Can we improve the statistical analysis of stroke trials? Statistical re-analysis of functional outcomes in stroke trials

Background: Most large acute stroke trials have been neutral. Functional outcome is usually analysed using a yes or no answer, e.g. death or dependency vs. independence. We assessed which statistical approaches are most efficient in analysing outcomes from stroke trials. Methods: Individual patie...

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Main Author: Bath, Philip M.W.
Format: Article
Published: American Heart Association 2007
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Online Access:https://eprints.nottingham.ac.uk/947/
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author Bath, Philip M.W.
author_facet Bath, Philip M.W.
author_sort Bath, Philip M.W.
building Nottingham Research Data Repository
collection Online Access
description Background: Most large acute stroke trials have been neutral. Functional outcome is usually analysed using a yes or no answer, e.g. death or dependency vs. independence. We assessed which statistical approaches are most efficient in analysing outcomes from stroke trials. Methods: Individual patient data from acute, rehabilitation and stroke unit trials studying the effects of interventions which alter functional outcome were assessed. Outcomes included modified Rankin Scale, Barthel Index, and ‘3 questions’. Data were analysed using a variety of approaches which compare two treatment groups. The results for each statistical test for each trial were then compared. Results: Data from 55 datasets were obtained (47 trials, 54,173 patients). The test results differed substantially so that approaches which use the ordered nature of functional outcome data (ordinal logistic regression, t-test, robust ranks test, bootstrapping the difference in mean rank) were more efficient statistically than those which collapse the data into 2 groups (chi square) (ANOVA p<0.001). The findings were consistent across different types and sizes of trial and for the different measures of functional outcome. Conclusions: When analysing functional outcome from stroke trials, statistical tests which use the original ordered data are more efficient and more likely to yield reliable results. Suitable approaches included ordinal logistic regression, t-test, and robust ranks test.
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spelling nottingham-9472024-08-15T15:33:28Z https://eprints.nottingham.ac.uk/947/ Can we improve the statistical analysis of stroke trials? Statistical re-analysis of functional outcomes in stroke trials Bath, Philip M.W. Background: Most large acute stroke trials have been neutral. Functional outcome is usually analysed using a yes or no answer, e.g. death or dependency vs. independence. We assessed which statistical approaches are most efficient in analysing outcomes from stroke trials. Methods: Individual patient data from acute, rehabilitation and stroke unit trials studying the effects of interventions which alter functional outcome were assessed. Outcomes included modified Rankin Scale, Barthel Index, and ‘3 questions’. Data were analysed using a variety of approaches which compare two treatment groups. The results for each statistical test for each trial were then compared. Results: Data from 55 datasets were obtained (47 trials, 54,173 patients). The test results differed substantially so that approaches which use the ordered nature of functional outcome data (ordinal logistic regression, t-test, robust ranks test, bootstrapping the difference in mean rank) were more efficient statistically than those which collapse the data into 2 groups (chi square) (ANOVA p<0.001). The findings were consistent across different types and sizes of trial and for the different measures of functional outcome. Conclusions: When analysing functional outcome from stroke trials, statistical tests which use the original ordered data are more efficient and more likely to yield reliable results. Suitable approaches included ordinal logistic regression, t-test, and robust ranks test. American Heart Association 2007-06 Article PeerReviewed Bath, Philip M.W. (2007) Can we improve the statistical analysis of stroke trials? Statistical re-analysis of functional outcomes in stroke trials. Stroke, 38 (6). pp. 1911-1915. ISSN 1524-4628 stroke; randomised controlled trial; statistical analysis http://stroke.ahajournals.org/content/38/6/1911 doi:10.1161/STROKEAHA.106.474080 doi:10.1161/STROKEAHA.106.474080
spellingShingle stroke; randomised controlled trial; statistical analysis
Bath, Philip M.W.
Can we improve the statistical analysis of stroke trials? Statistical re-analysis of functional outcomes in stroke trials
title Can we improve the statistical analysis of stroke trials? Statistical re-analysis of functional outcomes in stroke trials
title_full Can we improve the statistical analysis of stroke trials? Statistical re-analysis of functional outcomes in stroke trials
title_fullStr Can we improve the statistical analysis of stroke trials? Statistical re-analysis of functional outcomes in stroke trials
title_full_unstemmed Can we improve the statistical analysis of stroke trials? Statistical re-analysis of functional outcomes in stroke trials
title_short Can we improve the statistical analysis of stroke trials? Statistical re-analysis of functional outcomes in stroke trials
title_sort can we improve the statistical analysis of stroke trials? statistical re-analysis of functional outcomes in stroke trials
topic stroke; randomised controlled trial; statistical analysis
url https://eprints.nottingham.ac.uk/947/
https://eprints.nottingham.ac.uk/947/
https://eprints.nottingham.ac.uk/947/