Quality of Life Profiles in Brain Stroke Survivors Versus Community Controls: A Case–Control Study from an Under-Resourced District Hospital
Bibliographic record
Abstract
Background: Brain stroke is a leading cause of disability and mortality globally, profoundly impacting quality of life (QOL), particularly in under-resourced settings like rural Pakistan where rehabilitation access is limited. Few studies provide case-control comparisons of QOL, cognitive function, and functional independence in district-level hospitals, leaving gaps in understanding localized deficits and screening strategies. Objective: To compare QOL, cognitive function, and functional independence between stroke survivors and community controls at a district hospital in Narowal, Pakistan, and identify simple screening thresholds for low QOL. Methods: In a case-control study from September to November 2023 at District Head Quarter Hospital Narowal, 100 stroke survivors and 100 community controls were assessed using the WHOQOL-BREF, Montreal Cognitive Assessment (MoCA), and Barthel Index (BI). Independent t-tests, two-way ANOVA for age-stratified effects, and ROC analyses were conducted to compare groups and derive cut-offs for low QOL (≤25th percentile of control scores). Results: Stroke survivors showed significantly lower scores across all WHOQOL-BREF domains (p<0.01, Cohen’s d=1.57–3.02), MoCA (mean=15.35 vs. 29.15, p<0.001), and BI (mean=44.90 vs. 98.55, p<0.001), with older survivors (age >65) exhibiting steeper QOL declines (p<0.05). MoCA cut-offs (15–18) and BI cut-offs (45–55) achieved AUCs of 0.75–0.87 for detecting low QOL. Conclusion: Stroke survivors in rural Pakistan face substantial QOL, cognitive, and functional deficits, accentuated by age, necessitating accessible screening and targeted rehabilitation to improve outcomes. Keywords: Stroke, Quality of Life, Cognitive Impairment, Functional Independence, Case-Control Study, Pakistan
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How this classification was reachedexpand
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 | 0.015 | 0.031 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.008 |
| Insufficient payload (model declined to judge) | 0.003 | 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 itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
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".