hermes-24_score

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hermes-24_score [2025/07/04 13:46] – [Validation of the HERMES-24 Score for Outcome Prediction Post Large Vessel Occlusion Treatment in Later Time Window] administradorhermes-24_score [2025/07/04 13:47] (current) – [Validation of the HERMES-24 Score for Outcome Prediction Post Large Vessel Occlusion Treatment in Later Time Window] administrador
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 This well-powered meta-analysis utilizes pooled patient-level data from six late-window EVT trials, effectively excluding any overlap with the original HERMES cohort to reduce bias. The investigators clearly articulate the methodology and maintain rigorous exclusion criteria to ensure external validity. The study benefits from its straightforward scoring system (age/10 + NIHSS at 24h), which is practical for clinicians. However, the derivation and validation are still restricted to highly selected trial populations—limiting generalizability to broader real-world cohorts with comorbidities, imaging variability, and non-protocolized care. Moreover, using the NIHSS at 24 hours post-randomization (rather than at presentation) introduces a potential post-intervention bias, reducing its utility in true predictive modeling at decision time. The high predictive value reported might not fully translate to populations where clinical assessment and NIHSS at 24 hours are less reliable or systematically obtained. Despite these limitations, the score remains an intuitively useful and quantitatively validated tool that could augment prognostication in trial-like late-presenting LVO cases. This well-powered meta-analysis utilizes pooled patient-level data from six late-window EVT trials, effectively excluding any overlap with the original HERMES cohort to reduce bias. The investigators clearly articulate the methodology and maintain rigorous exclusion criteria to ensure external validity. The study benefits from its straightforward scoring system (age/10 + NIHSS at 24h), which is practical for clinicians. However, the derivation and validation are still restricted to highly selected trial populations—limiting generalizability to broader real-world cohorts with comorbidities, imaging variability, and non-protocolized care. Moreover, using the NIHSS at 24 hours post-randomization (rather than at presentation) introduces a potential post-intervention bias, reducing its utility in true predictive modeling at decision time. The high predictive value reported might not fully translate to populations where clinical assessment and NIHSS at 24 hours are less reliable or systematically obtained. Despite these limitations, the score remains an intuitively useful and quantitatively validated tool that could augment prognostication in trial-like late-presenting LVO cases.
  
-**Final Verdict:** Strong [[internal consistency]] and [[methodological rigor]], though real-world validation is imperative.  +**Final Verdict:** Strong [[internal consistency]] and [[methodological rigor]], though [[real-world validation]] is imperative.  
  
 **Takeaway for Neurosurgeons:** HERMES-24 can aid in post-intervention prognosis discussions in select late-window EVT patients, but it is not a [[decision-making]] tool.   **Takeaway for Neurosurgeons:** HERMES-24 can aid in post-intervention prognosis discussions in select late-window EVT patients, but it is not a [[decision-making]] tool.  
  • hermes-24_score.txt
  • Last modified: 2025/07/04 13:47
  • by administrador