Improving outcome assessment in stroke rehabilitation trials

Stroke rehabilitation is a multi-faceted process that typically involves a team approach. Post stroke interventions may address a range of impairments, functional deficits and challenges of participation.

Aims

The aim of this project is to build on current efforts to improve the standards of outcome assessment by developing utility measures for existing ordinal scales. The work has the potential to have global impact.

For that reason, the development of agreed standards for measuring outcome after stroke has been challenging and there is currently no universally accepted or adopted measure that is used in clinical trials. The absence of agreement about how we should measure outcome after stroke has hampered our ability to pool results across trials (e.g. meta-analysis) to build the evidence base, and/or foster development of new treatments. Most commonly used outcome measures are ordinal in nature, however these scales are limited in their usefulness. Currently no outcome measures exist in stroke rehabilitation that can effectively measure change.

The development of a utility measure will provide a common language that can be used clinically to track outcome, and as a measure of outcome in stroke rehabilitation research. Health utilities are cardinal values that reflect the individual’s preferences for different health outcomes. They are measured on an interval scale with zero reflecting states of health equivalent to death and one reflecting perfect health. Fitting utility weighted functions to an ordinal measure allows data analysis on an interval scale enabling use as a measure of change.

Students will work within the Centre for Research Excellence in Stroke, based at the Florey Institute in Heidelberg.