Literature DB >> 33402051

Predicting specific abilities after disabling stroke: Development and validation of prognostic models.

Akila Visvanathan1, Catriona Graham2, Martin Dennis1, Julia Lawton3, Fergus Doubal1, Gillian Mead1, William Whiteley1.   

Abstract

BACKGROUND: Predicting specific abilities (e.g. walk and talk) to provide a functional profile six months after disabling stroke could help patients/families prepare for the consequences of stroke and facilitate involvement in treatment decision-making. AIM: To develop new statistical models to predict specific abilities six months after stroke and test their performance in an independent cohort of patients with disabling stroke.
METHODS: We developed models to predict six specific abilities (to be independent, walk, talk, eat normally, live without major anxiety/depression, and to live at home) using data from seven large multicenter stroke trials with multivariable logistic regression. We included 13,117 participants recruited within three days of hospital admission. We assessed model discrimination and derived optimal cut-off values using four statistical methods. We validated the models in an independent single-center cohort of patients (n = 403) with disabling stroke. We assessed model discrimination and calibration and reported the performance of our models at the statistically derived cut-off values.
RESULTS: All six models had good discrimination in external validation (AUC 0.78-0.84). Four models (predicting to walk, eat normally, live without major anxiety/depression, live at home) calibrated well. Models had sensitivities between 45.0 and 97.9% and specificities between 21.6 and 96.5%.
CONCLUSIONS: We have developed statistical models to predict specific abilities and demonstrated that these models perform reasonably well in an independent cohort of disabling stroke patients. To aid decision-making regarding treatments, further evaluation of our models is required.

Entities:  

Keywords:  Prognostic models; decision-making; disability; prediction; prognosis; stroke

Mesh:

Year:  2021        PMID: 33402051      PMCID: PMC8554496          DOI: 10.1177/1747493020982873

Source DB:  PubMed          Journal:  Int J Stroke        ISSN: 1747-4930            Impact factor:   5.266


  16 in total

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Authors:  Claire J Creutzfeldt; W T Longstreth; Robert G Holloway
Journal:  BMJ       Date:  2015-08-06

2.  FOOD: a multicentre randomised trial evaluating feeding policies in patients admitted to hospital with a recent stroke.

Authors:  M Dennis; S Lewis; G Cranswick; J Forbes
Journal:  Health Technol Assess       Date:  2006-01       Impact factor: 4.014

3.  Anxiety and depression 3 years following stroke: demographic, clinical, and psychological predictors.

Authors:  Val Morrison; Beth Pollard; Marie Johnston; Ron MacWalter
Journal:  J Psychosom Res       Date:  2005-10       Impact factor: 3.006

Review 4.  A systematic review of case-mix adjustment models for stroke.

Authors:  Elizabeth A Teale; Anne Forster; Theresa Munyombwe; John B Young
Journal:  Clin Rehabil       Date:  2012-01-18       Impact factor: 3.477

5.  The Clots in Legs Or sTockings after Stroke (CLOTS) 3 trial: a randomised controlled trial to determine whether or not intermittent pneumatic compression reduces the risk of post-stroke deep vein thrombosis and to estimate its cost-effectiveness.

Authors:  Martin Dennis; Peter Sandercock; Catriona Graham; John Forbes; J Smith
Journal:  Health Technol Assess       Date:  2015-09       Impact factor: 4.014

6.  Shared decision making after severe stroke-How can we improve patient and family involvement in treatment decisions?

Authors:  Akila Visvanathan; Martin Dennis; Gillian Mead; William N Whiteley; Julia Lawton; Fergus Neil Doubal
Journal:  Int J Stroke       Date:  2017-09-12       Impact factor: 5.266

7.  Predicting functional outcome in acute stroke: comparison of a simple six variable model with other predictive systems and informal clinical prediction.

Authors:  C Counsell; M Dennis; M McDowall
Journal:  J Neurol Neurosurg Psychiatry       Date:  2004-03       Impact factor: 10.154

8.  The benefits and harms of intravenous thrombolysis with recombinant tissue plasminogen activator within 6 h of acute ischaemic stroke (the third international stroke trial [IST-3]): a randomised controlled trial.

Authors:  Peter Sandercock; Joanna M Wardlaw; Richard I Lindley; Martin Dennis; Geoff Cohen; Gordon Murray; Karen Innes; Graham Venables; Anna Czlonkowska; Adam Kobayashi; Stefano Ricci; Veronica Murray; Eivind Berge; Karsten Bruins Slot; Graeme J Hankey; Manuel Correia; Andre Peeters; Karl Matz; Phillippe Lyrer; Gord Gubitz; Stephen J Phillips; Antonio Arauz
Journal:  Lancet       Date:  2012-05-23       Impact factor: 79.321

Review 9.  Prediction of Walking and Arm Recovery after Stroke: A Critical Review.

Authors:  Li Khim Kwah; Robert D Herbert
Journal:  Brain Sci       Date:  2016-11-02

Review 10.  Prognosis Research Strategy (PROGRESS) 3: prognostic model research.

Authors:  Ewout W Steyerberg; Karel G M Moons; Danielle A van der Windt; Jill A Hayden; Pablo Perel; Sara Schroter; Richard D Riley; Harry Hemingway; Douglas G Altman
Journal:  PLoS Med       Date:  2013-02-05       Impact factor: 11.069

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  1 in total

1.  Prevalence and implications of frailty in acute stroke: systematic review & meta-analysis.

Authors:  Jennifer K Burton; Jennifer Stewart; Mairi Blair; Sinead Oxley; Amy Wass; Martin Taylor-Rowan; Terence J Quinn
Journal:  Age Ageing       Date:  2022-03-01       Impact factor: 12.782

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