title: Interobserver agreement in the classification of stroke in the Women's Health Study.
abstract: OBJECTIVE
  Accurate classification of stroke events is essential in large cohort studies of risk factor assessment and in treatment trials such as the Women's Health Study (WHS).
  
  
  METHODS
  Based on medical record review, we assessed interrater reliability in stroke classification and disability status in the WHS using the kappa statistic.
  
  
  RESULTS
  During 7.0 years of follow-up, 271 incident strokes occurred, of which 133 were reclassified. There was excellent interrater agreement in the diagnosis of major stroke types, hemorrhagic subtypes, and degree of disability, as well as substantial agreement in the definition of the vascular territory involved. Only moderate agreement was reached in the classification of ischemic subtypes.
  
  
  CONCLUSIONS
  Major stroke types, degree of disability, and vascular territory involved can be reliably classified on the basis of a review of medical records in the WHS, whereas classification of ischemic stroke subtypes needs further refinement of diagnostic criteria.
authors.affiliation: Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass 02215-1204, USA.
authors.forename: Monika
authors.initials: M
authors.lastname: Atiya
authors.forename: Tobias
authors.initials: T
authors.lastname: Kurth
authors.forename: Klaus
authors.initials: K
authors.lastname: Berger
authors.forename: Julie E
authors.initials: JE
authors.lastname: Buring
authors.forename: Carlos S
authors.initials: CS
authors.lastname: Kase
mesh_terms: D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D015588:Observer Variation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D020521:Stroke / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology*; D016387:Women's Health