title: Validity of the Meyer Scale for Assessment of Coiled Aneurysms and Aneurysm Recurrence.
abstract: Both the Meyer and Raymond scales are commonly used to report angiographic outcomes following coil embolization of intracranial aneurysms. The objectives of this study were the following: 1) to assess the interobserver agreement of the Meyer and Raymond scales, and 2) to evaluate and compare their performance in predicting major recurrence at follow-up.
  
  
  
  A retrospective series of 120 coiled aneurysms was included. Four investigators independently graded DSA images immediately posttreatment and at follow-up according to the Meyer and Raymond scales. On follow-up DSA, readers also evaluated recurrence outcome. Interobserver agreement was assessed via the intraclass correlation coefficient. The ability of posttreatment Meyer and Raymond scales to predict major recurrence was modeled by using logistic regression and assessed by using receiver operating characteristic analysis.
  
  
  
  For the Meyer scale, interobserver intraclass correlation coefficients were 0.58 (95% CI, 0.46-0.68) on posttreatment and 0.78 (95% CI, 0.72-0.83) on follow-up evaluations. For the Raymond scale, interobserver intraclass correlation coefficients were 0.50 (95% CI, 0.39-0.61) and 0.69 (95% CI, 0.62-0.76), respectively, for posttreatment and follow-up. The areas under the curve for the receiver operating characteristic analyses regarding the performance to predict major recurrence at follow-up were 0.69 (95% CI, 0.60-0.79) for the Meyer and 0.70 (95% CI, 0.61-0.78) for the Raymond scale.
  
  
  
  The Meyer scale appears consistent and reliable with observer agreement as high or higher than that of the Raymond scale. Performance of both scales in predicting the risk of major recurrence at follow-up is adequate, with no statistical difference between the scales.
authors.affiliation: From the Departments of Radiology (A.R., W.B., G.L., H.J.C., D.F.K.) Department of Interventional Neuroradiology (A.R., J.C.), Bicetre Hospital, Clichy, France aymeric.rouchaud@gmail.com Rouchaud.Aymeric@mayo.edu.
authors.forename: A
authors.identifier: 0000-0003-0902-3375
authors.initials: A
authors.lastname: Rouchaud
authors.affiliation: From the Departments of Radiology (A.R., W.B., G.L., H.J.C., D.F.K.).
authors.forename: W
authors.identifier: 0000-0001-5271-5524
authors.initials: W
authors.lastname: Brinjikji
authors.affiliation: Health Sciences Research, Division of Biomedical Statistics and Informatics (T.G.), Mayo Clinic, Rochester, Minnesota.
authors.forename: T
authors.identifier: 0000-0002-1678-8774
authors.initials: T
authors.lastname: Gunderson
authors.affiliation: Department of Interventional Neuroradiology (A.R., J.C.), Bicetre Hospital, Clichy, France.
authors.forename: J
authors.identifier: 0000-0002-0029-1835
authors.initials: J
authors.lastname: Caroff
authors.affiliation: Department of Interventional Neuroradiology (J.-C.G.), Notre-Dame Hospital, Montreal, Quebec, Canada Department of Interventional Neuroradiology (J.-C.G.), CHU Cavale Blanche, Brest, France.
authors.forename: J-C
authors.identifier: 0000-0002-1655-1371
authors.initials: JC
authors.lastname: Gentric
authors.affiliation: From the Departments of Radiology (A.R., W.B., G.L., H.J.C., D.F.K.) Neurosurgery (G.L., H.J.C., D.F.K.).
authors.forename: G
authors.identifier: 0000-0003-1479-465X
authors.initials: G
authors.lastname: Lanzino
authors.affiliation: From the Departments of Radiology (A.R., W.B., G.L., H.J.C., D.F.K.) Neurosurgery (G.L., H.J.C., D.F.K.).
authors.forename: H J
authors.identifier: 0000-0003-2590-3815
authors.initials: HJ
authors.lastname: Cloft
authors.affiliation: From the Departments of Radiology (A.R., W.B., G.L., H.J.C., D.F.K.) Neurosurgery (G.L., H.J.C., D.F.K.).
authors.forename: D F
authors.identifier: 0000-0002-8495-0040
authors.initials: DF
authors.lastname: Kallmes
mesh_terms: D015901:Angiography, Digital Subtraction / Q000379:methods*; D019540:Area Under Curve; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery*; D016015:Logistic Models; D008875:Middle Aged; D015588:Observer Variation; D012372:ROC Curve; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome