Statistical Considerations for Drawing Conclusions About Recovery.
Neurorehabil Neural Repair
; 35(1): 10-22, 2021 01.
Article
en En
| MEDLINE
| ID: mdl-33317423
ABSTRACT
BACKGROUND:
Numerous studies have found associations when change scores are regressed onto initial impairments in people with stroke (slopes ≈ 0.7). However, there are important statistical considerations that limit the conclusions we can draw about recovery from these studies.OBJECTIVE:
To provide an accessible checklist of conceptual and analytical issues on longitudinal measures of stroke recovery. Proportional recovery is an illustrative example, but these considerations apply broadly to studies of change over time.METHODS:
Using a pooled data set of n = 373 Fugl-Meyer Assessment upper extremity scores, we ran simulations to illustrate 3 considerations (1) how change scores can be problematic in this context; (2) how "nil" and nonzero null-hypothesis significance tests can be used; and (3) how scale boundaries can create the illusion of proportionality, whereas other analytical procedures (eg, post hoc classifications) can augment this problem.RESULTS:
Our simulations highlight several limitations of common methods for analyzing recovery. We find that uniform recovery leads to similar group-level statistics (regression slopes) and individual-level classifications (into fitters and nonfitters) that have been claimed as evidence for the proportional recovery rule. New analyses, however, also speak to the complexities in variance about the regression slope.CONCLUSIONS:
Our results highlight that one cannot identify whether proportional recovery is true or not based on commonly used methods. We illustrate how these techniques, measurement tools, and post hoc classifications (eg, nonfitters) can create spurious results. Going forward, the field needs to carefully consider the influence of these factors on how we measure, analyze, and conceptualize recovery.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Interpretación Estadística de Datos
/
Evaluación de Resultado en la Atención de Salud
/
Recuperación de la Función
/
Investigación Biomédica
/
Rehabilitación Neurológica
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Neurorehabil Neural Repair
Asunto de la revista:
NEUROLOGIA
/
REABILITACAO
Año:
2021
Tipo del documento:
Article
País de afiliación:
Estados Unidos