Abstract:
OBJECTIVE:To compare the prognostic accuracy of various acute stroke prognostic scales using a large, independent, clinical trials dataset. METHODS:We directly compared 8 stroke prognostic scales, chosen based on focused literature review (Acute Stroke Registry and Analysis of Lausanne [ASTRAL]; iSCORE; iSCORE-revised; preadmission comorbidities, level of consciousness, age, and neurologic deficit [PLAN]; stroke subtype, Oxfordshire Community Stroke Project, age, and prestroke modified Rankin Scale [mRS] [SOAR]; modified SOAR; Stroke Prognosis Instrument 2 [SPI2]; and Totaled Health Risks in Vascular Events [THRIVE]) using individual patient-level data from a clinical trials archive (Virtual International Stroke Trials Archive [VISTA]). We calculated area under receiver operating characteristic curves (AUROC) for each scale against 90-day outcomes of mRS (dichotomized at mRS >2), Barthel Index (>85), and mortality. We performed 2 complementary analyses: the first limited to patients with complete data for all components of all scales (simultaneous) and the second using as many patients as possible for each individual scale (separate). We compared AUROCs and performed sensitivity analyses substituting extreme outcome values for missing data. RESULTS:In total, 10,777 patients contributed to the analyses. Our simultaneous analyses suggested that ASTRAL had greatest prognostic accuracy for mRS, AUROC 0.78 (95% confidence interval [CI] 0.75-0.82), and SPI2 had poorest AUROC, 0.61 (95% CI 0.57-0.66). Our separate analyses confirmed these results: ASTRAL AUROC 0.79 (95% CI 0.78-0.80 and SPI2 AUROC 0.60 (95% CI 0.59-0.61). On formal comparative testing, there was a significant difference in modified Rankin Scale AUROC between ASTRAL and all other scales. Sensitivity analysis identified no evidence of systematic bias from missing data. CONCLUSIONS:Our comparative analyses confirm differences in the prognostic accuracy of stroke scales. However, even the best performing scale had prognostic accuracy that may not be sufficient as a basis for clinical decision-making.
journal_name
Neurologyjournal_title
Neurologyauthors
Quinn TJ,Singh S,Lees KR,Bath PM,Myint PK,VISTA Collaborators.doi
10.1212/WNL.0000000000004332subject
Has Abstractpub_date
2017-09-05 00:00:00pages
997-1002issue
10eissn
0028-3878issn
1526-632Xpii
WNL.0000000000004332journal_volume
89pub_type
杂志文章相关文献
NEUROLOGY文献大全abstract:OBJECTIVE:To investigate the risk factors of neutralizing antibody (NAB)-induced complete secondary treatment failure (cSTF) during long-term botulinum neurotoxin (BoNT) treatment in various neurologic indications. METHODS:This monocenter retrospective cohort study analyzed the data of 471 patients started on BoNT the...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000009444
更新日期:2020-05-19 00:00:00
abstract::Fourteen patients with Alzheimer's disease were evaluated by psychometric testing, fluorodeoxyglucose positron emission tomography (PET), and EEG. They were divided into two groups according to the EEG findings. Group A (seven patients) had normal alpha backgrounds and group B (seven patients) had decreased alpha back...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.38.5.747
更新日期:1988-05-01 00:00:00
abstract:BACKGROUND:Although about 7 million people in the US population use marijuana at least weekly, there is a paucity of scientific data on persistent neurocognitive effects of marijuana use. OBJECTIVE:To determine if neurocognitive deficits persist in 28-day abstinent heavy marijuana users and if these deficits are dose-...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000031422.66442.49
更新日期:2002-11-12 00:00:00
abstract:OBJECTIVE:To assess the determinants of amyotrophic lateral sclerosis (ALS) phenotypes in a population-based cohort. METHODS:The study population included 2,839 patients with ALS diagnosed in Piemonte, Italy (1995-2015). Patients were classified according to motor (classic, bulbar, flail arm, flail leg, predominantly ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000008869
更新日期:2020-02-25 00:00:00
abstract:OBJECTIVE:To determine the clinical value of JC virus (JCV) detection in various anatomic compartments for the diagnosis of progressive multifocal leukoencephalopathy (PML). METHODS:CSF, peripheral blood mononuclear cells (PBMC), plasma, and urine samples were evaluated from HIV-infected and uninfected individuals. JC...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.52.2.253
更新日期:1999-01-15 00:00:00
abstract:OBJECTIVE:To define the natural history of the C9orf72 amyotrophic lateral sclerosis (C9ALS) patient population, develop disease biomarkers, and characterize patient pathologies. METHODS:We prospectively collected clinical and demographic data from 116 symptomatic C9ALS and 12 non-amyotrophic lateral sclerosis (ALS) f...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000008359
更新日期:2019-10-22 00:00:00
abstract::A prospective trial of plasmapheresis and azathioprine or azathioprine alone was carrier out on 20 patients with chronic progressive MS. Seven of 10 patients in each group continued therapy for 12 months. When the groups were compared by disability ratings, the combination of plasmapheresis and azathioprine was no bet...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.32.7.739
更新日期:1982-07-01 00:00:00
abstract::In a 24-week, randomized, double-blind, placebo-controlled, multicenter study of rivastigmine, 487 patients with dementia associated with Parkinson disease underwent assessment of attention on the Cognitive Drug Research computerized cognitive assessment system before dosing and 16 and 24 weeks later. Significant bene...
journal_title:Neurology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1212/01.wnl.0000184517.69816.e9
更新日期:2005-11-22 00:00:00
abstract:OBJECTIVE:We aimed to create an index to stratify cryptogenic stroke (CS) patients with patent foramen ovale (PFO) by their likelihood that the stroke was related to their PFO. METHODS:Using data from 12 component studies, we used generalized linear mixed models to predict the presence of PFO among patients with CS, a...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0b013e3182a08d59
更新日期:2013-08-13 00:00:00
abstract::High plasma levels of 3-O-methyldopa (OMD) were found in parkinsonian patients chronically treated with levodopa, particularly in those with on-off phenomenon. However, no relation could be established between circulating levels of the levodopa metabolite and the presence of motor response fluctuations at any stage of...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.37.5.856
更新日期:1987-05-01 00:00:00
abstract::All Olmsted County, Minnesota, residents who experienced brain injury from 1935 through 1979 were identified and their medical records reviewed for survival and neurologic outcome. Minimum inclusion criteria included loss of consciousness or post-traumatic amnesia or neurologic evidence of brain injury or skull fractu...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.39.1.96
更新日期:1989-01-01 00:00:00
abstract::Plasma exchange (PE) was shown in a previous double-blind randomized controlled study to confer significant additional benefit at 1 year upon patients with chronic progressive multiple sclerosis (CPMS) treated with immunosuppressive drug therapy (ISDT). Efficacy over an extended term, indications for retreatment, and ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.41.3.409
更新日期:1991-03-01 00:00:00
abstract:OBJECTIVE:To identify the genetic and physiologic basis for recessive myasthenic congenital myopathy in 2 families, suggestive of a channelopathy involving the sodium channel gene, SCN4A. METHODS:A combination of whole exome sequencing and targeted mutation analysis, followed by voltage-clamp studies of mutant sodium ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000007185
更新日期:2019-03-26 00:00:00
abstract:BACKGROUND:Both AD and normal aging cause brain atrophy, limiting the ability of MRI to distinguish between AD and age-related brain tissue loss. MRS imaging (MRSI) measures the neuronal marker N-acetylaspartate (NAA), which could help assess brain change in AD and aging. OBJECTIVES:To determine the effects of AD on c...
journal_title:Neurology
pub_type: 杂志文章,多中心研究
doi:10.1212/wnl.58.6.928
更新日期:2002-03-26 00:00:00
abstract:OBJECTIVE:To assess whether hippocampal sclerosis (HS) severity is mirrored at the level of large-scale networks. METHODS:We studied preoperative high-resolution anatomical and diffusion-weighted MRI of 44 temporal lobe epilepsy (TLE) patients with histopathologic diagnosis of HS (n = 25; TLE-HS) and isolated gliosis ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000007447
更新日期:2019-05-07 00:00:00
abstract::A 33-year-old man with untreated hypertension had sudden onset of signs and symptoms suggestive of a dorsal lateral medullary syndrome. He died after 27 days. Postmortem studies revealed intramedullary hemorrhage with extension into the fourth ventricle and hypertensive cardiovascular disease. ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.35.6.925
更新日期:1985-06-01 00:00:00
abstract:OBJECTIVE:To investigate the role of intragenic deletions of ALDH7A1 in patients with clinical and biochemical evidence of pyridoxine-dependent epilepsy but only a single identifiable mutation in ALDH7A1. METHODS:We designed a custom oligonucleotide array with high-density probe coverage across the ALDH7A1 gene. We pe...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000001883
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVE:To demonstrate whether the cerebral hemispheres (language dominant versus nondominant) affect immune function differentially in humans by delineating the effects of resections for epilepsy surgery on T-cell indices. BACKGROUND:Cerebral lateralization has been postulated to affect immunomodulation. Differenti...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.52.6.1183
更新日期:1999-04-12 00:00:00
abstract:OBJECTIVE:To assess the contribution of microstructural normal-appearing white matter (NAWM) damage to social cognition impairment, specifically in the theory of mind (ToM), in multiple sclerosis (MS). METHODS:We enrolled consecutively 60 patients with MS and 60 healthy controls (HC) matched on age, sex, and education...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000004060
更新日期:2017-07-04 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Posterior cortical atrophy (PCA) is a progressive neurodegenerative syndrome that presents with cortical visual dysfunction and relatively preserved memory. Although higher cortical visual syndromes are well known in PCA, visual field defects detected by computerized visual field (CVF) perimetr...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0b013e31823e9f2a
更新日期:2011-12-13 00:00:00
abstract:OBJECTIVES:Observational and experimental studies suggest that nonsteroidal anti-inflammatory drugs (NSAIDs) may protect against Alzheimer disease (AD); however, clinical trials and other observational studies, including the Adult Changes in Thought (ACT) study, show no protection or promotion of AD. The objective of t...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0b013e3181f52db1
更新日期:2010-09-28 00:00:00
abstract:OBJECTIVE:-To determine whether pre-treatment cerebral microbleeds (CMBs) presence and burden are correlated with an increased risk of intracranial hemorrhage (ICH) or poor functional outcome following endovascular thrombectomy (EVT) for acute ischemic stroke (AIS). METHODS:-Consecutive patients treated by EVT for ant...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000011566
更新日期:2021-01-25 00:00:00
abstract::A patient with clinical and radiographic findings initially suggesting a neoplasm was diagnosed as having Hodgkin disease. Computerized axial tomography demonstrated profound diffuse decreased density similar to that seen in cases of cerebral edema or leukomalacia. Cerebral angiography showed blood vessels with a bead...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.27.6.588
更新日期:1977-06-01 00:00:00
abstract::Relating the onset of clinical attacks as recorded on a videotape to surface and depth electrographic events improves our ability to define the local or diffuse origin of seizures. In two patients with complex partial seizures, all 14 attacks appeared 3 to 6 seconds after focal discharges began in the amygdala or hipp...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.29.4.473
更新日期:1979-04-01 00:00:00
abstract::Ten patients with amyotrophic lateral sclerosis were given intrathecal injections of natural interferon alpha, 1 million units weekly for 7 to 24 weeks. Six patients completed the trial. Four voluntarily withdrew after 7 to 13 injections. The slopes of deterioration for 40 quantitative tests of neuromuscular function ...
journal_title:Neurology
pub_type: 临床试验,杂志文章
doi:10.1212/wnl.36.8.1137
更新日期:1986-08-01 00:00:00
abstract::Systematic screening of many compounds in animal models led to identification of the established antiepileptic drugs (AEDs). By contrast, the newer AEDs were specifically designed to enhance an inhibitory process or to inhibit a specific excitatory pathway. However, it was later discovered that some of the designed dr...
journal_title:Neurology
pub_type: 杂志文章,评审
doi:
更新日期:2000-01-01 00:00:00
abstract::Using MRI, we investigated the morphology and blood-nerve barrier function of the peripheral nerve trunk in 10 patients with chronic inflammatory demyelinating polyneuropathy (CIDP). Eight patients had a focal demyelinative segment in the median or ulnar nerve trunk that was defined by conduction block or abnormal tem...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.48.4.874
更新日期:1997-04-01 00:00:00
abstract:BACKGROUND:In acute cerebral ischemia, two variables characterize the extent of hypoperfusion: the volume of hypoperfused tissue and the intensity of hypoperfusion within these regions. We evaluated the determinants of the intensity of hypoperfusion within oligemic regions among patients who were eligible for recanaliz...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000335929.06390.d3
更新日期:2008-11-25 00:00:00
abstract::We analyzed the association of HLA-DR and -DQ haplotypes and alleles with multiple sclerosis (MS) in 91 patients and 91 controls from Iceland using the relative predispositional effect method. The aim was to establish whether there is heterogeneity in HLA associations with MS, whether there are both predispositional a...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.46.4.1107
更新日期:1996-04-01 00:00:00
abstract::We measured monoamine metabolites and biopterin in the CSF of 37 patients with dementia of the Alzheimer type (DAT), with or without extrapyramidal signs, and in 14 age-matched healthy controls. Compared with concentrations in DAT and controls, the concentrations of homovanillic acid (HVA) and biopterin were significa...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.38.4.554
更新日期:1988-04-01 00:00:00