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(Stroke. 2009;40:2297.)
© 2009 American Heart Association, Inc.

Editorials

Training and Consistency in Stroke Assessments

Kennedy R. Lees, MD, FRCP

From the Department of Medicine & Therapeutics, Faculty of Medicine, University of Glasgow, Western Infirmary, Glasgow, UK.

Correspondence to Kennedy R. Lees, University of Glasgow, Department of Medicine & Therapeutics, Western Infirmary, 44 Church Street, Glasgow G11 6NT, UK. E-mail k.r.lees@clinmed.gla.ac.uk

Key Words: NIHSS • outcome • scales

An extract of the first 250 words of the full text is provided, because this article has no abstract.

See related article, pages 2507–2511 and 2557–2559.

Stroke is a global disease. It needs global tools for description and outcome assessment, common definitions for risk factors, common definitions for complications such as symptomatic hemorrhage, and common investigation protocols.

Research into treatments for stroke depends on enrollment of large numbers of patients, possible only through international cooperation. Wide variation in initial stroke severity requires us to describe the population that we enroll. The National Institutes of Health Stroke Scale is now the most widely used scale for measuring stroke severity in clinical trials¹ and lies second only to the modified Rankin Scale for choice as a primary end point.² This trend to homogeneity is important; consistency in language is required within trials and to interpret their results. For example, use of common scales allowed pooling of data from the National Institute of Neurological Diseases and Stroke, Alteplase Thrombolysis for Acute Noninterventional Therapy in Ischemic Stroke, and European Cooperative Acute Stroke Study trials to examine the influence of onset to treatment time with alteplase.³ It assists selection of patients for routine care through translation of trial results into practice. It lets us understand trends in clinical practice, facilitating comparisons over time and across regions.⁴ With clinical trial data from 10s of thousands of patients archived by groups such as the Virtual International Stroke Trials Archive,⁵ it is now possible to examine trends in natural history, to plan selection criteria for future trials, and perhaps to crossvalidate trial results using data that . . . [Full Text of this Article]

Related Article:

National Institutes of Health Stroke Scale Certification Is Reliable Across Multiple Venues

Patrick Lyden, Rema Raman, Lin Liu, Marian Emr, Margo Warren, and John Marler
Stroke 2009 40: 2507-2511. [Abstract] [Full Text] [PDF]