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(Stroke. 2005;36:232-a.)
© 2005 American Heart Association, Inc.

Letters to the Editor

Telephone Assessment of Stroke Outcome Is Reliable

Section on Stroke Diagnostics and Therapeutics, National Institute of Neurological Disorders and Stroke (NINDS), Bethesda, Md

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

To the Editor:

The modified Rankin Scale (mRS) and Barthel Index (BI) are often used to evaluate long-term outcome in stroke studies.^1–3 However, there are several potential problems with their use. An investigator’s knowledge of the clinical data may bias scoring of the scales, and direct patient contact for outcome assessment months after the stroke is not always feasible. Telephone interviews can simplify study design and potentially avoid investigator bias. Telephone interviews have been used prospectively in stroke studies to evaluate clinical outcome, functioning and disability after stroke, cognitive status, stroke-free status, and cognitive function in community outpatients.^4,5 Newcommon et al conducted a study to validate assessment of the mRS over the telephone by nonphysician interviewers using a structured interview. They found that inter-rater reliability was excellent between physician observers in the clinic but less so between each of 2 clinical observers and the telephone interviewer (=0.38 [95% CI, 0.21 to 0.55] and =0.3 [95% CI, 0.13 to 0.47]).⁶ The agreement was higher for patients with Rankin scores at either end of the scale (mRS=0 or 4). The reliability of the commonly used scales to detect the cut-off points in the BI and the mRS when not interviewing the patient face-to-face is unknown.⁷

The objective of this pilot study was to test the hypothesis that mRS and BI scores obtained over the phone by an experienced research nurse correlate with scores taken during the clinical evaluation. We scored the BI and mRS of 33 consecutive stroke patients who returned . . . [Full Text of this Article]