The Relevance of Neurological and Functional Outcome Scales for Acute Stroke Trials

Abstract

Research in the field of medical treatment is based on the assessment of variables that are aimed at by the therapy under question. Even if it is tempting and easy to choose a single laboratory parameter for measurement, it is the improvement of the patient’s general clinical status that is of utmost importance before introducing a new therapy. The assessment of a stroke patient seems to be particularly difficult, as a stroke commonly leads to a variety of more or less independent signs that may or may not be improved by a drug in different ways. Is the treatment of benefit to the patient or not if his or her moderate paresis completely resolves but at the same time Broca’s aphasia deteriorates to global aphasia? In the following we will try to analyze how different stroke scales have dealt with this problem. We will focus on scales that attempt to quantify deficit or residual abilities once stroke has occurred. We will not touch on the methodological problems that one has to face in a stroke prevention trial when an ischemic event or death occurs in a previously healthy or at-risk patient.