Evidence map›Paper›PMID 36599699›Full record

Trial reportNeurology2023

Disentangling the Association Between Neurologic Deficits, Patient-Reported Impairments, and Quality of Life After Ischemic Stroke.

Nadinda A M van der Ende, Sanne J den Hartog, Joseph P Broderick, Pooja Khatri, Johanna M A Visser-Meily, Nikki van Leeuwen, Hester F Lingsma, Bob Roozenbeek, Diederik W J Dippel, IMS III Investigators

Registry-linked trialOpen access · hybridAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00359424 (Interventional Management of Stroke Trial), which is not on this 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
1.7field-weighted citation impact, top 16% 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.

NCT00359424 phase3terminatednot on this map

Interventional Management of Stroke Trial (IMS III): A Phase III Clinical Trial Examining Whether a Combined Intravenous (IV) and Intra-Arterial (IA) Approach to Recanalization is Superior to Standard IV Rt-PA (Activase®) Alone

TypeinterventionalSponsorJoseph BroderickRan2006 to 2013Enrolled656ConditionsStrokeArmsIV rt-PA alone, endovascular therapy
3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Clinical Outcome Assessments in Encephalitis: A Systematic ReviewNeurology(R) neuroimmunology & neuroinflammation · 2024
    Pooled it
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 1 institution in 2 countries.

Nadinda A M van der EndeFrom the Departments of Neurology (N.A.M.v.d.E., S.J.d.H., B.R., D.W.J.D.), Radiology and Nuclear Medicine (N.A.M.v.d.E., S.J.d.H., B.R.) and Public Health (S.J.d.H., N.v.L., H.F.L.), Erasmus MC University Medical Center, Rotterdam, the Netherlands; Departments of Neurology and Rehabilitation Medicine (J.P.B., P.K.) and Emergency Medicine (J.P.B., P.K.), University of Cincinnati Gardner Neuroscience Institute, University of Cincinnati Academic Health Center, OH; and Center of Excellence for Rehabilitation Medicine (J.M.A.V.-M.) and Department of Rehabilitation, Physical Therapy Science & Sports (J.M.A.V.-M.), University Medical Center Utrecht, the Netherlands. n.vanderende@erasmusmc.nl.ORCID 0000-0003-4681-8388
Sanne J den HartogFrom the Departments of Neurology (N.A.M.v.d.E., S.J.d.H., B.R., D.W.J.D.), Radiology and Nuclear Medicine (N.A.M.v.d.E., S.J.d.H., B.R.) and Public Health (S.J.d.H., N.v.L., H.F.L.), Erasmus MC University Medical Center, Rotterdam, the Netherlands; Departments of Neurology and Rehabilitation Medicine (J.P.B., P.K.) and Emergency Medicine (J.P.B., P.K.), University of Cincinnati Gardner Neuroscience Institute, University of Cincinnati Academic Health Center, OH; and Center of Excellence for Rehabilitation Medicine (J.M.A.V.-M.) and Department of Rehabilitation, Physical Therapy Science & Sports (J.M.A.V.-M.), University Medical Center Utrecht, the Netherlands.ORCID 0000-0002-1650-951X
Joseph P BroderickFrom the Departments of Neurology (N.A.M.v.d.E., S.J.d.H., B.R., D.W.J.D.), Radiology and Nuclear Medicine (N.A.M.v.d.E., S.J.d.H., B.R.) and Public Health (S.J.d.H., N.v.L., H.F.L.), Erasmus MC University Medical Center, Rotterdam, the Netherlands; Departments of Neurology and Rehabilitation Medicine (J.P.B., P.K.) and Emergency Medicine (J.P.B., P.K.), University of Cincinnati Gardner Neuroscience Institute, University of Cincinnati Academic Health Center, OH; and Center of Excellence for Rehabilitation Medicine (J.M.A.V.-M.) and Department of Rehabilitation, Physical Therapy Science & Sports (J.M.A.V.-M.), University Medical Center Utrecht, the Netherlands.ORCID 0000-0002-7323-7709
Pooja KhatriFrom the Departments of Neurology (N.A.M.v.d.E., S.J.d.H., B.R., D.W.J.D.), Radiology and Nuclear Medicine (N.A.M.v.d.E., S.J.d.H., B.R.) and Public Health (S.J.d.H., N.v.L., H.F.L.), Erasmus MC University Medical Center, Rotterdam, the Netherlands; Departments of Neurology and Rehabilitation Medicine (J.P.B., P.K.) and Emergency Medicine (J.P.B., P.K.), University of Cincinnati Gardner Neuroscience Institute, University of Cincinnati Academic Health Center, OH; and Center of Excellence for Rehabilitation Medicine (J.M.A.V.-M.) and Department of Rehabilitation, Physical Therapy Science & Sports (J.M.A.V.-M.), University Medical Center Utrecht, the Netherlands.
Johanna M A Visser-MeilyFrom the Departments of Neurology (N.A.M.v.d.E., S.J.d.H., B.R., D.W.J.D.), Radiology and Nuclear Medicine (N.A.M.v.d.E., S.J.d.H., B.R.) and Public Health (S.J.d.H., N.v.L., H.F.L.), Erasmus MC University Medical Center, Rotterdam, the Netherlands; Departments of Neurology and Rehabilitation Medicine (J.P.B., P.K.) and Emergency Medicine (J.P.B., P.K.), University of Cincinnati Gardner Neuroscience Institute, University of Cincinnati Academic Health Center, OH; and Center of Excellence for Rehabilitation Medicine (J.M.A.V.-M.) and Department of Rehabilitation, Physical Therapy Science & Sports (J.M.A.V.-M.), University Medical Center Utrecht, the Netherlands.ORCID 0000-0002-5955-8012
Nikki van LeeuwenFrom the Departments of Neurology (N.A.M.v.d.E., S.J.d.H., B.R., D.W.J.D.), Radiology and Nuclear Medicine (N.A.M.v.d.E., S.J.d.H., B.R.) and Public Health (S.J.d.H., N.v.L., H.F.L.), Erasmus MC University Medical Center, Rotterdam, the Netherlands; Departments of Neurology and Rehabilitation Medicine (J.P.B., P.K.) and Emergency Medicine (J.P.B., P.K.), University of Cincinnati Gardner Neuroscience Institute, University of Cincinnati Academic Health Center, OH; and Center of Excellence for Rehabilitation Medicine (J.M.A.V.-M.) and Department of Rehabilitation, Physical Therapy Science & Sports (J.M.A.V.-M.), University Medical Center Utrecht, the Netherlands.
Hester F LingsmaFrom the Departments of Neurology (N.A.M.v.d.E., S.J.d.H., B.R., D.W.J.D.), Radiology and Nuclear Medicine (N.A.M.v.d.E., S.J.d.H., B.R.) and Public Health (S.J.d.H., N.v.L., H.F.L.), Erasmus MC University Medical Center, Rotterdam, the Netherlands; Departments of Neurology and Rehabilitation Medicine (J.P.B., P.K.) and Emergency Medicine (J.P.B., P.K.), University of Cincinnati Gardner Neuroscience Institute, University of Cincinnati Academic Health Center, OH; and Center of Excellence for Rehabilitation Medicine (J.M.A.V.-M.) and Department of Rehabilitation, Physical Therapy Science & Sports (J.M.A.V.-M.), University Medical Center Utrecht, the Netherlands.
Bob RoozenbeekFrom the Departments of Neurology (N.A.M.v.d.E., S.J.d.H., B.R., D.W.J.D.), Radiology and Nuclear Medicine (N.A.M.v.d.E., S.J.d.H., B.R.) and Public Health (S.J.d.H., N.v.L., H.F.L.), Erasmus MC University Medical Center, Rotterdam, the Netherlands; Departments of Neurology and Rehabilitation Medicine (J.P.B., P.K.) and Emergency Medicine (J.P.B., P.K.), University of Cincinnati Gardner Neuroscience Institute, University of Cincinnati Academic Health Center, OH; and Center of Excellence for Rehabilitation Medicine (J.M.A.V.-M.) and Department of Rehabilitation, Physical Therapy Science & Sports (J.M.A.V.-M.), University Medical Center Utrecht, the Netherlands.ORCID 0000-0002-8320-8303
Diederik W J DippelFrom the Departments of Neurology (N.A.M.v.d.E., S.J.d.H., B.R., D.W.J.D.), Radiology and Nuclear Medicine (N.A.M.v.d.E., S.J.d.H., B.R.) and Public Health (S.J.d.H., N.v.L., H.F.L.), Erasmus MC University Medical Center, Rotterdam, the Netherlands; Departments of Neurology and Rehabilitation Medicine (J.P.B., P.K.) and Emergency Medicine (J.P.B., P.K.), University of Cincinnati Gardner Neuroscience Institute, University of Cincinnati Academic Health Center, OH; and Center of Excellence for Rehabilitation Medicine (J.M.A.V.-M.) and Department of Rehabilitation, Physical Therapy Science & Sports (J.M.A.V.-M.), University Medical Center Utrecht, the Netherlands.ORCID 0000-0002-9234-3515
IMS III Investigators
Erasmus MC · NL

Funding

Interventional Management of Stroke Study (IMS III)U01NS052220 · NINDS · UNIVERSITY OF CINCINNATI · PI BRODERICK, JOSEPH PAUL · 2005 to 2012
$21.9M
The ALIAS StudyU01NS054630 · NINDS · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI PALESCH, YUKO Y · 2005 to 2010
$6.9M
Interventional Management of Stroke Phase III Trial - SDCCU01NS077304 · NINDS · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI PALESCH, YUKO Y · 2011 to 2013
$1.4M
NINDS NIH HHS U01 NS052220NINDS NIH HHS U01 NS054630NINDS NIH HHS U01 NS077304
6 · The paper itself

Abstract

BACKGROUND AND

objectivesThe EuroQol Group 5-Dimension Self-Reported Questionnaire (EQ-5D) is a well-established instrument to assess quality of life and generates generic utility values for health states reported by patients, derived from assessments by the general public. We hypothesized that language problems and other nonmotor deficits are not captured as well as motor deficits by this system. We aimed to quantify the association between disabling neurologic deficits and the EQ-5D dimension scores and the utility score in patients with ischemic stroke.

methodsWe used data of the Interventional Management of Stroke III trial. Missing data were imputed by multiple imputation. The association between neurologic deficits (individual NIH Stroke Scale [NIHSS] item scores) and the EQ-5D-3L (5 three-level dimension scores and utility score) at 90 days was assessed with ordinal logistic regression and Tobit regression, respectively. The explained variance of each model was estimated with Nagelkerke pseudo-R

resultsIn total, 525 surviving patients were included. Complete data on both the NIHSS and EQ-5D were available for 481/525 (91.6%) patients. At 90 days, 161/491 (32.8%) patients had aphasia and 226/491 (46.0%) patients had paresis of at least 1 limb. Limb paresis, facial palsy, sensory loss, and dysarthria explained most of the variance in all EQ-5D dimension scores and the utility score. In the utility score, 8.9% of the variance was explained by neglect, 10.0% by aphasia, 10.8% by hemianopia, and 17.5%-24.1% by limb paresis. DISCUSSION: The impact of neurologic deficits on the EQ-5D in patients with ischemic stroke is mostly due to limb paresis, while the EQ-5D is less sensitive to other nonmotor deficits such as hemianopia, aphasia, and neglect. This may lead to overestimation of quality of life and, consequently, underestimation of the (cost-)effectiveness of treatments and interventions. TRIAL REGISTRATION INFORMATION: ClinicalTrials.gov. Unique identifier: NCT00359424.

Indexed as

Ischemic StrokeQuality of LifeHemianopsiaHumansPatient Reported Outcome MeasuresSurveys and Questionnaires

Identifiers

PMID36599699
PMCPMC10065207
OpenAlexW4313543484

What OpenQuestion holds

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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.