[Interobserver variation in the application of 2 disability scales in heart patients].
OBJECTIVE
To examine the use of the Rankin scale for the assessment of disability in patients with ischaemic heart disease.


METHODS
University Hospital Utrecht.


METHODS
Prospective interobserver study.


METHODS
Fifty-two outpatients with heart disease (previous myocardial infarction, angina or both) were separately interviewed by four physicians (residents or specialists), viz., two cardiologists and two neurologists. The degree of disability was recorded by each observer on two different scales: the modified Rankin scale, a six-point scale developed from a neurological background, and the four-point scale developed by the New York Heart Association (NYHA). The agreement rates for the observers (23 in all) were corrected for chance (kappa-statistics; maximum 1.0).


RESULTS
Total agreement on both scales was found for six of the participating 51 patients and for 10 and 11 patients when the Rankin scale and the NYHA scale were considered separately. Kappa values were 0.21 for the Rankin scale and 0.24 for the NYHA scale. The weighted kappa values were 0.56 and 0.47, respectively. The agreement among neurologists and cardiologists was comparable.


CONCLUSIONS
The agreement rates of cardiologists and neurologists in the use of the Rankin scale and the NYHA scale in outpatients with heart disease are at best satisfactory. The good results of an earlier study with the Rankin scale in stroke patients were not achieved. This study indicates that the Rankin scale may be useful for the assessment of disability from heart disease particularly in patients with neurological disease, but there is room for further improvement.
Visser
M C
MC
Afd. Neurologie, Academisch Ziekenhuis, Utrecht.
Koudstaal
P J
PJ
van Latum
J C
JC
Frericks
H
H
Berengholz-Zlochin
S N
SN
van Gijn
J
J
D000787:Angina Pectoris / Q000175:diagnosis*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D015588:Observer Variation; D011446:Prospective Studies
Variatie tussen waarnemers bij de toepassing van twee invaliditeitsschalen bij hartpatiënten.