Accuracy of the ABC/2 Score for Intracerebral Hemorrhage: Systematic Review and Analysis of MISTIE, CLEAR-IVH, and CLEAR III

Alastair J S Webb, Natalie L. Ullman, Tim C. Morgan, John Muschelli, Joshua Kornbluth, Issam A. Awad, Steven Mayo, Michael Aaron Rosenblum, Wendy C Ziai, Mario Zuccarrello, Francois Aldrich, Sayona John, Sagi Harnof, George Lopez, William C. Broaddus, Christine Wijman, Paul Vespa, Ross Bullock, Stephen J. Haines, Salvador Cruz-FloresStan Tuhrim, Michael D. Hill, Raj Narayan, Daniel F Hanley

Research output: Contribution to journalArticle

Abstract

Background and Purpose - The ABC/2 score estimates intracerebral hemorrhage (ICH) volume, yet validations have been limited by small samples and inappropriate outcome measures. We determined accuracy of the ABC/2 score calculated at a specialized reading center (RC-ABC) or local site (site-ABC) versus the reference-standard computed tomography-based planimetry (CTP). Methods - In Minimally Invasive Surgery Plus Recombinant Tissue-Type Plasminogen Activator for Intracerebral Hemorrhage Evacuation-II (MISTIE-II), Clot Lysis Evaluation of Accelerated Resolution of Intraventricular Hemorrhage (CLEAR-IVH) and CLEAR-III trials. ICH volume was prospectively calculated by CTP, RC-ABC, and site-ABC. Agreement between CTP and ABC/2 was defined as an absolute difference up to 5 mL and relative difference within 20%. Determinants of ABC/2 accuracy were assessed by logistic regression. Results - In 4369 scans from 507 patients, CTP was more strongly correlated with RC-ABC (r2=0.93) than with site-ABC (r2=0.87). Although RC-ABC overestimated CTP-based volume on average (RC-ABC, 15.2 cm3; CTP, 12.7 cm3), agreement was reasonable when categorized into mild, moderate, and severe ICH (κ=0.75; P

Original languageEnglish (US)
Pages (from-to)2470-2476
Number of pages7
JournalStroke
Volume46
Issue number9
DOIs
StatePublished - Sep 28 2015

Fingerprint

Cerebral Hemorrhage
Tomography
Hemorrhage
Minimally Invasive Surgical Procedures
Tissue Plasminogen Activator
Reading
Logistic Models
Outcome Assessment (Health Care)

Keywords

  • cerebral hemorrhage
  • controlled clinical trials, randomized
  • review, systematic
  • sensitivity and specificity
  • tissue-type plasminogen activator

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing

Cite this

Accuracy of the ABC/2 Score for Intracerebral Hemorrhage : Systematic Review and Analysis of MISTIE, CLEAR-IVH, and CLEAR III. / Webb, Alastair J S; Ullman, Natalie L.; Morgan, Tim C.; Muschelli, John; Kornbluth, Joshua; Awad, Issam A.; Mayo, Steven; Rosenblum, Michael Aaron; Ziai, Wendy C; Zuccarrello, Mario; Aldrich, Francois; John, Sayona; Harnof, Sagi; Lopez, George; Broaddus, William C.; Wijman, Christine; Vespa, Paul; Bullock, Ross; Haines, Stephen J.; Cruz-Flores, Salvador; Tuhrim, Stan; Hill, Michael D.; Narayan, Raj; Hanley, Daniel F.

In: Stroke, Vol. 46, No. 9, 28.09.2015, p. 2470-2476.

Research output: Contribution to journalArticle

Webb, AJS, Ullman, NL, Morgan, TC, Muschelli, J, Kornbluth, J, Awad, IA, Mayo, S, Rosenblum, MA, Ziai, WC, Zuccarrello, M, Aldrich, F, John, S, Harnof, S, Lopez, G, Broaddus, WC, Wijman, C, Vespa, P, Bullock, R, Haines, SJ, Cruz-Flores, S, Tuhrim, S, Hill, MD, Narayan, R & Hanley, DF 2015, 'Accuracy of the ABC/2 Score for Intracerebral Hemorrhage: Systematic Review and Analysis of MISTIE, CLEAR-IVH, and CLEAR III', Stroke, vol. 46, no. 9, pp. 2470-2476. https://doi.org/10.1161/STROKEAHA.114.007343
Webb, Alastair J S ; Ullman, Natalie L. ; Morgan, Tim C. ; Muschelli, John ; Kornbluth, Joshua ; Awad, Issam A. ; Mayo, Steven ; Rosenblum, Michael Aaron ; Ziai, Wendy C ; Zuccarrello, Mario ; Aldrich, Francois ; John, Sayona ; Harnof, Sagi ; Lopez, George ; Broaddus, William C. ; Wijman, Christine ; Vespa, Paul ; Bullock, Ross ; Haines, Stephen J. ; Cruz-Flores, Salvador ; Tuhrim, Stan ; Hill, Michael D. ; Narayan, Raj ; Hanley, Daniel F. / Accuracy of the ABC/2 Score for Intracerebral Hemorrhage : Systematic Review and Analysis of MISTIE, CLEAR-IVH, and CLEAR III. In: Stroke. 2015 ; Vol. 46, No. 9. pp. 2470-2476.
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abstract = "Background and Purpose - The ABC/2 score estimates intracerebral hemorrhage (ICH) volume, yet validations have been limited by small samples and inappropriate outcome measures. We determined accuracy of the ABC/2 score calculated at a specialized reading center (RC-ABC) or local site (site-ABC) versus the reference-standard computed tomography-based planimetry (CTP). Methods - In Minimally Invasive Surgery Plus Recombinant Tissue-Type Plasminogen Activator for Intracerebral Hemorrhage Evacuation-II (MISTIE-II), Clot Lysis Evaluation of Accelerated Resolution of Intraventricular Hemorrhage (CLEAR-IVH) and CLEAR-III trials. ICH volume was prospectively calculated by CTP, RC-ABC, and site-ABC. Agreement between CTP and ABC/2 was defined as an absolute difference up to 5 mL and relative difference within 20{\%}. Determinants of ABC/2 accuracy were assessed by logistic regression. Results - In 4369 scans from 507 patients, CTP was more strongly correlated with RC-ABC (r2=0.93) than with site-ABC (r2=0.87). Although RC-ABC overestimated CTP-based volume on average (RC-ABC, 15.2 cm3; CTP, 12.7 cm3), agreement was reasonable when categorized into mild, moderate, and severe ICH (κ=0.75; P",
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AU - Ullman, Natalie L.

AU - Morgan, Tim C.

AU - Muschelli, John

AU - Kornbluth, Joshua

AU - Awad, Issam A.

AU - Mayo, Steven

AU - Rosenblum, Michael Aaron

AU - Ziai, Wendy C

AU - Zuccarrello, Mario

AU - Aldrich, Francois

AU - John, Sayona

AU - Harnof, Sagi

AU - Lopez, George

AU - Broaddus, William C.

AU - Wijman, Christine

AU - Vespa, Paul

AU - Bullock, Ross

AU - Haines, Stephen J.

AU - Cruz-Flores, Salvador

AU - Tuhrim, Stan

AU - Hill, Michael D.

AU - Narayan, Raj

AU - Hanley, Daniel F

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