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

McMeekin, Peter, Flynn, Darren, Ford, Gary, Rodgers, Helen and Thomson, Richard G. (2012) Validating the Stroke-Thrombolytic Predictive Instrument in a Population in the United Kingdom. Stroke, 43 (12). pp. 3378-3381. ISSN 0039-2499

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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.

Item Type:	Article
Additional Information:	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.
Uncontrolled Keywords:	acute stroke, clinical decision support, predictive models, thrombolysis
Subjects:	B900 Others in Subjects allied to Medicine
Department:	Faculties > Health and Life Sciences > Nursing, Midwifery and Health
Depositing User:	Becky Skoyles
Date Deposited:	13 Aug 2015 08:22
Last Modified:	10 Nov 2021 11:27
URI:	http://nrl.northumbria.ac.uk/id/eprint/23557

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