Measurements of acute cerebral infarction: a clinical examination scale

T BROTT; H P Adams Jr; M RORICK; C. J MOOMAW; Michael  Walker; C. P OLINGER; J. R MARLER; W. G BARSAN; J BILLER; J SPILKER; R HOLLERAN; R EBERLE; V HERTZBERG

doi:10.1161/01.STR.20.7.864

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Measurements of acute cerebral infarction: a clinical examination scale

Journal article

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Peer reviewed

Measurements of acute cerebral infarction: a clinical examination scale

T BROTT, H P Adams Jr, M RORICK, C. J MOOMAW, Michael Walker, C. P OLINGER, J. R MARLER, W. G BARSAN, J BILLER, J SPILKER, …

Stroke (1970), Vol.20(7), pp.864-870

1989

DOI: 10.1161/01.STR.20.7.864

PMID: 2749846

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Abstract

We designed a 15-item neurologic examination stroke scale for use in acute stroke therapy trials. In a study of 24 stroke patients, interrater reliability for the scale was found to be high (mean kappa = 0.69), and test-retest reliability was also high (mean kappa = 0.66-0.77). Test-retest reliability did not differ significantly among a neurologist, a neurology house officer, a neurology nurse, or an emergency department nurse. The stroke scale validity was assessed by comparing the scale scores obtained prospectively on 65 acute stroke patients to the patients' infarction size as measured by computed tomography scan at 1 week and to the patients' clinical outcome as determined at 3 months. These correlations (scale-lesion size r = 0.68, scale-outcome r = 0.79) suggested acceptable examination and scale validity. Of the 15 test items, the most interrater reliable item (pupillary response) had low validity. Less reliable items such as upper or lower extremity motor function were more valid. We discuss methods for improving the reliability and validity of brief examination scales to be used in stroke therapy trials.

Neurology

Biological and medical sciences

Vascular diseases and vascular malformations of the nervous system

Medical sciences

Details

Title: Subtitle: Measurements of acute cerebral infarction: a clinical examination scale
Creators: T BROTT - Univ. Cincinnati, dep. neurology, Cincinnati OH 45267-0525, United States
H P Adams Jr - Univ. Cincinnati, dep. neurology, Cincinnati OH 45267-0525, United States
M RORICK - Univ. Cincinnati, dep. neurology, Cincinnati OH 45267-0525, United States
C. J MOOMAW - Univ. Cincinnati, dep. neurology, Cincinnati OH 45267-0525, United States
Michael Walker - Univ. Cincinnati, dep. neurology, Cincinnati OH 45267-0525, United States
C. P OLINGER - Univ. Cincinnati, dep. neurology, Cincinnati OH 45267-0525, United States
J. R MARLER - Univ. Cincinnati, dep. neurology, Cincinnati OH 45267-0525, United States
W. G BARSAN - Univ. Cincinnati, dep. neurology, Cincinnati OH 45267-0525, United States
J BILLER - Univ. Cincinnati, dep. neurology, Cincinnati OH 45267-0525, United States
J SPILKER - Univ. Cincinnati, dep. neurology, Cincinnati OH 45267-0525, United States
R HOLLERAN - Univ. Cincinnati, dep. neurology, Cincinnati OH 45267-0525, United States
R EBERLE - Univ. Cincinnati, dep. neurology, Cincinnati OH 45267-0525, United States
V HERTZBERG - Univ. Cincinnati, dep. neurology, Cincinnati OH 45267-0525, United States
Resource Type: Journal article
Publication Details: Stroke (1970), Vol.20(7), pp.864-870
DOI: 10.1161/01.STR.20.7.864
PMID: 2749846
NLM abbreviation: Stroke
ISSN: 0039-2499
eISSN: 1524-4628
Publisher: Lippincott Williams & Wilkins; Hagerstown, MD
Language: English
Date published: 1989
Academic Unit: Neurology; Iowa Neuroscience Institute
Record Identifier: 9984020782402771

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