Evidence map›Paper›PMID 30322381›Full record

ArticleBMC neurology2018

Validation of a prediction model for long-term outcome of aphasia after stroke.

Femke Nouwens, Evy G Visch-Brink, Hanane El Hachioui, Hester F Lingsma, Mieke W M E van de Sandt-Koenderman, Diederik W J Dippel, Peter J Koudstaal, Lonneke M L de Lau

Abstract readValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC neurology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Femke NouwensDepartment of Neurology, Erasmus MC University Medical Center, room Nb-324, PO Box 2040, 3000, CA, Rotterdam, the Netherlands. f.nouwens@erasmusmc.nl.
Evy G Visch-BrinkDepartment of Neurology, Erasmus MC University Medical Center, room Nb-324, PO Box 2040, 3000, CA, Rotterdam, the Netherlands.
Hanane El HachiouiRijndam Rehabilitation, Rotterdam, the Netherlands.
Hester F LingsmaDepartment of Public Health, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
Mieke W M E van de Sandt-KoendermanRijndam Rehabilitation, Rotterdam, the Netherlands.
Diederik W J DippelDepartment of Neurology, Erasmus MC University Medical Center, room Nb-324, PO Box 2040, 3000, CA, Rotterdam, the Netherlands.
Peter J KoudstaalDepartment of Neurology, Erasmus MC University Medical Center, room Nb-324, PO Box 2040, 3000, CA, Rotterdam, the Netherlands.
Lonneke M L de LauDepartment of Neurology, Erasmus MC University Medical Center, room Nb-324, PO Box 2040, 3000, CA, Rotterdam, the Netherlands.

Funding

Hersenstichting 2011(1)-20Nederlandse Organisatie voor Wetenschappelijk Onderzoek 017.002.083
6 · The paper itself

Abstract

backgroundAbout 30% of stroke patients suffer from aphasia. As aphasia strongly affects daily life, most patients request a prediction of outcome of their language function. Prognostic models provide predictions of outcome, but external validation is essential before models can be used in clinical practice. We aim to externally validate the prognostic model from the Sequential Prognostic Evaluation of Aphasia after stroKe (SPEAK-model) for predicting the long-term outcome of aphasia caused by stroke.

methodsWe used data from the Rotterdam Aphasia Therapy Study - 3 (RATS-3), a multicenter RCT with inclusion criteria similar to SPEAK, an observational prospective study. Baseline assessment in SPEAK was four days after stroke and in RATS-3 eight days. Outcome of the SPEAK-model was the Aphasia Severity Rating Scale (ASRS) at 1 year, dichotomized into good (ASRS-score of 4 or 5) and poor outcome (ASRS-score < 4). In RATS-3, ASRS-scores at one year were not available, but we could use six month ASRS-scores as outcome. Model performance was assessed with calibration and discrimination.

resultsWe included 131 stroke patients with first-ever aphasia. At six months, 86 of 124 (68%) had a good outcome, whereas the model predicted 88%. Discrimination of the model was good with an area under the receiver operation characteristic curve of 0.87 (95%CI: 0.81-0.94), but calibration was unsatisfactory. The model overestimated the probability of good outcome (calibration-in-the-large α = - 1.98) and the effect of the predictors was weaker in the validation data than in the derivation data (calibration slope β = 0.88). We therefore recalibrated the model to predict good outcome at six months.

conclusionThe original model, renamed SPEAK-12, has good discriminative properties, but needs further external validation. After additional external validation, the updated SPEAK-model, SPEAK-6, may be used in daily practice to discriminate between patients with good and patients with poor outcome of aphasia at six months after stroke.

trial registrationRATS-3 was registered on January 13th 2012 in the Netherlands Trial Register: NTR3271 . SPEAK was not listed in a trial registry.

Indexed as

AgedAged, 80 and overAphasiaFemaleHumansLanguageMaleMiddle AgedNetherlandsPrognosisProspective StudiesRandomized Controlled Trials as TopicROC CurveStrokeAphasiaOutcomePrognostic modelStrokeValidation

Identifiers

PMID30322381
PMCPMC6191997

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.