECTS), and clinicians' willingness to recruit patients in a randomized controlled trial (RCT) comparing medical management with or without MT. Materials and Methods. - Studies assessing agreement of IV tPA and MT were systematically reviewed. An electronic portfolio of 41 AIS patients was sent to randomly selected providers at French stroke centers. Raters were asked 4 questions for each case: (1) What is the DWI-ASPECTS? (2) Would you perform IV tPA? (3) Would you perform MT? (4) Would you include the patient in a RCT comparing standard medical therapy with or without MT? Twenty responders were randomly selected to study intrarater agreement. Agreement was assessed using Fleiss' Kappa statistics. Results. - The review yielded two single center studies involving 2-5 raters, with various results. The electronic survey was answered by 86 physicians (60 vascular neurologists and 26 interventional neuroradiologists). The interrater agreement was moderate for IV tPA treatment decisions (kappa = 0.565 [0.420-0.680]), but only fair for MT (kappa = 0.383 [0.289-0.491]) and for combined treatment decisions (kappa = 0.399 [0.320-0.486]). The intrarater agreement was at least substantial for the majority of raters. The interrater agreement for DWI-ASPECTS was fair (kappa = 0.325 [0.276-0.387]). Physicians were willing to include a mean of 14 +/- 9 patients (33.1% +/- 21.7%) in a RCT. Conclusion. - Disagreements regarding the use of IVtPA or MT in the management of AIS patients remain frequent. Further trials are needed to resolve the numerous areas of uncertainty.

Files and links (1)

url

Find in HALView

Metrics

1 Record Views

Details

Title: Intravenous thrombolysis and thrombectomy decisions in acute ischemic stroke: An interrater and intrarater agreement study
Creators - without role: Célina Ducroux - Fondation Ophtalmologique Adolphe de Rothschild
Robert Fahed - Fondation Ophtalmologique Adolphe de Rothschild
Naim Khoury
Guylaine Gevry - Centre Hospitalier de l’Université de Montréal
Erwah Kalsoum - Centre Hospitalier Universitaire Henri-Mondor
Marc-Antoine Labeyrie - Hôpital Lariboisière
Daniela Ziegler - Centre Hospitalier de l’Université de Montréal
Caroline Sauvé - Centre Hospitalier de l’Université de Montréal
Miguel Chagnon - Université du Québec à Montréal
Tim Darsaut
Jean Raymond - Centre Hospitalier de l’Université de Montréal
Philippe Niclot - Centre Hospitalier René-Dubos
Alain Ameri
Jerome Hodel - Université de Lille
Jean-Christophe Gentric - CIC Brest
Francois-Mathias Merrien - Hôpital Maison Blanche
Aurore Jourdain - Centre Hospitalier Régional Universitaire de Brest
Francois Rouhart - Hôpital Maison Blanche
Irina Viakhireva - Physiopathologie et Epidémiologie des Maladies Respiratoires
Serge Timsit - Hôpital Maison Blanche
Frederic Clarencon - Pitié-Salpêtrière Hospital
Silvia Pistocchi - Sorbonne Université
Charlotte Rosso - Institut du Cerveau
Chiara Zavanone - Sorbonne Paris Cité
Emmanuel Houdart - Assistance Publique – Hôpitaux de Paris
Marc-Antoine Labeyrie - Service de Neuroradiologie [CHU Lariboisière]
Peggy Reiner - Hôpital Fernand-Widal
Benjamin Gory - Imagerie Adaptative Diagnostique et Interventionnelle
Roberto Riva - Hospices Civils de Lyon
Norbert Nighoghossian - Université Claude Bernard Lyon 1
Tae-Hee Cho - Cerebrovascular Unit [Lyon]
Laurent Derex - Research on healthcare performance
Francois Eugene - Hôpital Pontchaillou
Jean-Christophe Ferré - Centre Hospitalier Universitaire de Rennes
Anthony Le Bras - Institut de Recherche Technologique B-com
Stephane Vannier - Centre Hospitalier Universitaire de Rennes
Maria Lassalle
Cyril Chivot - Centre Hospitalier Universitaire Amiens-Picardie
Audrey Arnoux - Laboratoire de Psychologie et NeuroCognition
Philippe Alla
Jean-Brice Veyrieres
Gaultier Marnat - Centre Hospitalier Universitaire de Bordeaux
Jerome Berge - Centre Hospitalier Universitaire de Bordeaux
Stephane Olindo - Centre Hospitalier Universitaire de Bordeaux
Igor Sibon - Université de Bordeaux
Bertrand Lapergue - Hôpital Foch
Adrien Wang - Hôpital Foch
Arturo Consoli - Hôpital Foch
Federico Di Maria - Hôpital Foch
Michael Obadia - Hôpital Rothschild
Candice Sabben - Fondation Ophtalmologique Adolphe de Rothschild
Mikael Mazighi - Centre Hospitalier Universitaire de Montpellier
Hocine Redjem - Fondation Ophtalmologique Adolphe de Rothschild
Michel Piotin - Hôpital Rothschild
William Boisseau - Fondation Ophtalmologique Adolphe de Rothschild
Lilia Razlog
Raoul Pop - Institut de Recherche contre les Cancers de l’Appareil Digestif
Remy Beaujeux - Hôpitaux Universitaires de Strasbourg
Dan Mihoc - Hôpital Civil, Strasbourg
Sebastian Richter - Biophysics Group Friedrich-Alexander University
Monica Manisor - Hôpital Civil, Strasbourg
Valerie Wolff - Conseil Elevage
Veronique Quenardelle - Mitochondrie, stress oxydant et protection musculaire
Lisa Zinchenko
Mihaela Diaconu
Marion Yger - Hôpital Saint-Antoine
Stephen Delorme - Sorbonne Université
Christina Iosif - Université de Limoges
Thierry Moulin - Centre Hospitalier Universitaire de Besançon
Hatem Zekri
Francois Lallement - Centre Hospitalier de Saint-Brieuc
Olivier Vercruysse - Université de Lille
Christanthi Papagiannaki
Ozlem Ozkul-Wermester - Hôpital Charles-Nicolle
Cyril Dargazanli - Centre Hospitalier Universitaire de Montpellier
Vincent Costalat - Département de Neuroradiologie[Montpellier]
Nicolas Gaillard - Centre Hospitalier Universitaire de Montpellier
Caroline Arquizan - Centre Hospitalier Universitaire de Montpellier
Mireille Cayrecastel
Serge Bracard - Imagerie Adaptative Diagnostique et Interventionnelle
Anne-Laure Derelle - Département de neuroradiologie diagnostique et thérapeutique [CHRU Nancy]
Sebastien Richard - Centre Hospitalier Régional et Universitaire de Nancy
Lisa Humbertjean - Centre Hospitalier Régional et Universitaire de Nancy
Yann Herve
Pascal Favrole - Service de Neurologie [Aix-en-Provence]
Patrick Le Coz
Thomas de Brouker
Marie-Isabelle Force
Serge Akono
Serkan Cakmak
Alexandru Florea
Thibault Lalu
Gregory Taurin
Duc Long Duong
Marie-Laure Chadenat
Fernando Pico - Neuroépidémiologie
Remi Allibert
Sarah Evain - Centre hospitalier Bretagne Atlantique
Philippe Tassan
Eric Berthier
Xavier Ducrocq - Centre Hospitalier Régional de Metz-Thionville
Matthieu Rigal
Marion Boulanger - Physiopathologie et imagerie des troubles neurologiques
Publication Details: Revue Neurologique, Vol.175(6), pp.380-389
Identifiers: 9934042309311
Academic Unit: Institut de Génomique Fonctionnelle - IGF
Language: English
Resource Type: Journal article
Local Fields: hal-03607023