Cited by 6,512Acute Ischemic Stroke ManagementStroke Rehabilitation and RecoveryReliability and Agreement in Measurement

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Interobserver agreement for the assessment of handicap in stroke patients

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van Swieten, J C, Koudstaal, P J, Visser, M C, Schouten, H J, van Gijn, J·1988·Stroke

DOI 10.1161/01.str.19.5.604

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Abstract

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.

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Authors: van Swieten, J. C., Koudstaal, P. J., Visser, M. C., Schouten, H. J., & van Gijn, J.
Affiliations: University Department of Neurology, Utrecht, The Netherlands.
Utrecht University (NL)
ORCID: Koudstaal, P J
Visser, M C
Venue: Stroke
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1988-05
Volume: 19
Issue: 5
Pages: 604-607
ISSN: 0039-2499 (ISSN-L)
1524-4628
DOI: 10.1161/01.str.19.5.604
OpenAlex: W1969661146
Cited by: 6,512
References: 26
Citations by year: 2026: 337 · 2025: 377 · 2024: 382 · 2023: 322 · 2022: 445 · 2021: 408 · 2020: 360 · 2019: 285 · 2018: 266 · 2017: 291 · 2016: 284 · 2015: 268 · 2014: 238 · 2013: 254 · 2012: 244
FWCI: 9.84
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Stroke (publishedVersion)
PubMed (publishedVersion)
Amsterdam UMC (VU Amsterdam) - Institutional Repository (submittedVersion, other-oa)
Topics: Health Sciences › Medicine › Clinical Neurology › Acute Ischemic Stroke Management
Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Reliability and Agreement in Measurement
Keywords: functional disability assessment, interobserver agreement, modified Rankin Scale, neurologists, medical residents, kappa statistic, weighted kappa
MeSH terms: Activities of Daily Living, Cerebrovascular Disorders, Humans, Neurologic Examination, Prognosis

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