Figure 5. UIATS case recommendation resulting in the lowest agreement among the internal and external reviewer cohorts.

Corresponding scores in accordance with unruptured intracranial aneurysm treatment score (UIATS) features are given in parentheses. A catheter angiogram of a 25-year-old woman (4 points favoring treatment for patient age younger than 40 years) who previously underwent MRI for persistent headaches, vertigo, and occasional bitemporal vision disturbances (due to a migraine aura) with (A) posterior-anterior and (B) lateral projection as well as (C) posterior-anterior and (D) lateral 3-dimensional reconstructions is shown. This left-sided wide-necked paraophthalmic internal carotid artery aneurysm had a maximum diameter of 3 mm with a neck diameter of 2.7 mm (3 points favoring conservative management for aneurysm complexity due to wide neck). The patient did not report any additional risk factors or comorbidities in her past medical history. The resulting scores based on the UIATS were 4 points in favor of aneurysm repair and 8 points (including 5 points favoring conservative management for the constant intervention-related risk) in favor of conservative management. The resulting UIATS recommendation was “conservative management.” Overall agreement with this UIATS recommendation was 3.7 (95% confidence interval 3.44–3.96) for both reviewer cohorts.