Reliability and validity of the mean flow index (Mx) for assessing cerebral autoregulation in humans: A systematic review of the methodology
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Reliability and validity of the mean flow index (Mx) for assessing cerebral autoregulation in humans : A systematic review of the methodology. / Olsen, Markus Harboe; Riberholt, Christian Gunge; Mehlsen, Jesper; Berg, Ronan M.G.; Møller, Kirsten.
In: Journal of Cerebral Blood Flow and Metabolism, Vol. 42, No. 1, 2022, p. 27-38.Research output: Contribution to journal › Review › Research › peer-review
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TY - JOUR
T1 - Reliability and validity of the mean flow index (Mx) for assessing cerebral autoregulation in humans
T2 - A systematic review of the methodology
AU - Olsen, Markus Harboe
AU - Riberholt, Christian Gunge
AU - Mehlsen, Jesper
AU - Berg, Ronan M.G.
AU - Møller, Kirsten
N1 - Publisher Copyright: © The Author(s) 2021.
PY - 2022
Y1 - 2022
N2 - Cerebral autoregulation is a complex mechanism that serves to keep cerebral blood flow relatively constant within a wide range of cerebral perfusion pressures. The mean flow index (Mx) is one of several methods to assess dynamic cerebral autoregulation, but its reliability and validity have never been assessed systematically. The purpose of the present systematic review was to evaluate the methodology, reliability and validity of Mx. Based on 128 studies, we found inconsistency in the pre-processing of the recordings and the methods for calculation of Mx. The reliability in terms of repeatability and reproducibility ranged from poor to excellent, with optimal repeatability when comparing overlapping recordings. The discriminatory ability varied depending on the patient populations; in general, those with acute brain injury exhibited a higher Mx than healthy volunteers. The prognostic ability in terms of functional outcome and mortality ranged from chance result to moderate accuracy. Since the methodology was inconsistent between studies, resulting in varying reliability and validity estimates, the results were difficult to compare. The optimal method for deriving Mx is currently unknown.
AB - Cerebral autoregulation is a complex mechanism that serves to keep cerebral blood flow relatively constant within a wide range of cerebral perfusion pressures. The mean flow index (Mx) is one of several methods to assess dynamic cerebral autoregulation, but its reliability and validity have never been assessed systematically. The purpose of the present systematic review was to evaluate the methodology, reliability and validity of Mx. Based on 128 studies, we found inconsistency in the pre-processing of the recordings and the methods for calculation of Mx. The reliability in terms of repeatability and reproducibility ranged from poor to excellent, with optimal repeatability when comparing overlapping recordings. The discriminatory ability varied depending on the patient populations; in general, those with acute brain injury exhibited a higher Mx than healthy volunteers. The prognostic ability in terms of functional outcome and mortality ranged from chance result to moderate accuracy. Since the methodology was inconsistent between studies, resulting in varying reliability and validity estimates, the results were difficult to compare. The optimal method for deriving Mx is currently unknown.
KW - autoregulation
KW - confounders
KW - Mean flow index
KW - methodology
KW - Mx
KW - reliability
KW - systematic review
KW - validity
U2 - 10.1177/0271678X211052588
DO - 10.1177/0271678X211052588
M3 - Review
C2 - 34617816
AN - SCOPUS:85116516525
VL - 42
SP - 27
EP - 38
JO - Journal of Cerebral Blood Flow and Metabolism
JF - Journal of Cerebral Blood Flow and Metabolism
SN - 0271-678X
IS - 1
ER -
ID: 284407456