Author response: Imaging markers of small vessel disease and brain frailty, and outcomes in acute stroke
Jason P.Appleton, Neurology SpR, Stroke, Division of Clinical Neurosciences, University of Nottingham (Nottingham, UK)
Joanna M.Wardlaw, Professor of Neuroradiology, Centre for Clinical Brain Sciences, University of Edinburgh (Edinburgh, UK)
Philip M.Bath, Stroke Association Professor of Stroke Medicine, Stroke, Division of Clinical Neurosciences, University of Nottingham (Nottingham, UK)
Submitted February 25, 2020
We thank Tourdias et al. for their comment on our article.1 We sought to establish the association between baseline imaging markers of small vessel disease and “brain frailty” with clinical outcomes after acute stroke. We used ordinal logistic regression with adjustment for prognostic variables for the primary outcome of modified Rankin Scale at 90 days. This method provides increased power compared with binary logistic regression, and it also allows assessment of the association with outcome independent of other potential drivers of clinical outcome.
Although we did not aim to determine predictive accuracy, we agree with Tourdias et al. that future work incorporating statistical prediction tools may prove instructive in understanding the independent impact of baseline imaging markers of brain frailty and small vessel disease on clinical outcomes.
Disclosure
The authors report no relevant disclosures. Contact journal@neurology.org for full disclosures.
Reference
Appleton JP, Woodhouse LJ, Adami A, et al. Imaging markers of small vessel disease and brain frailty, and outcomes in acute stroke. Neurology 2020;94:e439–e452.
We thank Tourdias et al. for their comment on our article.1 We sought to establish the association between baseline imaging markers of small vessel disease and “brain frailty” with clinical outcomes after acute stroke. We used ordinal logistic regression with adjustment for prognostic variables for the primary outcome of modified Rankin Scale at 90 days. This method provides increased power compared with binary logistic regression, and it also allows assessment of the association with outcome independent of other potential drivers of clinical outcome.
Although we did not aim to determine predictive accuracy, we agree with Tourdias et al. that future work incorporating statistical prediction tools may prove instructive in understanding the independent impact of baseline imaging markers of brain frailty and small vessel disease on clinical outcomes.
Disclosure
The authors report no relevant disclosures. Contact journal@neurology.org for full disclosures.
Reference