Operational Definitions Improve Reliability of the Age-Related White Matter Changes Scale.
Summary of "Operational Definitions Improve Reliability of the Age-Related White Matter Changes Scale."
Background and purpose:ā Although the age-related white matter changes (ARWMC) scale has been advocated to be applicable to both MRI and CT for assessing the severity of WMC, its inter-rater reliability on CT is only fair. We aimed to operationalize the ARWMC scale and investigate the effect of this operationalization on the reliability and validity on MRI and CT. Methods:ā Operational definitions of the ARWMC scale were derived from Erkinjuntti research criteria for subcortical vascular dementia and Scheltens scale. Using original and operationalized ARWMC scale, eight observers recorded the time for rating per MRI and per CT. We investigated the inter-rater and intrarater reliability as well as validity against volume using data from 97 stroke patients. Results:ā Inter-rater reliability of the operationalized scale on CT (0.874, 95% confidence interval [0.780-0.934]) was better than the original scale (0.569, 95% confidence interval [0.247-0.775]). Its intrarater reliability on CT (0.869) and reliability on MRI (inter-rater: 0.860; intrarater: 0.838) was comparable with the original scale (CT intrarater: 0.750 and on MRI inter-rater: 0.845; intrarater: 0.853). The time required to administer the operationalized scale (4'2ā³ for MRI and 1'18ā³ for CT) was similar to that of the original scale (3'56ā³ for MRI and 1'16ā³ for CT). The original scale and operationalized scale also significantly correlated with WMC volume (operationalized scale Ļā=ā0.613, Pā<ā0.001, original scale Ļā=ā0.638, Pā<ā0.001). Conclusion:ā Operational definitions improve the inter-rater reliability of ARWMC scale on CT, and it correlates with volumetric measurement.
Affiliation
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Department of Radiology and Organ Imaging, The Chinese University of Hong Kong, Hong Kong, China.
Journal Details
This article was published in the following journal.
Name: European journal of neurology : the official journal of the European Federation of Neurological Societies
ISSN: 1468-1331
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21138503
- DOI: http://dx.doi.org/10.1111/j.1468-1331.2010.03272.x
Medical and Biotech [MESH] Definitions
Corpus Striatum
Striped gray and white matter consisting of the NEOSTRIATUM and paleostriatum (GLOBUS PALLIDUS). It is located in front of and lateral to the thalamus in each cerebral hemisphere. The gray substance is made up of the CAUDATE NUCLEUS and the lentiform nucleus (the latter consisting of the GLOBUS PALLIDUS and PUTAMEN). The white matter is the internal capsule.
Leukomalacia, Periventricular
Degeneration of white matter adjacent to the CEREBRAL VENTRICLES following cerebral hypoxia or BRAIN ISCHEMIA in neonates. The condition primarily affects white matter in the perfusion zone between superficial and deep branches of the MIDDLE CEREBRAL ARTERY. Clinical manifestations include VISION DISORDERS; CEREBRAL PALSY; PARAPLEGIA; SEIZURES; and cognitive disorders. (From Adams et al., Principles of Neurology, 6th ed, p1021; Joynt, Clinical Neurology, 1997, Ch4, pp30-1)
Lissencephaly
A "smooth brain" malformation of the CEREBRAL CORTEX resulting from abnormal location of developing neurons during corticogenesis. It is characterized by an absence of normal convoluted indentations on the surface of the brain (agyria), or fewer and shallower indentations (pachygryia). There is a reduced number of cortical layers, typically 4 instead of 6, resulting in a thickened cortex, and reduced cerebral white matter that is a reversal of the normal ratio of cerebral white matter to cortex.
Posterior Leukoencephalopathy Syndrome
A condition that is characterized by HEADACHE; SEIZURES; and visual loss with edema in the posterior aspects of the CEREBRAL HEMISPHERES, such as the BRAIN STEM. Generally, lesions involve the white matter (nerve fibers) but occasionally the grey matter (nerve cell bodies).
Leukoencephalopathies
Any of various diseases affecting the white matter of the brain.
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