TY - JOUR
T1 - External validation and recalibration of an incidental meningioma prognostic model - IMPACT
T2 - protocol for an international multicentre retrospective cohort study
AU - IMPACT Study Investigators, International Consortium on Meningioma (ICOM) and British Neurosurgical Trainee Research Collaborative (BNTRC)
AU - Islim, Abdurrahman I
AU - Millward, Christopher P
AU - Piper, Rory J
AU - Fountain, Daniel M
AU - Mehta, Shaveta
AU - Kolamunnage-Dona, Ruwanthi
AU - Ali, Usama
AU - Koszdin, Shelli Diane
AU - Georgious, Theo
AU - Mills, Samantha J
AU - Brodbelt, Andrew R
AU - Mathew, Ryan K
AU - Santarius, Thomas
AU - Jenkinson, Michael D
N1 - © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.
PY - 2022/1/18
Y1 - 2022/1/18
N2 - INTRODUCTION: Due to the increased use of CT and MRI, the prevalence of incidental findings on brain scans is increasing. Meningioma, the most common primary brain tumour, is a frequently encountered incidental finding, with an estimated prevalence of 3/1000. The management of incidental meningioma varies widely with active clinical-radiological monitoring being the most accepted method by clinicians. Duration of monitoring and time intervals for assessment, however, are not well defined. To this end, we have recently developed a statistical model of progression risk based on single-centre retrospective data. The model Incidental Meningioma: Prognostic Analysis Using Patient Comorbidity and MRI Tests (IMPACT) employs baseline clinical and imaging features to categorise the patient with an incidental meningioma into one of three risk groups: low, medium and high risk with a proposed active monitoring strategy based on the risk and temporal trajectory of progression, accounting for actuarial life expectancy. The primary aim of this study is to assess the external validity of this model.METHODS AND ANALYSIS: IMPACT is a retrospective multicentre study which will aim to include 1500 patients with an incidental intracranial meningioma, powered to detect a 10% progression risk. Adult patients ≥16 years diagnosed with an incidental meningioma between 1 January 2009 and 31 December 2010 will be included. Clinical and radiological data will be collected longitudinally until the patient reaches one of the study endpoints: intervention (surgery, stereotactic radiosurgery or fractionated radiotherapy), mortality or last date of follow-up. Data will be uploaded to an online Research Electronic Data Capture database with no unique identifiers. External validity of IMPACT will be tested using established statistical methods.ETHICS AND DISSEMINATION: Local institutional approval at each participating centre will be required. Results of the study will be reported through peer-reviewed articles and conferences and disseminated to participating centres, patients and the public using social media.
AB - INTRODUCTION: Due to the increased use of CT and MRI, the prevalence of incidental findings on brain scans is increasing. Meningioma, the most common primary brain tumour, is a frequently encountered incidental finding, with an estimated prevalence of 3/1000. The management of incidental meningioma varies widely with active clinical-radiological monitoring being the most accepted method by clinicians. Duration of monitoring and time intervals for assessment, however, are not well defined. To this end, we have recently developed a statistical model of progression risk based on single-centre retrospective data. The model Incidental Meningioma: Prognostic Analysis Using Patient Comorbidity and MRI Tests (IMPACT) employs baseline clinical and imaging features to categorise the patient with an incidental meningioma into one of three risk groups: low, medium and high risk with a proposed active monitoring strategy based on the risk and temporal trajectory of progression, accounting for actuarial life expectancy. The primary aim of this study is to assess the external validity of this model.METHODS AND ANALYSIS: IMPACT is a retrospective multicentre study which will aim to include 1500 patients with an incidental intracranial meningioma, powered to detect a 10% progression risk. Adult patients ≥16 years diagnosed with an incidental meningioma between 1 January 2009 and 31 December 2010 will be included. Clinical and radiological data will be collected longitudinally until the patient reaches one of the study endpoints: intervention (surgery, stereotactic radiosurgery or fractionated radiotherapy), mortality or last date of follow-up. Data will be uploaded to an online Research Electronic Data Capture database with no unique identifiers. External validity of IMPACT will be tested using established statistical methods.ETHICS AND DISSEMINATION: Local institutional approval at each participating centre will be required. Results of the study will be reported through peer-reviewed articles and conferences and disseminated to participating centres, patients and the public using social media.
KW - Adult
KW - Humans
KW - Meningeal Neoplasms/diagnostic imaging
KW - Meningioma/diagnostic imaging
KW - Multicenter Studies as Topic
KW - Prognosis
KW - Radiosurgery
KW - Retrospective Studies
KW - Treatment Outcome
UR - https://www.scopus.com/pages/publications/85123660462
U2 - 10.1136/bmjopen-2021-052705
DO - 10.1136/bmjopen-2021-052705
M3 - Article
C2 - 35042706
SN - 2044-6055
VL - 12
SP - e052705
JO - BMJ Open
JF - BMJ Open
IS - 1
ER -