• Cerebrovascular diseases · Jan 2009

    Classification of minor stroke: intra- and inter-observer reliability.

    • Johann R Selvarajah, Matthew Glaves, Jane Wainwright, Animesh Jha, Andy Vail, and Pippa J Tyrrell.
    • Department of Neurology, Leeds General Infirmary, Leeds, UK.
    • Cerebrovasc. Dis. 2009 Jan 1;27(3):209-14.

    BackgroundThe Oxfordshire Community Stroke Project (OCSP) and Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classifications are widely used for the assessment of major ischaemic stroke. We explored their intra- and inter-observer reliability in the classification of outpatient minor stroke.MethodsFour physicians of differing seniority and training backgrounds classified minor stroke using clinical data from 90 patients.ResultsFor both the OCSP and TOAST classifications, the intra-observer reliability varied from moderate to excellent (kappa = 0.48-0.83). The inter-observer reliability was good (kappa = 0.64) for the OCSP and moderate (kappa = 0.42) for the TOAST. Thus, neither classification was consistently reliable.ConclusionsOur results may reflect the limited validity of these classifications in a typical minor stroke outpatient population and variable observer expertise.

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