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Stroke. 2016 Jan;47(1):167-72. doi: 10.1161/STROKEAHA.115.010374. Epub 2015 Nov 17.

Multilingual Validation of the Questionnaire for Verifying Stroke-Free Status in West Africa.

Author information

1
From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.). stephensarfo78@gmail.com.
2
From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).

Abstract

BACKGROUND AND PURPOSE:

The Questionnaire for Verifying Stroke-Free Status (QVSFS), a method for verifying stroke-free status in participants of clinical, epidemiological, and genetic studies, has not been validated in low-income settings where populations have limited knowledge of stroke symptoms. We aimed to validate QVSFS in 3 languages, Yoruba, Hausa and Akan, for ascertainment of stroke-free status of control subjects enrolled in an on-going stroke epidemiological study in West Africa.

METHODS:

Data were collected using a cross-sectional study design where 384 participants were consecutively recruited from neurology and general medicine clinics of 5 tertiary referral hospitals in Nigeria and Ghana. Ascertainment of stroke status was by neurologists using structured neurological examination, review of case records, and neuroimaging (gold standard). Relative performance of QVSFS without and with pictures of stroke symptoms (pictograms) was assessed using sensitivity, specificity, positive predictive value, and negative predictive value.

RESULTS:

The overall median age of the study participants was 54 years and 48.4% were males. Of 165 stroke cases identified by gold standard, 98% were determined to have had stroke, whereas of 219 without stroke 87% were determined to be stroke-free by QVSFS. Negative predictive value of the QVSFS across the 3 languages was 0.97 (range, 0.93-1.00), sensitivity, specificity, and positive predictive value were 0.98, 0.82, and 0.80, respectively. Agreement between the questionnaire with and without the pictogram was excellent/strong with Cohen k=0.92.

CONCLUSIONS:

QVSFS is a valid tool for verifying stroke-free status across culturally diverse populations in West Africa.

KEYWORDS:

Ghana; cross-sectional studies; neurology; sensitivity and specificity; stroke

PMID:
26578660
PMCID:
PMC4696900
DOI:
10.1161/STROKEAHA.115.010374
[Indexed for MEDLINE]
Free PMC Article

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