Determining the Modified Rankin Score After Stroke by Postal and Telephone Questionnaires

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Abstract

BACKGROUND AND PURPOSE: The modified Rankin Scale (mRS) is the most common outcome measure in large randomized controlled trials in stroke. We tested 2 postal mRS questionnaires and a telephone questionnaire to determine completion rates and intermodality agreement. METHODS: We sent postal questionnaires containing 2 versions of the mRS to surviving stroke patients. One version, tick box, involved the patient/proxy ticking 1 of the 5 descriptions equating to mRS scores; the other, the simplified modified Rankin questionnaire (smRSq), included 5 questions with yes/no responses from which the mRS is derived. We performed a semistructured telephone interview to consenting respondents, blinded to postal responses, to assign an mRS. We compared the mRS obtained by these different methods. RESULTS: We sent questionnaires to 343 of 356 surviving patients (96%) and received 225 responses (66%). The mRS could not be derived in 27 respondents (12%) and 10 respondents (4%) on the tick box and smRSq, respectively (difference in proportion, 8% [95% CI, 3-13]. One hundred three of 190 respondents (54%) to the postal questionnaire agreed on the tick box versus smRSq version (κ=0.44 [0.38, 0.50]). Agreements between the tick box versus telephone and smRSq versus telephone were 57% (ie, 87/152, κ=0.47 [0.40, 0.55], and 64% (ie, 104/161, κ=0.55 [0.47, 0.62], respectively. CONCLUSIONS: In large studies where face-to-face assessment of mRS is impractical, a postal smRSq with telephone follow-up to nonresponders will achieve higher levels of follow-up than will the tick box version and also good levels of intermodality agreement with least risk of bias.
Original languageEnglish
Pages (from-to)851-853
JournalStroke
Volume43
Issue number3
DOIs
Publication statusPublished - Mar 2011

Keywords

  • stroke
  • outcome
  • modified Rankin scale

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