Developing patient-centered outcome measures for evaluating vasospasm in aneurysmal subarachnoid hemorrhage

Acad Radiol. 2009 May;16(5):541-5. doi: 10.1016/j.acra.2009.01.018.


Rationale and objectives: Patient-centered outcome measures have become an essential focus in research methodology in recent years. This may be particularly challenging in imaging research at the technology assessment level to incorporate patient-centeredness. A primary issue in this field is designing a reference standard that is applicable to the entire study population.

Materials and methods: This important element is necessary for translation of findings into clinical practice. In our work, computed tomographic perfusion imaging is being evaluated as a new technology used in aneurysmal subarachnoid hemorrhage patients to detect cerebral vasospasm. We have developed a new reference standard employing a multistage hierarchical design incorporating both clinical and imaging criteria to determine a diagnosis of vasospasm.

Results: A flowchart of the reference standard levels is provided for illustration. The limitations and potential biases that may occur using this reference standard are discussed.

Conclusions: This reference standard will be applicable to the entire study population, including those with and without symptoms or further imaging with digital subtraction angiography.

MeSH terms

  • Angiography / standards*
  • Humans
  • Outcome Assessment, Health Care / standards*
  • Patient Satisfaction
  • Patient-Centered Care / standards*
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / standards*
  • Subarachnoid Hemorrhage / complications*
  • Subarachnoid Hemorrhage / diagnosis*
  • United States
  • Vasospasm, Intracranial / complications*
  • Vasospasm, Intracranial / diagnosis*