MEASUREMENTS OF ACUTE CEREBRAL INFARCTION - A CLINICAL EXAMINATION SCALE
MEASUREMENTS OF ACUTE CEREBRAL INFARCTION - A CLINICAL EXAMINATION SCALE
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DOI：
10.1161/01.str.20.7.864
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发表时间：
1989-07-01
期刊：
影响因子：
8.3
通讯作者：
WALKER, M
中科院分区：
文献类型：
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作者：
BROTT, T;ADAMS, HP;WALKER, M
我们设计了一个15项神经检查脑卒中量表用于急性脑卒中治疗试验。在对24例中风患者的研究中，发现量表的互译信度很高（平均。kappa）。= 0.69)，重测信度也很高(平均.kappa。= 0.66 - -0.77)。在神经科医生、神经科住院医生、神经科护士或急诊科护士之间，重测信度无显著差异。通过比较65例急性脑卒中患者的前瞻性量表得分与患者在1周时通过计算机断层扫描测量的梗死大小和患者在3个月时确定的临床结果，来评估卒中量表的效度。这些相关性（量表-病变大小r = 0.68，量表-结果r = 0.79）表明可以接受检查和量表效度。15个测试项目中，最具互信度的项目瞳孔反应效度较低。不太可靠的项目，如上肢或下肢运动功能更有效。我们讨论了在脑卒中治疗试验中提高简短检查量表的信度和效度的方法。
We designed a 15-item neurologic examination stroke scale for use in acute stroke therapy trials. In a study of 24 stroke patients, interrater reliability for the scale was found to be high (mean .kappa. = 0.69), and test-retest reliability was also high (mean .kappa. = 0.66-0.77). Test-retest reliability did not differ significantly among a neurologist, a neurology house officer, a neurology nurse, or an emergency department nurse. The stroke scale validity was assessed by comparing the scale scores obtained prospectively on 65 acute stroke patients to the patients'' infarction size as measured by computed tomography scan at 1 week and to the patients'' clinical outcome as determined at 3 months. These correlations (scale-lesion size r = 0.68, scale-outcome r = 0.79) suggested acceptable examination and scale validity. Of the 15 test items, the most interrater reliable item (pupillary response) had low validity. Less reliable items such as upper or lower extremity motor function were more valid. We discuss methods for improving the reliability and validity of brief examination scales to be used in stroke therapy trials.