Simplified modified Rankin Scale questionnaire correlates with stroke severity

Bruno, Askiel; Close, Brian; Switzer, Jeffrey A.; Hess, David C.; Gross, Hartmut; Nichols, Fenwick T.; Akinwuntan, Abiodun Emmanuel

doi:10.1177/0269215512470674

Cited by 24 publications

(20 citation statements)

References 16 publications

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“…Construct validity testing showed good correlations between the novel Chinese smRSq(2011) and both the NIHSS (0.82-0.83) and the BI (-0.86). This result is consistent with other validity studies using the conventional mRS [14], the English version smRSq(2011) [15], and our prior study of the Chinese smRSq(2010) [10].…”

Section: Discussionsupporting

confidence: 92%

The reliability and validity of a novel Chinese version simplified modified Rankin scale questionnaire(2011)

Yuan

wang

Bruno

2020

Preprint

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Background The modified Rankin Scale (mRS) is a key global outcome measure after stroke internationally. The latest English version of the simplified modified Rankin scale questionnaire (smRSq)(2011) is a reliable and valid tool in scoring the mRS after stroke. In order to use this tool in Chinese patients, we translated it into Chinese and tested its clinimetric properties. Methods The English version smRSq(2011) was translated into Chinese by a standard process. We recruited 300 consecutive hospitalized ischemic stroke patients in the department of neurology, Beijing Chaoyang Hospital. Six randomly paired raters scored the conventional mRS, the novel Chinese version smRSq(2011), the National Institutes of Health Stroke Scale (NIHSS), and the Barthel index (BI) in-person. Inter-rater reliability and validity were assessed. Results Among the 300 ischemic stroke patients, mean age was 64.9±12.1 years, and 220 (73%) were male. For inter-rater reliability of the smRSq(2011), the percent agreement among the paired raters was 87%, the kappa ( κ) was 0.84 (95% CI, 0.79-0.88), and the weighted kappa ( κ w ) was 0.96 (95% CI, 0.95-0.98). The percent agreement between the smRSq(2011) scores and the conventional mRS scores was 55%, κ =0.47 (95% CI, 0.40-0.54), and κ w =0.91 (95% CI, 0.89-0.93). In construct validity testing, the Spearman’s correlation coefficients comparing the smRSq(2011) scores with the NIHSS and the BI scores were 0.83 ( P <0.001) and -0.86 ( P <0.001), respectively. Conclusions Our results show good to excellent clinimetric properties of the novel Chinese version smRSq(2011) in scoring the mRS in Chinese stroke patients. Further validation in other clinical settings, including in communities and by remote methods in China is warranted.

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Section: Discussionsupporting

confidence: 92%

The reliability and validity of a novel Chinese version simplified modified Rankin scale questionnaire(2011)

Yuan

wang

Bruno

2020

Preprint

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“…Construct validity testing showed good correlations between the novel Chinese smRSq (2011) and both the Table 2 Cross-tabulation of the smRSq(2011) scores between the paired raters NIHSS (0.82-0.83) and the BI (− 0.86). This result is consistent with other validity studies using the conventional mRS [14], the English version smRSq (2011) [15], and our prior study of the Chinese smRSq (2010, 10].…”

Section: Discussionsupporting

confidence: 92%

The reliability and validity of a novel Chinese version simplified modified Rankin scale questionnaire (2011)

Yuan

Wang

et al. 2020

BMC Neurol

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Background: The modified Rankin Scale (mRS) is a key global outcome measure after stroke internationally. The latest English version of the simplified modified Rankin scale questionnaire (smRSq)(2011) is a reliable and valid tool in scoring the mRS after stroke. In order to use this tool in Chinese patients, we translated it into Chinese and tested its clinimetric properties. Methods: The English version smRSq (2011) was translated into Chinese by a standard process. We recruited 300 consecutive hospitalized ischemic stroke patients in the department of neurology, Beijing Chaoyang Hospital. Six randomly paired raters scored the conventional mRS, the novel Chinese version smRSq (2011), the National Institutes of Health Stroke Scale (NIHSS), and the Barthel index (BI) in-person. Inter-rater reliability and validity were assessed. Results: Among the 300 ischemic stroke patients, mean age was 64.9 ± 12.1 years, and 220 (73%) were male. For interrater reliability of the smRSq (2011), the percent agreement among the paired raters was 87%, the kappa (κ) was 0.84 (95% CI, 0.79-0.88), and the weighted kappa (κ w) was 0.96 (95% CI, 0.95-0.98). The percent agreement between the smRSq (2011) scores and the conventional mRS scores was 55%, κ = 0.47 (95% CI, 0.40-0.54), and κ w = 0.91 (95% CI, 0.89-0.93). In construct validity testing, the Spearman's correlation coefficients comparing the smRSq (2011) scores with the NIHSS and the BI scores were 0.83 (P < 0.001) and − 0.86 (P < 0.001), respectively. Conclusions: Our results show good to excellent clinimetric properties of the novel Chinese version smRSq (2011) in scoring the mRS in Chinese stroke patients. Further validation in other clinical settings, including in communities and by remote methods in China is warranted.

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“…Some neurological scales, such as the NIHSS and mRS (Schlegel et al, 2003; Wilson et al, 2005; Bruno et al, 2013; Kim et al, 2013), can predict stroke patient outcomes. However, it is very difficult to evaluate patient outcomes using scales when patients suffer from apraxia, aphasia, or disorientation.…”

Section: Discussionmentioning

confidence: 99%

No Association between Elevated Total Homocysteine Levels and Functional Outcome in Elderly Patients with Acute Cerebral Infarction

Wang

Gao

et al. 2017

Front. Aging Neurosci.

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Background: An elevated plasma total homocysteine (tHcy) level is an independent risk factor for vascular events. The aim of the present study was to investigate the association between tHcy levels in the acute phase of cerebral infarction and functional outcome among elderly patients.Methods: Between October 2009 and December 2012, we recruited 594 elderly patients (age > 75) with first-onset acute cerebral infarction who were consecutively admitted to the Department of Neurology of Tianjin Huanhu Hospital, China. Levels of tHcy and other biochemical values were measured within 24 h after admission. tHcy values were classified according to quartiles (<9.94; 9.94 to <12.7; 12.7 to <16.8; and ≥16.8 μmol/L). We examined the relationship between tHcy levels at admission and modified Rankin Scale scores (mRS) using univariate and multivariate analyses. Patients were followed up at 3 months and 1 year after stroke.Results: Within 3 months after stroke, 64 patients died, 37 had recurrent ischemic stroke, and 22 were lost to follow-up; thus, 471 patients were reviewed and analyzed. By the time of the 1-year follow-up, an additional 48 patients had died, 44 had recurrent ischemic stroke, and 40 had been lost to follow-up; the remaining 339 patients were thus reviewed and analyzed. Elevated tHcy levels were not associated with functional outcome among elderly patients with acute cerebral infarction (p > 0.05). Only the National Institutes of Health Stroke Scale score was associated with a poor outcome after adjusting for confounders at 3 months and 1 year (adjusted odds ratio, 1.38; 95% CI, 1.28–1.49; p < 0.01; adjusted odds ratio, 1.34; 95% CI, 1.25–1.44; p < 0.01, respectively).Conclusion: Among elderly patients with acute cerebral infarction, elevated tHcy at admission was not a predictive factor of outcome at 3 months and 1 year after stroke onset.

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Simplified modified Rankin Scale questionnaire correlates with stroke severity

Abstract: The good correlation of the smRSq with the initial stroke severity further confirms the smRSq validity in assessing functional outcome after stroke.

Cited by 24 publications

References 16 publications

The reliability and validity of a novel Chinese version simplified modified Rankin scale questionnaire(2011)

The reliability and validity of a novel Chinese version simplified modified Rankin scale questionnaire(2011)

The reliability and validity of a novel Chinese version simplified modified Rankin scale questionnaire (2011)

No Association between Elevated Total Homocysteine Levels and Functional Outcome in Elderly Patients with Acute Cerebral Infarction

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