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Stroke. 2002;33:218-223
doi: 10.1161/hs0102.100532
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(Stroke. 2002;33:218.)
© 2002 American Heart Association, Inc.


Original Contributions

Different Measures for Assessing Stroke Outcome

An Analysis From the International Stroke Trial in Italy

Maria Grazia Celani, MD; Teresa Anna Cantisani, MD; Enrico Righetti, MD; Lorenzo Spizzichino, SD Stefano Ricci, MD on behalf of the Italian International Stroke Trial (IST) Collaborators

From the Servizio Malattie Cerebrovascolari, USL 2, Perugia, Italy.

Correspondence to Dr Maria Grazia Celani, Servizio Malattie Cerebrovascolari, USL 2, Via Guerra 17, 06127 Perugia, Italy. E-mail istitaly{at}unipg.it

Background and Purpose We sought to assess the relationship between 2 simple questions on recovery (question 1: do you feel that you have made a complete recovery from your stroke?) and dependency (question 2: do you require help from another person for everyday activities?) and the Barthel Index (BI) and Oxford Handicap Scale (OHS), as well as the relationship between BI and OHS, in a large number of Italian stroke survivors who participated in the International Stroke Trial (IST).

Methods We used data from 2423 patients interviewed by telephone at 6 months after the event. The {kappa} statistic, sensitivity, and specificity were calculated for several comparisons. Internal consistency for BI was calculated.

Results The reliability of the dependency question compared with BI=20 ({kappa}=0.93) and the reliability of the recovery question compared with OHS=0 ({kappa}=0.89) were good. Sensitivity of the dependency question in predicting whether patients scored BI >18 was 0.98; sensitivity of the recovery question in predicting whether patients scored OHS=0 was 0.99. The reliability of BI=20 compared with OHS <3 was good ({kappa}=0.87). Internal consistency of BI was very high (Cronbach’s {alpha}=0.96).

Conclusions The 2 simple questions are a good means of evaluating outcome from a patient’s view and of dichotomizing the stroke survivor in a time-effective and reliable way.


Key Words: disability evaluation • outcome assessment • stroke, acute




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