scholarly journals The reliability and validity of a slightly revised Chinese version simplified modified Rankin scale questionnaire

2019 ◽  
Author(s):  
Junliang yuan ◽  
yunxiao wang ◽  
Wenli Hu ◽  
Askiel Bruno
Keyword(s):  
Ischemic Stroke ◽  
Reliability And Validity ◽  
Weighted Kappa ◽  
Chinese Version ◽  
The Novel ◽  
Modified Rankin Scale ◽  
English Version ◽  
Stroke Patients ◽  
Rater Reliability ◽  
Percent Agreement

Abstract Background: The slightly revised English version simplified modified Rankin scale questionnaire smRSq(2011) was shown to be reliable, valid, and useful in scoring the modified Rankin scale (mRS) after stroke. Our aim was to assess the inter-rater reliability and validity of a novel Chinese version smRSq(2011). Methods: The English version smRSq(2011) was translated into Chinese by a standard process. We recruited 300 consecutive hospitalized ischemic stroke patients in the department of neurology, Beijing Chaoyang Hospital. Six randomly paired raters scored the conventional mRS, the novel Chinese version smRSq(2011), the National Institutes of Health Stroke Scale (NIHSS), and the Barthel index (BI) in-person. Inter-rater reliability and validity were assessed. Results: Among the 300 ischemic stroke patients, mean age was 64.9±12.1 years, and 220 (73%) were male. For inter-rater reliability of the smRSq(2011), the percent agreement among the paired raters was 87%, the kappa (κ) was 0.84 (95% CI, 0.79-0.88), and the weighted kappa (κw) was 0.96 (95% CI, 0.95-0.98). The percent agreement between the smRSq(2011) scores by the first rater and the conventional mRS scores by the second rater in each pair was 55%, κ=0.47 (95% CI, 0.40-0.54), and κw=0.91 (95% CI, 0.89-0.93). In construct validity testing, the Spearman’s correlation coefficients comparing the smRSq(2011) scores by the first rater with the NIHSS and the BI scores by the second rater were 0.83 (P<0.001) and -0.86 (P<0.001), respectively. Conclusions: Our results suggest usefulness of the novel Chinese version smRSq(2011) in scoring the mRS in Chinese stroke patients. Further validation in other clinical settings, including in communities and by remote methods in China is warranted.

scholarly journals The reliability and validity of a slightly revised Chinese version simplified modified Rankin scale questionnaire

2020 ◽  
Author(s):  
Junliang yuan ◽  
yunxiao wang ◽  
Wenli Hu ◽  
Askiel Bruno
Keyword(s):  
Ischemic Stroke ◽  
Reliability And Validity ◽  
Weighted Kappa ◽  
Chinese Version ◽  
The Novel ◽  
Modified Rankin Scale ◽  
English Version ◽  
Stroke Patients ◽  
Rater Reliability ◽  
Percent Agreement

Abstract Background The slightly revised English version simplified modified Rankin scale questionnaire smRSq(2011) was shown to be reliable, valid, and useful in scoring the modified Rankin scale (mRS) after stroke. Our aim was to assess the inter-rater reliability and validity of a novel Chinese version smRSq(2011). Methods The English version smRSq(2011) was translated into Chinese by a standard process. We recruited 300 consecutive hospitalized ischemic stroke patients in the department of neurology, Beijing Chaoyang Hospital. Six randomly paired raters scored the conventional mRS, the novel Chinese version smRSq(2011), the National Institutes of Health Stroke Scale (NIHSS), and the Barthel index (BI) in-person. Inter-rater reliability and validity were assessed. Results Among the 300 ischemic stroke patients, mean age was 64.9±12.1 years, and 220 (73%) were male. For inter-rater reliability of the smRSq(2011), the percent agreement among the paired raters was 87%, the kappa (κ) was 0.84 (95% CI, 0.79-0.88), and the weighted kappa (κw) was 0.96 (95% CI, 0.95-0.98). The percent agreement between the smRSq(2011) scores by the first rater and the conventional mRS scores by the second rater in each pair was 55%, κ=0.47 (95% CI, 0.40-0.54), and κw=0.91 (95% CI, 0.89-0.93). In construct validity testing, the Spearman’s correlation coefficients comparing the smRSq(2011) scores by the first rater with the NIHSS and the BI scores by the second rater were 0.83 (P<0.001) and -0.86 (P<0.001), respectively. Conclusions Our results show good clinimetric properties of the novel Chinese version smRSq(2011) in scoring the mRS in Chinese stroke patients. Further validation in other clinical settings, including in communities and by remote methods in China is warranted.

scholarly journals The reliability and validity of a slightly optimized Chinese version simplified modified Rankin scale questionnaire

2019 ◽  
Author(s):  
Junliang yuan ◽  
yunxiao wang ◽  
Wenli Hu ◽  
Askiel Bruno
Keyword(s):  
Ischemic Stroke ◽  
Reliability And Validity ◽  
Weighted Kappa ◽  
Chinese Version ◽  
The Novel ◽  
Modified Rankin Scale ◽  
English Version ◽  
Stroke Patients ◽  
Rater Reliability ◽  
Percent Agreement

Abstract Background: The slightly optimized English version simplified modified Rankin scale questionnaire smRSq(2011) was shown to be reliable, valid, and useful in scoring the modified Rankin scale (mRS) after stroke. Our aim was to assess the inter-rater reliability and validity of a novel Chinese version smRSq(2011). Methods: The English version smRSq(2011) was translated into Chinese by a standard process. We recruited 300 consecutive hospitalized ischemic stroke patients in the department of neurology, Beijing Chaoyang Hospital. Six randomly paired raters scored the conventional mRS, the novel Chinese version smRSq(2011), the National Institutes of Health Stroke Scale (NIHSS), and the Barthel index (BI) in-person. Inter-rater reliability and validity were assessed. Results: Among the 300 ischemic stroke patients, mean age was 64.9±12.1 years, and 220 (73%) were male. For inter-rater reliability of the smRSq(2011), the percent agreement among raters was 87%, the kappa (κ) was 0.84 (95% CI, 0.79-0.88), and the weighted kappa (κw) was 0.96 (95% CI, 0.95-0.98). The percent agreement between the conventional mRS and the smRSq(2011) was 63%, κ=0.57 (95% CI, 0.50-0.63) and κw=0.93 (95% CI, 0.91-0.95). In construct validity testing, the Spearman’s correlation coefficients comparing the smRSq(2011) to the NIHSS and the BI were 0.83 (P<0.001) and 0.86 (P<0.001), respectively. Conclusions: Our results suggest usefulness of the novel Chinese version smRSq(2011) in scoring the mRS in Chinese stroke patients. Further validation in other clinical settings, including in communities and by remote methods in China is warranted.

scholarly journals The reliability and validity of a novel Chinese version simplified modified Rankin scale questionnaire(2011)

2020 ◽  
Author(s):  
Junliang yuan ◽  
yunxiao wang ◽  
Wenli Hu ◽  
Askiel Bruno
Keyword(s):  
Ischemic Stroke ◽  
Reliability And Validity ◽  
Chinese Version ◽  
Chinese Patients ◽  
The Novel ◽  
Modified Rankin Scale ◽  
English Version ◽  
Stroke Patients ◽  
Rater Reliability ◽  
Percent Agreement

Abstract Background The modified Rankin Scale (mRS) is a key global outcome measure after stroke internationally. The latest English version of the simplified modified Rankin scale questionnaire (smRSq)(2011) is a reliable and valid tool in scoring the mRS after stroke. In order to use this tool in Chinese patients, we translated it into Chinese and tested its clinimetric properties. Methods The English version smRSq(2011) was translated into Chinese by a standard process. We recruited 300 consecutive hospitalized ischemic stroke patients in the department of neurology, Beijing Chaoyang Hospital. Six randomly paired raters scored the conventional mRS, the novel Chinese version smRSq(2011), the National Institutes of Health Stroke Scale (NIHSS), and the Barthel index (BI) in-person. Inter-rater reliability and validity were assessed. Results Among the 300 ischemic stroke patients, mean age was 64.9±12.1 years, and 220 (73%) were male. For inter-rater reliability of the smRSq(2011), the percent agreement among the paired raters was 87%, the kappa (κ) was 0.84 (95% CI, 0.79-0.88), and the weighted kappa (κw) was 0.96 (95% CI, 0.95-0.98). The percent agreement between the smRSq(2011) scores and the conventional mRS scores was 55%, κ=0.47 (95% CI, 0.40-0.54), and κw=0.91 (95% CI, 0.89-0.93). In construct validity testing, the Spearman’s correlation coefficients comparing the smRSq(2011) scores with the NIHSS and the BI scores were 0.83 (P<0.001) and -0.86 (P<0.001), respectively. Conclusions Our results show good to excellent clinimetric properties of the novel Chinese version smRSq(2011) in scoring the mRS in Chinese stroke patients. Further validation in other clinical settings, including in communities and by remote methods in China is warranted.

scholarly journals The reliability and validity of a novel Chinese version simplified modified Rankin scale questionnaire(2011)

2020 ◽  
Author(s):  
Junliang yuan ◽  
yunxiao wang ◽  
Wenli Hu ◽  
Askiel Bruno
Keyword(s):  
Ischemic Stroke ◽  
Reliability And Validity ◽  
Chinese Version ◽  
Chinese Patients ◽  
The Novel ◽  
Modified Rankin Scale ◽  
English Version ◽  
Stroke Patients ◽  
Rater Reliability ◽  
Percent Agreement

Abstract Background The modified Rankin Scale (mRS) is a key global outcome measure after stroke internationally. The latest English version of the simplified modified Rankin scale questionnaire (smRSq)(2011) is a reliable and valid tool in scoring the mRS after stroke. In order to use this tool in Chinese patients, we translated it into Chinese and tested its clinimetric properties. Methods The English version smRSq(2011) was translated into Chinese by a standard process. We recruited 300 consecutive hospitalized ischemic stroke patients in the department of neurology, Beijing Chaoyang Hospital. Six randomly paired raters scored the conventional mRS, the novel Chinese version smRSq(2011), the National Institutes of Health Stroke Scale (NIHSS), and the Barthel index (BI) in-person. Inter-rater reliability and validity were assessed. Results Among the 300 ischemic stroke patients, mean age was 64.9±12.1 years, and 220 (73%) were male. For inter-rater reliability of the smRSq(2011), the percent agreement among the paired raters was 87%, the kappa ( κ) was 0.84 (95% CI, 0.79-0.88), and the weighted kappa ( κ w ) was 0.96 (95% CI, 0.95-0.98). The percent agreement between the smRSq(2011) scores and the conventional mRS scores was 55%, κ =0.47 (95% CI, 0.40-0.54), and κ w =0.91 (95% CI, 0.89-0.93). In construct validity testing, the Spearman’s correlation coefficients comparing the smRSq(2011) scores with the NIHSS and the BI scores were 0.83 ( P <0.001) and -0.86 ( P <0.001), respectively. Conclusions Our results show good to excellent clinimetric properties of the novel Chinese version smRSq(2011) in scoring the mRS in Chinese stroke patients. Further validation in other clinical settings, including in communities and by remote methods in China is warranted.

Are the Naranjo Criteria Reliable and Valid for Determination of Adverse Drug Reactions in the Intensive Care Unit?

2005 ◽  
Vol 39 (11) ◽  
pp. 1823-1827 ◽  
Author(s):  
Sandra L Kane-Gill ◽  
Levent Kirisci ◽  
Dev S Pathak
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Adverse Drug Reactions ◽  
Reliability And Validity ◽  
Kappa Statistic ◽  
Weighted Kappa ◽  
Drug Reactions ◽  
Rater Reliability ◽  
Cronbach Alpha

BACKGROUND The Naranjo criteria are frequently used for determination of causality for suspected adverse drug reactions (ADRs); however, the psychometric properties have not been studied in the critically ill. OBJECTIVE To evaluate the reliability and validity of the Naranjo criteria for ADR determination in the intensive care unit (ICU). METHODS All patients admitted to a surgical ICU during a 3-month period were enrolled. Four raters independently reviewed 142 suspected ADRs using the Naranjo criteria (review 1). Raters evaluated the 142 suspected ADRs 3–4 weeks later, again using the Naranjo criteria (review 2). Inter-rater reliability was tested using the kappa statistic. The weighted kappa statistic was calculated between reviews 1 and 2 for the intra-rater reliability of each rater. Cronbach alpha was computed to assess the inter-item consistency correlation. The Naranjo criteria were compared with expert opinion for criterion validity for each rater and reported as a Spearman rank (rs) coefficient. RESULTS The kappa statistic ranged from 0.14 to 0.33, reflecting poor inter-rater agreement. The weighted kappa within raters was 0.5402–0.9371. The Cronbach alpha ranged from 0.443 to 0.660, which is considered moderate to good. The rs coefficient range was 0.385–0.545; all rs coefficients were statistically significant (p < 0.05). CONCLUSIONS Inter-rater reliability is marginal; however, within-rater evaluation appears to be consistent. The inter-item correlation is expected to be higher since all questions pertain to ADRs. Overall, the Naranjo criteria need modification for use in the ICU to improve reliability, validity, and clinical usefulness.

scholarly journals Dysphagia in Patients with Acute Ischemic Stroke: Early Dysphagia Screening May Reduce Stroke-Related Pneumonia and Improve Stroke Outcomes

2016 ◽  
Vol 42 (1-2) ◽  
pp. 81-89 ◽  
Author(s):  
Mohamed Al-Khaled ◽  
Christine Matthis ◽  
Andreas Binder ◽  
Jonas Mudter ◽  
Joern Schattschneider ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Case Fatality ◽  
National Institutes Of Health ◽  
Modified Rankin Scale ◽  
Stroke Patients ◽  
Stroke Outcomes ◽  
Increased Risk ◽  
Reduced Risk

Background: Dysphagia is associated with poor outcome in stroke patients. Studies investigating the association of dysphagia and early dysphagia screening (EDS) with outcomes in patients with acute ischemic stroke (AIS) are rare. The aims of our study are to investigate the association of dysphagia and EDS within 24 h with stroke-related pneumonia and outcomes. Methods: Over a 4.5-year period (starting November 2007), all consecutive AIS patients from 15 hospitals in Schleswig-Holstein, Germany, were prospectively evaluated. The primary outcomes were stroke-related pneumonia during hospitalization, mortality, and disability measured on the modified Rankin Scale ≥2-5, in which 2 indicates an independence/slight disability to 5 severe disability. Results: Of 12,276 patients (mean age 73 ± 13; 49% women), 9,164 patients (74%) underwent dysphagia screening; of these patients, 55, 39, 4.7, and 1.5% of patients had been screened for dysphagia within 3, 3 to <24, 24 to ≤72, and >72 h following admission. Patients who underwent dysphagia screening were likely to be older, more affected on the National Institutes of Health Stroke Scale score, and to have higher rates of neurological symptoms and risk factors than patients who were not screened. A total of 3,083 patients (25.1%; 95% CI 24.4-25.8) had dysphagia. The frequency of dysphagia was higher in patients who had undergone dysphagia screening than in those who had not (30 vs. 11.1%; p < 0.001). During hospitalization (mean 9 days), 1,271 patients (10.2%; 95% CI 9.7-10.8) suffered from stroke-related pneumonia. Patients with dysphagia had a higher rate of pneumonia than those without dysphagia (29.7 vs. 3.7%; p < 0.001). Logistic regression revealed that dysphagia was associated with increased risk of stroke-related pneumonia (OR 3.4; 95% CI 2.8-4.2; p < 0.001), case fatality during hospitalization (OR 2.8; 95% CI 2.1-3.7; p < 0.001) and disability at discharge (OR 2.0; 95% CI 1.6-2.3; p < 0.001). EDS within 24 h of admission appeared to be associated with decreased risk of stroke-related pneumonia (OR 0.68; 95% CI 0.52-0.89; p = 0.006) and disability at discharge (OR 0.60; 95% CI 0.46-0.77; p < 0.001). Furthermore, dysphagia was independently correlated with an increase in mortality (OR 3.2; 95% CI 2.4-4.2; p < 0.001) and disability (OR 2.3; 95% CI 1.8-3.0; p < 0.001) at 3 months after stroke. The rate of 3-month disability was lower in patients who had received EDS (52 vs. 40.7%; p = 0.003), albeit an association in the logistic regression was not found (OR 0.78; 95% CI 0.51-1.2; p = 0.2). Conclusions: Dysphagia exposes stroke patients to a higher risk of pneumonia, disability, and death, whereas an EDS seems to be associated with reduced risk of stroke-related pneumonia and disability.

Acute intracranial stenting with mechanical thrombectomy is safe and efficacious in patients diagnosed with underlying intracranial atherosclerotic disease

2021 ◽  
pp. 159101992110394
Author(s):  
Ameer E Hassan ◽  
Victor M Ringheanu ◽  
Laurie Preston ◽  
Wondwossen G Tekle ◽  
Adnan I Qureshi
Keyword(s):  
Ischemic Stroke ◽  
Length Of Stay ◽  
Intracerebral Hemorrhage ◽  
Cerebral Infarction ◽  
Acute Ischemic Stroke ◽  
Mechanical Thrombectomy ◽  
Modified Rankin Scale ◽  
Stroke Patients ◽  
Intracranial Stenting ◽  
Intracranial Atherosclerotic Disease

Objective To investigate whether significant differences exist in recanalization rates and primary outcomes between patients who undergo mechanical thrombectomy alone versus those who undergo mechanical thrombectomy with acute intracranial stenting. Methods Through the utilization of a prospectively collected endovascular database at a comprehensive stroke center between 2012 and 2020, variables such as demographics, co-morbid conditions, symptomatic intracerebral hemorrhage, mortality rate at discharge, and good/poor outcomes in regard to modified thrombolysis in cerebral infarction score and modified Rankin Scale were examined. The outcomes between patients receiving acute intracranial stenting + mechanical thrombectomy and patients that underwent mechanical thrombectomy alone were compared. Results There were a total of 420 acute ischemic stroke patients who met criteria for the study (average age 70.6 ± 13.01 years; 46.9% were women). Analysis of 46 patients from the acute stenting + mechanical thrombectomy group (average age 70.34 ± 13.75 years; 37.0% were women), and 374 patients from the mechanical thrombectomy alone group (average age 70.64 ± 12.92 years; 48.1% were women). Four patients (8.7%) in the acute stenting + mechanical thrombectomy group experienced intracerebral hemorrhage versus 45 patients (12.0%) in the mechanical thrombectomy alone group ( p = 0.506); no significant increases were noted in the median length of stay (7 vs 8 days; p = 0.208), rates of modified thrombolysis in cerebral infarction 2B-3 recanalization ( p = 0.758), or good modified Rankin Scale scores ( p = 0.806). Conclusion Acute intracranial stenting in addition to mechanical thrombectomy was not associated with an increase in overall length of stay, intracerebral hemorrhage rates, or any change in discharge modified Rankin Scale. Further research is required to determine whether mechanical thrombectomy and acute intracranial stenting in acute ischemic stroke patients is unsafe.

Abstract 268: Is There a Weekend Effect on Telestroke Code Time Metrics?

2018 ◽  
Vol 11 (suppl_1) ◽  
Author(s):  
Ganesh Asaithambi ◽  
Amy L Castle ◽  
Emily H Marino ◽  
Bridget M Ho ◽  
Sandra K Hanson
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Scale Score ◽  
Mortality Rates ◽  
Weekend Effect ◽  
Favorable Outcome ◽  
Modified Rankin Scale ◽  
Stroke Patients ◽  
Code Process

Background: It has been suggested that there is a “weekend effect” resulting in higher mortality rates for stroke patients admitted on weekends. We examine this phenomenon for acute ischemic stroke (AIS) patients presenting to telestroke (TS) sites to determine its effect on stroke code process times and outcomes. Methods: From October 2015-June 2017, we reviewed consecutive AIS patients receiving IV alteplase within our TS network who then were transferred to our CSC. We compared patients presenting to TS sites on weekdays (Monday 0700 to Friday 1859) to patients presenting on weekends (Friday 1900 to Monday 0659). We analyzed door to code activation, code activation to TS evaluation, door to imaging, and door to needle times. Rates of favorable outcome (modified Rankin Scale score ≤2) and death at 90 days were compared. Results: We identified 89 (54 weekday, 35 weekend) patients (mean age 71.8±13.3 years, 47.2% women) during the study period. Median door to code activation (15 [5, 27] vs 8 [1, 17] mins, p=0.01) and door to needle (61 [49, 73] vs 47 [35, 59] mins, p=0.003) times were significantly longer for patients presenting on weekends compared to weekdays. There were no significant differences in median door to imaging (weekend 17 [7, 30] vs weekday 11 [6, 21], p=0.1) and code activation to TS evaluation (weekend 7 [6, 10] vs weekday 5 [4, 9], p=0.14) times. The rates of favorable outcome (weekend 50% vs weekday 66.7%, p=0.18) and death (weekend 8.3% vs weekday 4.8%, p=0.56) at 90 days were not significantly different. Conclusion: While there were no significant differences in outcomes, the “weekend effect” results in slower door to code activation and door to needle times. Efforts to improve methods in increasing efficiency of care on weekends should be considered.

scholarly journals A study of the reliability and validity of the Chinese version of the Nociception Coma Scale–Revised

2020 ◽  
Vol 34 (8) ◽  
pp. 1112-1121
Author(s):  
Jing Wang ◽  
Haibo Di ◽  
Wen Hua ◽  
Liwen Cheng ◽  
Zhigang Xia ◽  
...  
Keyword(s):  
Internal Consistency ◽  
Concurrent Validity ◽  
Reliability And Validity ◽  
Disorders Of Consciousness ◽  
Chinese Version ◽  
Rater Reliability ◽  
Validity Data ◽  
Retest Reliability ◽  
Coma Scale ◽  
Test Retest Reliability

Objective: The aim of the study was to check on the reliability and validity of the translated version of Nociception Coma Scale–Revised. Design: Prospective psychometric study. Setting: Rehabilitation and neurology unit in hospital. Subjects: Patients with prolonged disorders of consciousness. Interventions: None. Main measures: The original English version of the Nociception Coma Scale–Revised was translated into Chinese. The reliability and validity were undertaken by trained raters. Intraclass correlation coefficients were used to assess inter-rater reliability and test–retest reliability. Cronbach’s alpha test was used to investigate internal consistency. Spearman’s correlation was used to calculate concurrent validity. The Coma Recovery Scale–revised was used to assess the consciousness of patients. Results: Eighty-four patients were enrolled in the study. Inter-rater reliability of the Chinese version of Nociception Coma Scale–Revised was high for total scores and motor and verbal subscores and good for facial subscores. Test–retest reliability was high for total score and for all subscores. Analysis revealed a moderate internal consistency for subscores. For the concurrent validity, a strong correlation was found between the Nociception Coma Scale–Revised and the Face, Legs, Activity, Cry, and Consolability behavioral scale for all patients. A moderate correlation was found between the Nociception Coma Scale–Revised and the Coma Recovery Scale–revised scores for all patients. Conclusion: The Chinese version of Nociception Coma Scale–Revised has good reliability and validity data for assessing responses to pain in patients with prolonged disorders of consciousness.

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