The adaption and evaluation of a Latvian version of the National Institutes of Health Stroke Scale

Objectives To determine the validity and reliability of a Latvian version of the National Institutes of Health Stroke Scale (LV-NIHSS) for evaluating Latvian stroke patients. Methods The adaption of the LV-NIHSS followed standard methods used for the adaption and validation of clinical assessment tools. The scale validity was tested by comparison with the Glasgow Coma Scale (GCS) and the modified Rankin scale (mRs). The reliability of the LV-NIHSS was evaluated by intra-rater and inter-rater agreement using intra-class correlation coefficient (ICC) analysis. Results A total of 296 stroke patients and 101 control subjects were evaluated. The mean age of the overall study population was 73.6 years (range, 37 – 94 years; 227 [57.2%] were female). The mean LV-NIHSS score of the patients with stroke was 8.4 ± 6.2. In terms of construct validity of the LV-NIHSS, it correlated with the GCS ( r = −0.571) and mRs ( r = 0.755). In terms of the reliability of the LV-NIHSS, the inter-rater agreement had an ICC of 0.99 and the intra-rater agreement had an ICC of 0.99. Conclusion The adaption of LV-NIHSS was successful and the evaluation showed that the scale was valid and reliable for evaluating Latvian stroke patients.

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Correlation of neutrophil-to-lymphocyte ratio and clinical outcome of acute thrombotic stroke in patients with COVID-19

Narra J ◽

10.52225/narra.v1i3.50 ◽

2021 ◽

Vol 1 (3) ◽

Author(s):

Rizky Sarengat ◽

Mohammad S. Islam ◽

Mohammad S. Ardhi

Keyword(s):

Ischemic Stroke ◽

Clinical Outcome ◽

Acute Ischemic Stroke ◽

National Institutes Of Health ◽

Neutrophil To Lymphocyte Ratio ◽

Stroke Patients ◽

Cross Sectional ◽

Lymphocyte Ratio ◽

Life Threatening ◽

The Mean

The coronavirus disease 2019 (COVID-19) pandemic has caused millions of deaths worldwide. Acute ischemic stroke is a life-threatening risk factor for COVID-19 infection. Neutrophil-to-lymphocyte ratio (NLR) is one of the predictors of poor prognosis in acute ischemic stroke. The aim of this study was to assess the correlation between NLR values and the clinical outcome of acute thrombotic stroke patients with COVID-19 that was measured using the National Institutes of Health Stroke Scale (NIHSS). A cross-sectional hospital-based study was conducted in Dr. Soetomo General Hospital Surabaya, Indonesia. Patients with acute thrombotic stroke and COVID-19 admitted between 1 March 2020 and 31 May 2021 were recruited. The NLR values and the NIHSS scores were assessed during the admission and the correlation between NLR and NIHSS scores was calculated. This study included 21 patients with acute thrombotic stroke and COVID-19, consisting of 12 males and 9 females. The mean age was 57.6 years old. The mean NLR values was 8.33±6.7 and the NIHSS scores ranging from 1 to 33. Our data suggested a positive correlation between NLR values and NIHSS scores, r=0.45 with p=0.041. In conclusion, the NLR value is potentially to be used as a predictor of the clinical outcome in acute thrombotic stroke patients with COVID-19. However, further study is warranted to validate this finding.

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Evaluation and validation of a patient completed psoriatic arthritis flare questionnaire

The Journal of Rheumatology ◽

10.3899/jrheum.201317 ◽

2021 ◽

pp. jrheum.201317

Author(s):

Philip S. Helliwell ◽

William Tillett ◽

Robin Waxman ◽

Laura C. Coates ◽

Mel Brooke ◽

...

Keyword(s):

Psoriatic Arthritis ◽

Disease Activity ◽

Loss Of Function ◽

Intra Class Correlation ◽

The Mean ◽

Definition Of ◽

Multiple Domains ◽

Intra Class Correlation Coefficient ◽

Symptoms And Signs ◽

Patient Opinion

Objective Evaluation of a psoriatic arthritis (PsA), multidimensional, patient completed disease flare questionnaire (FLARE). Methods The FLARE questionnaire was administered to 139 patients in a prospective observational study. The ‘gold standard’ of flare was based on patient opinion. Test-retest was evaluated by intra-class correlation coefficient (ICC). Disease activity was measured by the PASDAS, GRACE, CPDAI and DAPSA. Results The most common symptoms of a PsA flare were musculoskeletal, followed by fatigue, frustration, loss of function and an increase in cutaneous symptoms. The test-retest ICC for the FLARE questionnaire was 0.87 (95% CI 0.72 – 0.94). The optimum cut-off to identify a flare of disease was 4/10 (sensitivity 0.82, specificity 0.76; area under curve 0.85). For those patients scoring 4 or above, the mean score for the composite measures was as follows (score for those not reporting a flare in brackets): PASDAS, 5.3 ± 1.3 (3.1 ± 1.6); GRACE, 4.5 ± 1.2 (2.2 ± 1.4); CPDAI, 8.9 ± 2.5 (4.7 ± 3.1); DAPSA, 38.2 ± 20.3 (16.8 ± 14.9). In a new flare the increase in composite measure score was calculated as follows; 1 for PASDAS and GRACE, 2 for CPDAI, 7 for DAPSA. Moderate agreement was found between the definition of flare using the cut-off of 4, indicated by subjects in a separate question. Conclusion A PsA flare displays escalation of symptoms and signs across multiple domains; the FLARE questionnaire has external validity both in terms of composite disease activity and overall patient opinion of the state of their condition.

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Validity and Reliability of Socio-Cognitive Determinants of Water Intake Questionnaire in Kidney Stones Patients

10.21203/rs.2.12175/v2 ◽

2020 ◽

Author(s):

Mehdi Mirzaei-Alavijeh ◽

Farzad Jalilian ◽

Halimeh Fatahi ◽

Laleh Solaimanizadeh ◽

Abdollah Saadatfar ◽

...

Keyword(s):

Internal Consistency ◽

Water Intake ◽

Kidney Stones ◽

Psychometric Evaluation ◽

Field Studies ◽

Validity And Reliability ◽

Intra Class Correlation ◽

Theoretical Assumptions ◽

Cognitive Determinants ◽

Intra Class Correlation Coefficient

Abstract Background Developing a valid and reliable questionnaire is an important step in field studies. This study aimed to evaluate the psychometric propertiesof the socio-cognitive determinants of water intake questionnaire behaviors among patients with kidney stones in the west of Iran.Methods Construct items were elicited from interviews with kidney stones patients, experts and socio-cognitive items pool-related similar questionnaires. Internal consistency, face, content, and construct validity were evaluated. Data were analyzed by SPSS (ver. 20.0).Results Based on Eigenvalues of ≥ 1.00 and factor loadings of ≥ 0.40, five determinants were extracted. The calculated Kaiser–Meyer–Olkin (KMO) value was 0.697. The socio-cognitive determinants of water intake questionnaires were found to have acceptable internal consistency (Cronbach alpha of determinants between 0.65-0.85) and the theoretical assumptions for face, content, and construct validities were confirmed. The Intra-class Correlation Coefficient (ICC) of socio-cognitive determinants was high (ICC between 0.810 - 0.911). Overall, the five studied socio-cognitive determinants explained 73.83% of the variance in the proposed model.Conclusions The socio-cognitive determinants of water intake questionnaire were revealed to have an acceptable psychometric evaluation. The questionnaire could be used to predict or explain water intake behavior in order to develop programs to increase water intake behavior among kidney stones patients.

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Clot composition of embolic strokes of undetermined source: a feasibility study

BMC Neurology ◽

10.1186/s12883-020-01969-w ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Amre Nouh ◽

Tapan Mehta ◽

Mohamed Hussain ◽

Xianyuan Song ◽

Martin Ollenschleger

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Mechanical Thrombectomy ◽

National Institutes Of Health ◽

Carotid Dissection ◽

Stroke Patients ◽

Stroke Etiology ◽

The Mean ◽

Undetermined Etiology ◽

A Prospective Study

Abstract Background A number of emerging studies have evaluated clot composition in acute ischemic stroke. Studies of clot composition of embolic strokes of undetermined strokes are lacking. Objectives We sought to analyze the RBC to platelet ratios in clots and correlated our findings with stroke etiology. Methods This was a prospective study analyzing clots retrieved by mechanical thrombectomy in acute ischemic stroke patients at our institution. All clots were stained and scanned at 200x magnification by using a Scanscope XT digital scanner (Apergio, Vista, California). Image-J software (National Institutes of Health, Bethesda, Maryland) was used for semi quantitative analysis of percentage RBC’s and platelets. Unpaired t-test was used to compare means of RBC to Platelet ratios. Correlation of RBC to Platelet ratios with stroke etiology was performed. Results A total of 33 clots from 33 patients were analyzed. Stroke etiology was undetermined in 6 patients, cardioembolic in 14, large vessel atherosclerosis (LVA) in 9, and carotid dissection in 4. The mean RBC to platelet ratio was 0.78:1 (+/− 0.65) in cardioembolic clots, 1.73:1 (+/− 2.38) in LVA and 1.4:1(+/− 0.70) in carotid dissections. Although patients with undetermined etiology had a similar clot composition to cardioembolic stroke (0.36:1+/− 0.33), (p = 0.19), it differed significantly from LVA and dissections respectively (p = 0.037, p = 0.01). Conclusion In our study, a low RBC to Platelet ratio was found among patients with embolic strokes of undetermined source, however shared similar characteristics with cardioembolic thrombi. Ongoing collection and analysis is needed to confirm these findings and its significance in evaluating stroke etiology.

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Embolic stroke of undetermined source (ESUS) cohort of Brazilian patients in a university hospital

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20190045 ◽

2019 ◽

Vol 77 (5) ◽

pp. 315-320

Author(s):

Gabriel Pinheiro Modolo ◽

Juli Thomaz De Souza ◽

Fernanda Cristina Winckler ◽

Natalia Cristina Ferreira ◽

Marcos Cristiano Lange ◽

...

Keyword(s):

Risk Factors ◽

Medical Records ◽

Health Financing ◽

National Institutes Of Health ◽

Embolic Stroke ◽

University Hospital ◽

Stroke Patients ◽

Important Group ◽

Small Cohort ◽

The Mean

ABSTRACT Embolic stroke of undetermined source (ESUS) is an important group of cryptogenic strokes that are in evidence due recent ongoing trials. We reviewed medical records at discharge from the stroke unit of all patients who met ESUS criteria and attended our institution between February 2016 and July 2017. Among 550 stroke patients, 51 had ESUS. We found that hypertension (60%), diabetes mellitus (34%), and smoking (36%) were the most prevalent risk factors. The mean National Institutes of Health Stroke Scale (NIHSS) scores were 7 at admission and 4 at discharge, while median scores on the modified Rankin scale were 0 and 2 at admission and discharge, respectively. Our sample had similar ages, risk factors prevalence and NIHSS scores at admission and discharge when compared with European and North American cohorts. Although a small cohort, our study suggests that the ESUS population is similar in countries with different health financing.

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Low level of stroke care awareness among stroke patients’ caregivers: an important but neglected area of stroke care

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v9i3.10208 ◽

2014 ◽

Vol 9 (3) ◽

pp. 1-11

Author(s):

N Sharma ◽

M Sharma ◽

M Lopchan ◽

L Thapa ◽

PVS Rana

Keyword(s):

Knowledge Score ◽

Stroke Care ◽

Validity And Reliability ◽

Medical Sciences ◽

Stroke Patients ◽

Mortality And Morbidity ◽

Low Level ◽

Causes Of Mortality ◽

The Mean ◽

Stroke Knowledge

Objective Stroke is one of the leading causes of mortality and morbidity worldwide. Stroke patients require longterm care for better outcome. Most often family members are the back bone of the service provided to people affected by stroke. Stroke patients and their caregivers are known to have large gaps in stroke knowledge and have suboptimal personal health behaviors, thereby putting the patient at high risk for complications. Our study was designed to explore the stroke care awareness among stroke patients' caregivers.Methods 50 stroke caregivers aged >18 years from neurology ward of College of Medical Sciences-Teaching Hospital were selected by non-probability purposive sampling from June 2012 to July 2012. Questionnaire focusing basic stroke care was prepared by researchers with the help of literature and a neurophysician. Validity and reliability of the tools were tested and data collected. Analysis of collected data was done using SPSS 16.0.Results The mean age of the respondents was 40 years (range: 20-80 years). Thirty-nine (78%) were either spouse or children. Thirty-eight (76%) caregivers were literate. Overall, 27 (54%) caregivers had low level of awareness regarding stroke care and mean knowledge score was 23.7.Conclusion This study has revealed the existence of low level of stroke care awareness amongst stroke caregivers. Interventional education program oriented to address this important yet neglected area can improve the stroke care in countries like Nepal where recent advancement for stroke management is lacking. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-3, 1-8

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HUBUNGAN ANTARA DERAJAT KEPARAHAN STROKE DENGAN KEJADIAN STROKE-ASSOCIATED PNEUMONIA

Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia ◽

10.52386/neurona.v35i2.20 ◽

2018 ◽

Vol 35 (2) ◽

Author(s):

Rega Dwi Wandira ◽

Lisda Amalia ◽

Iwan Fuadi

Keyword(s):

National Institutes Of Health ◽

Stroke Severity ◽

Stroke Patients ◽

Exclusion Criteria ◽

Chi Square ◽

Historical Cohort ◽

Cohort Design ◽

Study Population ◽

Neurological Ward

ASSOCIATION BETWEEN STROKE SEVERITY AND STROKE-ASSOCIATED PNEUMONIAABSTRACTIntroduction: Stroke-associated pneumonia (SAP) occurs in 5-26% and decreases the quality of life and clinical outcomes of stroke patients. One of the factors that affect the incidence of SAP is the stroke severity.Aims: To determine the association between the stroke severity and the incidence of stroke-associated pneumonia in the neurological ward of Dr. Hasan Sadikin Hospital, Bandung.Methods: This is an analytic retrospective (historical) cohort design study. The study population was stroke patients who were treated in the neurological ward of Dr. Hasan Sadikin Hospital, Bandung between 2014-2016. Exclusion criteria were patient with pneumonia other than SAP and using mechanical ventilation. Stroke severity was assessed using NIHSS (National Institute of Health Stroke Scale). Chi-square was used to determine inter-variable association.Results: Among 81 subjects, 24 were assessed as SAP (29.6%). The SAP prevalence were mostly male (58.3%), age group between 65-74 year old (41.7%) with hypertension risk (87.5%), stroke onset <48 hours, lesion location on left hemisphere, onset of SAP≥48 hours, and those with consciousness impairment. Those with high stroke severity tend to have higher risk of pneumonia 3.063 times compare to patients with low stroke severity.Discussion: There was a significant association between the severity of stroke and the incidence of SAP in the neu- rological ward of Dr. Hasan Sadikin Hospital, Bandung.Keywords: NIHSS, stroke-associated pneumonia, stroke severityABSTRAKPendahuluan: Stroke-associated pneumonia (SAP) cukup sering terjadi (5-26%) pada pasien stroke, sehingga menurunkan angka kualitas hidup dan luaran klinis. Salah satu faktor yang memengaruhi kejadian SAP adalah derajat keparahan stroke.Tujuan: Mengetahui hubungan antara derajat keparahan stroke dengan kejadian SAP di Ruang Rawat NeurologiRSUP Dr. Hasan Sadikin, Bandung.Metode: Penelitian analitik dengan desain kohort retrospektif (historikal) terhadap pasien stroke iskemik yang di rawat di Ruang Rawat Neurologi RSUP Dr. Hasan Sadikin, Bandung pada tahun 2014-2016. Kriteria eksklusi adalah pasien dengan pneumonia selain SAP dan menggunakan alat ventilasi mekanik. Derajat keparahan stroke dinilai menggu- nakan skor NIHSS (National Institutes of Health Stroke Scale). Uji korelasi Chi-square digunakan untuk melihat hubungan antar-variabel.Hasil: Didapatkan 81 subjek yang 24 orang di antaranya mengalami SAP (29,6%). Prevalensi SAP tertinggi pada laki-laki (58,3%) kelompok usia 65-74 tahun (41,7%) dengan faktor risiko hipertensi (87,5%), onset stroke<48 jam, lokasi lesi di hemisfer kiri, onset SAP≥48 jam, serta pada subjek dengan penurunan kesadaran. Subjek dengan derajat keparahan stroke berat memiliki risiko terjadinya pneumonia 3,063 lebih tinggi dibandingkan dengan derajat keparahan ringan.Diskusi: Terdapat hubungan yang bermakna antara derajat keparahan stroke dengan kejadian SAP di Ruang Rawat Neurologi RSUP Dr. Hasan Sadikin, Bandung.Kata kunci: Derajat keparahan stroke, NIHSS, stroke-associated pneumonia

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Validity and reliability of the English and translated Chinese versions of the Integrated Palliative care Outcome Scale (IPOS) in Singapore

10.21203/rs.3.rs-120229/v1 ◽

2020 ◽

Author(s):

Victoria Long ◽

Yin Bun Cheung ◽

Debra Qu ◽

Katherine Lim ◽

Guozhang Lee ◽

...

Keyword(s):

Correlation Coefficient ◽

Internal Consistency ◽

Validity And Reliability ◽

Cronbach’S Alpha ◽

Rater Reliability ◽

Intra Class Correlation ◽

Retest Reliability ◽

Cronbach's Alpha ◽

Test Retest Reliability ◽

Intra Class Correlation Coefficient

Abstract Context: Measurement of patient-centred outcomes enables clinicians to focus on patient and family priorities and enables quality of palliative care to be assessed.Objectives: This study aimed to evaluate the validity and reliability of the English and translated Chinese IPOS among advanced cancer patients in Singapore.Methods: IPOS was forward and backward translated from English into Chinese. Structural validity was assessed by confirmatory factor analysis; known-group validity by comparing inpatients and community patients; construct validity by correlating IPOS with Edmonton Symptom Assessment System-revised (ESAS-r) and Functional Assessment of Cancer Therapy–General (FACT-G); internal consistency by Cronbach’s alpha; inter-rater reliability between patient and staff responses; test-retest reliability of patient responses between two timepoints.Results: 111 English-responding and 109 Chinese-responding patients participated. The three-factor structure (Physical Symptoms, Emotional Symptoms and Communication and Practical Issues) was confirmed with Comparative Fit Index and Tucker-Lewis-Index > 0.9 and Root Mean Square Error of Approximation < 0.08. Inpatients scored higher than outpatients as hypothesised. Construct validity (Pearson’s correlation coefficient, r≥|0.608|) was shown between the related subscales of IPOS and FACT-G and ESAS-r. Internal consistency was confirmed for total and subscale scores (Cronbach's alpha ≥ 0.84), except for the Communication and Practical Issues subscale (Cronbach’s alpha = 0.29–0.65). Inter-rater reliability (Intra-class correlation coefficient [ICC] ≤ 0.43) between patient and staff responses was insufficient. Test-retest reliability was confirmed with Intra-class correlation coefficient ICC = 0.80 (English) and 0.88 (Chinese) for IPOS Total.Conclusion: IPOS in English and Chinese showed good validity, good internal consistency, and good test-retest reliability, except for the Communication and Practical Issues subscale. There was poor inter-rater reliability between patients and staff.

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Developing a safety audit checklist for in-operation administrative buildings

Work ◽

10.3233/wor-205011 ◽

2021 ◽

pp. 1-10

Author(s):

Hiro Kaleh ◽

Farough Mohammadian ◽

Mostafa Pouyakian

Keyword(s):

Content Validity ◽

Intrinsic Value ◽

Face Validity ◽

Audit Tool ◽

Validity And Reliability ◽

Intra Class Correlation ◽

Factors Affecting ◽

Building Safety ◽

Intra Class Correlation Coefficient ◽

Early Warnings

BACKGROUND: The structure of buildings is in degradation over time, monitoring their safety status and providing timely warnings is crucial. Therefore, an efficient visual inspection of the building’s safety has intrinsic value to give early warnings to owners and managers. OBJECTIVE: This study aimed to provide an audit tool for evaluation of the administrative in-operation buildings’ safety status. METHODS: Factors affecting the administrative buildings’ safety status was determined based on the National Building Regulations of Iran (NBRI) and other studies. checklist items and their guidelines were prepared. Face validity (quantitative and qualitative), content validity ratio (CVR), and content validity index (CVI) were calculated for the checklist. The Intra-class correlation coefficient (ICC) used for inter-rater reliability and Cronbach’s α was used to evaluate internal consistency of the checklist. RESULTS: Forty-seven items related to in-operation building safety were extracted from literature review. Based on the results of the psychometric analysis, 5 items were removed and 42 items remained. The values of different psychometric indices for the other items indicated their acceptable validity. (α= 0.82, ICC≥0.75). CONCLUSION: The designed checklist had a good level of validity and reliability for inspecting architectural, technical services, and managerial safety aspects of administrative in-operation buildings. Stakeholders can use it for quick and comprehensive assessment of building safety. Use of this checklist are expected to give early warnings about the safety of buildings to the stakeholders.

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Development of a Radiographic Index for Periodontitis

Dentistry Journal ◽

10.3390/dj9020019 ◽

2021 ◽

Vol 9 (2) ◽

pp. 19

Author(s):

Zeyad M. H. Shaker ◽

Azin Parsa ◽

Keyvan Moharamzadeh

Keyword(s):

Correlation Coefficient ◽

Gold Standard ◽

Alveolar Bone ◽

Strong Association ◽

Visual Interpretation ◽

Intra Class Correlation ◽

Furcation Involvement ◽

The Mean ◽

Examiner Agreement ◽

Intra Class Correlation Coefficient

The use of radiographic indices is noticeably diminished due to the lack of simplicity and standardisation among the existing ones. The aim of this study was to introduce a radiographic index to aid clinicians in determining the extent and severity of interproximal alveolar bone loss (iABL), in relation to individual root lengths, among patients suffering from periodontitis. A retrospective analysis of 50 anonymised dental panoramic tomograms (DPTs) of patients with periodontitis was conducted. Visual interpretation of iABL was recorded by a single investigator and by 20 volunteering clinicians for the ‘worst site’ in each quintet. Results were compared to a gold standard quantification method. Intra-examiner and inter-examiner agreement were measured using the Kappa coefficient and the intra-class correlation coefficient, respectively. Validity was assessed using Cramér’s V test. The mean intra-examiner agreement on the severity and pattern of iABL was 0.808 (K) and 0.802 (K), respectively. A stronger overall inter-examiner agreement was noted when the severity in contrast to the pattern of iABL and presence/absence of furcation involvement were analysed. The statistically significant total mean agreement values from this correlation coefficient were 0.892 and 0.739, respectively. A very strong association between all the visual interpretations carried out by all participants and the gold standard measurements was evident. Within the limitations of this study, the proposed radiographic index may serve as a simple, yet valid and reliable, adjunctive screening tool to further assist clinicians in determining the extent and severity of iABL in patients with periodontitis.

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