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Record W4396920057 · doi:10.1136/jnnp-2024-333505

Implications for driving based on the risk of seizures after ischaemic stroke

2024· article· en· W4396920057 on OpenAlexaff
K Schubert, Giulio Bicciato, Lúcia Sinka, Laura Abraira, Estevo Santamarina, José Álvarez‐Sabín, Carolina Ferreira‐Atuesta, Mira Katan, Natalie Scherrer, Robert Terziev, Nico Döhler, Barbara Erdélyi‐Canavese, Ansgar Felbecker, Philip Siebel, Michael Winklehner, Tim J. von Oertzen, Judith Wagner, Gian Luigi Gigli, Annacarmen Nilo, Francesco Janes, Giovanni Merlino, Mariarosaria Valente, María Paula Zafra-Sierra, Luis Carlos Mayor‐Romero, Julian Conrad, Stefan Evers, Piergiorgio Lochner, Frauke Roell, Francesco Brigo, Carla Bentes, Ana Rita Peralta, Teresa Pinho e Melo, Mark R. Keezer, John S. Duncan, Josemir W. Sander, Barbara Tettenborn, Matthias J. Koepp, Marian Galovic

Bibliographic record

VenueJournal of Neurology Neurosurgery & Psychiatry · 2024
Typearticle
Languageen
FieldMedicine
TopicAcute Ischemic Stroke Management
Canadian institutionsCentre Hospitalier de l’Université de Montréal
FundersEpilepsy SocietySchweizerische HerzstiftungUniversity College LondonNational Institute for Health and Care ResearchSchweizerischer Nationalfonds zur Förderung der Wissenschaftlichen ForschungNational Science Foundation
KeywordsStatus epilepticusStroke (engine)MedicineIschaemic strokeEpilepsyAcute strokeCohortConfidence intervalEmergency medicineInternal medicineAnesthesiaPsychiatry

Abstract

fetched live from OpenAlex

Background In addition to other stroke-related deficits, the risk of seizures may impact driving ability after stroke. Methods We analysed data from a multicentre international cohort, including 4452 adults with acute ischaemic stroke and no prior seizures. We calculated the Chance of Occurrence of Seizure in the next Year (COSY) according to the SeLECT2.0prognostic model. We considered COSY<20% safe for private and <2% for professional driving, aligning with commonly used cut-offs. Results Seizure risks in the next year were mainly influenced by the baseline risk-stratified according to the SeLECT2.0score and, to a lesser extent, by the poststroke seizure-free interval (SFI). Those without acute symptomatic seizures (SeLECT2.00–6 points) had low COSY (0.7%–11%) immediately after stroke, not requiring an SFI. In stroke survivors with acute symptomatic seizures (SeLECT2.03–13 points), COSY after a 3-month SFI ranged from 2% to 92%, showing substantial interindividual variability. Stroke survivors with acute symptomatic status epilepticus (SeLECT2.07–13 points) had the highest risk (14%–92%). Conclusions Personalised prognostic models, such as SeLECT2.0, may offer better guidance for poststroke driving decisions than generic SFIs. Our findings provide practical tools, including a smartphone-based or web-based application, to assess seizure risks and determine appropriate SFIs for safe driving.

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.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.010
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.007
Threshold uncertainty score0.014

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0010.010
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.001
Bibliometrics0.0010.001
Science and technology studies0.0000.000
Scholarly communication0.0010.001
Open science0.0000.001
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0030.000

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.

Opus teacher head0.012
GPT teacher head0.268
Teacher spread0.256 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations6
Published2024
Admission routes1
Has abstractyes

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