Different measures for assessing stroke outcome - An analysis from the international stroke trial in Italy

Background and Purpose-We sought to assess the relationship between 2 simple questions on recovery (question 1: do you feel that you have made a complete recovery from your stroke?) and dependency (question 2: do you require help from another person for everyday activities?) and the Barthel Index (BI) and Oxford Handicap Scale (OHS), as well as the relationship between BI and OHS, in a large number of Italian stroke survivors who participated in the International Stroke Trial (IST). Methods-We used data from 2423 patients interviewed by telephone at 6 months after the event. The K statistic, sensitivity, and specificity were calculated for several comparisons. Internal consistency for BI was calculated. Results-The reliability of the dependency question compared with BI=20 (kappa=0.93) and the reliability of the recovery question compared with OHS=0 (kappa=0.89) were good. Sensitivity of the dependency question in predicting whether patients scored BI>18 was 0.98; sensitivity of the recovery question in predicting whether patients scored OHS=0 was 0.99. The reliability of BI=20 compared with OHS<3 was good (κ=0.87). Internal consistency of BI was very high (Cronbach's α=0.96). Conclusions-The 2 simple questions are a good means of evaluating outcome from a patient's view and of dichotomizing the stroke survivor in a time-effective and reliable way.