Validating the Stroke-Thrombolytic Predictive Instrument in a Population in the United Kingdom

Peter McMeekin; Darren Flynn; Gary A. Ford; Helen Rodgers; Richard G. Thomson

doi:10.1161/STROKEAHA.112.671073

Validating the Stroke-Thrombolytic Predictive Instrument in a Population in the United Kingdom

Peter McMeekin, Darren Flynn, Gary A. Ford, Helen Rodgers, Richard G. Thomson

Nursing Midwifery and Health Department

Research output: Contribution to journal › Article › peer-review

7 Citations (Scopus)

Abstract

Background and Purpose: This study aimed to test the explanatory qualities of the Stroke-Thrombolytic Predictive Instrument (S-TPI) when applied to patients treated in routine practice. Methods: S-TPI predictions were compared with observed outcomes in terms of normal/near-normal (modified Rankin Scale score, ≤1) and catastrophic outcome (modified Rankin Scale score, ≥5) at 3 months. Logistic regression was used to calibrate and expand the S-TPI. Results: The S-TPI overestimated probability of catastrophic outcomes and overestimated the probability of a normal/near normal outcome above 0.4 and underestimated those below. Calibrating the S-TPI minimized discrepancies between predicted and observed outcomes, in the case of normal/near-normal outcomes, where including additional predictors (serum glucose and signs of current infarction on pretreatment brain scan) further reduced discrepancies between predicted and observed outcomes. Conclusions: The explanatory power of the S-TPI in thrombolytic-treated patients can be improved to reflect outcomes seen in routine practice.

Original language	English
Pages (from-to)	3378-3381
Number of pages	4
Journal	Stroke
Volume	43
Issue number	12
Early online date	25 Sept 2012
DOIs	https://doi.org/10.1161/STROKEAHA.112.671073
Publication status	Published - 1 Dec 2012

Keywords

acute stroke
clinical decision support
predictive models
thrombolysis

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1161/STROKEAHA.112.671073

Cite this

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title = "Validating the Stroke-Thrombolytic Predictive Instrument in a Population in the United Kingdom",

abstract = "Background and Purpose: This study aimed to test the explanatory qualities of the Stroke-Thrombolytic Predictive Instrument (S-TPI) when applied to patients treated in routine practice. Methods: S-TPI predictions were compared with observed outcomes in terms of normal/near-normal (modified Rankin Scale score, ≤1) and catastrophic outcome (modified Rankin Scale score, ≥5) at 3 months. Logistic regression was used to calibrate and expand the S-TPI. Results: The S-TPI overestimated probability of catastrophic outcomes and overestimated the probability of a normal/near normal outcome above 0.4 and underestimated those below. Calibrating the S-TPI minimized discrepancies between predicted and observed outcomes, in the case of normal/near-normal outcomes, where including additional predictors (serum glucose and signs of current infarction on pretreatment brain scan) further reduced discrepancies between predicted and observed outcomes. Conclusions: The explanatory power of the S-TPI in thrombolytic-treated patients can be improved to reflect outcomes seen in routine practice.",

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AU - Thomson, Richard G.

N1 - Funding information: This article presents independent research commissioned by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research scheme (RP-PG-0606-1241). The views -expressed in this publication are those of the authors and are not -necessarily those of the NHS, the NIHR, or the Department of Health.

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Y1 - 2012/12/1

N2 - Background and Purpose: This study aimed to test the explanatory qualities of the Stroke-Thrombolytic Predictive Instrument (S-TPI) when applied to patients treated in routine practice. Methods: S-TPI predictions were compared with observed outcomes in terms of normal/near-normal (modified Rankin Scale score, ≤1) and catastrophic outcome (modified Rankin Scale score, ≥5) at 3 months. Logistic regression was used to calibrate and expand the S-TPI. Results: The S-TPI overestimated probability of catastrophic outcomes and overestimated the probability of a normal/near normal outcome above 0.4 and underestimated those below. Calibrating the S-TPI minimized discrepancies between predicted and observed outcomes, in the case of normal/near-normal outcomes, where including additional predictors (serum glucose and signs of current infarction on pretreatment brain scan) further reduced discrepancies between predicted and observed outcomes. Conclusions: The explanatory power of the S-TPI in thrombolytic-treated patients can be improved to reflect outcomes seen in routine practice.

AB - Background and Purpose: This study aimed to test the explanatory qualities of the Stroke-Thrombolytic Predictive Instrument (S-TPI) when applied to patients treated in routine practice. Methods: S-TPI predictions were compared with observed outcomes in terms of normal/near-normal (modified Rankin Scale score, ≤1) and catastrophic outcome (modified Rankin Scale score, ≥5) at 3 months. Logistic regression was used to calibrate and expand the S-TPI. Results: The S-TPI overestimated probability of catastrophic outcomes and overestimated the probability of a normal/near normal outcome above 0.4 and underestimated those below. Calibrating the S-TPI minimized discrepancies between predicted and observed outcomes, in the case of normal/near-normal outcomes, where including additional predictors (serum glucose and signs of current infarction on pretreatment brain scan) further reduced discrepancies between predicted and observed outcomes. Conclusions: The explanatory power of the S-TPI in thrombolytic-treated patients can be improved to reflect outcomes seen in routine practice.

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Validating the Stroke-Thrombolytic Predictive Instrument in a Population in the United Kingdom

Abstract

Keywords

UN SDGs

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