Derivation and External Validation of the "FORECAST-PC" Prediction Scores

NCT07750015 | Completed

• 1 other identifier: FORECAST-PC
• Study Type: observational
• Target: 732
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to develop and externally validate machine learning prediction models (FORECAST-PC) to determine 90-day functional outcomes for patients suffering from acute ischemic stroke in the posterior circulation who are selected for endovascular thrombectomy (EVT)

Conditions

Posterior Ischemic Stroke; Cerebral Infarction; Cerebrovascular Disorders

Keywords

Machine Learning; Posterior Cerebral Artery; Basilar Artery; Vertebral Artery; Endovasculat treatment; Thrombectomy; Prediction Algorithm

Outcome Measures

Primary Outcomes (1)

• Unfavorable Functional Outcome at 90 Days

  Defined as a dichotomized 90-day modified Rankin Scale (mRS) score of 3 to 6 (where 0-2 is favorable and 3-6 is unfavorable).

  90 days

Study Arms (2)

Derivation cohort

Patients with PC stroke selected for EVT from three primary training centers (Lausanne University Hospital, Bern University Hospital, and Charité-Universitätsmedizin Berlin).

Other: FORECAST-PC Prediction Models

External Validation Cohort

Unseen patients with PC stroke selected for EVT from 11 independent, world-wide comprehensive stroke centers

Other: FORECAST-PC Prediction Models

Interventions

FORECAST-PC Prediction Models OTHER

Application of machine learning gradient-boosted decision tree models (Full-Feature and Light versions) at admission and 24-hours to predict 90-day functional outcome.

Derivation cohort; External Validation Cohort

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study population comprises adult patients (older than 18 years) presenting with acute ischemic stroke (AIS) attributed to a radiologically confirmed posterior circulation large vessel occlusion. These individuals were treated at 14 international comprehensive stroke centers, with initial participation rooted in the European EVA-TRISP network. Patients were included if they were selected for endovascular thrombectomy (EVT) within 24 hours of the last known well time, regardless of whether they received prior intravenous thrombolysis (IVT) or were managed via mothership or drip-and-ship pathways. Participants were required to have a pre-stroke modified Rankin Scale (mRS) of 0 to 3. The cohort explicitly excludes patients whose strokes occurred in-hospital, patients treated beyond the 24-hour window, and patients treated prior to 2015.

You may qualify if:

• Age \> 18 years
• Presentation with acute ischemic stroke (AIS) attributed to a radiologically confirmed posterior circulation occlusion
• Selected for Endovascular Thrombectomy (EVT) according to the treating physician
• Pre-stroke modified Rankin Scale (mRS) 0-3
• EVT initiated or attempted within 24-hours of the last known well (LKW) time
• Includes cases with/without prior intravenous thrombolysis (IVT), mothership, and drip-and-ship pathways

You may not qualify if:

• EVT carried out beyond 24 hours from stroke onset
• EVT performed secondarily after in-hospital worsening or stroke recurrence
• In-hospital strokes (to avoid the confounding influence of prior systemic comorbidities and the acute event that necessitated initial admission)
• Missing primary outcome data
• Inconsistencies between descriptive dependence status and raw pre-stroke mRS
• Stroke cases occurring prior to 2015 (to account for major changes in endovascular treatment techniques)

Sponsors & Collaborators

• Dr. med. Alexander Salerno, MD-PhD: lead

Study Sites (1)

Centre Hospitalier Universitaire Vaudois

Lausanne, 1010, Switzerland

Location

MeSH Terms

Conditions

Cerebral Infarction; Cerebrovascular Disorders

Condition Hierarchy (Ancestors)

Brain Infarction; Brain Ischemia; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Stroke; Vascular Diseases; Cardiovascular Diseases; Infarction; Ischemia; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Necrosis

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Dr. med., MD-PhD, MERc-PD

Study Record Dates

• First Submitted: August 2, 2026
• First Posted: August 6, 2026
• Study Start: January 1, 2015
• Primary Completion: December 31, 2024
• Study Completion: December 31, 2024
• Last Updated: August 6, 2026

Record last verified: 2026-08

Locations

CH (1)