{"corpus_id":8754539,"paper_sha":"282144b080a2ef1347edc8739f3113be2a28c8eb","doi":"10.1161/01.STR.30.8.1538","arxiv_id":null,"pmid":10436097,"pmcid":null,"mag_id":1996336451,"dblp_id":null,"acl_id":null,"title":"Use of the Barthel index and modified Rankin scale in acute stroke trials.","year":1999,"publication_date":"1999-08-01","venue":"Stroke","journal":{"name":"Stroke","pages":"\n          1538-41\n        ","volume":"30 8"},"journal_issn":null,"journal_title":null,"publication_types":["JournalArticle","Study"],"pubmed_pub_types":["Comparative Study","Journal Article","Research Support, Non-U.S. Gov't"],"s2_fields_of_study":["Medicine"],"reference_count":27,"citation_count":1102,"influential_citation_count":30,"is_open_access":true,"arxiv_categories":null,"arxiv_license":null,"arxiv_journal_ref":null,"mesh_headings":[{"d":"Acute Disease","mj":false,"ui":"D000208"},{"d":"Brain Ischemia","mj":false,"qs":[{"q":"classification","mj":false,"ui":"Q000145"},{"q":"drug therapy","mj":false,"ui":"Q000188"},{"q":"rehabilitation","mj":true,"ui":"Q000534"}],"ui":"D002545"},{"d":"Clinical Trials, Phase III as Topic","mj":true,"ui":"D017326"},{"d":"Disability Evaluation","mj":true,"ui":"D004185"},{"d":"Fibrinolytic Agents","mj":false,"qs":[{"q":"therapeutic use","mj":false,"ui":"Q000627"}],"ui":"D005343"},{"d":"Humans","mj":false,"ui":"D006801"},{"d":"Randomized Controlled Trials as Topic","mj":false,"ui":"D016032"},{"d":"Retrospective Studies","mj":false,"ui":"D012189"},{"d":"Severity of Illness Index","mj":true,"ui":"D012720"},{"d":"Thrombolytic Therapy","mj":false,"ui":"D015912"},{"d":"Treatment Outcome","mj":false,"ui":"D016896"}],"chemicals":[{"n":"Fibrinolytic Agents","ui":"D005343","reg":"0"}],"comments_corrections":null,"source_flags":5,"s2_open_access_pdf_url":"https://www.ahajournals.org/doi/pdf/10.1161/01.STR.30.8.1538","s2_open_access_landing_url":"https://www.semanticscholar.org/paper/282144b080a2ef1347edc8739f3113be2a28c8eb","s2_open_access_license":null,"s2_open_access_status":"BRONZE","pmc_open_access_pdf_url":null,"pmc_open_access_landing_url":null,"pmc_open_access_license":null,"pmc_open_access_status":null,"unpaywall_open_access_pdf_url":null,"unpaywall_open_access_landing_url":null,"unpaywall_open_access_license":null,"unpaywall_open_access_status":null,"abstract":"BACKGROUND AND PURPOSE: The Barthel Index (BI) and the Modified Rankin Scale (MRS) are commonly used scales that measure disability or dependence in activities of daily living in stroke victims. The objective of this study was to investigate how these scales were used and interpreted in acute stroke trials. METHODS: We identified from MEDLINE the major efficacy trials with neuroprotective drugs, thrombolytic drugs, and anticoagulants in acute ischemic stroke published between January 1995 and December 1998. We selected those trials that used the BI and/or MRS as outcome parameters. RESULTS: Fifteen trials fulfilling the inclusion criteria were identified. The BI was used in 13 and the MRS in 8. In 4 trials mean and median scores of the BI were used, and in 1 trial median scores of the MRS were compared. Primary end points included the BI in 7, the MRS in 6, and both the BI and MRS in 3. With regard to the BI, a variety of sum scores between 50 and 95 were used as cutoff scores to define favorable outcome. Favorable outcome on the MRS was defined as either </=1 or </=2. CONCLUSIONS: Among the efficacy trials in acute stroke, we found remarkable differences in the choice of primary end points and in the definition of favorable outcome on both the BI and MRS. This lack of consensus strongly hinders the design, interpretation, and comparison of acute stroke trials. In general, it may be easier to define poor outcome instead of favorable outcome. Poor outcome could be defined if any of the following end points are reached: death, institutionalization due to stroke, MRS >3, or BI <60.","claims":[{"public_id":"cl_a9c8fe17c8db0f301324632e8187fdef","status":"active","text":"Defining poor outcome may be easier than defining favorable outcome, potentially using endpoints such as death, institutionalization, Modified Rankin Scale greater than 3, or Barthel Index less than 60.","confidence":0.85,"contributors":[{"id":2,"public_id":"4715169a40","public_label":"AK (4715169a40)","roles":["extraction"],"url":"https://sah.borca.ai/u/4715169a40"},{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["review"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_a9c8fe17c8db0f301324632e8187fdef"},{"public_id":"cl_c43d455cb011148c5944e750430db97d","status":"active","text":"Efficacy trials in acute stroke show remarkable differences in the choice of primary endpoints and the definition of favorable outcome on the Barthel Index and Modified Rankin Scale.","confidence":0.95,"contributors":[{"id":2,"public_id":"4715169a40","public_label":"AK (4715169a40)","roles":["extraction"],"url":"https://sah.borca.ai/u/4715169a40"},{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["review"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_c43d455cb011148c5944e750430db97d"},{"public_id":"cl_9274f082dd96c932dd0af520e14ae345","status":"active","text":"Favorable outcome on the Barthel Index was defined using a variety of sum scores between 50 and 95, while on the Modified Rankin Scale it was defined as a score of less than or equal to 1 or 2.","confidence":0.9,"contributors":[{"id":2,"public_id":"4715169a40","public_label":"AK (4715169a40)","roles":["extraction"],"url":"https://sah.borca.ai/u/4715169a40"},{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["review"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_9274f082dd96c932dd0af520e14ae345"}],"concepts":[{"public_id":"co_0556c53b67825cddcfa08f0f5aec40cf","status":"active","name":"primary endpoint","description":"The primary outcome measure used to determine the success of an intervention in clinical trials.","types":["study design"],"aliases":[],"contributors":[{"id":2,"public_id":"4715169a40","public_label":"AK (4715169a40)","roles":["extraction"],"url":"https://sah.borca.ai/u/4715169a40"},{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["review"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_0556c53b67825cddcfa08f0f5aec40cf"},{"public_id":"co_1703883239cdbad816196c58e201a5e4","status":"active","name":"favorable outcome","description":"A predefined threshold on a disability scale indicating a successful or positive treatment result.","types":["outcome definition"],"aliases":[],"contributors":[{"id":2,"public_id":"4715169a40","public_label":"AK (4715169a40)","roles":["extraction"],"url":"https://sah.borca.ai/u/4715169a40"},{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["review"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_1703883239cdbad816196c58e201a5e4"},{"public_id":"co_27d6fe60f57bcd2050efacf489766023","status":"active","name":"poor outcome","description":"A predefined threshold on a disability scale indicating a negative or unsuccessful treatment result.","types":["outcome definition"],"aliases":[],"contributors":[{"id":2,"public_id":"4715169a40","public_label":"AK (4715169a40)","roles":["extraction"],"url":"https://sah.borca.ai/u/4715169a40"},{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["review"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_27d6fe60f57bcd2050efacf489766023"},{"public_id":"co_57e8249ad430f89428bc3cc12e1fd5cc","status":"active","name":"sum scores","description":"The statistical summary of scores (mean or median) used to compare groups in the identified trials.","types":["statistical measure"],"aliases":[],"contributors":[{"id":2,"public_id":"4715169a40","public_label":"AK (4715169a40)","roles":["extraction"],"url":"https://sah.borca.ai/u/4715169a40"},{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["review"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_57e8249ad430f89428bc3cc12e1fd5cc"},{"public_id":"co_599d15a0622cf254b6a603d9d6a5e50c","status":"active","name":"lack of consensus","description":"The lack of agreement on how to define success or failure in stroke trials, hindering comparison.","types":["study finding"],"aliases":[],"contributors":[{"id":2,"public_id":"4715169a40","public_label":"AK (4715169a40)","roles":["extraction"],"url":"https://sah.borca.ai/u/4715169a40"},{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["review"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_599d15a0622cf254b6a603d9d6a5e50c"},{"public_id":"co_5c4af9bff63b9b6c9f32224fc9bbb87f","status":"active","name":"Modified Rankin Scale","description":"A scale measuring disability or dependence in activities of daily living in stroke victims.","types":["measurement scale"],"aliases":["MRS"],"contributors":[{"id":2,"public_id":"4715169a40","public_label":"AK (4715169a40)","roles":["extraction"],"url":"https://sah.borca.ai/u/4715169a40"},{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["review"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_5c4af9bff63b9b6c9f32224fc9bbb87f"},{"public_id":"co_71a99dfd2e09bb687534780b753f4abb","status":"active","name":"Barthel Index","description":"A scale measuring disability or dependence in activities of daily living in stroke victims.","types":["measurement scale"],"aliases":["BI"],"contributors":[{"id":2,"public_id":"4715169a40","public_label":"AK (4715169a40)","roles":["extraction"],"url":"https://sah.borca.ai/u/4715169a40"},{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["review"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_71a99dfd2e09bb687534780b753f4abb"},{"public_id":"co_fba8b72c4aaa5364add09d38c54eede3","status":"active","name":"acute stroke trials","description":"Clinical trials evaluating neuroprotective, thrombolytic, or anticoagulant drugs for acute ischemic stroke.","types":["study design"],"aliases":[],"contributors":[{"id":2,"public_id":"4715169a40","public_label":"AK (4715169a40)","roles":["extraction"],"url":"https://sah.borca.ai/u/4715169a40"},{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["review"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_fba8b72c4aaa5364add09d38c54eede3"}],"external_ids":{"DOI":"10.1161/01.STR.30.8.1538","ArXiv":null,"PubMed":10436097,"PubMedCentral":null,"MAG":1996336451,"DBLP":null,"ACL":null},"open_access":{"is_open_access":true,"pdf_url":"https://www.ahajournals.org/doi/pdf/10.1161/01.STR.30.8.1538","landing_url":"https://www.semanticscholar.org/paper/282144b080a2ef1347edc8739f3113be2a28c8eb","source":"semantic_scholar","pdf_url_source":"semantic_scholar_open_access_pdf","license":null,"status":"BRONZE","reason":null},"reference_availability":{"status":"available","references_indexed":true,"full_text_available":false,"full_text_source":null,"count_basis":"semantic_scholar_metadata","extraction_status":"not_applicable","reason":null},"source":{"provider":"episteme2","base_corpus":"semantic_scholar_dump","freshness_mode":"unknown","basis":["semantic_scholar_metadata","postgres_metadata"],"limits":["paper metadata is based on indexed upstream scholarly datasets","claims and concepts are available only for extracted papers","absence of claims or concepts means no extracted graph data is available in this response"],"status":"available","degraded":false,"degraded_reasons":[],"diagnostics":{"status":"available","degraded":false,"degraded_reasons":[],"metadata_status":"available","graph_status":"available","abstract_status":"available"},"source_flags":5},"paper_id":630547,"paper_uid":"8aa42d4b-d8dc-41c5-aba0-737fdbd1e253","canonical_identity":{"paper_id":630547,"paper_uid":"8aa42d4b-d8dc-41c5-aba0-737fdbd1e253","identity_status":"available","lookup_basis":"semantic_scholar_external_id","compatibility_path":"corpus_id"},"url":"https://sah.borca.ai/papers/8754539"}