• Cerebrovascular diseases · Jan 2009

    Validation of the National Institutes of Health Stroke Scale, modified Rankin Scale and Barthel Index in Brazil: the role of cultural adaptation and structured interviewing.

    • Carolina Cincura, Octavio M Pontes-Neto, Iuri S Neville, Henrique F Mendes, Daniela F Menezes, Débora C Mariano, Issana F Pereira, Larissa A Teixeira, Pedro A P Jesus, Danilo C L de Queiroz, Davidson F Pereira, Elen Pinto, João P Leite, Antonio A Lopes, and Jamary Oliveira-Filho.
    • Stroke Clinic, Federal University of Bahia, Salvador, Brazil.
    • Cerebrovasc. Dis. 2009 Jan 1; 27 (2): 119-22.

    BackgroundWe aimed to validate three widely used scales in stroke research in a multiethnic Brazilian population.MethodsThe National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS) and Barthel Index (BI) were translated, culturally adapted and applied by two independent investigators. The mRS was applied with or without a previously validated structured interview. Interobserver agreement (kappa statistics) and intraclass correlation coefficients were calculated.Results84 patients underwent mRS (56 with and 28 without a structured interview), 57 BI and 62 NIHSS scoring. Intraclass correlation coefficient was 0.902 for NIHSS and 0.967 for BI. For BI, interobserver agreement was good (kappa = 0.70). For mRS, the structured interview improved interobserver agreement (kappa = 0.34 without a structured interview; 0.75 with a structured interview).ConclusionThe NIHSS, BI and mRS show good validity when translated and culturally adapted. Using a structured interview for the mRS improves interobserver concordance rates.Copyright (c) 2008 S. Karger AG, Basel.

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