TY - JOUR T1 - Computerised patient-specific prediction of the recovery profile of upper limb capacity within stroke services: the next step JF - Journal of Neurology, Neurosurgery & Psychiatry JO - J Neurol Neurosurg Psychiatry SP - 574 LP - 581 DO - 10.1136/jnnp-2020-324637 VL - 92 IS - 6 AU - Ruud W Selles AU - Eleni-Rosalina Andrinopoulou AU - Rinske H Nijland AU - Rick van der Vliet AU - Jorrit Slaman AU - Erwin EH van Wegen AU - Dimitris Rizopoulos AU - Gerard M Ribbers AU - Carel GM Meskers AU - Gert Kwakkel Y1 - 2021/06/01 UR - http://jnnp.bmj.com/content/92/6/574.abstract N2 - Introduction Predicting upper limb capacity recovery is important to set treatment goals, select therapies and plan discharge. We introduce a prediction model of the patient-specific profile of upper limb capacity recovery up to 6 months poststroke by incorporating all serially assessed clinical information from patients.Methods Model input was recovery profile of 450 patients with a first-ever ischaemic hemispheric stroke measured using the Action Research Arm Test (ARAT). Subjects received at least three assessment sessions, starting within the first week until 6 months poststroke. We developed mixed-effects models that are able to deal with one or multiple measurements per subject, measured at non-fixed time points. The prediction accuracy of the different models was established by a fivefold cross-validation procedure.Results A model with only ARAT time course, finger extension and shoulder abduction performed as good as models with more covariates. For the final model, cross-validation prediction errors at 6 months poststroke decreased as the number of measurements per subject increased, from a median error of 8.4 points on the ARAT (Q1–Q3:1.7–28.1) when one measurement early poststroke was used, to 2.3 (Q1–Q3:1–7.2) for seven measurements. An online version of the recovery model was developed that can be linked to data acquisition environments.Conclusion Our innovative dynamic model can predict real-time, patient-specific upper limb capacity recovery profiles up to 6 months poststroke. The model can use all available serially assessed data in a flexible way, creating a prediction at any desired moment poststroke, stand-alone or linked with an electronic health record system.Data are available on reasonable request. ER -