title: Inter-rater reliability of the A-S-C-O classification system for ischemic stroke.
abstract: Atherosclerosis-small vessel disease-cardiac source-other (A-S-C-O) is a new phenotypic system that categorizes stroke according to a combination of etiologic characteristics. The purpose of this study was to establish the inter-rater reliability of ischemic stroke subtyping by applying A-S-C-O criteria to retrospectively reviewed medical records. A total of 419 patients with acute ischemic stroke were classified according to A-S-C-O criteria by two stroke neurologists independently. Inter-rater reliability was assessed by means of the κ statistic. The neurologists agreed on A-S-C-O subtype diagnosis for only 190 of the 419 patients (45.3%). The κ statistics for four stroke phenotypes were: (i) atherosclerosis, 0.786; (ii) small vessel disease, 0.798; (iii) cardiac source, 0.870; and (iv) other causes, 0.860. All p values were <0.001. Ischemic stroke can be reliably described with regard to four etiologic categories using the A-S-C-O system based on a review of medical records, whereas the overall agreement for stroke subtype diagnosis was only moderate.
authors.affiliation: Neurology Department, West China Hospital, Sichuan University, Wainan Guoxue Xiang, No. 37, Chengdu 610041, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Chen
authors.forename: Muke
authors.initials: M
authors.lastname: Zhou
authors.forename: Yucai
authors.initials: Y
authors.lastname: Wang
authors.forename: Hui
authors.initials: H
authors.lastname: Wang
authors.forename: Mi
authors.initials: M
authors.lastname: Yang
authors.forename: Jian
authors.initials: J
authors.lastname: Guo
authors.forename: Xue
authors.initials: X
authors.lastname: Yang
authors.forename: Hongbo
authors.initials: H
authors.lastname: Zheng
authors.forename: Dong
authors.initials: D
authors.lastname: Zhou
authors.forename: Li
authors.initials: L
authors.lastname: He
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D020521:Stroke / Q000145:classification* / Q000175:diagnosis* / Q000209:etiology; D055815:Young Adult