Department of Academic Geriatric Medicine, Institute of Cardiovascular and Medical Services, University of Glasgow, UK.
Stroke. 2011 Apr;42(4):1146-51. doi: 10.1161/STROKEAHA.110.598540. Epub 2011 Mar 3.
Robust measures of functional outcome are required to determine treatment effects in stroke trials. Of the various measures available, the Barthel index (BI) is one of the more prevalent. We aimed to describe validity, reliability, and responsiveness (clinimetric properties) of the BI in stroke trials.
Narrative review of published articles describing clinimetric properties or use of the BI as a stroke trial end point.
Definitive statements on properties of BI are limited by heterogeneity in methodology of assessment and in the content of "BI" scales. Accepting these caveats, evidence suggests that BI is a valid measure of activities of daily living; sensitivity to change is limited at extremes of disability (floor and ceiling effects), and reliability of standard BI assessment is acceptable. However, these data may not be applicable to contemporary multicenter stroke trials.
Substantial literature describing BI clinimetrics in stroke is available; however, questions remain regarding certain properties. The "BI" label is used for a number of instruments and we urge greater consistency in methods, content, and scoring. A 10-item scale, scoring 0 to 100 with 5-point increments, has been used in several multicenter stroke trials and it seems reasonable that this should become the uniform stroke trial BI.
需要使用稳健的功能结果测量指标来确定中风试验的治疗效果。在各种可用的测量方法中，巴氏指数（BI）是最常见的方法之一。我们旨在描述 BI 在中风试验中的有效性、可靠性和反应性（临床计量特性）。
对描述 BI 临床计量特性或作为中风试验终点的 BI 使用情况的已发表文章进行叙述性综述。
由于评估方法和“BI”量表内容的异质性，对 BI 特性的明确说明受到限制。在接受这些警告的情况下，有证据表明 BI 是日常生活活动的有效衡量标准；在残疾的极端情况下（下限和上限效应），变化的敏感性有限，标准 BI 评估的可靠性是可以接受的。然而，这些数据可能不适用于当代多中心中风试验。
有大量描述 BI 在中风中的临床计量学的文献，但关于某些特性仍存在疑问。BI 标签用于多种仪器，我们敦促在方法、内容和评分方面更加一致。在几项多中心中风试验中使用了一个包含 10 个项目的量表，评分范围为 0 到 100，分数为 5 分，这似乎很合理，应该成为统一的中风试验 BI。
