Interrater Reliability of the Pediatric National Institutes of Health Stroke Scale (PedNIHSS) in a Multicenter Study

被引：133

作者：

Ichord, Rebecca N. ^{[1
]}

Bastian, Rachel ^{[1
]}

Abraham, Lisa ^{[1
,2
]}

Askalan, Rand ^{[3
]}

Benedict, Susan ^{[4
]}

Bernard, Timothy J. ^{[5
]}

Beslow, Lauren

deVeber, Gabrielle ^{[3
]}

Dowling, Michael ^{[6
]}

Friedman, Neil ^{[7
]}

Fullerton, Heather ^{[8
]}

Jordan, Lori ^{[9
]}

Kan, Li ^{[10
]}

Kirton, Adam ^{[11
]}

Amlie-Lefond, Catherine ^{[12
]}

Licht, Daniel ^{[1
]}

Lo, Warren ^{[13
]}

McClure, Chalmer ^{[14
]}

Pavlakis, Steve ^{[15
]}

Smith, Sabrina E. ^{[1
]}

Tan, Marilyn ^{[16
]}

Kasner, Scott ^{[17
]}

Jawad, Abbas F. ^{[18
]}

机构：

[1] Univ Penn, Dept Neurol, Childrens Hosp Philadelphia, Philadelphia, PA 19104 USA

[2] Schenectady Neurol Consultants PC, Dept Pediat, Schenectady, NY USA

[3] Hosp Sick Children, Dept Pediat, Div Neurol, Toronto, ON M5G 1X8, Canada

[4] Univ Utah, Dept Pediat, Div Neurol, Primary Childrens Hosp, Salt Lake City, UT USA

[5] Univ Colorado, Sect Child Neurol, Denver Childrens Hosp, Aurora, CO USA

[6] Univ Texas SW, Dept Neurol, Childrens Med Ctr Dallas, Dallas, TX USA

[7] Cleveland Clin, Neurol Inst, Ctr Pediat Neurol Desh S60, Cleveland, OH 44106 USA

[8] Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA

[9] Johns Hopkins Univ, Dept Neurol, Baltimore, MD 21218 USA

[10] Schneider Childrens Hosp, Div Pediat Neurol, New Hyde Pk, NY USA

[11] Univ Calgary, Dept Pediat Clin Neurosci, Alberta Childrens Hosp, Calgary, AB, Canada

[12] Med Coll Wisconsin, Childrens Hosp Wisconsin, Dept Neurol, Milwaukee, WI 53226 USA

[13] Ohio State Univ, Dept Neurol, Nationwide Childrens Hosp, Columbus, OH 43210 USA

[14] Loma Linda Univ, Dept Neurol, Loma Linda, CA 92350 USA

[15] Maimonides Infants Childrens Hosp, Dept Dev Med & Child Neurol, Brooklyn, NY USA

[16] Univ Philippines, Dept Neurosci, Manila, Philippines

[17] Univ Penn, Dept Neurol, Philadelphia, PA 19104 USA

[18] Univ Penn, Childrens Hosp Philadelphia, Dept Pediat, Philadelphia, PA 19104 USA

来源：

STROKE | 2011年 / 42卷 / 03期

基金：

美国国家卫生研究院;

关键词：

childhood; ischemic stroke; outcome; stroke scale; validation; ARTERIAL ISCHEMIC-STROKE; CHILDREN; PREDICTORS; RISK;

D O I：

10.1161/STROKEAHA.110.607192

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background and Purpose-Stroke is an important cause of death and disability among children. Clinical trials for childhood stroke require a valid and reliable acute clinical stroke scale. We evaluated interrater reliability (IRR) of a pediatric adaptation of the National Institutes of Health Stroke Scale. Methods-The pediatric adaptation of the National Institutes of Health Stroke Scale was developed by pediatric and adult stroke experts by modifying each item of the adult National Institutes of Health Stroke Scale for children, retaining all examination items and scoring ranges of the National Institutes of Health Stroke Scale. Children 2 to 18 years of age with acute arterial ischemic stroke were enrolled in a prospective cohort study from 15 North American sites from January 2007 to October 2009. Examiners were child neurologists certified in the adult National Institutes of Health Stroke Scale. Each subject was examined daily for 7 days or until discharge. A subset of patients at 3 sites was scored simultaneously and independently by 2 study neurologists. Results-IRR testing was performed in 25 of 113 a median of 3 days (interquartile range, 2 to 4 days) after symptom onset. Patient demographics, total initial pediatric adaptation of the National Institutes of Health Stroke Scale scores, risk factors, and infarct characteristics in the IRR subset were similar to the non-IRR subset. The 2 raters' total scores were identical in 60% and within 1 point in 84%. IRR was excellent as measured by concordance correlation coefficient of 0.97 (95% CI, 0.94 to 0.99); intraclass correlation coefficient of 0.99 (95% CI, 0.97 to 0.99); precision measured by Pearson rho of 0.97; and accuracy measured by the bias correction factor of 1.0. Conclusions-There was excellent IRR of the pediatric adaptation of the National Institutes of Health Stroke Scale in a multicenter prospective cohort performed by trained child neurologists. (Stroke. 2011; 42: 613-617.)

引用

页码：613 / 617

页数：5

共 16 条

[1] Predictors of Cerebral Arteriopathy in Children With Arterial Ischemic Stroke Results of the International Pediatric Stroke Study [J].

Amlie-Lefond, Catherine ;

Bernard, Timothy J. ;

Sebire, Guillaume ;

Friedman, Neil R. ;

Heyer, Geoffrey L. ;

Lerner, Norma B. ;

de Veber, Gabrielle ;

Fullerton, Heather J. .

CIRCULATION, 2009, 119 (10) :1417-U110

[2]

Bland JM, 1999, STAT METHODS MED RES, V8, P135, DOI 10.1177/096228029900800204

[3] MEASUREMENTS OF ACUTE CEREBRAL INFARCTION - A CLINICAL EXAMINATION SCALE [J].

BROTT, T ;

ADAMS, HP ;

OLINGER, CP ;

MARLER, JR ;

BARSAN, WG ;

BILLER, J ;

SPILKER, J ;

HOLLERAN, R ;

EBERLE, R ;

HERTZBERG, V ;

RORICK, M ;

MOOMAW, CJ ;

WALKER, M .

STROKE, 1989, 20 (07) :864-870

[4] Predictors of good outcome after intravenous tPA for acute ischemic stroke [J].

Demchuk, AM ;

Tanne, D ;

Hill, MD ;

Kasner, SE ;

Hanson, S ;

Grond, M ;

Levine, SR .

NEUROLOGY, 2001, 57 (03) :474-480

[5] Neurologic outcome in survivors of childhood arterial ischemic stroke and sinovenous thrombosis [J].

deVeber, GA ;

MacGregor, D ;

Curtis, R ;

Mayank, S .

JOURNAL OF CHILD NEUROLOGY, 2000, 15 (05) :316-324

[6] EQUIVALENCE OF WEIGHTED KAPPA AND INTRACLASS CORRELATION COEFFICIENT AS MEASURES OF RELIABILITY [J].

FLEISS, JL ;

COHEN, J .

EDUCATIONAL AND PSYCHOLOGICAL MEASUREMENT, 1973, 33 (03) :613-619

[7] Risk of stroke in children - Ethnic and gender disparities [J].

Fullerton, HJ ;

Wu, YW ;

Zhao, SJ ;

Johnston, SC .

NEUROLOGY, 2003, 61 (02) :189-194

[8] Investigation of risk factors in children with arterial ischemic stroke [J].

Ganesan, V ;

Prengler, M ;

McShane, MA ;

Wade, AM ;

Kirkham, FJ .

ANNALS OF NEUROLOGY, 2003, 53 (02) :167-173

[9] CEREBROVASCULAR-DISEASE IN CHILDREN UNDER 16 YEARS OF AGE IN THE CITY OF DIJON, FRANCE - A STUDY OF INCIDENCE AND CLINICAL-FEATURES FROM 1985 TO 1993 [J].

GIROUD, M ;

LEMESLE, M ;

GOUYON, JB ;

NIVELON, JL ;

MILAN, C ;

DUMAS, R .

JOURNAL OF CLINICAL EPIDEMIOLOGY, 1995, 48 (11) :1343-1348

[10] Reliability of the National Institutes of Health Stroke Scale - Extension to non-neurologists in the context of a clinical trial [J].

Goldstein, LB ;

Samsa, GP .

STROKE, 1997, 28 (02) :307-310

← 1 2 →