Evidence map›Paper›PMID 36309002›Full record

ArticleJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Association2022

Evidence-based interconversion of the Glasgow Outcome and modified Rankin scales: pitfalls and best practices.

Ben Gaastra, Dianxu Ren, Sheila Alexander, Issam A Awad, Spiros Blackburn, Sylvain Doré, Dan Hanley, Paul Nyquist, Diederik Bulters, Ian Galea

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05918705 (Is the Ratio of Optic Nerve Sheath Diameter to Eyeball Transverse Diameter Correlated with the Prognosis of Sepsis Associated Encephalopathy in Critically Ill Patients), which is not on this map. Cited by 21 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 7 pooled it
–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.

NCT05918705 completednot on this mapstarted 2023, after this paper: background citation

Is the Ratio of Optic Nerve Sheath Diameter to Eyeball Transverse Diameter Correlated with the Prognosis of Sepsis Associated Encephalopathy in Critically Ill Patients

TypeobservationalSponsorZagazig UniversityRan2023 to 2024Enrolled89ConditionsSepsis-associated EncephalopathyArmsUltrasound optic nerve sheath diameter / eyeball transverse diameter ratio
3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 7 syntheses or guidelines pooled it.

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  6. Thrombolysis for aneurysmal subarachnoid haemorrhage.The Cochrane database of systematic reviews · 2025
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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

10 authors.

Ben GaastraClinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO17 6YD, UK; Department of Neurosurgery, Wessex Neurological Centre, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK.
Dianxu RenSchool of Nursing, University of Pittsburgh, Pittsburgh, PA, United States.
Sheila AlexanderSchool of Nursing, University of Pittsburgh, Pittsburgh, PA, United States.
Issam A AwadUniversity of Chicago, Chicago, IL, United States.
Spiros BlackburnUniversity of Texas Houston Health Science Center, Houston, TX, United States.
Sylvain DoréDepartments of Anesthesiology, Neurology, Psychiatry, Pharmaceutics, and Neuroscience, College of Medicine, Center for Translational Research in Neurodegenerative Disease, McKnight Brain Institute, University of Florida, Gainesville, FL, United States.
Dan HanleyJohns Hopkins School of Medicine, Baltimore, MD, United States.
Paul NyquistJohns Hopkins School of Medicine, Baltimore, MD, United States.
Diederik BultersDepartment of Neurosurgery, Wessex Neurological Centre, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK.
Ian GaleaClinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO17 6YD, UK. Electronic address: i.galea@soton.ac.uk.

Funding

MISTIE III_ Lead Grant_ Cluster Application for the Clinical Coordinating CenterU01NS080824 · NINDS · JOHNS HOPKINS UNIVERSITY · PI HANLEY, DANIEL F · 2013 to 2017
$23.2M
Clot Lysis: Evaluating Accelerated Resolution of IVH Phase III (CLEAR III)U01NS062851 · NINDS · JOHNS HOPKINS UNIVERSITY · PI HANLEY, DANIEL F · 2009 to 2013
$21.6M
NINDS NIH HHS U01 NS062851NINDS NIH HHS U01 NS080824
6 · The paper itself

Abstract

objectiveThe aim of this study was to provide the evidence base to guide interconversion of the modified Rankin Scale (mRS) and Glasgow Outcome Scale (GOS) in neurological research.

methodsA retrospective analysis of paired mRS and GOS recordings was conducted using datasets with the following selection criteria: (1) patients had haemorrhagic stroke, (2) simultaneous mRS and GOS measurements were available, and (3) data sharing was possible. The relationship between mRS and GOS was assessed using correlation analysis. The optimum dichotomisation thresholds for agreement between the mRS and GOS were identified using Cohen's kappa coefficient. Two-way conversion tables between mRS and GOS were developed based on the highest agreement between scores. Finally, to identify which direction of conversion (mRS to GOS or vice versa) was better, the Kolmogorov-Smirnov D statistic was calculated.

resultsUsing 3474 paired recordings the mRS and GOS were shown to be highly correlated (ρ = 0.90, p < 0.0001). The greatest agreement between the two scoring systems occurred when mRS=0-2 and GOS=4-5 was used to define good outcome (κ=0.83, 95% confidence interval: 0.81-0.85). Converting from mRS to GOS was better than the reverse direction as evidenced by a lower Kolmogorov-Smirnov statistic (D=0.054 compared to D=0.157).

conclusionsThis study demonstrates that the mRS and GOS are highly correlated, establishes the optimum dichotomisation threshold for agreement, provides a method for interconversion and shows that mRS to GOS conversion is superior to the reverse direction if a choice is available.

Indexed as

StrokeGlasgow Outcome ScaleHumansRetrospective StudiesGlasgow outcome scaleModified Rankin scaleOutcomeStroke

Identifiers

PMID36309002
PMCPMC11295112

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Registered trials

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.