National Stroke Research Institute, Florey Neuroscience Institutes, Melbourne, Australia.
Int J Stroke. 2013 Apr;8(3):204-10. doi: 10.1111/j.1747-4949.2012.00787.x. Epub 2012 Jul 19.
The appropriateness of a software platform for rapid MRI assessment of the amount of salvageable brain tissue after stroke is critical for both the validity of the Extending the Time for Thrombolysis in Emergency Neurological Deficits (EXTEND) Clinical Trial of stroke thrombolysis beyond 4.5 hours and for stroke patient care outcomes.
The objective of this research is to develop and implement a methodology for selecting the acute stroke imaging software platform most appropriate for the setting of a multi-centre clinical trial.
A multi-disciplinary decision making panel formulated the set of preferentially independent evaluation attributes. Alternative Multi-Attribute Value Measurement methods were used to identify the best imaging software platform followed by sensitivity analysis to ensure the validity and robustness of the proposed solution.
Four alternative imaging software platforms were identified. RApid processing of PerfusIon and Diffusion (RAPID) software was selected as the most appropriate for the needs of the EXTEND trial. A theoretically grounded generic multi-attribute selection methodology for imaging software was developed and implemented.
The developed methodology assured both a high quality decision outcome and a rational and transparent decision process. This development contributes to stroke literature in the area of comprehensive evaluation of MRI clinical software. At the time of evaluation, RAPID software presented the most appropriate imaging software platform for use in the EXTEND clinical trial. The proposed multi-attribute imaging software evaluation methodology is based on sound theoretical foundations of multiple criteria decision analysis and can be successfully used for choosing the most appropriate imaging software while ensuring both robust decision process and outcomes.
对于脑卒中溶栓治疗时间延长至 4.5 小时后的 EXTEND 临床试验以及脑卒中患者的治疗结果，评估脑卒中后可挽救脑组织的快速 MRI 评估软件平台的适宜性至关重要。
本研究旨在开发并实施一种选择最适合多中心临床试验环境的急性脑卒中影像软件平台的方法。
一个多学科决策小组制定了一组优先独立评估属性。使用多属性价值测量方法来确定最佳影像软件平台，然后进行敏感性分析，以确保所提出解决方案的有效性和稳健性。
确定了四种替代影像软件平台。RAPID 软件（RApid processing of PerfusIon and Diffusion）被选为 EXTEND 试验最适合的软件。开发并实施了一种基于理论的通用影像软件多属性选择方法。
所开发的方法确保了高质量的决策结果和合理透明的决策过程。这一发展为磁共振成像临床软件的综合评估领域的脑卒中文献做出了贡献。在评估时，RAPID 软件是 EXTEND 临床试验中最适合使用的影像软件平台。所提出的多属性影像软件评估方法基于多准则决策分析的坚实理论基础，可以成功地用于选择最合适的影像软件，同时确保稳健的决策过程和结果。
