The Orpington Prognostic Scale for patients with stroke: reliability and pilot predictive data for discharge destination and therapeutic services.
OBJECTIVE
To determine the inter-rater and test-retest reliability of the Orpington Prognostic Scale (OPS) in patients with stroke. Pilot data were gathered to evaluate its predictive validity for discharge destination and therapeutic services required on discharge.


METHODS
Ninety-four consecutive patients, admitted to hospital due to stroke participated. Pairs of physiotherapists (PT) and occupational therapists (OT) assessed patients using the OPS on days 7 and 14 post stroke. For inter-rater reliability, one rater performed the OPS while the other observed, each scoring the scale independently. For test-retest reliability, two different raters tested the subjects separately within the same day. Data were gathered on the discharge destination and the number of follow-up services prescribed.


RESULTS
The inter-rater reliability as measured by the intraclass correlation coefficient (ICC) was 0.99 (95% CI 0.97 - 0.99). For test-retest reliability, the ICC was 0.95 (95% CI 0.90 - 0.98). The accuracy for predicting discharge to home using OPS 5.0 was 65% (95% CI 0.52 - 0.76). OPS scores were not related to number of follow-up services prescribed.


CONCLUSIONS
Despite high inter-rater and test-retest reliability, the OPS has limited predictive accuracy for discharge destination and is a poor predictor of follow-up services.
Rieck
Mary
M
Therapy Services Department, Joseph Brant Memorial Hospital, Burlington, Ontario, Canada.
Moreland
Julie
J
D000368:Aged; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007326:Institutionalization; D008297:Male; D015588:Observer Variation; D009788:Occupational Therapy; D010351:Patient Discharge; D026761:Physical Therapy Specialty; D010865:Pilot Projects; D011379:Prognosis; D015203:Reproducibility of Results; D012111:Residence Characteristics; D012680:Sensitivity and Specificity; D020521:Stroke / Q000175:diagnosis; D000071939:Stroke Rehabilitation