Cardiac arrest & resuscitation
Quantitative analysis of apparent diffusion coefficients to predict neurological prognosis in cardiac arrest survivors: an observational derivation and internal–external validation study
Authors' conclusion
In this validation study, by consistently restricting the MRI types and timing during quantitative analysis of ADC values in brain MRI, we observed high reproducibility and sensitivity at a 0% FPR.
Study context
- Population
- Out-of-hospital cardiac arrest (OHCA) survivors with brain magnetic resonance imaging (MRI) at 3 T within 72–96 h after OHCA
- Participants
- 448 brain MRI scans
- Comparison
- Derivation vs Internal validation vs External validation
- Derivationn = 224
- Internal validationn = 96
- External validationn = 128
- Outcome
- Poor neurological outcome (cerebral performance categories 3-5) predicted by proportion of brain volume below specific ADC values
- Follow-up
- 6 months
Methodological detailsobservational, derivation and internal–external validation, prospectively collected data, two tertiary academic hospitals
- Observational
- Derivation and internal–external validation
- Prospectively collected data
- Two tertiary academic hospitals
Performance
As reported in the abstract
Proportion of brain volume with ADC below 600 × 10-6 mm²/s, threshold > 13.2%
| Test or model | False-positive rate | Sensitivity | Specificity |
|---|---|---|---|
| Derivation | 0% | 76% (95% CI 68-83) | |
| Internal validation | 71% (95% CI 58-81) | 100% | |
| External validation | 78% (95% CI 66-87) | 100% |
False-positive rate
Derivation0%
Internal validation— not stated in the abstract
External validation— not stated in the abstract
Sensitivity
Derivation76% (95% CI 68-83)
Internal validation71% (95% CI 58-81)
External validation78% (95% CI 66-87)
Specificity
Derivation— not stated in the abstract
Internal validation100%
External validation100%
Further findings
| Outcome | Derivation |
|---|---|
| Proportion of brain volume with ADC below 450, 500, 550, 600 and 650 × 10-6 mm²/s for poor outcome | |
| AUC | 0.89-0.91 |
- Proportion of brain volume with apparent diffusion coefficient (ADC) below 450, 500, 550, 600 and 650 × 10-6 mm²/s for poor outcome — No statistically significant differences in performance among derivation, internal validation and external validation groups
- all P > 0.5
Original publication
Quantitative analysis of apparent diffusion coefficients to predict neurological prognosis in cardiac arrest survivors: an observational derivation and internal–external validation study. Crit Care. Published 25 April 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →