caa a22 4500 477107788 CHVBK 20180405111600.0 cr unu---uuuuu 170330e19961001xx s 000 0 eng 10.1007/BF01809743 doi (NATIONALLICENCE)springer-10.1007/BF01809743 Acoustic detection of intracranial aneurysms: A decision analysis [Elektronische Daten] [A. van Bruggen, D. Dippel, J. Habbema, J. Mooij] Summary: We present a further evaluation of an improved recording method for the acoustic detection of intracranial aneurysms (ADA). A sensor was applied to the patient's eyes. Two measures were derived to summarize the power spectral density functions of the sound frequencies that were obtained from each patient: the power median (PM), the median of the power spectral density function, and the mean difference error (MDE), a measure of the difference between the normalized, logarithmically transformed spectra of the patient and a template, the normal spectrum. The capability of these two measures (alone or combined) to discriminate between patients with and without an intracranial aneurysm was tested in a series of 89 patients harbouring a total of 109 aneurysms and 73 controls, using multiple logistic regression analysis. When PM and MDE were combined, the accuracy of the predictions amounted to 79%. Individualized threshold values of the likelihood ratio of harbouring an aneurysm, for ordering four-vessel angiography are suggested, depending on the prior probability of harbouring an aneurysm, the risks of unnecessary angiography and the risk of living with an undetected aneurysm. Our decision analysis suggests that using these recommendations, employing acoustic detection results in a small gain in quality adjusted life expectancy (0.01 life year) for patients aged between 40 and 60, compared to no diagnostic testing, and 0.02 life year compared to angiography, which cannot be recommended. For patients with a three times increased prior risk of harbouring an intracranial aneurysm, the benefit of ADA compared to angiography increases to 0.05 life year. We conclude that acoustic detection has the potential of becoming a useful tool in the non-invasive diagnosis of occult, asymptomatic intracranial aneurysms. Springer-Verlag, 1996 Intracranial aneurysm nationallicence non-invasive diagnosis nationallicence sound recording nationallicence decision analysis nationallicence van Bruggen A. Department of Neurosurgery, University Hospital Groningen, Groningen aut Dippel D. Department of Neurology, University Hospital Dijkzigt, Rotterdam aut Habbema J. Centre for Clinical Decision Sciences, Department of Public Health, Erasmus University, Rotterdam, The Netherlands aut Mooij J. Department of Neurosurgery, University Hospital Groningen, Groningen aut Acta Neurochirurgica Springer-Verlag 138/10(1996-10-01), 1148-1156 0001-6268 138:10<1148 1996 138 701 https://doi.org/10.1007/BF01809743 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF01809743 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- van Bruggen A. Department of Neurosurgery, University Hospital Groningen, Groningen aut NATIONALLICENCE 700 1- Dippel D. Department of Neurology, University Hospital Dijkzigt, Rotterdam aut NATIONALLICENCE 700 1- Habbema J. Centre for Clinical Decision Sciences, Department of Public Health, Erasmus University, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- Mooij J. Department of Neurosurgery, University Hospital Groningen, Groningen aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer-Verlag 138/10(1996-10-01), 1148-1156 0001-6268 138:10<1148 1996 138 701 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer