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Biomedical subjects

K Sheikh

Publications and source records attributed to K Sheikh.

At least 55 records · Page 3Linked to original sources
PubMed1983

Predictors of mortality and disability in stroke.

The increasingly accurate prediction of survival and functional recovery in patients with stroke will be of value in planning both their individual management and the health and social services needed. To establish the independent predictive effects of a range of personal and clinical characteristics, data on 900 patients admitted to Northwick Park Hospital with stroke were analysed by stepwise multiple regression. Older patients who lose consciousness at the outset and show signs of multiple neurological deficits, abnormal pupils, and conjugate deviation of the eyes are more likely to die within a year than those without these characteristics. Those who survive the acute episode and are discharged alive are more likely to die within a year if they are old and have sensory loss with severe physical disability. Older female patients who are incontinent, lose consciousness at the onset of stroke, sustain extensive motor deficits in combination with other neurological deficits, and have residual disabilities from previous strokes are particularly likely to be severely disabled on discharge from hospital. Routinely collected clinical data enable useful forecasts about mortality and disability after stroke. The accuracy of these forecasts can probably be improved further.

Adult↗
PubMed1981

Remedial therapy after stroke: a randomised controlled trial.

Of 1094 patients with a confirmed stroke admitted to Northwick Park, a district general hospital, 364 (33%) died while in hospital, 215 (20%) were fully recovered when discharged, and 329 (30%) were too frail or too ill from diseases other than stroke to be considered for active rehabilitation. Only 121 (11%) were suitable for intensive treatment. They and 12 patients referred direct to outpatients were allocated at random to one of three different courses of rehabilitation. Intensive was compared with conventional rehabilitation and with a third regimen which included no routine rehabilitation, but under which patients were encouraged to continue with exercises taught while in hospital and were regularly seen at home by a health visitor. Progress at three months and 12 months was measured by an index of activities of daily living. Improvement was greatest in those receiving intensive treatment, intermediate in those receiving conventional treatment, and least in those receiving no routine treatment. Decreasing intensity of treatment was associated with a significant increase in the proportions of patients who deteriorated and in the extent to which they deteriorated. Probably only a few stroke patients, mostly men, are suitable for intensive outpatient rehabilitation, but for those patients the treatment is effective and realistic.

Activities of Daily Living↗
PubMed1981

Investigating non-response bias in mail surveys.

Losses in follow-up that are biased with respect to outcome invalidate the results. There are many ways of dealing with non-response in follow-up studies. Three separate methods were used to investigate a potential bias in a mail survey of 2471 disabled people. At a response rate of 84%, the non-respondents were significantly different from the respondents with respect to the outcome, return to work and vocational training. The success rate in terms of the outcome was negatively related to the number of reminders. Significant differences were found in response rates according to age, social class, impairments, previous employment record, and completion of rehabilitation courses. There is no safe level of response rates below 100%. However small the non-response, a possible bias as a result of it must be investigated.

Adolescent↗
PubMed1981

Long-term disability and return to work.

In a study of 2,113 physically or mentally disabled adults, an early return to stable employment was found to be largely dependent on two interrelated factors: motivation for work and the duration of unemployment before rehabilitation. If doctors refer such patients for medical and vocational rehabilitation at the earliest opportunity, they can help to reduce the period of unemployment and to restore patients' confidence and motivation.

Adolescent↗
PubMed1980

Unemployment and the disabled.

An analysis of Employment Services Division statistics show a close relationship between the levels of unemployment in the disabled rehabilitated at the Employment Rehabilitation Centres (ERCs) and the rates of unemployment in the general population in the whole of Great Britain (r = 0.90) or in the local areas of the Centres (r = 0.66). There is also a significant association between the levels of unemployment in 749 rehabilitees passing through one ERC and the rates of unemployment in their home areas. The results have practical implications for both the employment and medical rehabilitation services.

Disability Evaluation↗
PubMed1979

Repeatability and validity of a modified activities of daily living (ADL) index in studies of chronic disability.

In order to measure disability in a randomised controlled trial of different intensities of rehabilitation following stroke, a modification of existing methods has been developed; it makes use of 17 items of activities of daily living (ADL) which are rated on a three-point scale, and it has been subjected to tests of repeatability and validity. While some activities (e.g. use of taps, ascending or descending stairs) are either redundant or repetitive, others provide independent measures of disability. There was no significant inter-observer variability; the assessors disagreed on 78 (3.7%) out of a total of 2,125 paired observations. In a study of short-term within-patient variability, different scores were assigned on 49 (14.4%) out of a total of 340 observations made on two separate occasions. Minor differences (mainly in activities involving equipment e.g. cookers) emerged when scores obtained in hospital were compared with those obtained at home, but the two sets of scores were still highly correlated (r = 0.962. There was, however, considerable discrepancy between the hospital scores and those derived from the patients' own estimates of their activities at home, the latter falling below actual capabilities as indicated by the hospital scores. A clinical validation of the index showed a significant association between the hospital ADL scores and the extent of cerebral lesions determined by the number of neurological deficits. This modified ADL index is sufficiently repeatable and valid for the assessment of patients with moderate disability as a result of stroke and other chronic diseases; in most circumstances, it can probably be simplified to include only five or six items.

Activities of Daily Living↗