Evidence map›Paper›PMID 42496900›Full record

ArticleNeuroradiology2026

Machine learning versus conventional grading systems for prognostication in aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis.

Donald Ogolo, Obioma Akwada, Enyereibe Ajare, Brenda Opara, Francis Campbell, Okwunodulu Okwuoma, Wilfred Mezue, Samuel Ohaegbulam

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Article in Neuroradiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Donald OgoloDivision of Neurosurgery, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria. donald.ogolo@npmcn.edu.ng.
Obioma AkwadaDivision of Neurosurgery, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria.
Enyereibe AjareDepartment of Radiation Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria.
Brenda OparaCollege of Medicine, Alex Ekwueme Federal University Ndufu-Alike, Abakaliki, Nigeria.
Francis CampbellDivision of Neurosurgery, Delta State University Teaching Hospital, Oghara, Delta State, Nigeria.
Okwunodulu OkwuomaDepartment of Neurosurgery, Memfys Hospital for Neurosurgery, Enugu, Nigeria.
Wilfred MezueDepartment of Neurosurgery, Memfys Hospital for Neurosurgery, Enugu, Nigeria.
Samuel OhaegbulamDepartment of Neurosurgery, Memfys Hospital for Neurosurgery, Enugu, Nigeria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAccurate prognostication after aneurysmal subarachnoid hemorrhage (aSAH) remains challenging. Conventional clinical and radiological grading systems, including the World Federation of Neurosurgical Societies (WFNS), Hunt-Hess, and Fisher scales, are widely used but have limited discriminative capacity. This study aimed to systematically compare machine learning (ML)-based prognostic models with conventional grading systems for predicting functional outcomes and mortality after aSAH, and to evaluate factors influencing ML performance.

methodsA systematic review and meta-analysis were conducted according to PRISMA 2020 guidelines. PubMed, Embase, Scopus, Web of Science, and the Cochrane Library were searched for studies published between 2010 and 2025. Eligible studies evaluated ML-based models for outcome prediction in adult aSAH patients and reported performance of conventional grading systems. Prognostic discrimination was pooled using random-effects meta-analysis of the area under the receiver operating characteristic curve (AUC), with predefined subgroup analyses.

resultsFourteen studies including 6,247 patients were analyzed. ML models demonstrated good to excellent discrimination, with AUCs ranging from 0.81 to 0.97. The pooled ML AUC for predicting unfavourable neurological outcome was 0.86 (95% CI 0.83-0.89; p < 0.0001), with substantial heterogeneity (I² = 96.1%). ML models outperformed conventional grading systems in most studies and showed comparable performance in the remainder. Subgroup analyses confirmed statistically significant prognostic accuracy across clinical-only, imaging-based, and multimodal ML models.

conclusionMachine learning-based prognostic models demonstrate statistically significant and clinically meaningful performance for outcome prediction after aSAH, exceeding conventional grading systems and supporting their role as complementary risk stratification tools.

Indexed as

Aneurysmal subarachnoid hemorrhageGrading systemsMachine learningMeta-analysisOutcome predictionPrognostic models

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.