Domínguez Raúl, Vila José F, Augustovski Federico, Irazola Vilma, Castillo Pablo R, Rotta Escalante Roberto, Brott Thomas G, Meschia James F
University of Buenos Aires Hospital Sirio Libanés, Instituto Médico ENERI, Ciudad Autónoma de Buenos Aire, Argentina.
Mayo Clin Proc. 2006 Apr;81(4):476-80. doi: 10.4065/81.4.476.
To adapt and validate a Spanish-language version (SV) of the National Institutes of Health Stroke Scale (NIHSS) to facilitate its use in Spanish-speaking contexts.
The methods recommended by the International Quality of Life Assessment Project were followed. Two forward translations and 1 back translation of the NIHSS were developed to ensure lingual and cultural equivalence. A final revised SV-NIHSS was administered by 8 physicians to patients with stroke in 3 clinics in Buenos Aires, Argentina, from September 2003 to December 2003.
The study included 102 patients (mean +/- SD age, 73.3+/-6.5 years; 56% women) with stroke (86% ischemic). The SV-NIHSS mean baseline score was 9.78+/-7.04. Interrater reliability was Independently evaluated for 98 patients, showing a high agreement: kappa, 0.77 to 0.99 for the 15 items; interrater correlation coefficient, 0.991 (95% confidence Interval, 0.987-0.994). Intrarater reliability was excellent: kappa, 0.86 to 1.00 for the 15 items; mean intrarater correlation coefficient, 0.994 (95% confidence interval, 0.991-0.996). Construct validity was also adequate; the SV-NIHSS had a negative correlation with baseline Glasgow Coma Scale (Spearman coefficient = -0.574, P < .001) and with Barthel index at 3 months (Spearman coefficient = -0.658, P < .001). Patients with different Rankin scores at 3 months also had significantly different baseline SV-NIHSS scores, from a mean of 4.29+/-2.21 for Rankin score of 0 to a mean of 29.40+/-3.97 for Rankin score of 6 (P < .001).
This study shows that a Spanish-language version of the NIHSS developed with internationally recommended methods is reliable and valid when applied in a Spanish-speaking setting.
对美国国立卫生研究院卒中量表（NIHSS）的西班牙语版本（SV）进行改编和验证，以方便其在讲西班牙语的环境中使用。
遵循国际生活质量评估项目推荐的方法。对NIHSS进行了两次正向翻译和一次反向翻译，以确保语言和文化等效性。2003年9月至2003年12月，8名医生在阿根廷布宜诺斯艾利斯的3家诊所对卒中患者使用最终修订的SV-NIHSS进行评估。
该研究纳入了102例卒中患者（平均年龄±标准差为73.3±6.5岁；56%为女性）（86%为缺血性卒中）。SV-NIHSS的平均基线评分为9.78±7.04。对98例患者独立评估了评分者间信度，显示高度一致：15个项目的kappa值为0.77至0.99；评分者间相关系数为0.991（95%置信区间为0.987 - 0.994）。评分者内信度极佳：15个项目的kappa值为0.86至1.00；平均评分者内相关系数为0.994（95%置信区间为0.991 - 0.996）。结构效度也足够；SV-NIHSS与基线格拉斯哥昏迷量表呈负相关（斯皮尔曼系数 = -0.574，P < .001），与3个月时的巴氏指数呈负相关（斯皮尔曼系数 = -0.658，P < .001）。3个月时具有不同Rankin评分的患者其基线SV-NIHSS评分也有显著差异，Rankin评分为0时平均分为4.29±2.21，Rankin评分为6时平均分为29.40±3.97（P < .001）。
本研究表明，采用国际推荐方法开发的NIHSS西班牙语版本在讲西班牙语的环境中应用时是可靠且有效的。
