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(Stroke. 2003;34:377.)
© 2003 American Heart Association, Inc.

Letters to the Editor

Improving the Assessment of Outcomes in Stroke: Use of a Structured Interview to Assign Grades on the Modified Rankin Scale

Nancy J. Newcommon, RN, MN; Teri L. Green, MScHRM; Eryka Haley, RN; Timothy Cooke, BSc Michael D. Hill, MD, FRCPC

Calgary Stroke Program, Calgary Health Region, University of Calgary, Alberta, Canada

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

To the Editor:

We read with interest the article by Wilson et al,¹ describing the use of a structured interview for the modified Rankin Scale (mRS). We attempted a similar exercise to validate the assessment of the mRS over the telephone by nonphysician interviewers using an analogously structured interview.

Thirty-four patients with a discharge diagnosis of stroke participated in the study 3 to 6 months from the day of admission. All patients were seen in person first, where they provided informed consent, by two trained personnel (one stroke neurologist or one of three stroke nurses). Each patient was interviewed consecutively by two interviewers in the Stroke Prevention Clinic or, for badly disabled patients, at a current place of residence (long-term care facility, nursing home, or rehabilitation facility) and the mRS assigned. Each face-to-face interview was followed by a telephone interview conducted by trained interviewers following a structured questionnaire within 5 days of the original interview. No proxy interviews were used. Each person rated the patient on the mRS, blind to the other raters’ score. Overall, three observers scored each patient’s outcome.

Two telephone interviewers were not medical professionals (RN or MD) but had 5 or more years of experience with telephone interviewing, had completed a course in telephone interviewing, and were considered experienced. Questions were scripted and deviations from the script were not permitted. The study was approved by the local Ethics Review Board.

Agreement, assessed using unweighted statistics with 95% confidence limits, was excellent between the two observers in the stroke clinic . . . [Full Text of this Article]

J.T.L. Wilson, PhD

Department of Psychology, University of Stirling, Stirling, UK

A. Hareendran, PhD

Outcomes Research Pfizer Ltd Sandwich, UK

T. Baird, MD; K.W. Muir, MD I. Bone, MD

Department of Neurology Institute of Neurological Sciences Glasgow, UK

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