Interrater Reliability of the Pediatric National Institutes of Health Stroke Scale (PedNIHSS) in a Multicenter Study
Interrater Reliability of the Pediatric National Institutes of Health Stroke Scale (PedNIHSS) in a Multicenter Study
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DOI：
10.1161/strokeaha.110.607192
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发表时间：
2011-03-01
期刊：
影响因子：
8.3
通讯作者：
Jawad, Abbas F.
中科院分区：
文献类型：
--
作者：
Ichord, Rebecca N.;Bastian, Rachel;Jawad, Abbas F.
背景和目的-脑卒中是儿童死亡和残疾的重要原因。儿童卒中的临床试验需要一个有效和可靠的急性临床卒中量表。我们评估了评估者间的信度（IRR）的儿科适应美国国立卫生研究院卒中量表。方法儿科适应美国国立卫生研究院卒中量表是由儿科和成人卒中专家修改成人美国国立卫生研究院卒中量表的儿童，保留所有的检查项目和评分范围的美国国立卫生研究院卒中量表。2007年1月至2009年10月，在北美15家研究中心进行的一项前瞻性队列研究中，纳入了2至18岁的急性动脉缺血性卒中儿童。检查员是在成人国立卫生研究院中风量表认证的儿童神经学家。每例受试者每天接受检查，持续7天或直至出院。一个子集的患者在3个网站同时和独立的2个研究neurologists.Results-IRR测试进行了113个中位数为3天（四分位数间距，2至4天）后症状发作。IRR亚组的患者人口统计学资料、美国国立卫生研究院卒中量表评分的总初始儿科适应性、风险因素和梗死特征与非IRR亚组相似。60%的评分者总分相同，84%的评分者总分在1分以内。通过0.97的一致性相关系数测量，IRR非常好（95% CI，0.94 - 0.99）;组内相关系数为0.99（95% CI，0.97 - 0.99）;通过Pearson rho测量的精密度为0.97;和准确度测量的偏差校正因子为1.0。结论-在一项由经过培训的儿童神经科医生进行的多中心前瞻性队列研究中，美国国立卫生研究院卒中量表的儿科适应性IRR非常好。（中风。2011; 42：613-617）。
Background and Purpose-Stroke is an important cause of death and disability among children. Clinical trials for childhood stroke require a valid and reliable acute clinical stroke scale. We evaluated interrater reliability (IRR) of a pediatric adaptation of the National Institutes of Health Stroke Scale.Methods-The pediatric adaptation of the National Institutes of Health Stroke Scale was developed by pediatric and adult stroke experts by modifying each item of the adult National Institutes of Health Stroke Scale for children, retaining all examination items and scoring ranges of the National Institutes of Health Stroke Scale. Children 2 to 18 years of age with acute arterial ischemic stroke were enrolled in a prospective cohort study from 15 North American sites from January 2007 to October 2009. Examiners were child neurologists certified in the adult National Institutes of Health Stroke Scale. Each subject was examined daily for 7 days or until discharge. A subset of patients at 3 sites was scored simultaneously and independently by 2 study neurologists.Results-IRR testing was performed in 25 of 113 a median of 3 days (interquartile range, 2 to 4 days) after symptom onset. Patient demographics, total initial pediatric adaptation of the National Institutes of Health Stroke Scale scores, risk factors, and infarct characteristics in the IRR subset were similar to the non-IRR subset. The 2 raters' total scores were identical in 60% and within 1 point in 84%. IRR was excellent as measured by concordance correlation coefficient of 0.97 (95% CI, 0.94 to 0.99); intraclass correlation coefficient of 0.99 (95% CI, 0.97 to 0.99); precision measured by Pearson rho of 0.97; and accuracy measured by the bias correction factor of 1.0.Conclusions-There was excellent IRR of the pediatric adaptation of the National Institutes of Health Stroke Scale in a multicenter prospective cohort performed by trained child neurologists. (Stroke. 2011; 42: 613-617.)