This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by McKevitt, C. Articles by Wolfe, C. Search for Related Content PubMed PubMed Citation Articles by McKevitt, C. Articles by Wolfe, C. Related Collections Health policy and outcome research

(Stroke. 2001;32:681.)
© 2001 American Heart Association, Inc.

Original Contributions

Two Simple Questions to Assess Outcome After Stroke

A European Study

Christopher McKevitt, PhD; Ruth Dundas, MSc; Charles Wolfe, MD on behalf of the European BIOMED II Study of Stroke Care Group

From the Department of Public Health Sciences, Guy’s King’s and St Thomas’ School of Medicine, King’s College London (UK).

Correspondence to Christopher McKevitt, PhD, Department of Public Health Sciences, Guy’s King’s and St Thomas’ School of Medicine, King’s College London, Capital House, 42 Weston Street, London SE1 3QD, UK. E-mail christopher.mckevitt{at}kcl.ac.uk

Background and Purpose—The "2 simple questions" were designed as an efficient way of measuring outcome after stroke. We assessed the sensitivity and specificity of this tool, adapted for use in 8 European centers, and used it to compare outcomes across centers.

Methods—Data were taken from the Biomed II prospective study of stroke care and outcomes. Three-month poststroke data from 8 European centers were analyzed. Sensitivity and specificity were assessed by comparing responses to the 2 simple questions with Barthel Index and modified Rankin scale scores. Adjusting for case mix, logistic regression was used to compare patients in each center with "good" outcome (not dependent and fully recovered) at 3 months.

Results—Data for 793 patients were analyzed. For the total sample, the dependency question had a sensitivity of 88% and a specificity of 77%; the recovery question had a sensitivity of 78% and a specificity of 90%. Dependency data from Riga had much lower sensitivity. There was variation in good outcome between centers (P=0.0015). Compared with the reference center (Kaunas), patients in Dijon, Florence, and Menorca were more likely to have good outcome, after adjusting for case mix.

Conclusions—Dependency and recovery questions showed generally high sensitivity and specificity. There were significant differences across centers in outcome, but reasons for these are unclear. Such differences raise particular questions about how patients interpreted and answered the simple questions and the extent to which expectations of recovery and perceived needs for assistance vary cross-culturally.

Key Words: disability • outcome assessment • recovery

This article has been cited by other articles:

				C. Winward, C. Sackley, Z. Metha, and P. M. Rothwell A Population-Based Study of the Prevalence of Fatigue After Transient Ischemic Attack and Minor Stroke Stroke, March 1, 2009; 40(3): 757 - 761. [Abstract] [Full Text] [PDF]

				J. Y. Chong, H. S. Lee, B. Boden-Albala, M. C. Paik, and R. L. Sacco Gender differences in self-report of recovery after stroke: The Northern Manhattan Study. Neurology, October 10, 2006; 67(7): 1282 - 1284. [Abstract] [Full Text] [PDF]

				J. W. Sturm, H. M. Dewey, G. A. Donnan, R. A.L. Macdonell, J. J. McNeil, and A. G. Thrift Handicap After Stroke: How Does It Relate to Disability, Perception of Recovery, and Stroke Subtype?: The North East Melbourne Stroke Incidence Study (NEMESIS) Stroke, March 1, 2002; 33(3): 762 - 768. [Abstract] [Full Text] [PDF]