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Papers by Rohit Bhattacharjee
Neurological Research, 2015
The growing burden of stroke in China, along with the increasing cost of health care calls for ne... more The growing burden of stroke in China, along with the increasing cost of health care calls for new, more effective strategies for stroke prevention. These strategies should include increasing awareness of stroke symptoms, awareness of risk factors, and provision of easily available information on means of modifying risk factors. The Stroke Riskometer App is exactly such a tool, available in Mandarin, for adult individuals to calculate their risk of stroke over the next 5 and 10 years, and to identify their individual stroke risk factors and linking them to possible means of modifying these risk factors. The use of this App could reduce the risk of stroke for individuals in the Chinese population and contribute to significant reduction in stroke burden in China.
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, Jan 9, 2014
Stroke is a major cause of long-term adult disability with many survivors living in the community... more Stroke is a major cause of long-term adult disability with many survivors living in the community relying on family members for on-going support. However, reports of inadequate understanding of rehabilitation techniques are common. A self-management DVD-based observational learning tool may help improve functional outcomes for survivors of stroke and reduce caregivers' burden. This article describes the methodology of the stroke self-management rehabilitation trial. The overall aim of this pilot trial is to assess the feasibility and preliminary efficacy of a DVD-based intervention for improving functional outcomes of survivors of stroke 2 months postrandomization to inform the design of a full-scale randomized clinical trial. Recruitment of a minimum of 20 survivors of stroke and their informal caregivers (where available) in each of the participating centers will occur across multiple international sites. After baseline assessments, participants will be randomly assigned to an...
Neuroepidemiology, 2014
Determining the prevalence of neuromuscular disorders for the general population is important to ... more Determining the prevalence of neuromuscular disorders for the general population is important to identify the scope of burden on society and enable comparisons with other health conditions. This systematic review aims to identify and collate the findings of studies published between 1960 and 2013 on the prevalence of all types of muscular dystrophies. Relevant articles were identified through electronic database searches and manual searches of reference lists. There were 38 articles from across 19 countries that met the inclusion criteria. The total combined prevalence for all muscular dystrophies for studies classified as having a low risk of bias ranged between 19.8 and 25.1 per 100,000 person-years. Myotonic dystrophy (0.5-18.1 per 100,000), Duchenne muscular dystrophy (1.7-4.2) and facioscapulohumeral muscular dystrophy (3.2-4.6 per 100,000) were found to be the most common types of disorder. There was wide variation in study methodology, case ascertainment, and verification pro...
International Journal of Stroke, 2014
The greatest potential to reduce the burden of stroke is by primary prevention of first-ever stro... more The greatest potential to reduce the burden of stroke is by primary prevention of first-ever stroke, which constitutes three quarters of all stroke. In addition to population-wide prevention strategies (the 'mass' approach), the 'high risk' approach aims to identify individuals at risk of stroke and to modify their risk factors, and risk, accordingly. Current methods of assessing and modifying stroke risk are difficult to access and implement by the general population, amongst whom most future strokes will arise. To help reduce the burden of stroke on individuals and the population a new app, the Stroke Riskometer TM , has been developed. We aim to explore the validity of the app for predicting the risk of stroke compared with current best methods. Methods 752 stroke outcomes from a sample of 9501 individuals across three countries (New Zealand, Russia and the Netherlands) were utilized to investigate the performance of a novel stroke risk prediction tool algorithm (Stroke Riskometer TM ) compared with two established stroke risk score prediction algorithms (Framingham Stroke Risk Score [FSRS] and QStroke). We calculated the receiver operating characteristics (ROC) curves and area under the ROC curve (AUROC) with 95% confidence intervals, Harrels C-statistic and D-statistics for measure of discrimination, R 2 statistics to indicate level of variability accounted for by each prediction algorithm, the Hosmer-Lemeshow statistic for calibration, and the sensitivity and specificity of each algorithm. Results The Stroke Riskometer TM performed well against the FSRS five-year AUROC for both males (FSRS = 75·0% (95% CI 72·3%-77·6%), Stroke Riskometer TM = 74·0(95% CI 71·3%-76·7%) and females [FSRS = 70·3% (95% CI 67·9%-72·8%, Stroke Riskometer TM = 71·5% (95% CI 69·0%-73·9%)], and better than QStroke [males -59·7% (95% CI 57·3%-62·0%) and comparable to females = 71·1% (95% CI 69·0%-73·1%)]. Discriminative ability of all algorithms was low (C-statistic ranging from 0·51-0·56, D-statistic ranging from 0·01-0·12). Hosmer-Lemeshow illustrated that all of the predicted risk scores were not well calibrated with the observed event data (P < 0·006). Conclusions The Stroke Riskometer TM is comparable in performance for stroke prediction with FSRS and QStroke. All three algorithms performed equally poorly in predicting stroke events. The Stroke Riskometer TM will be continually developed and validated to address the need to improve the current stroke risk scoring systems to more accurately predict stroke, particularly by identifying robust ethnic/race ethnicity group and country specific risk factors.
Stroke; a journal of cerebral circulation, Jan 16, 2015
Neurological Research, 2015
The growing burden of stroke in China, along with the increasing cost of health care calls for ne... more The growing burden of stroke in China, along with the increasing cost of health care calls for new, more effective strategies for stroke prevention. These strategies should include increasing awareness of stroke symptoms, awareness of risk factors, and provision of easily available information on means of modifying risk factors. The Stroke Riskometer App is exactly such a tool, available in Mandarin, for adult individuals to calculate their risk of stroke over the next 5 and 10 years, and to identify their individual stroke risk factors and linking them to possible means of modifying these risk factors. The use of this App could reduce the risk of stroke for individuals in the Chinese population and contribute to significant reduction in stroke burden in China.
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, Jan 9, 2014
Stroke is a major cause of long-term adult disability with many survivors living in the community... more Stroke is a major cause of long-term adult disability with many survivors living in the community relying on family members for on-going support. However, reports of inadequate understanding of rehabilitation techniques are common. A self-management DVD-based observational learning tool may help improve functional outcomes for survivors of stroke and reduce caregivers' burden. This article describes the methodology of the stroke self-management rehabilitation trial. The overall aim of this pilot trial is to assess the feasibility and preliminary efficacy of a DVD-based intervention for improving functional outcomes of survivors of stroke 2 months postrandomization to inform the design of a full-scale randomized clinical trial. Recruitment of a minimum of 20 survivors of stroke and their informal caregivers (where available) in each of the participating centers will occur across multiple international sites. After baseline assessments, participants will be randomly assigned to an...
Neuroepidemiology, 2014
Determining the prevalence of neuromuscular disorders for the general population is important to ... more Determining the prevalence of neuromuscular disorders for the general population is important to identify the scope of burden on society and enable comparisons with other health conditions. This systematic review aims to identify and collate the findings of studies published between 1960 and 2013 on the prevalence of all types of muscular dystrophies. Relevant articles were identified through electronic database searches and manual searches of reference lists. There were 38 articles from across 19 countries that met the inclusion criteria. The total combined prevalence for all muscular dystrophies for studies classified as having a low risk of bias ranged between 19.8 and 25.1 per 100,000 person-years. Myotonic dystrophy (0.5-18.1 per 100,000), Duchenne muscular dystrophy (1.7-4.2) and facioscapulohumeral muscular dystrophy (3.2-4.6 per 100,000) were found to be the most common types of disorder. There was wide variation in study methodology, case ascertainment, and verification pro...
International Journal of Stroke, 2014
The greatest potential to reduce the burden of stroke is by primary prevention of first-ever stro... more The greatest potential to reduce the burden of stroke is by primary prevention of first-ever stroke, which constitutes three quarters of all stroke. In addition to population-wide prevention strategies (the 'mass' approach), the 'high risk' approach aims to identify individuals at risk of stroke and to modify their risk factors, and risk, accordingly. Current methods of assessing and modifying stroke risk are difficult to access and implement by the general population, amongst whom most future strokes will arise. To help reduce the burden of stroke on individuals and the population a new app, the Stroke Riskometer TM , has been developed. We aim to explore the validity of the app for predicting the risk of stroke compared with current best methods. Methods 752 stroke outcomes from a sample of 9501 individuals across three countries (New Zealand, Russia and the Netherlands) were utilized to investigate the performance of a novel stroke risk prediction tool algorithm (Stroke Riskometer TM ) compared with two established stroke risk score prediction algorithms (Framingham Stroke Risk Score [FSRS] and QStroke). We calculated the receiver operating characteristics (ROC) curves and area under the ROC curve (AUROC) with 95% confidence intervals, Harrels C-statistic and D-statistics for measure of discrimination, R 2 statistics to indicate level of variability accounted for by each prediction algorithm, the Hosmer-Lemeshow statistic for calibration, and the sensitivity and specificity of each algorithm. Results The Stroke Riskometer TM performed well against the FSRS five-year AUROC for both males (FSRS = 75·0% (95% CI 72·3%-77·6%), Stroke Riskometer TM = 74·0(95% CI 71·3%-76·7%) and females [FSRS = 70·3% (95% CI 67·9%-72·8%, Stroke Riskometer TM = 71·5% (95% CI 69·0%-73·9%)], and better than QStroke [males -59·7% (95% CI 57·3%-62·0%) and comparable to females = 71·1% (95% CI 69·0%-73·1%)]. Discriminative ability of all algorithms was low (C-statistic ranging from 0·51-0·56, D-statistic ranging from 0·01-0·12). Hosmer-Lemeshow illustrated that all of the predicted risk scores were not well calibrated with the observed event data (P < 0·006). Conclusions The Stroke Riskometer TM is comparable in performance for stroke prediction with FSRS and QStroke. All three algorithms performed equally poorly in predicting stroke events. The Stroke Riskometer TM will be continually developed and validated to address the need to improve the current stroke risk scoring systems to more accurately predict stroke, particularly by identifying robust ethnic/race ethnicity group and country specific risk factors.
Stroke; a journal of cerebral circulation, Jan 16, 2015