Translation, cross-cultural adaptation, and validation of the Los Angeles Prehospital Stroke Screen for use in Brazil

Abstract

Background: Stroke is one of the leading causes of death and neurological disability in the world. Several scales help professionals in the early recognition of the disease. However, none of these were developed in Brazil. Objectives: To translate the Los Angeles Prehospital Stroke Screen (LAPSS) into Brazilian Portuguese, and cross-culturally adapt and validate the scale in a representative sample of the Brazilian population. Methods: This study was carried out in two phases: the first consisted in the translation and cross-cultural validation of the LAPSS, and the second in a cross-sectional study with prospectively collected data in patients with suspected stroke treated in a Brazilian prehospital and referred to a stroke center. Statistical analysis was used to assess the sensitivity, specificity, and accuracy of the scale. Cohen's Kappa coefficient (κ) was used for psychometric assessment. Results: After translation and cross-cultural adaptation, the scale was applied to 86 patients. The scale presented a sensitivity of 83.8%, positive predictive value of 79.50%, specificity of 40.70%, negative predictive value of 47.80%, and accuracy of 77%. Cohen’s kappa coefficient was calculated using data from 26 (30.23%) patients and the results showed excellent inter-rater reliability in the majority of the items (52.96%). Conclusions: The scale was translated and cross-culturally adapted for use in Brazil. The scale presented high sensitivity and accuracy but low specificity, and the Cohen’s kappa demonstrated inter-rater reliability. The greatest difficulties occurred when the evaluation included subjective identifications. The scale excluded patients < 45 years old as stroke suspects.

Revisão por pares das estratégias de busca para revisões sistemáticas: o PRESS, histórico, tradução para o português e funcionalidade

“…O PRESS original foi elaborado em língua inglesa e, assim como muitos instrumentos para mensuração de dimensões objetivas e subjetivas do status de saúde de populações humanas, tem sua aplicação posterior em diversos contextos socioculturais e idiomáticos. O desenvolvimento de metodologias para adaptação transcultural e a utilização dessas ferramentas em diferentes idiomas, que não se resumem a uma simples tradução do modelo original, tornaram-se prática comum nas áreas relacionadas à saúde, principalmente no uso de questionários para abordagem de aspectos clínicos dos pacientes (Almeida et al, 2022), mas que também incluem protocolos e diretrizes para uso de evidências. Assim, a tradução do PRESS para o português do Brasil foi sendo percebida como necessária para promover seu melhor uso e sua aplicação às revisões conduzidas no Brasil.…”