Assessment of functional outcome in a national quality register for acute stroke: can simple self-reported items be transformed into the modified Rankin Scale?
OBJECTIVE
To enable self-reporting of functional outcome in quality registers, the corresponding questions have to be easy to interpret. In scientific research, the modified Rankin Scale (mRS) is a standard assessment method. Such methods, with an outsider observer, are not feasible to use in quality registers. For several aspects, eg, comparisons between outcome in clinical studies and observational studies, we determined to see whether the functional outcome, as assessed in a quality register, can be transformed into mRS grades.


METHODS
The agreement between self-reported functional outcome (including dependency, living situation, mobility, dressing and toileting) and mRS were analyzed using 555 stroke patients registered in Riks-Stroke, the Swedish quality register for acute stroke, during a 5-month period in 4 hospitals. The self-reported outcome and the mRS grades were concurrently assessed by a telephone interview performed by an experienced nurse 3 months after stroke.


RESULTS
A translation using 5 of the questions from Riks-Stroke classified 76% of the patients to the correct mRS grade. The correlation between Riks-Stroke and mRS was 0.821 and Cohen's kappa (weighted) was 0.853.


CONCLUSIONS
The study shows that self-reported functional outcome can be transformed into mRS grades with a high precision, making the translation useful for future comparative purposes in stroke outcome studies.
Eriksson
Marie
M
Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. marie.eriksson@medicin.umu.se
Appelros
Peter
P
Norrving
Bo
B
Terént
Andreas
A
Stegmayr
Birgitta
B
D000203:Activities of Daily Living; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D051346:Mobility Limitation; D017063:Outcome Assessment, Health Care / Q000379:methods* / Q000592:standards; D011785:Quality Assurance, Health Care / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D011788:Quality of Life; D012042:Registries / Q000592:standards* / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012655:Self-Evaluation Programs / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D020521:Stroke / Q000453:epidemiology*; D000071939:Stroke Rehabilitation; D013548:Sweden