1555. Role of Formal Training of Residents for Evaluation of Alberta Stroke Program Early CT Score (ASPECTS) in Patients With Acute MCA Infarction
Authors * Denotes Presenting Author
  1. Yusra Waheed *; Aga Khan Hospital
  2. Jehanzeb Shahid; Aga Khan Hospital
  3. Fatima Mubarak; Aga Khan Hospital
  4. Ismail Alvi; Aga Khan Hospital
The Alberta Stroke Program Early Computed Tomography Score (ASPECTS) is a semiquantitative grading system developed to quantify the extent of early ischemic changes (EIC) in the middle cerebral artery territory. Current American Heart Association/ American Stroke Association (AHA/ASA) guidelines recommend calculating ASPECTS to interpret non-contrast CT scans in emergency situations of large vessel strokes presenting with an National Institutes of Health Stroke Scale (NIHSS) >6 and within 6 hours of symptom onset to determine the treatment strategy. However adequate score calculation by residents and its inter observer agreement remains a diagnostic challenge. Therefore, we proposed that formal resident training for ASPECT score calculation is necessary which in turn can have a significant impact on possible treatment options and patient outcome. The purpose of this study is to asses the effectiveness of online ASPECTS course certification among residents for calculation of ASPECTS in patients with acute Middle Cerebral Artery (MCA) territory infarction.

Materials and Methods:
After taking informed consent , 24 radiology residents from year I to IV who were currently under training at Aga Khan Hospital were asked to fill ten image-based cases with multiple choice questions without any formal training.The participants were kept blinded from results.The cases were already diagnosed cases of acute MCA infarctions available on the official website http://www.aspectsinstroke.com. Subsequently, residents were asked to go for a free online course of ASPECTS calculation. Post-training test was conducted one week after completion of their certification.The pre- and post-test scores were compared using paired student's t-test.

There was no significant improvement in pre and post test scores (p value 0.50). Out of 24 residents, 7 (29%) had pretest scores between 5 and 8 and 18 (71%) secured scores less than 5. After certification, 9 (37 %) secured scores between 5 and 8, while 15 (63%) scored below 5. No statistically significant difference was noted among residents on the basis of gender and training year.

The online available ASPECTS certification does not appear to be an effective learning tool for acquiring training in calculation of ASPECTS for middle cerebral artery (MCA) infarct. Formal resident training can be achieved by Continuing Medical Education (CME) activities and by dedicated lectures from experienced and trained faculties.