Inter-rater reliability of stroke sub-type classification by neurologists and nurses within a community-based stroke incidence study

The stroke classification developed for use in the Oxfordshire Community Stroke Project (OCSP) is simple, clinically meaningful and requires no investigations. However, its inter-rater reliability in a community setting is unknown. We aimed to assess the inter-rater reliability of this classification among neurologists and nurses within a community-based stroke incidence study, Fifty-four stroke patients with cerebral infarction who were registered in the North East Me[bourne Stroke Incidence Study (NEMESIS) were assigned OCSP classifications by two neurologists and one of seven research nurses. There was moderate agreement between neurologists (K =0.53), fair agreement between neurologist 1 and nurse (K=0.31) and moderate agreement between neurologist 2 and nurse (K=0.45), Disagreement about the neurological signs was an important reason for classification differences. The OCSP classification can be easily applied in a community setting with moderate inter-rater reliability and is thus a useful instrument for community-based epidemiological studies. (C) 2001 Harcourt Publishers Ltd.