Classification of minor stroke: intra- and inter-observer reliability.
BACKGROUND
The Oxfordshire Community Stroke Project (OCSP) and Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classifications are widely used for the assessment of major ischaemic stroke. We explored their intra- and inter-observer reliability in the classification of outpatient minor stroke.


METHODS
Four physicians of differing seniority and training backgrounds classified minor stroke using clinical data from 90 patients.


RESULTS
For both the OCSP and TOAST classifications, the intra-observer reliability varied from moderate to excellent (kappa = 0.48-0.83). The inter-observer reliability was good (kappa = 0.64) for the OCSP and moderate (kappa = 0.42) for the TOAST. Thus, neither classification was consistently reliable.


CONCLUSIONS
Our results may reflect the limited validity of these classifications in a typical minor stroke outpatient population and variable observer expertise.
Selvarajah
Johann R
JR
Department of Neurology, Leeds General Infirmary, Leeds, UK.
Glaves
Matthew
M
Wainwright
Jane
J
Jha
Animesh
A
Vail
Andy
A
Tyrrell
Pippa J
PJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010045:Outpatients; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000145:classification / Q000175:diagnosis*