Multiattribute selection of acute stroke imaging software platform for Extending the Time for Thrombolysis in Emergency Neurological Deficits (EXTEND) clinical trial.
BACKGROUND
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.


OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
National Stroke Research Institute, Florey Neuroscience Institutes, Melbourne, Australia. lchurilov@nsri.org.au
Leonid
L
Churilov
Daniel
D
Liu
Henry
H
Ma
Soren
S
Christensen
Yoshinari
Y
Nagakane
Bruce
B
Campbell
Mark W
MW
Parsons
Christopher R
CR
Levi
Stephen M
SM
Davis
Geoffrey A
GA
Donnan
D002986:Clinical Trials as Topic; D003657:Decision Making; D003661:Decision Support Techniques; D003936:Diagnosis, Computer-Assisted / Q000379:methods* / Q000592:standards; D004638:Emergency Treatment / Q000379:methods; D006801:Humans; D018810:Magnetic Resonance Angiography; D015337:Multicenter Studies as Topic; D010348:Patient Care Team; D018579:Patient Selection; D012680:Sensitivity and Specificity; D012984:Software / Q000592:standards*; D020521:Stroke / Q000175:diagnosis* / Q000188:drug therapy; D015912:Thrombolytic Therapy / Q000379:methods; D061665:Time-to-Treatment