The Barthel Index and modified Rankin Scale as prognostic tools for long-term outcomes after stroke: a qualitative review of the literature
Why this work is in the frame
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Bibliographic record
Abstract
OBJECTIVE: Providing a quantitative prognosis after a stroke is important to clinicians and patients as well as to researchers interested in projecting the results of clinical trials and other studies. Thus, we critically reviewed the evidence supporting the prognostic value of two frequently-used measures, the Barthel Index (BI) and modified Rankin Scale (mRS) for long-term outcomes. METHODS: A narrative review of the peer-reviewed medical literature obtained by searching Medline 1966 to January 2004--using the phrase '[stroke] AND [Barthel OR Rankin]'--was conducted to assess the strength of the evidence for these measures and answer three main questions: How good are the BI and mRS at predicting (1) the level of care required, (2) the time-course of recovery, and (3) mortality. Abstracts were screened for the presence of actual data on the prognostic impact of BI and mRS on these endpoints, and selected articles were fully reviewed and abstracted. Additional articles were identified from bibliographies of the retrieved papers. RESULTS: Of 753 abstracts screened, 89 articles were selected for detailed assessment. Early disability and global outcome (< or = 7 days) were shown in 21 studies to be strong predictors of care needs. This relation appears to be mainly biological, not country-specific. Recovery was shown in 18 studies to be strongly related to early BI. In contrast, the 11 studies examining mortality provided insufficient information to directly support the prognostic value of either measure. Key limitations of this review include heterogeneity of available studies (e.g., time-points, outcome, parameterization) and relative lack of information on the mRS. CONCLUSIONS: Despite the lack of uniformity in existing studies, the evidence overall is quite strong, supporting the use of BI and mRS as prognostic tools. External non-treatment modifiable factors which also determine long-term outcome (e.g., social support) have to be taken into account.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.025 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it