The Causative Classification of Stroke system An international reliability and optimization study
(2010) In Neurology 75(14). p.1277-1284- Abstract
- 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... (More)
- 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 (Less)
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- author
- organization
- publishing date
- 2010
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Neurology
- volume
- 75
- issue
- 14
- pages
- 1277 - 1284
- publisher
- Lippincott Williams & Wilkins
- external identifiers
-
- wos:000282883900013
- scopus:77958177965
- pmid:20921513
- ISSN
- 1526-632X
- DOI
- 10.1212/WNL.0b013e3181f612ce
- language
- English
- LU publication?
- yes
- id
- 9ad9da53-2906-4df4-9713-12500653aacb (old id 1725697)
- date added to LUP
- 2016-04-01 13:51:55
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- 2022-04-22 00:05:10
@article{9ad9da53-2906-4df4-9713-12500653aacb,
abstract = {{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}},
author = {{Arsava, E. M. and Ballabio, E. and Benner, T. and Cole, J. W. and Delgado-Martinez, M. P. and Dichgans, M. and Fazekas, F. and Furie, K. L. and Illoh, K. and Jood, K. and Kittner, S. and Lindgren, Arne and Majersik, J. J. and Macleod, M. J. and Meurer, W. J. and Montaner, J. and Olugbodi, A. A. and Pasdar, A. and Redfors, P. and Schmidt, R. and Sharma, P. and Singhal, A. B. and Sorensen, A. G. and Sudlow, C. and Thijs, V. and Worrall, B. B. and Rosand, J. and Ay, H.}},
issn = {{1526-632X}},
language = {{eng}},
number = {{14}},
pages = {{1277--1284}},
publisher = {{Lippincott Williams & Wilkins}},
series = {{Neurology}},
title = {{The Causative Classification of Stroke system An international reliability and optimization study}},
url = {{http://dx.doi.org/10.1212/WNL.0b013e3181f612ce}},
doi = {{10.1212/WNL.0b013e3181f612ce}},
volume = {{75}},
year = {{2010}},
}