Stroke, Vol 19, 604-607, Copyright © 1988 by American Heart Association
JC van Swieten, PJ Koudstaal, MC Visser, HJ Schouten and J van Gijn
Interobserver agreement for the assessment of handicap in stroke patients
was investigated in a group of 10 senior neurologists and 24 residents from
two centers. One hundred patients were separately interviewed by two
physicians in different combinations. The degree of handicap was recorded
by each observer on the modified Rankin scale, which has six grades (0-5).
The agreement rates were corrected for chance (kappa statistics). Both
physicians agreed on the degree of handicap in 65 patients; they differed
by one grade in 32 patients and by two grades in 3 patients. Kappa for all
pairwise observations was 0.56; the value for weighted kappa (with
quadratic disagreement weights) was 0.91. Our results confirm the value of
the modified Rankin scale in the assessment of handicap in stroke patients;
nevertheless, further improvements are possible.
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Interobserver agreement for the assessment of handicap in stroke patients
University Department of Neurology, Utrecht, The Netherlands.
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