Developing Patient-centered Outcome Measures for Evaluating Vasospasm in Aneurysmal Subarachnoid Hemorrhage

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.

Key Words: Aneurysmal subarachnoid hemorrhage, vasospasm, patient-centered outcomes, outcome measures, CT perfusion