Prognostic rules for predicting cognitive syndromes following stroke: A systematic review.
Bogna A DrozdowskaKris McGillMichael McKayRoisin BartlamPeter LanghorneTerence J QuinnPublished in: European stroke journal (2021)
Of 17,390 titles, we included 10 studies (3143 participants), presenting the development of 11 prognostic rules - 7 for post-stroke cognitive impairment and 4 for delirium. Most commonly incorporated predictors were: demographics, imaging findings, stroke type and symptom severity. Among studies assessing predictive discrimination, the area under the receiver operating characteristic (AUROC) in apparent validation ranged from 0.80 to 0.91. The overall risk of bias for each study was high. Only one prognostic rule had been externally validated.Discussion/conclusion: Research into the prognosis of cognitive outcomes following stroke is an expanding field, still at its early stages. Recommending use of specific prognostic rules is limited by the high risk of bias in all identified studies, and lack of supporting evidence from external validation. To ensure the quality of future research, investigators should adhere to current, endorsed best practice guidelines for conduct of prediction model studies.