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10.1161/STROKEAHA.114.007362

http://scihub22266oqcxt.onion/10.1161/STROKEAHA.114.007362
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suck abstract from ncbi


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pmid25378430      Stroke 2014 ; 45 (12): 3589-96
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  • Etiologic Ischemic Stroke Phenotypes in the NINDS Stroke Genetics Network #MMPMID25378430
  • Ay H; Arsava EM; Andsberg G; Benner T; Brown RD; Chapman SN; Cole JW; Delavaran H; Dichgans M; Engström G; Giralt-Steinhauer E; Grewal RP; Gwinn K; Jern C; Jimenez-Conde J; Jood K; Katsnelson M; Kissela B; Kittner SJ; Kleindorfer DO; Labovitz DL; Lanfranconi S; Lee JM; Lehm M; Lemmens R; Levi C; Li L; Lindgren A; Markus HS; McArdle PF; Melander O; Norrving B; Peddareddygari LR; Pedersén A; Pera J; Rannikmäe K; Rexrode KM; Rhodes D; Rich SS; Roquer J; Rosand J; Rothwell PM; Rundek T; Sacco RL; Schmidt R; Schürks M; Seiler S; Sharma P; Slowik A; Sudlow C; Thijs V; Woodfield R; Worrall BB; Meschia JF
  • Stroke 2014[Dec]; 45 (12): 3589-96 PMID25378430show ga
  • Background and Purpose: NINDS Stroke Genetics Network (SiGN) is an international consortium of ischemic stroke studies that aims to generate high quality phenotype data to identify the genetic basis of etiologic stroke subtypes. This analysis characterizes the etiopathogenetic basis of ischemic stroke and reliability of stroke classification in the consortium. Methods: Fifty-two trained and certified adjudicators determined both phenotypic (abnormal test findings categorized in major etiologic groups without weighting towards the most likely cause) and causative ischemic stroke subtypes in 16,954 subjects with imaging-confirmed ischemic stroke from 12 US studies and 11 studies from 8 European countries using the web-based Causative Classification of Stroke System. Classification reliability was assessed with blinded re-adjudication of 1509 randomly selected cases. Results: The distribution of etiologic categories varied by study, age, sex, and race (p<0.001 for each). Overall, only 40% to 54% of cases with a given major ischemic stroke etiology (phenotypic subtype) were classified into the same final causative category with high confidence. There was good agreement for both causative (kappa 0.72, 95%CI:0.69-0.75) and phenotypic classifications (kappa 0.73, 95%CI:0.70-0.75). Conclusions: This study demonstrates that etiologic subtypes can be determined with good reliability in studies that include investigators with different expertise and background, institutions with different stroke evaluation protocols and geographic location, and patient populations with different epidemiological characteristics. The discordance between phenotypic and causative stroke subtypes highlights the fact that the presence of an abnormality in a stroke patient does not necessarily mean that it is the cause of stroke.
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