Department of Neurology, University Medical Centre Utrecht, Utrecht, The Netherlands.
Cerebrovasc Dis. 2010 Jan;29(2):137-9. doi: 10.1159/000262309. Epub 2009 Dec 1.
A structured interview improves the reliability of the modified Rankin Scale (mRS), a commonly used functional outcome scale in stroke trials. Telephone interview is a fast and convenient way to assess the mRS grade, but its validity is unknown. We assessed the validity of a telephone interview in patients who had had an aneurysmal subarachnoid haemorrhage (SAH) by comparing it with a face-to-face assessment.
Eighty-three SAH patients were interviewed twice, once face-to-face and once by telephone, by 2 of 5 observers who used a structured interview to assess the mRS grade. Intermodality agreement was measured using weighted kappa statistics. To check for systematic differences between face-to-face and telephone assessment the Wilcoxon test for matched pairs was used.
Agreement between telephone and face-to-face assessment was perfect in 47 (57%) patients. A difference of 1 level occurred in 31 (37%) patients and this was almost equally distributed over the grades of the mRS. Weighted kappa was 0.71 (95% CI 0.59-0.82). Telephone assessment did not result in a consistently more or less favourable grade than face-to-face assessment (Wilcoxon test for matched pairs, p = 0.33).
Telephone assessment of the mRS with a structured interview has a good agreement with face-to-face assessment and can thus be used reliably in the setting of a clinical trial.
改良 Rankin 量表（mRS）是一种常用于中风临床试验的常用功能结局量表，结构式访谈可提高其可靠性。电话访谈是评估 mRS 等级的快速便捷方法，但尚未明确其有效性。我们通过与面对面评估进行比较，评估了电话访谈在经历蛛网膜下腔出血（SAH）的患者中的有效性。
83 例 SAH 患者由 5 名观察者中的 2 名通过面对面和电话访谈进行了 2 次访谈，采用结构化访谈来评估 mRS 等级。使用加权κ统计量评估模态间一致性。为了检查面对面和电话评估之间是否存在系统差异，使用配对Wilcoxon 检验。
47 例（57%）患者的电话和面对面评估结果完全一致。31 例（37%）患者的评估结果相差 1 个级别，mRS 等级的分布几乎相等。加权κ为 0.71（95%CI 0.59-0.82）。电话评估的等级并不总是比面对面评估的等级更有利或更不利（配对Wilcoxon 检验，p=0.33）。
使用结构化访谈进行电话 mRS 评估与面对面评估具有良好的一致性，因此可以在临床试验中可靠使用。
