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Evaluating Hematoma Expansion Scores in Acute Spontaneous Intracerebral Hemorrhage: A Systematic Scoping Review.
Stroke ( IF 8.3 ) Pub Date : 2020-01-22 , DOI: 10.1161/strokeaha.119.028574
Vignan Yogendrakumar 1 , Margaret Moores 1 , Lindsey Sikora 2 , Michel Shamy 1 , Tim Ramsay 3 , Dean Fergusson 3 , Dar Dowlatshahi 1
Affiliation  

Background and Purpose- In acute spontaneous intracerebral hemorrhage, multiple hematoma expansion scores have been proposed for use in clinical trial environments. We performed a systematic scoping review to identify all existing hematoma expansion scores and describe their development, validation, and relative performance. Methods- Two reviewers searched MEDLINE, PUBMED, EMBASE, and CENTRAL (Cochrane Central Register of Controlled Trials) for studies that derived or validated a hematoma expansion prediction score in adults presenting with spontaneous intracerebral hemorrhage. A descriptive analysis of the extracted data was performed, focusing on score development techniques and predictive capabilities. Results- Of the 14 434 records retrieved, 15 studies met inclusion criteria and 10 prediction scores were identified. Validation analysis using independent samples was performed in 9 studies on 5 scores. All derivation studies reported high performance with C statistics ranging from 0.72 to 0.93. In validation, the C-statistic range was broader with studies reporting 0.62 to 0.77. For every score, the risk of expansion increased with each point increase, although patients with high scores were rare. Conclusions- At present, 10 hematoma expansion scores have been developed, of which 5 have been externally validated. Real-world performance in validation studies was lower than performance in derivation studies. Data from the current literature are insufficient to support a meaningful meta-analysis.

中文翻译:

在急性自发性脑出血中评估血肿扩展评分:系统的研究范围。

背景和目的-在急性自发性脑出血中,已提出在临床试验环境中使用多个血肿扩展评分。我们进行了系统的范围界定审查,以识别所有现有的血肿扩展评分,并描述其发展,验证和相对性能。方法-两名评价者在MEDLINE,PUBMED,EMBASE和CENTRAL(对照试验的Cochrane中央登记册)中进行了研究,以得出或验证患有自发性脑出血的成年人血肿扩展预测分数。对提取的数据进行了描述性分析,重点是分数开发技术和预测能力。结果-在检索到的14 434条记录中,有15项研究符合纳入标准,并且确定了10项预测得分。在9个研究中对5个评分进行了使用独立样本的验证分析。所有派生研究均报告了高性能,C统计量介于0.72至0.93之间。在验证中,C统计量范围更广,研究报告为0.62至0.77。尽管得分高的患者很少,但是对于每个得分,扩张的风险都随着得分的增加而增加。结论-目前,已开发出10个血肿扩展评分,其中5个已通过外部验证。验证研究中的实际性能低于衍生研究中的性能。当前文献的数据不足以支持有意义的荟萃分析。C统计范围更广,研究报告为0.62至0.77。尽管得分高的患者很少,但是对于每个得分,扩张的风险都随着得分的增加而增加。结论-目前,已开发出10个血肿扩展评分,其中5个已通过外部验证。验证研究中的实际性能低于衍生研究中的性能。当前文献的数据不足以支持有意义的荟萃分析。C统计范围更广,研究报告为0.62至0.77。尽管得分高的患者很少,但是对于每个得分,扩张的风险都随着得分的增加而增加。结论-目前,已开发出10个血肿扩展评分,其中5个已通过外部验证。验证研究中的实际性能低于衍生研究中的性能。当前文献的数据不足以支持有意义的荟萃分析。验证研究中的实际性能低于衍生研究中的性能。当前文献的数据不足以支持有意义的荟萃分析。验证研究中的实际性能低于衍生研究中的性能。当前文献的数据不足以支持有意义的荟萃分析。
更新日期:2020-01-22
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