External validation of cerebral aneurysm rupture probability model with data from two patient cohorts

Detmer, Felicitas J.; Fajardo-Jiménez, Daniel; Mut, Fernando; Juchler, Norman; Hirsch, Sven; Pereira, Vitor Mendes; Bijlenga, Philippe; Cebral, Juan R.

doi:10.1007/s00701-018-3712-8

Publication type:	Article in scientific journal
Type of review:	Peer review (publication)
Title:	External validation of cerebral aneurysm rupture probability model with data from two patient cohorts
Authors:	Detmer, Felicitas J. Fajardo-Jiménez, Daniel Mut, Fernando Juchler, Norman Hirsch, Sven Pereira, Vitor Mendes Bijlenga, Philippe Cebral, Juan R.
DOI:	10.1007/s00701-018-3712-8
Published in:	Acta Neurochirurgica
Issue Date:	30-Oct-2018
Publisher / Ed. Institution:	Springer
ISSN:	0001-6268 0942-0940
Language:	English
Subjects:	Cerebral aneurysm; Hemodynamics; Prediction; Risk factors; Rupture; Shape
Subject (DDC):	616.8: Neurology, diseases of nervous system
Abstract:	Background: For a treatment decision of unruptured cerebral aneurysms, physicians and patients need to weigh the risk of treatment against the risk of hemorrhagic stroke caused by aneurysm rupture. The aim of this study was to externally evaluate a recently developed statistical aneurysm rupture probability model, which could potentially support such treatment decisions. Methods: Segmented image data and patient information obtained from two patient cohorts including 203 patients with 249 aneurysms were used for patient-specific computational fluid dynamics simulations and subsequent evaluation of the statistical model in terms of accuracy, discrimination, and goodness of fit. The model’s performance was further compared to a similarity-based approach for rupture assessment by identifying aneurysms in the training cohort that were similar in terms of hemodynamics and shape compared to a given aneurysm from the external cohorts. Results: When applied to the external data, the model achieved a good discrimination and goodness of fit (area under the receiver operating characteristic curve AUC = 0.82), which was only slightly reduced compared to the optimism-corrected AUC in the training population (AUC = 0.84). The accuracy metrics indicated a small decrease in accuracy compared to the training data (misclassification error of 0.24 vs. 0.21). The model’s prediction accuracy was improved when combined with the similarity approach (misclassification error of 0.14). Conclusions: The model’s performance measures indicated a good generalizability for data acquired at different clinical institutions. Combining the model-based and similarity-based approach could further improve the assessment and interpretation of new cases, demonstrating its potential use for clinical risk assessment.
URI:	https://digitalcollection.zhaw.ch/handle/11475/12682
Fulltext version:	Published version
License (according to publishing contract):	Licence according to publishing contract
Departement:	Life Sciences and Facility Management
Organisational Unit:	Institute of Computational Life Sciences (ICLS)
Published as part of the ZHAW project:	AneuX
Appears in collections:	Publikationen Life Sciences und Facility Management

Files in This Item:

There are no files associated with this item.

Show full item record

Detmer, F. J., Fajardo-Jiménez, D., Mut, F., Juchler, N., Hirsch, S., Pereira, V. M., Bijlenga, P., & Cebral, J. R. (2018). External validation of cerebral aneurysm rupture probability model with data from two patient cohorts. Acta Neurochirurgica. https://doi.org/10.1007/s00701-018-3712-8

Detmer, F.J. et al. (2018) ‘External validation of cerebral aneurysm rupture probability model with data from two patient cohorts’, Acta Neurochirurgica [Preprint]. Available at: https://doi.org/10.1007/s00701-018-3712-8.

F. J. Detmer et al., “External validation of cerebral aneurysm rupture probability model with data from two patient cohorts,” Acta Neurochirurgica, Oct. 2018, doi: 10.1007/s00701-018-3712-8.

DETMER, Felicitas J., Daniel FAJARDO-JIMÉNEZ, Fernando MUT, Norman JUCHLER, Sven HIRSCH, Vitor Mendes PEREIRA, Philippe BIJLENGA und Juan R. CEBRAL, 2018. External validation of cerebral aneurysm rupture probability model with data from two patient cohorts. Acta Neurochirurgica. 30 Oktober 2018. DOI 10.1007/s00701-018-3712-8

Detmer, Felicitas J., Daniel Fajardo-Jiménez, Fernando Mut, Norman Juchler, Sven Hirsch, Vitor Mendes Pereira, Philippe Bijlenga, and Juan R. Cebral. 2018. “External Validation of Cerebral Aneurysm Rupture Probability Model with Data from Two Patient Cohorts.” Acta Neurochirurgica, October. https://doi.org/10.1007/s00701-018-3712-8.

Detmer, Felicitas J., et al. “External Validation of Cerebral Aneurysm Rupture Probability Model with Data from Two Patient Cohorts.” Acta Neurochirurgica, Oct. 2018, https://doi.org/10.1007/s00701-018-3712-8.