Number needed to screen for acute revascularization trials in stroke: Prognostic and predictive imaging biomarkers.

Détails

ID Serval
serval:BIB_97B527A48554
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Number needed to screen for acute revascularization trials in stroke: Prognostic and predictive imaging biomarkers.
Périodique
International journal of stroke
Auteur(s)
Hou Q., Patrie J.L., Xin W., Michel P., Jovin T., Eskandari A., Wintermark M.
ISSN
1747-4949 (Electronic)
ISSN-L
1747-4930
Statut éditorial
Publié
Date de publication
06/2017
Peer-reviewed
Oui
Volume
12
Numéro
4
Pages
356-367
Langue
anglais
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Résumé
Objective To systematically assess imaging biomarkers on CT-based multimodal imaging for their being predictive versus prognostic biomarkers for intravenous and endovascular (IA) revascularization therapy, and for their prevalence. Methods Our retrospective study included patients suspected of acute ischemic stroke with admission work-up including a non-contrast head CT, perfusion CT, and CT angiography. Modified Rankin scores at 90 days were used as outcomes. For each imaging biomarker, the effect size of the test of interaction between the presence of the biomarker and the treatment effect was calculated, allowing the inference of a total sample size. The total sample size required was combined with the prevalence of the biomarker to determine the number needed to screen. Results In the 0-4.5-h time window, the two predictive biomarkers associated with the smallest number needed to screen were perfusion CT penumbra ≥ 20% (404 NNS) and CT angiography collateral score ≥ 2 (581 NNS). In the 3-9-h time window, the four predictive biomarkers associated with the smallest number needed to screen were clot burden score (CBS) on CT angiography (1181 NNS), clot length ≥ 10 mm (1924 NNS), CBS and clot length ≥ 10 mm (1132 NNS), and CBS and perfusion CT penumbra ≥ 100% (1374 NNS). Perfusion CT ischemic core was a prognostic biomarker in both time windows. Interpretation Predictive biomarkers need to be differentiated from prognostic biomarkers when being considered to select patients for a trial, and their prevalence should be assessed to determine the number needed to screen and overall feasibility of the trials.

Mots-clé
Biomarkers/analysis, Cerebral Revascularization, Humans, Predictive Value of Tests, Stroke/diagnostic imaging, Stroke/therapy, Time Factors, Tissue Plasminogen Activator/therapeutic use, Stroke, biomarker, endovascular treatment, imaging, revascularization, tissue-type plasminogen activator
Pubmed
Web of science
Création de la notice
05/12/2016 17:27
Dernière modification de la notice
20/08/2019 14:59
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