Kobayashi Ryu, Kobayashi Norikazu
Department of Occupational Therapy, School of Health Science, International University of Health and Welfare, Narita, Japan.
Department of Occupational Therapy, Graduate School of Human Health Science, Tokyo Metropolitan University, Arakawa, Japan.
Front Neurol. 2024 Aug 19;15:1419405. doi: 10.3389/fneur.2024.1419405. eCollection 2024.
Recently, a method was developed to predict the motor Functional Independence Measure (FIM) score at discharge in patients with stroke by stratifying the effects of factors such as age and cognitive function and multiplying those by the influence coefficients of these factors. However, an evaluation of the predictive performance of the method is required for clinical application. The present study aimed to evaluate the predictive performance of this prediction method.
Patients with stroke discharged from a rehabilitation ward between April 2021 and September 2022 were included. Predicted values of the motor FIM score at discharge were calculated after data collection from the hospital's patient database. The concordance between predicted and actual values was evaluated using the interclass correlation coefficient; moreover, the residual values were calculated.
In total, 207 patients were included in the analysis. The median age was 79 (69-85) years, and 112 (54.1%) patients were male. The interclass correlation coefficient between predicted and actual values was 0.84 (95% confidence interval 0.75-0.89) for the motor FIM score at discharge. Meanwhile, the median residual value was 5.3 (-2.0-10.3) for the motor FIM score at discharge.
The prediction method was validated with good performance. However, the residual values indicated that some cases deviated from the prediction. In future studies, it will be necessary to improve the predictive performance of the method by clarifying the characteristics of cases that deviate from the prediction.
最近，开发了一种方法，通过对年龄和认知功能等因素的影响进行分层，并将这些因素乘以其影响系数，来预测中风患者出院时的运动功能独立性测量（FIM）评分。然而，该方法的预测性能需要进行临床应用评估。本研究旨在评估这种预测方法的预测性能。
纳入2021年4月至2022年9月从康复病房出院的中风患者。从医院的患者数据库收集数据后，计算出院时运动FIM评分的预测值。使用组内相关系数评估预测值与实际值之间的一致性；此外，还计算了残差值。
总共207例患者纳入分析。中位年龄为79（69 - 85）岁，112例（54.1%）为男性。出院时运动FIM评分的预测值与实际值之间的组内相关系数为0.84（95%置信区间0.75 - 0.89）。同时，出院时运动FIM评分的中位残差值为5.3（-2.0 - 10.3）。
该预测方法经验证具有良好性能。然而，残差值表明一些病例偏离了预测。在未来的研究中，有必要通过阐明偏离预测的病例特征来提高该方法的预测性能。
