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Evaluation Of Computed Tomography Scoring Systems In The Prediction Of Short-term Mortality In Traumatic Brain Injury Patients From A Low- To Middle-income Country Pmc

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Previous studies suggest that biomarkers may perform in the outcome prediction of TBI better in combination within isolation (50, 61, 62). Czeiter et al. (63) have reported that GFAP has an added value when combined with a modified IMPACT model consisting of age, GCS motor score, and pupil status. Both Gradisek and Vos have reported that GFAP and S100B improve the performance of clinical parameters in outcome prediction (61, 62). These findings are consistent with a current study by Thelin et al. (18), where they reported that GFAP and NF-L enhanced the predictive ability of the IMPACT model combined with the Stockholm CT findings. With regard to current results, there was no benefit to combining HCTS, GFAP, and S100B with HCTS. Traumatic brain injury (TBI) is a highly heterogeneous disease (1) and a leading cause of long-term disability globally (2).

• It should also be noted that dataset like Siena Scalp EEG contains other signals such as oxygen saturation (SPO2) containing values of 0.
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Another limitation is the discrepancy in the unit of measurement provided for some of the characteristics across the datasets, such as the use of a number of “seizure segments” or “seizure events” depending on the datasets. This might cause confusion when comparing the datasets since some might consider seizure segments and seizure events as the same definition. Some of the scalp datasets include other channels that we were not able to deduce due to unrecognizable names and a lack of information in the documentation and studies. It should also be noted that dataset like Siena Scalp EEG contains other signals such as oxygen saturation (SPO2) containing values of 0.

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Further, TUSZ has less than 1 hour of pruned segments and various epoch lengths (minutes to hours) across patients in the Siena Scalp EEG dataset. The other exception is the CHB‐MIT dataset with 1‐hour length except for six patients, and occasional shorter segment lengths. The other datasets had a majority of segments with identical length, with the shortest being 1‐second segments in Kaggle UPenn dataset and the longest segments of 10 minutes in both of the Kaggle seizure prediction datasets. Demographics of the main study cohort—Computed tomography-positive patients divided into patients with favorable outcome (Glasgow Outcome Scale—Extended 5–8) and unfavorable outcome (Glasgow Outcome Scale—Extended 1–4). The normality of distribution of the biomarker levels was assessed with the Kolmogorov–Smirnov test and by visually inspecting histograms.

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• Primary characteristics of a dataset can be subdivided into 7 features (left), while structural properties consist of 3 features (right).
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It is clear that outcome after TBI solely does not depend only on the given care in the acute and late phases, but also on the injury type and severity, patient’s clinical characteristics, and eventual brain tissue fate (3, 4). Improved outcome models may help better stratify patients for different treatment and monitoring strategies and provide information about expected gross outcomes to clinicians, patients, and their families. Aviator is one of the key games for money that is available on a number of online betting platforms.

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• The other exception is the CHB‐MIT dataset with 1‐hour length except for six patients, and occasional shorter segment lengths.

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The findings of the datasets summarized above enable both clinicians and ML researchers to make an informed decision about the algorithm and model based on the task. This section explains how the characteristics of the current datasets might impact the algorithms and models proposed by clinicians and ML researchers. Based on Table 4, none of the continuous data, short‐ or long‐term, underwent major preprocessing, except for the different segmentation strategies. Datasets with random segmentation have unique preprocessing steps.

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Table 2

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The patients/participants provided their written informed consent to participate in this study. The first round of the head CT scan review included reviews by RR and JP. The inter-rater reliability was assessed with Cohen’s kappa statistic. The overall inter-rater reliability between the three reviewers was assessed with the intraclass correlation coefficient (two-way mixed-effects).

• While studies such as TUSZ included the total seizure duration, most datasets did not.
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In other words, when using only the HCTS, 11 patients out of the 49 with favorable outcomes were correctly detected, and when using the HCTS together with biomarkers, 29 patients with favorable outcomes were correctly detected. When studied alone, the HCTS had the highest pAUCs of the tested covariates, followed by Aβ40 and Aβ42. The individual specificities of the HCTS and biomarkers remained low (2–33%) in isolation, but the optimal combination panel yielded a specificity of 59% when the sensitivity was set above 90%. The main task of the study, i.e., whether it is a seizure detection or prediction task, will affect the choice of the dataset. Noncontinuous datasets such as the University of Bonn and Kaggle UPenn datasets only include ictal segments without preictal segments, so they should only be used for seizure detection classification. Similarly, noncontinuous datasets, such as the remaining Kaggle datasets that include only preictal and interictal segments should only be used for seizure prediction classification.