The ‘Standard’ for Poststroke Aphasia Recovery

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See related article, pages 1485–1488. The past 2 decades may be remembered as the decades of metrics in medicine. All aspects of our work have been measured and charted by relative value units, H-indices, case mix indices, mean lengths of stay, mean patient satisfaction scores, and so on. Some metrics are important, some less so. However, 1 important measure is the degree to which a patient with stroke will be able to improve in the next 90 days. Decisions need to be made about whether to apply for disability, move to assisted living, or whether to wait for improvement to occur. We as stroke neurologists think we know the answers, but we all give different answers based on very little data; we often say it depends on the size of the stroke, the patient’s age and education, the severity and type of the deficit, the quality and duration of therapy, and so on. However, seemingly within a wide range of these variables, Lazar and colleagues1 have found that that there is a single answer that does not depend on any of these variables; by 90 days, patients improve by approximately 70% of the maximum potential recovery (the maximum potential language score minus their initial score) as long as they receive at …