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Proposed multitiered reference standard in DCI. Three-tiered DCI reference standard algorithm, ordered from top to bottom. Asterisk indicates neuromonitoring devices such as cerebral microdialysis and oximetry. Double asterisks indicate whether the reference standard is used for clinical assessment and treatment decisions based on the risk/benefit ratio for treatment. If there is low risk, treatment for DCI is recommended. If there is high risk, the patient should re-enter the algorithm.
