Article
Clinical Neurology
Michelle Y. Zhang, Michael Mlynash, Kristin L. Sainani, Gregory W. Albers, Maarten G. Lansberg
Summary: This study aimed to create a model predicting mRS scores in ischemic stroke patients at discharge to day 90, successfully using data from three prospective studies to develop the model and achieving high accuracy in predicting mRS scores within one point in an external validation set.
FRONTIERS IN NEUROLOGY
(2021)
Article
Clinical Neurology
Xiaoying Chen, Jingwei Li, Craig S. Anderson, Richard Lindley, Maree L. Hackett, Thompson Robinson, Pablo M. Lavados, Xia Wang, Hisatomi Arima, John Chalmers, Candice Delcourt
Summary: The study demonstrates the utility of the structured, simplified modified Rankin scale questionnaire in acute stroke research, showing high reliability and agreement with the standard modified Rankin scale. It can be used as a reliable alternative measure of functional status after acute ischemic stroke.
INTERNATIONAL JOURNAL OF STROKE
(2021)
Article
Clinical Neurology
Manuel Cappellari, Valentina Saia, Giovanni Procucci, Fainardi Enrico, Arturo Consoli, Sergio Nappini, Lucio Castellon, Sandra Bracco, Mauro Bergui, Mirco Cosottini, Alessandra Briatico Vangosa, Sergio Vinci, Maria Ruggiero, Edoardo Puglielli, Luigi Chiumarulo, Giacomo Cester, Chiara Comelli, Umberto Silvagni, Daniele Morosetti, Valentina Caldiera, Nicola Cavasin, Valeria Ledda, Giuseppina Sanfilippo, Andrea Saletti, Pietro Filauri, Ivan Gallesio, Nunzio Paolo Nuzzi, Pitero Amista, Cecilia Zivelonghi, Mauro Plebani, Marco Pavia, Daniele Romano, Francesco Biraschi, Roberto Menozzi, Roberto M. Gasparotti, Andrea Giorgianni, Andrea Zini, Domenico Inzitari, Danilo Toni, Salvatore Mangiafico
Summary: The Careggi Collateral Score (CCS) is a helpful tool for predicting outcomes in stroke patients undergoing thrombectomy for middle cerebral artery occlusion. A higher CCS score is associated with better prognosis, with CCS >= 3 being the optimal threshold for predicting excellent outcomes and CCS >= 1 for predicting survival.
JOURNAL OF NEUROLOGY
(2022)
Article
Clinical Neurology
Natalia Pozarowszczyk, Iwona Kurkowska-Jastrzebska, Iwona Sarzynska-Dlugosz, Maciej Nowak, Michal Karlinski
Summary: The aim of this study was to assess the consistency between neurologists and physical and rehabilitation medicine physicians in using the Modified Rankin Scale (mRS) to rate post-stroke disability. The results showed a modest agreement in using mRS, but it may be considered sufficient for observational studies or stroke registries.
FRONTIERS IN NEUROLOGY
(2023)
Article
Rehabilitation
Yan Gao, Yulong Wang, Dongxia Li, Jingpu Zhao, Zhiyuan Dong, Jing Zhou, Guanqi Fu, Jing Zhang
Summary: This study explored the correlations and differentiate ability among the Longshi Scale, Barthel Index, and modified Rankin Scale in stroke patients. The results indicate that the Longshi Scale has better ability than the modified Rankin Scale in differentiating disability, especially for patients with higher levels of activities of daily living.
CLINICAL REHABILITATION
(2021)
Article
Clinical Neurology
E. Nobels-Janssen, E. N. Postma, I. L. Abma, J. M. C. van Dijk, R. Haeren, H. Schenck, W. A. Moojen, M. H. den Hertog, D. Nanda, A. R. E. Potgieser, B. A. Coert, W. I. M. Verhagen, R. H. M. A. Bartels, P. J. van der Wees, D. Verbaan, H. D. Boogaarts
Summary: The study evaluates the inter-method reliability of different assessment methods of the modified Rankin Scale in patients with aneurysmal subarachnoid hemorrhage. Results show that self-assessment of the mRS tends to result in higher scores compared to physician assessment, but is proven to be feasible.
JOURNAL OF NEUROLOGY
(2022)
Article
Surgery
Yoel Solomon, Christina L. Marcaccio, Vinamr Rastogi, Jinny J. Lu, Mahmoud B. Malas, Grace J. Wang, Peter A. Schneider, Gert J. de Borst, Marc L. Schermerhorn
Summary: This study aimed to evaluate the impact of timing of intervention and stroke severity on postoperative outcomes for carotid endarterectomy (CEA) in stroke patients. Severe disability patients (mRS score 5) had a high risk from CEA at any time point, while mild disability patients (mRS score 0-1) may benefit from CEA within 3-14 days. In contrast to current guidelines, patients with moderate disability (mRS score 2) may benefit from delaying CEA to 15-90 days, and those with moderate disability (mRS score 3-4) might benefit from CEA within 3-90 days. These data should be considered in the context of the clinical situation to determine the net benefit of delayed CEA.
JOURNAL OF VASCULAR SURGERY
(2023)
Article
Cardiac & Cardiovascular Systems
Alexander Chye, Maree L. Hackett, Graeme J. Hankey, Erik Lundstrom, Osvaldo P. Almeida, John Gommans, Martin Dennis, Stephen Jan, Gillian E. Mead, Andrew H. Ford, Christopher Etherton Beer, Leon Flicker, Candice Delcourt, Laurent Billot, Craig S. Anderson, Katharina Stibrant Sunnerhagen, Qilong Yi, Severine Bompoint, Thang Huy Nguyen, Thomas Lung
Summary: This study compares the analytical implications of single-measure and repeated-measures analyses of the modified Rankin Scale (mRS) in evaluating functional recovery after acute stroke. The findings suggest that repeated-measures analysis can improve trial precision in identifying trial associations and effects.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2022)
Article
Clinical Neurology
Craig I. Coleman, Mauricio Concha, Bruce Koch, Belinda Lovelace, Mary J. Christoph, Alexander T. Cohen
Summary: The aim of this study was to develop a composite score for predicting functional outcome post-intracerebral hemorrhage (ICeH) using proxy measures that can be assessed retrospectively. Data from the ERICH study were analyzed to derive the SAVED(2) score and its discriminative ability was measured using the area under the curve (AUC). External validation was performed in the ATACH-2 trial. The SAVED(2) score showed good predictive ability for unfavorable 90-day modified Rankin scale (mRS) score in ICeH patients.
FRONTIERS IN NEUROLOGY
(2023)
Article
Clinical Neurology
Xiangxiang Liu, Mingchao Zhou, Jingpu Zhao, Yan Gao, Yao Wang, Jing Zhou, Li Wan, Guohui Nie, Yulong Wang
Summary: The study aimed to identify the optimal cut-off scores of LS and BI according to the mRS in Chinese stroke patients with different levels of functional disability. Results showed that mRS is more precise to determine mild functional disability, whereas BI provides more specific information on moderate and severe levels in stroke patients.
FRONTIERS IN NEUROLOGY
(2022)
Article
Neurosciences
Kenichiro Yi, Makoto Nakajima, Tomoaki Ikeda, Mineko Yoshigai, Mitsuharu Ueda
Summary: This study aimed to determine the reliability of the Japanese version of the simplified mRS questionnaire (J-RASQ) in a telephone survey administered by non-medical staff. The results showed a high agreement between mRS scores and J-RASQ scores, indicating that J-RASQ is a feasible option for assessment in telephone surveys.
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
(2022)
Article
Neurosciences
Kenichiro Yi, Yuichiro Inatomi, Makoto Nakajima, Toshiro Yonehara, Mitsuharu Ueda
Summary: The Japanese version of the simplified modified Rankin Scale questionnaire showed decent reliability and similarity to the modified Rankin Scale assessed by physicians in another hospital. The questionnaire could be a reliable indicator for assessing stroke functional outcomes even when implemented by non-medical staff.
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
(2021)
Article
Clinical Neurology
A. Fernandez Sanz, J. Ruiz Serrano, H. Tejada Meza, J. Marta Moreno
Summary: The Spanish-language telephone smRSq is reliable and simple, saving time in functional assessment after a stroke.
Article
Clinical Neurology
Venesha Rethnam, Julie Bernhardt, Hannah Johns, Kathryn S. Hayward, Janice M. Collier, Fiona Ellery, Lan Gao, Marj Moodie, Helen Dewey, Geoffrey A. Donnan, Leonid Churilov
Summary: This study investigates multidimensional patterns of post-stroke burden, finding that individual domains of Assessment of Quality of Life and Barthel Index show different patterns of decrease as the modified Rankin Scale increases. Patients with Rankin Scale 0-1 experience the largest burden in Mental Health and Relationship domains, while those with Rankin Scale >3 show the greatest burden in Independent Living, Mobility and Self-care domains.
INTERNATIONAL JOURNAL OF STROKE
(2021)
Article
Multidisciplinary Sciences
Chih-Wei Sung, Jen-Tang Sun, Edward Pei-Chuan Huang, Sang Do Shin, Kyoung Jun Song, Ki Jeong Hong, Sabariah Faizah Jamaluddin, Do Ngoc Son, Ming-Ju Hsieh, Matthew Huei-Ming Ma, Li-Min Hsu, Wen-Chu Chiang
Summary: This study investigated the association between prehospital fluid resuscitation and outcomes of trauma patients in Asia. The results showed that prehospital fluid resuscitation was associated with higher in-hospital mortality and poor functional outcomes.
SCIENTIFIC REPORTS
(2022)
Article
Health Care Sciences & Services
Sungwon Yoon, Pei Shan Hoe, Angelique Chan, Rahul Malhotra, Abhijit Visaria, David Matchar, Hendra Goh, Bridget Seng, Chandrika Ramakrishnan, Mariko S. Koh, Tiew Pei Yee, Gayathri Devi Nadarajan, Yong Mong Bee, Nicholas Graves, Tazeen H. Jafar, Marcus E. H. Ong
Summary: This study examines the impact of COVID-19 measures on wellbeing and self-management in medically vulnerable non-COVID patients. The results indicate that the pandemic has negatively affected patients' subjective wellbeing, particularly in terms of emotional distress and interference in self-care.
Article
Medical Informatics
Sean Shao Wei Lam, Andrew Hao Sen Fang, Mariko Siyue Koh, Sumitra Shantakumar, See-Hwee Yeo, David Bruce Matchar, Marcus Eng Hock Ong, Ken Mei Ting Poon, Liming Huang, Sudha Harikrishan, Dominique Milea, Des Burke, Dave Webb, Narayanan Ragavendran, Ngiap Chuan Tan, Chian Min Loo
Summary: The SingHealth-Duke-GlaxoSmithKline COPD and Asthma Real-world Evidence (SDG-CARE) collaboration aims to accelerate the use of Singaporean real-world evidence in research and clinical care. A near real-time database, the SingHealth COPD and Asthma Data Mart (SCDM), was developed to inform healthcare decision-making and research studies on asthma and COPD.
BMC MEDICAL INFORMATICS AND DECISION MAKING
(2023)
Article
Radiology, Nuclear Medicine & Medical Imaging
Tian Kai Woon, Ke Zhou, Bien Soo Tan, David B. Matchar
Summary: This study compares the cost-benefit of active surveillance (AS) with immediate fine needle aspiration (FNA) for sonographically suspicious subcentimeter thyroid nodules. The results suggest that surveillance of nodules with positive cytology is more cost-beneficial than surveillance of all nodules. Patients with positive cytology may opt for either AS or surgery according to their level of comfort with AS.
JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY
(2023)
Review
Economics
Wenjia Chen, Yi Wang, Yaroslava Zemlyanska, Dimple Butani, Nigel Chong Boon Wong, Suchin Virabhak, David Bruce Matchar, Yot Teerawattananon
Summary: This study comprehensively reviewed the modeling approaches, methodological and policy challenges in the economic evaluation of precision medicine across clinical stages. The findings revealed the challenges in capturing the value of precision medicine, differentiating early evaluations from conventional evaluations, and the importance of budget impact, cost savings, and cost-effectiveness in decision making. It emphasizes the need to modify existing guidelines or develop a new reference case to guide decision making in research and development and market access.
Article
Medicine, General & Internal
Pey June Tan, Mimaika Luluina Ginting, Zoe Zon Be Lim, Nivedha Balachandar, Rehena Sultana, Mumtaz Mohamed Kadir, Tianma Xu, Noor Hafizah Ismail, Joyce Kwee Yong Yap, Sweet Fun Wong, Joanne Yoong, David Bruce Matchar, Keith Hill, Chek Hooi Wong
Summary: This study evaluates the impact of community falls prevention programmes on falls risk and health outcomes for older adults in Singapore. It uses a pragmatic closed cohort stepped-wedge cluster randomised trial design, with sequential crossover of clusters from the waitlist control condition to the intervention condition. The results will be disseminated through publications and other relevant platforms.
Article
Economics
Semra Ozdemir, John Ansah, David Matchar
Summary: By conducting discrete choice experiments, this study identified the most important factors for enhancing primary care services for community-dwelling older individuals and primary care providers. Out-of-pocket cost and types of services offered were the most important factors for users, while working hours and patient load were the most important factors for providers.
APPLIED HEALTH ECONOMICS AND HEALTH POLICY
(2023)
Review
Respiratory System
Zheng An Toh, Ling Jie Cheng, Xi Vivien Wu, Deidre Anne De Silva, Hui Xian Oh, Si Xian Ng, Hong-Gu He, Minna Pikkarainen
Summary: Positive airway pressure (PAP) therapy has beneficial effects on post-stroke outcomes, such as reducing recurrent vascular events and improving neurological deficit, cognition, functional independence, and daytime sleepiness. However, its effect on depression is insignificant.
EUROPEAN RESPIRATORY REVIEW
(2023)
Article
Social Sciences, Interdisciplinary
Ashish Kumar, Zhenghong Liu, John Pastor Ansah, Yih Yng Ng, Benjamin Sieu-Hon Leong, David Bruce Matchar, Marcus Eng Hock Ong, Fahad Javaid Siddiqui
Summary: Globally, Emergency Care Systems (ECS) are critical resources that require careful use due to the potential for demand to exceed capacity. In Singapore, policymakers are considering the introduction of Alternate Care Service Pathways (ACSPs) to address overcrowding in Emergency Departments (EDs). However, developing ACSPs is costly and carries the risk of unintended consequences.
Article
Geriatrics & Gerontology
Wei Xuan Lai, Angelique Wei-Ming Chan, David Bruce Matchar, John Pastor Ansah, Christopher Tsung Chien Lien, Noor Hafizah Ismail, Chek Hooi Wong, Tianma Xu, Vanda Wen Teng Ho, Pey June Tan, June May Ling Lee, Rita Siew Choo Sim, Normala Manap
Summary: Falls in older adults result from a complex interaction of various causes, leading to physical, emotional, and psychological consequences. Developing a conceptual framework can help clarify goals in falls intervention and improve understanding of the problem.
Article
Geriatrics & Gerontology
Vanessa Jean Wen Koh, David B. Matchar, Angelique Wei-Ming Chan, June May-Ling Lee, Wei Xuan Lai, Dulcie Rosario, Anne George, Vanda Ho, Noor Hafizah Bte Ismail, Christopher Tsung Chien Lien, Reshma A. Merchant, Shuyan Melissa Tan, Chek Hooi Wong, Tianma Xu
Summary: This study aims to uncover the factors that facilitate or inhibit implementing community-based fall prevention programs in Singapore, with a focus on the interrelationship between those factors. Health care professionals familiar with fall prevention programs were invited to discuss the enablers and challenges to the implementation. Results showed that implementation is influenced by health care provider factors and patient factors, and key leverage points for potential interventions were identified.
INNOVATION IN AGING
(2023)
Editorial Material
Health Care Sciences & Services
Chuan De Foo, Hui Xiang Chia, Ken Wah Teo, Aysha Farwin, Jumana Hashim, Gerald Choon-Huat Koh, David Bruce Matchar, Helena Legido-Quigley, Jason C. H. Yap
LANCET REGIONAL HEALTH-WESTERN PACIFIC
(2023)
Article
Rehabilitation
John Pastor Ansah, Aloysius Wei-Yan Chia, Vanessa Jean Wen Koh, Wei Xuan Lai, Joyce Suang Bee Koh, Kiat Sern Goh, William Yeo, Tet Sen Howe, Dennis Chuen Chai Seow, Kaysar Mamun, Diraviyam Balasubramanian, Surendra Doraiswamy Varman, Andy Kuei Siong Yeo, Amal Elamin, Angelique Wei-Ming Chan, David Bruce Matchar
Summary: Due to an aging population, the rising prevalence and incidence of hip fractures pose a challenge to healthcare systems worldwide. This research aims to engage stakeholders and develop a comprehensive qualitative model of the factors that affect hip fracture recovery, using the Group Model Building approach. The findings highlight the importance of expectation formation, rehabilitation, affordability/availability, and resilience building in the journey of hip fracture recovery.
FRONTIERS IN REHABILITATION SCIENCES
(2023)
Article
Health Care Sciences & Services
Ken Wah Teo, Yun Hu, Kwee Tiang Chew, Wee Yang Pek, Hong Choon Chua, David Bruce Matchar, Yeuk Fan Ng
Summary: Health system transformation is a complex journey with limitations in existing methods. The Health System Transformation Playbook, using design, systems, and complexity-thinking, tackles the scale of complex adaptive systems through iterative story-telling, model-building, and pathfinding processes.
FRONTIERS IN HEALTH SERVICES
(2023)
Review
Public, Environmental & Occupational Health
Wenjia Chen, Nigel Chong Boon Wong, Yi Wang, Yaroslava Zemlyanska, Dimple Butani, Suchin Virabhak, David Bruce Matchar, Thittaya Prapinvanich, Yot Teerawattananon
Summary: This study aimed to determine the heterogeneity in the value for money of precision medicine (PM) across different application types and contexts. The analysis of cost-effectiveness of PM interventions showed that publicly sponsored studies found genetic testing and gene therapy to be not cost-effective, while studies funded by commercial entities and early stage evaluations had contradictory results. Evidence of cost-effectiveness was found in genetic tests for screening, diagnosis, or companion diagnostics, as well as multigene panel testing, but only in specific disease areas and high-income countries. Incremental effectiveness was a key driver for value in genetic tests but not in gene therapy.
FRONTIERS IN PUBLIC HEALTH
(2023)
Article
Medicine, General & Internal
Sean Shao Wei Lam, Jingwei Chen, Jun Tian Wu, Chun Fan Lee, Narayanan Ragavendran, Marcus Eng Hock Ong, Ngiap Chuan Tan, Chian Min Loo, David Bruce Matchar, Mariko Siyue Koh
Summary: This study evaluated the impact of asthma education, asthma control assessment, and spirometry testing on the time to severe exacerbation (TTSE). The results showed that asthma education and asthma control assessment were associated with a decrease in exacerbation frequency and an extended TTSE, highlighting the importance of ensuring quality care in clinical practice.
ANNALS ACADEMY OF MEDICINE SINGAPORE
(2023)