NDLI: The modified Rankin Scale in acute stroke has good inter-rater-reliability but questionable validity.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Zhao, Henry Collier, Janice M. Quah, Dorcas M. Purvis, Tara Bernhardt, Julie
Spatial Coverage	Victoria
Description	Country affiliation: Australia Author Affiliation: Zhao H ( School of Medicine, University of Melbourne, Victoria, Australia.)
Abstract	BACKGROUND AND PURPOSE: The modified Rankin Scale (mRS), designed as a measure of disability in the community, has increasingly been administered in the acute stroke setting but has been poorly studied within the hospital environment. We prospectively studied the interrater reliability of the mRS in acutely hospitalised stroke patients and examined the effect of prior experience with the scale and use of a decision tool on the interrater agreement of trained raters. METHODS: Patients <4 days after stroke were recruited. Individuals from 3 trained rater groups (experienced, inexperienced and inexperienced with decision tool) independently scored each patient within 6 h of each other. Agreement was measured with the intraclass correlation (ICC) and the weighted kappa statistic (kappa(w)), with systematic bias evaluated using the bias index. RESULTS: Twelve raters scored 56 patients with overall agreement of ICC = 0.675. Agreement of kappa(w) = 0.686 was found between experienced and inexperienced raters but a modest systematic bias was present. Experience in rating patients appeared to play some role in affecting agreement but the decision tool did not improve the performance of inexperienced raters. CONCLUSIONS: Trained raters were found to have good interrater agreement overall when the mRS was scored in acute stroke patients but obvious problems with the interpretation and relevancy of the scale in this setting raise concerns about validity. The use of the mRS to rate disability in the acute hospital environment should be questioned.
File Format	HTM / HTML
ISSN	10159770
e-ISSN	14219786
Journal	Cerebrovascular Diseases
Issue Number	2
Volume Number	29
Language	English
Publisher	Karger
Publisher Date	2010-01-01
Publisher Place	Switzerland
Access Restriction	Open
Subject Keyword	Discipline Vascular Diseases Discipline Cardiology Disability Evaluation Stroke Diagnosis Clinical Competence Inpatients Observer Variation Predictive Value Of Tests Prospective Studies Reproducibility Of Results Severity Of Illness Index Time Factors Victoria
Content Type	Text
Resource Type	Article
Subject	Neurology Neurology (clinical) Cardiology and Cardiovascular Medicine

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

Classification of minor stroke: intra- and inter-observer reliability.

Prestroke modified rankin stroke scale has moderate interobserver reliability and validity in an acute stroke setting.

Comparison of telephone and face-to-face assessment of the modified Rankin Scale.

Rater experience influences reliability and validity of the Brief International Classification of Functioning, Disability, and Health Core Set for Stroke.

Validation of a structured interview for telephone assessment of the modified Rankin Scale in Brazilian stroke patients.

Reliability (inter-rater agreement) of the Barthel Index for assessment of stroke survivors: systematic review and meta-analysis.

Reliability of structured modified rankin scale assessment.

Validation of the National Institutes of Health Stroke Scale, modified Rankin Scale and Barthel Index in Brazil: the role of cultural adaptation and structured interviewing.

Deriving modified Rankin scores from medical case-records.

The modified Rankin Scale in acute stroke has good inter-rater-reliability but questionable validity.

Similar Documents

Classification of minor stroke: intra- and inter-observer reliability.

Prestroke modified rankin stroke scale has moderate interobserver reliability and validity in an acute stroke setting.

Comparison of telephone and face-to-face assessment of the modified Rankin Scale.

Rater experience influences reliability and validity of the Brief International Classification of Functioning, Disability, and Health Core Set for Stroke.

Validation of a structured interview for telephone assessment of the modified Rankin Scale in Brazilian stroke patients.

Reliability (inter-rater agreement) of the Barthel Index for assessment of stroke survivors: systematic review and meta-analysis.

Reliability of structured modified rankin scale assessment.

Validation of the National Institutes of Health Stroke Scale, modified Rankin Scale and Barthel Index in Brazil: the role of cultural adaptation and structured interviewing.

Deriving modified Rankin scores from medical case-records.

The modified Rankin Scale in acute stroke has good inter-rater-reliability but questionable validity.