INTERRATER RELIABILITY OF AN ETIOLOGIC CLASSIFICATION OF ISCHEMIC STROKE
INTERRATER RELIABILITY OF AN ETIOLOGIC CLASSIFICATION OF ISCHEMIC STROKE
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DOI：
10.1161/01.str.26.1.46
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发表时间：
1995-01-01
期刊：
影响因子：
8.3
通讯作者：
PRICE, TR
中科院分区：
文献类型：
--
作者：
JOHNSON, CJ;KITTNER, SJ;PRICE, TR
背景和目的准确识别卒中的病因对研究和临床实践至关重要。已发表的一系列缺血性卒中显示，动脉粥样硬化性大血管疾病、腔隙梗死、心栓性卒中、其他已知原因的卒中以及病因不明的卒中的病例比例有相当大的差异。我们描述了缺血性卒中病因分类的发展和应用。方法由配对的神经科医生对160例青年缺血性卒中病例进行回顾，并将病例分配到优先类别。对每一种潜在原因的配对评级结果进行了评估。评分者之间的一致性采用kappa的方法进行评估，kappa是标准配对的机会调整百分比一致性结果，除了腔隙卒中(kappa=0.31)外，所有原因的kappa都是一般到良好的；然而，对于腔隙卒中，配对之间的差异最大。未确定原因的卒中和血液学/其他原因的卒中具有接近一般的可靠性。结论卒中分类系统的实用性取决于其预期用途。病因学分类在中风的流行病学和病理生理学基础研究中是有用的。当标准明确时，卒中病因学分类的可靠性可以达到中等到良好的水平。
Background and Purpose Precise identification of the cause of stroke is critical to research and clinical practice. Published series of ischemic stroke show considerable variation in the proportion of cases classified as atherosclerotic large-vessel disease, lacunar infarct, cardioembolic stroke, stroke of other known cause, and stroke of undetermined etiology. We describe the development and use of an etiology-specific classification of ischemic stroke. The interrater reliability of the classification is then evaluated.Methods A total of 160 cases of ischemic strokes in young adults were reviewed by paired neurologists who assigned cases to prioritized categories. The results of paired ratings were evaluated for each of the potential causes. Interrater agreement was assessed by means of kappa, which is the chance-adjusted percent agreement Results For standard pairs, kappa was fair to good for all causes except lacunar stroke (kappa=0.31); however, pair-to-pair variation was greatst for lacunar strokes. Strokes of undetermined cause and hematologic/other cause were of borderline fair reliability.Conclusions The utility of a stroke classification system is dependent on its intended use. An etiologic classification is useful in studies of the epidemiology and pathophysiological basis of stroke. Fair to good reliability for an etiologic classification of stroke can be obtained when criteria an explicit.