van Swieten J C, Koudstaal P J, Visser M C, Schouten H J, van Gijn J
University Department of Neurology, Utrecht, The Netherlands.
Stroke. 1988 May;19(5):604-7. doi: 10.1161/01.str.19.5.604.
Interobserver agreement for the assessment of handicap in stroke patients was investigated in a group of 10 senior neurologists and 24 residents from two centers. One hundred patients were separately interviewed by two physicians in different combinations. The degree of handicap was recorded by each observer on the modified Rankin scale, which has six grades (0-5). The agreement rates were corrected for chance (kappa statistics). Both physicians agreed on the degree of handicap in 65 patients; they differed by one grade in 32 patients and by two grades in 3 patients. Kappa for all pairwise observations was 0.56; the value for weighted kappa (with quadratic disagreement weights) was 0.91. Our results confirm the value of the modified Rankin scale in the assessment of handicap in stroke patients; nevertheless, further improvements are possible.
在来自两个中心的10名资深神经科医生和24名住院医生组成的小组中，对评估中风患者残疾情况的观察者间一致性进行了调查。100名患者由两名医生以不同组合分别进行访谈。每位观察者根据改良Rankin量表记录残疾程度，该量表有六个等级（0 - 5级）。一致性率经机遇校正（kappa统计量）。两位医生对65名患者的残疾程度达成一致；他们在32名患者中相差一个等级，在3名患者中相差两个等级。所有成对观察的kappa值为0.56；加权kappa值（采用二次不一致权重）为0.91。我们的结果证实了改良Rankin量表在评估中风患者残疾情况方面的价值；然而，仍有可能进一步改进。
