Apply the PREP2 upper-limb prognosis algorithm

Implements the day-3 PREP2 decision tree from SAFE score, age, motor-evoked potential status, and NIH Stroke Scale score.

Usage

prep2(safe_score, age, mep_status = NULL, nihss = NULL)

Arguments

safe_score

Shoulder Abduction and Finger Extension MRC sum, an integer from 0 to 10.

age

Age in years.

mep_status

Optional MEP status: logical, "present"/"MEP+", or "absent"/"MEP-".

nihss

Optional day-3 NIHSS total, an integer from 0 to 42.

Value

A prep2_result containing category, decision pathway, inputs, and a clinical description.

References

Stinear CM, Byblow WD, Ackerley SJ, Smith MC, Stinear JW, Barber PA (2017). PREP2: A biomarker-based algorithm for predicting upper limb function after stroke. Annals of Clinical and Translational Neurology, 4:811-820. doi:10.1002/acn3.488

Examples

prep2(safe_score = 8, age = 65)
#> PREP2 prognosis: Excellent 
#>   Pathway: SAFE>=5 -> age<80 
#>   Full or near-full upper-limb recovery is expected. 
prep2(2, 70, mep_status = "absent", nihss = 5)
#> PREP2 prognosis: Limited 
#>   Pathway: SAFE<5 -> MEP- -> NIHSS<7 
#>   Modest recovery is expected; emphasize task-specific training.