Prognosis for Stroke Recovery: Current Evidence & Future Directions

Friday, November 11, 2022

11:00 AM – 12:15 PM

Presenter(s)

Allan J. Kozlowski, PhD, B.Sc. (PT)

Consultant
Mary Free Bed Rehabilitation Hospital
Grand Rapids, Michigan, United States

Slides Slides and Audio
Marianne H. Mortera, PhD, OTR/L

Visiting Assistant Professor
New York Uinversity
New York, New York, United States
Pey-Shan Wen, MHS, PHD, OTR/L

Associate professor
Georgia State University
Atlanta, Georgia, United States
John L. Melvin, MD, MMSc

Emeritus Professor and Chair
Sidney Kimmel Medical College at Thomas Jefferson University
Philadelphia, Pennsylvania, United States

Predicting recovery from stroke remains a challenge for clinicians, patients and their families, administrators, and payers. Most available prognostic models predict categorical probabilities at a single time point (e.g., 3- or 6-months post-stroke) that may be of limited utility in clinical practice. The PREP2 Algorithm, a newer categorical probability model predicts recovery at 3-months post-stroke with more granularity. In-development models predict recovery as individual-level trajectories offering more granularity over time and on the outcome. The trajectory predicts recovery on an outcome at all time points across a specified time frame adjusted to account for patients’ unique combination of individual characteristics. However, none of the available or in-development models fully meet the requirements of prognostic accuracy. Following presentation of the strengths and limitations of available models, we will engage the audience in a moderated panel discussion on future directions for development of prognostic models for recovery from stroke.

Learning Objectives:

Discuss criteria for predictive accuracy of prognostic models for stroke recovery
Compare and contrast two current prognostic models for recovery after stroke; one for upper extremity and one for lower extremity functioning
Compare and contrast two prototype trajectory models for prognosis of individual-level recovery
Discuss the strengths and limitations of outcomes based on body functions versus activity-level functioning
Discuss the implications of prognostic models for key stakeholders including clinicians, patients and their families, administrators, and payers