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Response to letter regarding article, "Neurological, functional, and cognitive stroke outcomes in Mexican Americans"
Letter/Communication   Open access   Peer reviewed

Response to letter regarding article, "Neurological, functional, and cognitive stroke outcomes in Mexican Americans"

Lynda D Lisabeth, Brisa N Sánchez and Lewis B Morgenstern
Stroke (1970), v 45(8), pp e168-e168
Aug 2014
PMID: 24947285
url
https://doi.org/10.1161/STROKEAHA.114.005914View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze) Open

Abstract

Cognition Disorders - physiopathology Mexican Americans - statistics & numerical data Humans Recovery of Function - physiology Stroke - ethnology Female Male Cognition Disorders - ethnology Stroke - physiopathology
We thank Chen and colleagues1 for their sincere interest in our article,2 including their attention to the supplementary material. We disagree with their assertion that the activity of daily living (ADL) and instrumental activity of daily living (IADL) subscores should be treated as ordinal variables; these subscores have 22 and 46 distinct values, respectively, such that an analysis that treats these variables as ordinal is unwarranted.3 Although an ordinal regression analysis may be appropriate for the individual items of the ADL and IADL scales from a statistical standpoint, ordinal regression would give odds ratios to quantify ethnic differences. Odds ratios are less informative in the context of the total ADL/IADL score, which is the primary outcome in the main text of the article. The results for individual items, obtained from linear regression with robust standard errors, are informative about shifts in the means of the individual items.4,5 From a lay perspective, the differences given in the supplementary material allow the reader to understand how ethnic differences in an individual item contribute to the ethnic difference in the average of all the items (total ADL/IADL score). As can be observed from the supplementary material, ethnic differences in the total AIDL/ADL score are because of differences across all of the items, rather than driven by a few items, whereas ethnic differences in National Institutes of Health Stroke Scale are because of a subset of the items.

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Web of Science research areas
Clinical Neurology
Peripheral Vascular Disease
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