Improving modified Rankin Scale assessment with a simplified questionnaire.
OBJECTIVE
The modified Rankin Scale (mRS) is a popular primary stroke outcome measure, but its usefulness is limited by suboptimal reliability (inter-rater agreement).


METHODS
We developed and tested the reliability of a simplified mRS questionnaire (smRSq) in 50 patients after stroke seen in outpatient clinics. Randomly chosen paired raters administered the smRSq within 20 minutes of each other and the ratings were blinded until the end of this study.


RESULTS
Agreement among the raters was 78%, the kappa statistic was 0.72 (95% CI, 0.58-0.86), and the weighted kappa(w) statistic taking into account the extent of disagreement was 0.82 (95% CI, 0.72-0.92). The average time to administer the smRSq was 1.67 minutes.


CONCLUSIONS
The smRSq appears to have very good reliability that is similar to that of a structured interview mRS and is considerably less time-consuming.
Department of Neurology, Medical College of Georgia, 1120 15th Street BI 3076, Augusta, GA 30912, USA. abruno@mcg.edu
Askiel
A
Bruno
Neel
N
Shah
Chen
C
Lin
Brian
B
Close
David C
DC
Hess
Kristin
K
Davis
Vanessa
V
Baute
Jeffrey A
JA
Switzer
Jennifer L
JL
Waller
Fenwick T
FT
Nichols
D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000592:standards*; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis / Q000628:therapy; D011795:Surveys and Questionnaires / Q000592:standards*