Replication and Extension of the Simplified Modified Rankin Scale in 150 Chinese Stroke Patients

Abstract

Background: Recently, a simplified modified Rankin Scale (mRS) questionnaire (smRSq) showed good reliability but has not been tested for its validity by its original creators. Our study aimed to test its reliability and validity in Chinese stroke patients. Methods: Randomly chosen paired raters scored the smRSq, the conventional mRS, and the NIH Stroke Scale (NIHSS) face-to-face in 150 hospitalized stroke patients. Inter-rater reliability and concurrent validity were assessed for this translated questionnaire. Results: For inter-rater reliability of the smRSq, the overall agreement among the raters was 84%, the ĸ was 0.79 (95% CI 0.72–0.87), and the ĸw was 0.91 (95% CI 0.88–0.94). For inter-rater reliability of the mRS, the overall agreement among the raters was 81%, the ĸ was 0.75 (95% CI 0.67–0.83), and the ĸw was 0.88 (95% CI 0.84–0.92). The agreement between the mRS and smRSq was 71%, ĸ = 0.63 (95% CI 0.54–0.71), and ĸw = 0.83 (95% CI 0.79–0.88). The correlation between the NIHSS and the smRSq (concurrent validity) was moderate (Spearman’s correlation coefficient 0.70, p < 0.0001). Conclusions: Our results confirm the value of the smRSq in the assessment of stroke functional outcome in China. As this is a novel stroke tool, further validations are needed.

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

“…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].…”

The reliability and validity of a slightly revised Chinese version simplified modified Rankin scale questionnaire

“…First, we translated the smRSq(2011) from English to Chinese with forward and backward translation to allow for inconsistency detection, and the draft questionnaire was checked for face validity, as with our prior translation process of the original smRSq [11]. We anticipated that the Chinese version smRSq(2011)( Figure 1.e) would be improved in comparison to the original Chinese version smRSq(2010), similar to the results for the English version smRSq(2011) [9].…”

“…The simplified mRS questionnaire (smRSq)(2010) was initially reported in 2010 with good reliability among a wide variety of raters in addition to being relatively simple to use, and an average time to score the mRS of <2 minutes [7]. The initial version of the smRSq has been translated into Chinese and validated in Chinese stroke patients [11].…”

Angioplasty and stenting for patients with symptomatic intracranial atherosclerosis: study protocol of a randomised controlled trial

“…The secondary outcomes are the incidence of recurrent ischaemic stroke in the stenting-involved vascular territory at 30 days, 3 and 12 months after randomisation, the rate of patients with residual stenosis <30% at 3 and 12 months after randomisation, the incidence of in-stent restenosis at 12 months after randomisation, the incidence of cerebral parenchymal, subarachnoid or intraventricular haemorrhage at 30 days, 3 and 12 months after randomisation, the incidence of myocardial infarction or major non-stroke haemorrhage (epidural or subdural haemorrhage or haemorrhage in major organs) at 30 days after randomisation, the Chinese version of National Institutes of Health Stroke Scale (C-NIHSS),28 the mRS,29 and the CSQoL30 at 30 days, 3 and 12 months after randomisation. To assess whether residual stenosis or in-stent restenosis exists, we will use the trans-femoral cerebral angiography.…”