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Stroke. 2008 Dec;39(12):3421-3. doi: 10.1161/STROKEAHA.108.519306. Epub 2008 Sep 4.

Deriving modified Rankin scores from medical case-records.

Author information

1
Division of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. Tjq1t@clinmed.gla.ac.uk

Abstract

BACKGROUND AND PURPOSE:

Modified Rankin score (mRS) is traditionally graded using a face-to-face or telephone interview. Certain stroke assessment scales can be derived from a review of a patient's case-record alone. We hypothesized that mRS could be successfully derived from the narrative within patient case-records.

METHODS:

Sequential patients attending our cerebrovascular outpatient clinic were included. Two independent, blinded clinicians, trained in mRS, assessed case-records to derive mRS. They scored "certainty" of their grading on a 5-point Likert scale. Agreement between derived and traditional face-to-face mRS was calculated using attribute agreement analysis.

RESULTS:

Fifty patients with a range of disabilities were included. Case-record appraisers were poor at deriving mRS (k=0.34 against standard). Derived mRS grades showed poor agreement between observers (k=0.33). There was no relationship between certainty of derived mRS and proportion of correct grades (P=0.727).

CONCLUSIONS:

Accurate mRS cannot be derived from standard hospital records. Direct mRS interview is still required for clinical trials.

PMID:
18772445
DOI:
10.1161/STROKEAHA.108.519306
[Indexed for MEDLINE]
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