http://stroke.ahajournals.org/content/44/11/3161.abstract.html?etoc
- Myzoon Ali, PhD;
- Rachael Fulton, MSc;
- Terry Quinn, MD;
- Marian Brady, PhD
- on behalf of the VISTA Collaboration*
+ Author Affiliations
- Correspondence to Myzoon Ali, PhD, Nursing, Midwifery and Allied Health Professions Research Unit, Buchanan House, Glasgow Caledonian University, Glasgow, G4 0B, United Kingdom. E-mail myzoon.ali@gcu.ac.uk
Abstract
Background and Purpose—Quality of life (QoL) is important to stroke survivors yet is often recorded as a secondary measure in acute stroke randomized
controlled trials. We examined whether commonly used stroke outcome measures captured aspects of QoL.
Methods—We examined
primary outcomes by National Institutes of Health Stroke Scale (NIHSS),
Barthel Index (BI) and modified Rankin
Scale (mRS), and QoL by Stroke Impact Scale
(SIS) and European Quality of Life Scale (EQ-5D) from the Virtual
International
Stroke Trials Archive (VISTA). Using Spearman
correlations and logistic regression, we described the relationships
between
QoL mRS, NIHSS, and BI at 3 months,
stratified by respondent (patient or proxy). Using χ2 analyses, we examined the mismatch between good primary outcome (mRS ≤1, NIHSS ≤5, or BI ≥95) but poor QoL, and poor primary
outcome (mRS ≥3, NIHSS ≥20, or BI ≤60) but good QoL.
Results—Patient-assessed QoL had a stronger association with mRS (EQ-5D weighted score n=2987, P<0.0001, r=−0.7, r2=0.53; SIS recovery n=2970, P<0.0001, r=−0.71, r2=0.52). Proxy responses had a stronger association with BI (EQ-5D weighted score n=837, P<0.0001, r=0.78, r2=0.63; SIS recovery n=867, P<0.0001, r=0.68, r2=0.48). mRS explained more of the variation in QoL (EQ-5D weighted score=53%, recovery by SIS v3.0=52%) than NIHSS or BI and
resulted in fewer mismatches between good primary outcome and poor QoL (P<0.0001, EQ-5D weighted score=8.5%; SIS recovery=10%; SIS-16=4.4%).
Conclusions—The mRS
seemed to align closely with stroke survivors’ interests, capturing
more information on QoL than either NIHSS or BI.
This further supports its recommendation as a
primary outcome measure in acute stroke randomized controlled trials.
Hmmm ... I was mRS 2 on discharge, and still am now. Not enough precision, you think? I'd hate to look up the ORIGINAL RS.
ReplyDeleteI've also been a 2 for years, it doesn't align with my interests at all.
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