This Article Full Text Full Text (PDF) All Versions of this Article: 39/12/3421    most recent STROKEAHA.108.519306v1 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 Quinn, T. J. Articles by Lees, K. R. Search for Related Content PubMed PubMed Citation Articles by Quinn, T. J. Articles by Lees, K. R. Pubmed/NCBI databases Medline Plus Health Information Personal Medical Records Stroke Related Collections Acute Cerebral Infarction

(Stroke. 2008;39:3421.)
© 2008 American Heart Association, Inc.

Research Letters

Deriving Modified Rankin Scores From Medical Case-Records

Terence J. Quinn, MRCP; Gautamananda Ray, MRCP; Sari Atula, MD; Matthew R. Walters, MD; Jesse Dawson, MRCP Kennedy R. Lees, MD

From the Division of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.

Correspondence to Terence J. Quinn, MRCP, Gardiner Institute of Cardiovascular and Medical Sciences, University of Glasgow, Western Infirmary, Church Street, Glasgow G11 6NT, UK. E-mail Tjq1t{at}clinmed.gla.ac.uk

Background and Purpose— Modified Rankin score (mRS) is traditionally graded using a face-to-face or telephone interview. Certain stroke assessment scales can be derived from a review of a patient’s case-record alone. We hypothesized that mRS could be successfully derived from the narrative within patient case-records.

Methods— Sequential patients attending our cerebrovascular outpatient clinic were included. Two independent, blinded clinicians, trained in mRS, assessed case-records to derive mRS. They scored "certainty" of their grading on a 5-point Likert scale. Agreement between derived and traditional face-to-face mRS was calculated using attribute agreement analysis.

Results— Fifty patients with a range of disabilities were included. Case-record appraisers were poor at deriving mRS (k=0.34 against standard). Derived mRS grades showed poor agreement between observers (k=0.33). There was no relationship between certainty of derived mRS and proportion of correct grades (P=0.727).

Conclusion— Accurate mRS cannot be derived from standard hospital records. Direct mRS interview is still required for clinical trials.

Key Words: clinical trials • drug trials • methodology • outcomes • randomized, controlled trials • scales • therapy • treatment

This article has been cited by other articles:

				J. C. Hemphill III, M. Farrant, and T. A. Neill Jr Prospective validation of the ICH Score for 12-month functional outcome Neurology, October 6, 2009; 73(14): 1088 - 1094. [Abstract] [Full Text] [PDF]