Children’s Stroke Program, The Hospital for Sick Children, Toronto, Canada.
Stroke. 2012 Jun;43(6):1602-8. doi: 10.1161/STROKEAHA.111.639583. Epub 2012 Apr 3.
The Pediatric Stroke Outcome Measure (PSOM) is an objective, disease-specific outcome measure containing 115 test items suitable for newborn to adult ages. The PSOM measures neurological deficit and function across 5 subscales: right sensorimotor, left sensorimotor, language production, language comprehension, and cognitive/behavior yielding a final 10-point deficit score. The goal of this study was to examine PSOM construct validity in measuring neurological outcome in pediatric stroke survivors and interrater reliability (IRR) for both prospective and retrospective scoring.
For construct validity, PSOM subscale scores were correlated with scores on standardized neuropsychological measures matched by functional domain. We assessed IRR by comparing same-day "live" PSOM scores from 2 independent raters in 10 children (prospective IRR) and by comparing PSOM scores estimated from medical dictations across 5 raters in another 10 children (retrospective IRR).
We analyzed PSOM scores from 203 children with ischemic stroke. PSOM subscales show good construct validity (ρ=0.2-0.4; P<0.05). PSOM subscale scores of normal/abnormal demonstrate strong agreement for domain-matched neuropsychology scores (alternative chance-corrected statistic=0.4-0.8). IRR was excellent with the 2 prospective raters' scores in almost perfect agreement (intraclass correlation coefficient, 0.93; 95% CI, 0.76-0.98). Retrospective IRR demonstrated strong agreement with an intraclass correlation coefficient of 0.77 (95% CI, 0.56-0.92).
The PSOM is a valid and reliable outcome measure for pediatric stroke. It is useful for retrospective scoring from health records and prospective serial longitudinal outcome assessments and is ideally suited for prospective clinical trials in pediatric stroke.
儿科中风结局测量量表（PSOM）是一种客观的、针对特定疾病的结局测量工具，包含 115 个测试项目，适用于新生儿至成人年龄。PSOM 通过 5 个分量表测量神经缺损和功能：右侧感觉运动、左侧感觉运动、语言产生、语言理解和认知/行为，得出最终的 10 分缺损评分。本研究的目的是检验 PSOM 在测量儿科中风幸存者神经结局方面的结构效度和前瞻性及回顾性评分的评定者间信度（IRR）。
为了检验结构效度，PSOM 分量表得分与功能域相匹配的标准化神经心理学测量得分相关。我们通过比较 10 名儿童的 2 位独立评定者同日的“现场”PSOM 评分（前瞻性 IRR），以及比较另外 10 名儿童的 5 位评定者对医疗记录的 PSOM 评分（回顾性 IRR）来评估 IRR。
我们分析了 203 名缺血性中风患儿的 PSOM 评分。PSOM 分量表具有良好的结构效度（ρ=0.2-0.4；P<0.05）。PSOM 分量表的正常/异常评分与域匹配的神经心理学评分具有很强的一致性（替代机会校正统计量=0.4-0.8）。2 位前瞻性评定者的评分具有极好的 IRR，几乎完全一致（组内相关系数，0.93；95%置信区间，0.76-0.98）。回顾性 IRR 表现出很强的一致性，组内相关系数为 0.77（95%置信区间，0.56-0.92）。
PSOM 是一种用于儿科中风的有效且可靠的结局测量工具。它可用于从健康记录进行回顾性评分和前瞻性连续纵向结局评估，非常适合儿科中风的前瞻性临床试验。
