{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T05:06:36Z","timestamp":1777611996032,"version":"3.51.4"},"reference-count":45,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,1,7]],"date-time":"2024-01-07T00:00:00Z","timestamp":1704585600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neuroimaging"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Purpose<\/jats:title><jats:p>The Alberta Stroke Program Early CT Score (ASPECTS) is a widely used scoring system for evaluating ischemic stroke to determine therapeutic strategy. However, there is variation in the interobserver agreement of ASPECTS. This systematic review and meta\u2010analysis aimed to investigate the interobserver agreement of total and regional ASPECTS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A comprehensive search was conducted in the Web of Sciences, PubMed, and Scopus databases to identify relevant studies. Inclusion criteria were studies of noncontrast CT performed within 24\u00a0hours of ischemic stroke in the middle cerebral artery territory.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 20 studies, with 3482 patients, reporting interobserver agreement of total and regional ASPECTS were included in the meta\u2010analysis. The interobserver agreement for total ASPECTS in studies using Kappa coefficient (<jats:italic>\u03ba<\/jats:italic>) analysis was substantial (<jats:italic>\u03ba<\/jats:italic>\u00a0=\u00a0.67, 95% confidence interval [CI]: .57\u2010.78). In studies using intraclass correlation coefficient (ICC) analysis, agreement was excellent (ICC\u00a0=\u00a0.84, 95% CI: .77\u2010.90). Interobserver agreement was higher in studies in which the observer was unblinded to clinical scenario in both groups (<jats:italic>\u03ba<\/jats:italic>\u00a0=\u00a0.74, 95% CI: .59\u2010.89, and ICC\u00a0=\u00a0.82, 95% CI: .79\u2010.85). Per\u2010region analysis showed that the caudate nucleus had the highest agreement (<jats:italic>\u03ba<\/jats:italic>\u00a0=\u00a0.68, 95% CI: .60\u2010.76, and ICC\u00a0=\u00a0.84, 95% CI: .74\u2010.93), while M2 and internal capsule in Kappa studies (<jats:italic>\u03ba<\/jats:italic>\u00a0=\u00a0.45, 95% CI: .34\u2010.55 and <jats:italic>\u03ba<\/jats:italic>\u00a0=\u00a0.47, 95% CI: .28\u2010.66), and M4 and internal capsule in ICC studies (ICC\u00a0=\u00a0.54, 95% CI: .43\u2010.64 and ICC\u00a0=\u00a0.55, 95% CI: .18\u2010.91) had the lowest agreement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This meta\u2010analysis demonstrates substantial to excellent interobserver agreement for total ASPECTS, which supports using this method for stroke treatment. However, findings emphasize the need to consider interobserver agreement in specific regions of ASPECTS for treatment decisions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jon.13184","type":"journal-article","created":{"date-parts":[[2024,1,8]],"date-time":"2024-01-08T03:49:42Z","timestamp":1704685782000},"page":"195-204","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Region\u2010specific interobserver agreement of the Alberta Stroke Program Early Computed Tomography Score: A meta\u2010analysis"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1217-648X","authenticated-orcid":false,"given":"Armin","family":"Zarrintan","sequence":"first","affiliation":[{"name":"Department of Radiology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed K.","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Department of Radiology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noha","family":"Hamouda","sequence":"additional","affiliation":[{"name":"Department of Radiology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2891-8633","authenticated-orcid":false,"given":"Mohamed Sobhi","family":"Jabal","sequence":"additional","affiliation":[{"name":"Department of Radiology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zahra","family":"Beizavi","sequence":"additional","affiliation":[{"name":"Department of Radiology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sherief","family":"Ghozy","sequence":"additional","affiliation":[{"name":"Department of Radiology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David F.","family":"Kallmes","sequence":"additional","affiliation":[{"name":"Department of Radiology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,1,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/ncpcardio0908"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02237-6"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A5236"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.024583"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jon.12564"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000127082.19473.45"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2019-015473"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2019-015442"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.47895\/amp.v53i1.229"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2017.05.042"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A2942"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2214403"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnis-2022-019849"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnis-2022-019874"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnis-2023-020219"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_8_18_1","unstructured":"MoonsC HooftL HaydenJ.Systematic reviews of prognostic studies II: assessing bias in studies of prognostic factors using the QUIPS tool. 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