TY - JOUR
T1 - Development and Reliability of a User-Friendly Multicenter Phenotyping Application for Hemorrhagic and Ischemic Stroke
AU - SIREN Team
AU - Owolabi, Mayowa
AU - Ogbole, Godwin
AU - Akinyemi, Rufus
AU - Salaam, Kehinde
AU - Akpa, Onoja
AU - Mongkolwat, Pattanasak
AU - Omisore, Adeleye
AU - Agunloye, Atinuke
AU - Efidi, Richard
AU - Odo, Joseph
AU - Makanjuola, Akintomiwa
AU - Akpalu, Albert
AU - Sarfo, Fred
AU - Owolabi, Lukman
AU - Obiako, Reginald
AU - Wahab, Kolawole
AU - Sanya, Emmanuel
AU - Adebayo, Philip
AU - Komolafe, Morenikeji
AU - Adeoye, Abiodun Moshood
AU - Fawale, Michael B.
AU - Akinyemi, Joshua
AU - Osaigbovo, Godwin
AU - Sunmonu, Taofiki
AU - Olowoyo, Paul
AU - Chukwuonye, Innocent
AU - Obiabo, Yahaya
AU - Ibinaiye, Philip
AU - Dambatta, Abdul
AU - Mensah, Yaw
AU - Abdul, Salaam
AU - Olabinri, Eunice
AU - Ikubor, Joyce
AU - Oyinloye, Olalekan
AU - Odunlami, Femi
AU - Melikam, Ezinne
AU - Saulson, Raelle
AU - Kolo, Philip
AU - Ogunniyi, Adesola
AU - Ovbiagele, Bruce
N1 - Publisher Copyright:
© 2017 National Stroke Association
PY - 2017/11
Y1 - 2017/11
N2 - Background Annotation and Image Markup on ClearCanvas Enriched Stroke–phenotyping Software (ACCESS) is a novel stand-alone computer software application that allows the creation of simple standardized annotations for reporting brain images of all stroke types. We developed the ACCESS application and determined its inter-rater and intra-rater reliability in the Stroke Investigative Research and Educational Network (SIREN) study to assess its suitability for multicenter studies. Methods One hundred randomly selected stroke imaging reports from 5 SIREN sites were re-evaluated by 4 trained independent raters to determine the inter-rater reliability of the ACCESS (version 12.0) software for stroke phenotyping. To determine intra-rater reliability, 6 raters reviewed the same cases previously reported by them after a month of interval. Ischemic stroke was classified using the Oxfordshire Community Stroke Project (OCSP), Trial of Org 10172 in Acute Stroke Treatment (TOAST), and Atherosclerosis, Small-vessel disease, Cardiac source, Other cause (ASCO) protocols, while hemorrhagic stroke was classified using the Structural lesion, Medication, Amyloid angiopathy, Systemic disease, Hypertensive angiopathy and Undetermined (SMASH-U) protocol in ACCESS. Agreement among raters was measured with Cohen's kappa statistics. Results For primary stroke type, inter-rater agreement was.98 (95% confidence interval [CI],.94-1.00), while intra-rater agreement was 1.00 (95% CI, 1.00). For OCSP subtypes, inter-rater agreement was.97 (95% CI,.92-1.00) for the partial anterior circulation infarcts,.92 (95% CI,.76-1.00) for the total anterior circulation infarcts, and excellent for both lacunar infarcts and posterior circulation infarcts. Intra-rater agreement was.97 (.90-1.00), while inter-rater agreement was.93 (95% CI,.84-1.00) for TOAST subtypes. Inter-rater agreement ranged between.78 (cardioembolic) and.91 (large artery atherosclerotic) for ASCO subtypes and was.80 (95% CI,.56-1.00) for SMASH-U subtypes. Conclusion The ACCESS application facilitates a concordant and reproducible classification of stroke subtypes by multiple investigators, making it suitable for clinical use and multicenter research.
AB - Background Annotation and Image Markup on ClearCanvas Enriched Stroke–phenotyping Software (ACCESS) is a novel stand-alone computer software application that allows the creation of simple standardized annotations for reporting brain images of all stroke types. We developed the ACCESS application and determined its inter-rater and intra-rater reliability in the Stroke Investigative Research and Educational Network (SIREN) study to assess its suitability for multicenter studies. Methods One hundred randomly selected stroke imaging reports from 5 SIREN sites were re-evaluated by 4 trained independent raters to determine the inter-rater reliability of the ACCESS (version 12.0) software for stroke phenotyping. To determine intra-rater reliability, 6 raters reviewed the same cases previously reported by them after a month of interval. Ischemic stroke was classified using the Oxfordshire Community Stroke Project (OCSP), Trial of Org 10172 in Acute Stroke Treatment (TOAST), and Atherosclerosis, Small-vessel disease, Cardiac source, Other cause (ASCO) protocols, while hemorrhagic stroke was classified using the Structural lesion, Medication, Amyloid angiopathy, Systemic disease, Hypertensive angiopathy and Undetermined (SMASH-U) protocol in ACCESS. Agreement among raters was measured with Cohen's kappa statistics. Results For primary stroke type, inter-rater agreement was.98 (95% confidence interval [CI],.94-1.00), while intra-rater agreement was 1.00 (95% CI, 1.00). For OCSP subtypes, inter-rater agreement was.97 (95% CI,.92-1.00) for the partial anterior circulation infarcts,.92 (95% CI,.76-1.00) for the total anterior circulation infarcts, and excellent for both lacunar infarcts and posterior circulation infarcts. Intra-rater agreement was.97 (.90-1.00), while inter-rater agreement was.93 (95% CI,.84-1.00) for TOAST subtypes. Inter-rater agreement ranged between.78 (cardioembolic) and.91 (large artery atherosclerotic) for ASCO subtypes and was.80 (95% CI,.56-1.00) for SMASH-U subtypes. Conclusion The ACCESS application facilitates a concordant and reproducible classification of stroke subtypes by multiple investigators, making it suitable for clinical use and multicenter research.
KW - Africa
KW - DICOM application
KW - Stroke
KW - developing country
KW - ischemic stroke
KW - phenotyping
KW - reporting software intracerebral hemorrhage
UR - http://www.scopus.com/inward/record.url?scp=85026313574&partnerID=8YFLogxK
U2 - 10.1016/j.jstrokecerebrovasdis.2017.06.042
DO - 10.1016/j.jstrokecerebrovasdis.2017.06.042
M3 - Article
C2 - 28760409
AN - SCOPUS:85026313574
SN - 1052-3057
VL - 26
SP - 2662
EP - 2670
JO - Journal of Stroke and Cerebrovascular Diseases
JF - Journal of Stroke and Cerebrovascular Diseases
IS - 11
ER -