Yi Kenichiro, Inatomi Yuichiro, Nakajima Makoto, Yonehara Toshiro, Ueda Mitsuharu
Department of Neurology, Saiseikai Kumamoto Hospital, Chikami 5-3-1, Minami-ku, Kumamoto 861-4193, Japan; Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Department of Neurology, Saiseikai Kumamoto Hospital, Chikami 5-3-1, Minami-ku, Kumamoto 861-4193, Japan.
J Stroke Cerebrovasc Dis. 2021 Feb;30(2):105517. doi: 10.1016/j.jstrokecerebrovasdis.2020.105517. Epub 2020 Dec 4.
We developed a Japanese version of the simplified modified Rankin Scale questionnaire, of which the agreement between patients or their family members and neurologists was verified in a previous single-center study. In the present study, the reliability of the questionnaire was evaluated in another hospital.
The participants were prospectively-registered patients with acute ischemic stroke admitted to Saiseikai Kumamoto Hospital. The questionnaire was administered to the patients or their family members at discharge. At the same time, the attending physician assessed the Japanese version of a guidance scheme for the modified Rankin Scale. The agreement rate between the scores from both assessments was examined using the κ statistic and weighted κ statistic. We examined the factors related to disagreement between the modified Rankin Scale score by the attending physicians and the questionnaire score by patients/family members.
A total of 146 patients (age 77 ± 12 years; 53% men) were included. Agreement between the raters was 39%; the κ statistic was 0.27, but the weighted κ statistic, taking into account the extent of disagreement, was 0.81. In multivariate analysis, the disagreement between the modified Rankin Scale score and the questionnaire score was negatively associated with a modified Rankin Scale score of 5 at discharge (odds ratio, 0.02 per score point; 95% confidence interval, 0.00-0.34).
The questionnaire showed decent reliability and similarity to the modified Rankin Scale assessed by physicians. The questionnaire could be a reliable indicator for assessing stroke functional outcomes even when implemented by non-medical staff.
我们开发了简化版改良Rankin量表问卷的日语版本，在之前的一项单中心研究中已验证了患者或其家属与神经科医生之间的一致性。在本研究中，对该问卷在另一家医院进行了可靠性评估。
参与者为前瞻性登记入住熊本济生会医院的急性缺血性卒中患者。在出院时向患者或其家属发放问卷。同时，主治医生对改良Rankin量表的日语版指导方案进行评估。使用κ统计量和加权κ统计量检查两种评估得分之间的一致率。我们研究了与主治医生的改良Rankin量表得分和患者/家属的问卷得分之间不一致相关的因素。
共纳入146例患者（年龄77±12岁；53%为男性）。评估者之间的一致性为39%；κ统计量为0.27，但考虑到不一致程度的加权κ统计量为0.81。在多变量分析中，改良Rankin量表得分与问卷得分之间的不一致与出院时改良Rankin量表得分为5呈负相关（比值比，每得分点0.02；95%置信区间，0.00 - 0.34）。
该问卷显示出良好的可靠性，且与医生评估的改良Rankin量表相似。即使由非医务人员实施，该问卷也可能是评估卒中功能结局的可靠指标。
