Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Showing posts with label disability prediction. Show all posts
Showing posts with label disability prediction. Show all posts

Wednesday, September 18, 2024

Logistic regression analysis and machine learning for predicting post-stroke gait independence: a retrospective study

 What the fuck good does this prediction do? You need to do useful research; like creating EXACT PROTOCOLS that deliver gait independence.  Are your mentors and senior researchers that blitheringly stupid?

Send me hate mail on this: oc1dean@gmail.com. I'll print your complete statement with your name and my response in my blog. Or are you afraid to engage with my stroke-addled mind? Your patients need an explanation of why you aren't working on 100% recovery protocols, not this useless prediction crapola!

Logistic regression analysis and machine learning for predicting post-stroke gait independence: a retrospective study

Abstract

This study investigated whether machine learning (ML) has better predictive accuracy than logistic regression analysis (LR) for gait independence at discharge in subacute stroke patients (n = 843) who could not walk independently at admission. We developed prediction models using LR and five ML algorithms—specifically, the decision tree (DT), support vector machine, artificial neural network, ensemble learning, and k-nearest neighbor methods. Functional Independence Measure sub-items were used to evaluate the ability to walk independently. Model predictive accuracies were evaluated using areas under receiver operating characteristic curves (AUCs) as well as accuracy, precision, recall, F1 score, and specificity. The AUC for DT (0.812) was significantly lower than those for the other algorithms (p < 0.01); however, the AUC for LR (0.895) did not differ significantly from those for the other models (0.893–0.903). Other performance metrics showed no substantial differences between LR and ML algorithms. In conclusion, the DT algorithm had significantly low predictive accuracy, and LR showed no significant difference in predictive accuracy compared with the other ML algorithms. As its predictive accuracy is similar to that of ML, LR can continue to be used for predicting the prognosis of gait independence, with additional advantages of being easily understandable and manually computable.

Tuesday, September 22, 2020

Early neurological deterioration following thrombolysis for minor stroke with isolated internal carotid artery occlusion

 

And just WHY THE FUCK are you predicting disability rather than producing recovery? Useless.

 The latest here:

Early neurological deterioration following thrombolysis for minor stroke with isolated internal carotid artery occlusion

First published: 21 September 2020

This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi:10.1111/ene.14541

Abstract

Background

Better understanding the incidence, predictors and mechanisms of early neurological deterioration (END) following intravenous thrombolysis (IVT) for acute stroke with mild symptoms and isolated internal carotid artery occlusion (iICAo) may inform therapeutic decisions.

Methods

From a multicenter retrospective database we extracted all patients with both NIHSS<6 and iICAo (i.e. not involving the Willis circle) on admission imaging, intended for IVT alone. END was defined as ≥4 NIHSS points increase within 24hrs. END and no‐END patients were compared for i) pre‐treatment clinical and imaging variables, and ii) occurrence of intracranial occlusion, carotid recanalization and parenchymal hemorrhage on follow‐up imaging.

Results

Seventy‐four patients were included, among whom 22 (30%) patients experienced END. Among pre‐treatment variables, supra‐bulbar carotid occlusion was the only admission predictor of END following stepwise variable selection (OR=4.0; 95%CI 1.3‐12.2; P=0.015). On follow‐up imaging, there was no instance of parenchymal hemorrhage but an intracranial occlusion was now present in 76% vs. 0% of END and no‐END patients, respectively (P<0.001), and there was a trend towards higher carotid recanalization rate in END patients (29% vs. 9%, P=0.07). As compared to no‐END, END was strongly associated with poor 3‐month outcome.

Conclusions

END is a frequent and highly deleterious event after IVT for minor stroke with iICAo, and is of thrombo‐embolic origin in 3 out of 4 patients. The strong association with iICAo site –largely a function of underlying stroke etiology– may point to a different response of the thrombus to IVT. These findings suggest END may be preventable in this setting.