Evidence map›Paper›PMID 37456628›Full record

ArticleFrontiers in neurology2023

Staged use of ordinal and linear disability scales: a practical approach to granular assessment of acute stroke outcome.

Napasri Chaisinanunkul, Sidney Starkman, Jeffrey Gornbein, Scott Hamilton, Fiona Chatfield, Robin Conwit, Jeffrey L Saver

Erratum issuedAbstract read
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In one paragraph

Article in Frontiers in neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Trial
  2. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Napasri ChaisinanunkulStroke Center, Phyathai 1 Hospital, Bangkok, Thailand.
Sidney StarkmanComprehensive Stroke Center and Departments of Emergency Medicine and Neurology, University of California, Los Angeles, Los Angeles, CA, United States.
Jeffrey GornbeinDepartment of Biomathematics, University of California, Los Angeles, Los Angeles, CA, United States.
Scott HamiltonDepartment of Neurology, Stanford University, Palo Alto, CA, United States.
Fiona ChatfieldComprehensive Stroke Center and Department of Neurology, University of California, Los Angeles, Los Angeles, CA, United States.
Robin ConwitNational Institutes of Health, Bethesda, MD, United States.
Jeffrey L SaverComprehensive Stroke Center and Department of Neurology, University of California, Los Angeles, Los Angeles, CA, United States.

Funding

Field Administration of Stroke Therapy-Magnesium Trial (FAST-MAG)U01NS044364 · NINDS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI SAVER, JEFFREY L · 2003 to 2013
$46.4M
NINDS NIH HHS U01 NS044364
6 · The paper itself

Abstract

Background: The modified Rankin Scale (mRS) assessment of global disability is the most common primary endpoint in acute stroke trials but lacks granularity (7 broad levels) and is ordinal (scale levels unknown distances apart), which constrains study power. Disability scales that are linear and continuous may better discriminate outcomes, but computerized administration in stroke patients is challenging. We, therefore, undertook to develop a staged use of an ordinal followed by a linear scale practical to use in multicenter trials. Methods: Consecutive patients undergoing 3-month final visits in the NIH FAST-MAG phase 3 trial were assessed with the mRS followed by 15 mRS level-specific yes-no items of the Academic Medical Center Linear Disability Score (ALDS), a linear disability scale derived using item response theory. Results: Among 55 patients, aged 71.2 (SD ± 14.2), 67% were men and the entry NIHSS was 10.7 (SD ± 9.5). At 90 days, the median mRS score was 3 (IQR, 1-4), and the median ALDS score was 78.8 (IQR, 3.3-100). ALDS scores correlated strongly with 90 days outcome measures, including the Barthel Index ( Conclusion: Among patients enrolled in an acute neuroprotective stroke trial, the ALDS showed strong convergent validity and superior discrimination characteristics compared with the modified Rankin Scale and increased projected trial power to detect clinically meaningful treatment benefits.

Indexed as

acute cerebral hemorrhageacute cerebral infarctionacute stroke syndromescerebrovascular disease/strokeclinical trialsemergency treatment of strokeoutcome assessment

Identifiers

PMID37456628
PMCPMC10344771

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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.