The accuracy of predictions about progress of patients on a stroke unit.

Lincoln, Nadina B.; Jackson, J; Edmans, Judi; Walker, Marion F; Farrow, V M; Latham, Alex James; Coombes, Kay

doi:10.1136/jnnp.53.11.972

Cited by 27 publications

(17 citation statements)

References 14 publications

(2 reference statements)

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“…Finally, 13 studies validated a prediction model with that of a second stroke group or were specifically focused on validation [40,41,99] or improvement [85] of an already published prediction model in an independent cohort.…”

Section: Resultsmentioning

confidence: 99%

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Predicting Disability in Stroke—A Critical Review of the Literature

Kwakkel

Wagenaar

Kollen³

et al. 1996

Age Ageing

409

294

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SummaryResearch articles on the prognosis of stroke patients were analysed to identify studies that met sound methodological principles of prognostic research as well as to identify variables capable of predicting functional outcome (ADL) after stroke. Data sources comprised a computer-aided search of published prognostic studies and references to literature used in prognostic studies. Seventy-eight studies were tested for adherence to the following key methodological criteria: reliability and validity of measurement instruments used to assess dependent and independent variables; inclusion of an inception cohort; adequate and uniform end-point of observation; control for drop-outs during period of observation; statistical testing of presumed relationship between dependent and independent variables; sufficient sample size in relation to number of determinants; control for multicollinearity; specification of patient characteristics (i.e. age, type, recurrent stroke and localization of stroke); description of interfering treatment effects during the period of observation; and crossvalidation of the prediction model in a second independent group of patients.Only three studies satisfied nine out of 11 criteria and ten studies eight criteria for the determination of valid prognostic research. The results of these studies indicate that the following variables are valid predictors for functional recovery after stroke: age; previous stroke; urinary continence; consciousness at onset; disorientation in time and place; severity of paralysis; sitting balance; admission ADL score; level of social support and metabolic rate of glucose outside the infarct area in hypertensive patients. This study supports the general opinion that not only are differences in objectives and heterogeneity in stroke patients responsible for the lack of accuracy in predicting functional outcome, but also the methodological flaws in published prognostic research.

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Section: Resultsmentioning

confidence: 99%

“…The results of the analysis of internal, statistical and external validity are summarized in Table II. Four of these involve validation studies of pre-existing prediction models {40, 41,85,99].…”

Section: Resultsmentioning

confidence: 99%

Predicting Disability in Stroke—A Critical Review of the Literature

Kwakkel

Wagenaar

Kollen³

et al. 1996

Age Ageing

409

294

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“…Calculating the percentages of the number of patients who returned to work, we found that 37.50% had a left hemisphere lesion with nonfluent aphasia; 15 …”

Section: Return To Workmentioning

confidence: 99%

The influence of depression, social activity, and family stress on functional outcome after stroke.

Angeleri

Foschi

et al. 1993

Stroke

151

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“…The same group 45 has provided a lucid summary of what these stroke outcome studies and formulas can and cannot illuminate. Formulas and correlations only have actuarial (ie, group) significance; they have weak predictive power for individuals.…”

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confidence: 99%

Stroke rehabilitation outcome. A potential use of predictive variables to establish levels of care.

Alexander¹

1994

Stroke

194

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Background and PurposeThe most powerful predictors of functional recovery and eventual home discharge among stroke survivors are the initial severity of the stroke and the patient's age. We analyzed a large population of stroke rehabilitation admissions by stratifying subgroups with coherent outcomes in an attempt to define potentially more efficient patterns of providing rehabilitation care.Methods We retrospectively analyzed 520 consecutive patients admitted to a rehabilitation hospital (1 calendar year) with cerebral infarction or hemorrhage. Side of index stroke, age, and functional disability at admission were the independent variables. Change in functional disability and home versus nursing home discharge were the dependent measures.Results Recovery was overall most closely related to admission severity and age, but the relations between recovery and independent measures were complex. Patients aged <55 years all were discharged home whatever their initial severity.

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The accuracy of predictions about progress of patients on a stroke unit.

Abstract: The aim of the study was

Cited by 27 publications

References 14 publications

Predicting Disability in Stroke—A Critical Review of the Literature

Predicting Disability in Stroke—A Critical Review of the Literature

The influence of depression, social activity, and family stress on functional outcome after stroke.

Stroke rehabilitation outcome. A potential use of predictive variables to establish levels of care.

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