Utility-Weighted改良Rankin范围:推导和应用程序来完成中风试验(P5.008)

文摘

摘要目的:和评估的性能,得出utility-weighted版本的改良Rankin规模(夫人)评估全球残疾。背景:夫人是最普遍采用的主要终点急性中风试验,但它的力量是有限的,当分析以一分为二的方式和解释能力有限,当以顺序的方式进行了分析。加权7兰金水平公用事业规模可以提高精度,将从任意排列间距固定的间隔距离,直接反映病人和社会的估值结果残疾状态。设计/方法:效用值加权平均(UW-mRS)导出了二夫人的病人以人群为基础的研究和卫生专业人员在person-tradeoff研究。结果UW-mRS、标准顺序夫人,夫人一分为二在0 - 1,0,0 - 4被应用于13日试验和结果急性中风的治疗通常被认为是有益的。结果:效用值是:mrs0 - 1.0;mrs1 - 0.91;mrs2 - 0.76;mrs3 - 0.65;mrs4 - 0.33;mRS5-0;mRS6-0。结局公用事业增加了名义上的干涉臂在所有13个治疗比较,除了4.5 6 h IV TPA治疗窗口。UW-mRS通常平行顺序夫人掌权,除非治疗影响是双向的(益处和害处)。在所有的比较> 3 h干预对于大型缺血性中风,UW-mRS,序数,夫人和一分为二0 - 2 3 5的试验,都积极和一分为二在2 5 0 - 1和0 - 4积极。 The UW-mRS, similar to the ordinal, showed superior power to dichotomized analyses when treatment benefits accrued at multiple health state transitions, and less power when treatment effects concentrated at a single health state transition.结论:太太太太utility-weighted执行同样的标准依次检测治疗效果在实际中风试验和在保证定量的结果是一个有效的反映了以病人为中心的好处。研究支持:

披露:Chaisinanunkul博士没有披露。节省博士已经收到个人活动与加州大学的补偿BrainsGate, CoAxia, ev3, Talecris, PhotoThera Sygnis, Stryker。节省博士已经收到了来自加州大学的研究支持和美国国立卫生研究院。Jovin博士已经收到个人活动与Covidein补偿,同心医疗Inc . Stryker,丝绸之路的医疗。Jovin博士已经收到个人补偿能力神经影像学杂志》的一篇社论。贝里博士已经收到个人活动与Stryker补偿。刘易斯博士已经收到个人活动与Stryker补偿。李医生已收到个人活动与Stryker补偿。李医生收到各公司及机构的研究支持。可•福尔兰正博士已经收到个人活动与NMT波士顿医疗补偿,森林实验室,Inc . Bristol-Meyers施贵宝制药公司,Stryker,赛诺菲-安万特制药。 Dr. Baxter has received personal compensation for activities with Stryker. Dr. Lutsep has received personal compensation for activities with Concentric Medical, Stryker, Co-Axia and AGA Medical. Dr. Lutsep has received personal compensation in an editorial capacity for the eMedicine Neurology Journal, Dr. Ribo has received personal compensation for activities with Stryker. Dr. Jansen has received personal compensation for activities with Stryker. Dr. Gupta has received personal compensation for activities with Stryker Neurovascular, Rapid Medical, and Covidien. Dr. Gupta has received personal compensation in an editorial capacity with the Journal of Neuroimaging, and Interventional Neurology. Dr. Pereira-Mendes has received personal compensation for activities with Stryker. Dr. Nogueira has received personal compensation for activities with Concentric Medical, Inc., ev3 Neurovascular, Inc., Coaxia, Inc., and Rapid Medical, Inc.