Evidence map›Paper›PMID 32179868›Full record

ArticlePediatric research2020

Validation of the pediatric stroke outcome measure for classifying overall neurological deficit.

Mahmoud Slim, Christine K Fox, Sharon Friefeld, Nomazulu Dlamini, Robyn Westmacott, Mahendranath Moharir, Daune MacGregor, Gabrielle deVeber, SIPS Investigators

Abstract readValidation Study
PubMed Publisher
In one paragraph

Article in Pediatric research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
2.3field-weighted citation impact, top 12% of its field
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

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 2 countries.

Mahmoud SlimDepartment of Pediatrics, Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada.
Christine K FoxDepartments of Neurology and Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
Sharon FriefeldDepartment of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada.
Nomazulu DlaminiDepartment of Pediatrics, Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada.
Robyn WestmacottDepartment of Psychology, The Hospital for Sick Children, Toronto, ON, Canada.
Mahendranath MoharirDepartment of Pediatrics, Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada.
Daune MacGregorDepartment of Pediatrics, Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada.
Gabrielle deVeberDepartment of Pediatrics, Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada. gabrielle.deveber@sickkids.ca.
SIPS Investigators
Hospital for Sick Children · CAUniversity of California, San Francisco · USUniversity of Toronto · CA

Funding

Clinical and Transtional Science InstituteKL2TR000143 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI GRANDIS, JENNIFER RUBIN · 2012 to 2015
$11.9M
Translating discoveries in neurological diseases of infancy and childhoodK12NS001692 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI FULLERTON, HEATHER J · 1993 to 2018
$6.4M
NCATS NIH HHS KL2 TR000143NINDS NIH HHS K12 NS001692
6 · The paper itself

Abstract

backgroundThe pediatric stroke outcome measure (PSOM) is a standardized, disease-specific outcome measure. We aimed to validate the overall classification of neurological deficit severity using PSOM.

methodsWe identified 367 neonates/children with arterial ischemic stroke (AIS) (Derivation Cohort). We analyzed the PSOM subscales (scored as 0 [no deficit], 0.5 [minimal/mild deficit; normal function], 1 [moderate deficit; slowing function], or 2 [severe deficit; missing function]) to derive severity levels using latent class analysis (LCA). We validated a severity classification scheme (PSOM-SCS) in: (a) children who had Pediatric Evaluation of Disability Inventory (PEDI; n = 63) and/or the Pediatric Quality-of-Life Inventory (PedsQL; n = 97) scored; and (b) an external cohort (AIS; n = 102) with concurrently scored modified Rankin Scale (mRS), King's Outcome Scale for Childhood Head-Injury (KOSCHI) and PSOM.

resultsWithin the Derivation Cohort, LCA identified three severity levels: "normal/mild," "moderate," and "severe" (83.7%, 13.3%, and 3%, respectively). We developed severity classification based on PSOM subscale scores: "normal/mild"-normal function in all domains or slowing in one domain, "moderate"-slowing in ≥2 domains or missing function in one domain, and "severe"-missing function in ≥2 domains or slowing in ≥1 plus missing in one domain. PEDI and PedsQL both differed significantly across the severity groups. PSOM-SCS displayed high concordance with mRS (agreement coefficient [AC2] = 0.88) and KOSCHI (AC2 = 0.79).

conclusionThe PSOM-SCS constitutes a valid tool for classifying overall neurological severity emphasizing function and encompassing the full range of severity in pediatric stroke. IMPACT: Arithmetic summing of the PSOM subscales scores to assess severity classification is inadequate.The prior severity classification using PSOM overestimates poor outcomes.Three distinct severity profiles using PSOM subscales are identified.The PSOM-SCS is in moderate to excellent agreement with other disability measures.PSOM-SCS offers a valid tool for classifying the overall neurological deficit severity.

Indexed as

AdolescentChildChild, PreschoolCohort StudiesCraniocerebral TraumaDisability EvaluationFemaleHospitals, PediatricHumansInfantInfant, NewbornMaleNervous System DiseasesProspective StudiesQuality of LifeRetrospective Studies

Identifiers

PMID32179868
OpenAlexW3011166350

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.