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Improved Turnaround Times | Median time to first decision: 12 days

Research ArticleNeurointervention

Effect of Core Laboratory and Multiple-Reader Interpretation of Angiographic Images on Follow-Up Outcomes of Coiled Cerebral Aneurysms: A Systematic Review and Meta-Analysis

I. Rezek, G. Mousan, Z. Wang, M.H. Murad and D.F. Kallmes
American Journal of Neuroradiology July 2013, 34 (7) 1380-1384; DOI: https://doi.org/10.3174/ajnr.A3398
I. Rezek
aFrom the Department of Radiology (I.R., D.F.K.)
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G. Mousan
dChildren's Hospital of Michigan (G.M.), Detroit, Michigan.
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Z. Wang
bDivison of Preventive Medicine (Z.W., M.H.M.)
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M.H. Murad
bDivison of Preventive Medicine (Z.W., M.H.M.)
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D.F. Kallmes
aFrom the Department of Radiology (I.R., D.F.K.)
cDepartment of Neurosurgery (D.F.K.), Mayo Clinic, Rochester, Minnesota
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    Fig 1.

    This figure depicts the search strategy in a flow chart along with reasons for exclusion.

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    Table 1:

    Baseline characteristics of study groups

    Type of InterpretationNo. of Studies (%)Mean Aneurysm Size (IRQ) (mm)P ValueInitially Ruptured Aneurysms (%)P ValueMean Follow-Up Duration (IRQ) (mo.)P ValueBare Platinum-Coiled Aneurysms (%)P Value
    Noncore laboratory96 (92.3)7.8 (9.5).9111,844/17,631 (67.2).0719.7 (67.4).1813,100/19,385 (67.6).16
    Core laboratory8 (7.7)7.6 (0)853/2232 (38.2)11.2 (2.5)1072/2749 (39)
    Single-reader73 (70.2)7.8 (7.9).729018/14,578 (61.9).0815.9 (45.4).0210,044/16,127 (62.3).39
    Multiple-reader31 (29.8)7.6 (6.0)3679/5285 (69.6)25.5 (66.0)4128/6007 (68.7)
    • IRQ indicates interquartile range.

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    Table 2:

    Unadjusted, pooled rate of unfavorable outcomes

    Rate95% CII2 (%)PValuea
    Overall0.1700.153–0.19090.3−
    Noncore laboratory interpretation0.1630.144–0.18490.6<.001
    Core laboratory interpretation0.2340.193–0.28385.2
    Single-reader0.1680.148–0.19190.8.06
    Multiple-reader0.1740.142–0.21389.1
    • ↵a Analysis of variance was used to test the difference between categories.

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    Table 3:

    Multivariate random-effects meta-regression

    VariableORSE95% CIP Value
    Core laboratory vs noncore laboratory5.602.872.01–15.60.001
    Single-reader vs multiple-reader studies0.850.530.24–2.95.794
    • SE indicates standard error.

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American Journal of Neuroradiology: 34 (7)
American Journal of Neuroradiology
Vol. 34, Issue 7
1 Jul 2013
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I. Rezek, G. Mousan, Z. Wang, M.H. Murad, D.F. Kallmes
Effect of Core Laboratory and Multiple-Reader Interpretation of Angiographic Images on Follow-Up Outcomes of Coiled Cerebral Aneurysms: A Systematic Review and Meta-Analysis
American Journal of Neuroradiology Jul 2013, 34 (7) 1380-1384; DOI: 10.3174/ajnr.A3398

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Effect of Core Laboratory and Multiple-Reader Interpretation of Angiographic Images on Follow-Up Outcomes of Coiled Cerebral Aneurysms: A Systematic Review and Meta-Analysis
I. Rezek, G. Mousan, Z. Wang, M.H. Murad, D.F. Kallmes
American Journal of Neuroradiology Jul 2013, 34 (7) 1380-1384; DOI: 10.3174/ajnr.A3398
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