Document Detail


Interrater reliability of the Pediatric National Institutes of Health Stroke Scale (PedNIHSS) in a multicenter study.
MedLine Citation:
PMID:  21317270     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Stroke is an important cause of death and disability among children. Clinical trials for childhood stroke require a valid and reliable acute clinical stroke scale. We evaluated interrater reliability (IRR) of a pediatric adaptation of the National Institutes of Health Stroke Scale.
METHODS: The pediatric adaptation of the National Institutes of Health Stroke Scale was developed by pediatric and adult stroke experts by modifying each item of the adult National Institutes of Health Stroke Scale for children, retaining all examination items and scoring ranges of the National Institutes of Health Stroke Scale. Children 2 to 18 years of age with acute arterial ischemic stroke were enrolled in a prospective cohort study from 15 North American sites from January 2007 to October 2009. Examiners were child neurologists certified in the adult National Institutes of Health Stroke Scale. Each subject was examined daily for 7 days or until discharge. A subset of patients at 3 sites was scored simultaneously and independently by 2 study neurologists.
RESULTS: IRR testing was performed in 25 of 113 a median of 3 days (interquartile range, 2 to 4 days) after symptom onset. Patient demographics, total initial pediatric adaptation of the National Institutes of Health Stroke Scale scores, risk factors, and infarct characteristics in the IRR subset were similar to the non-IRR subset. The 2 raters' total scores were identical in 60% and within 1 point in 84%. IRR was excellent as measured by concordance correlation coefficient of 0.97 (95% CI, 0.94 to 0.99); intraclass correlation coefficient of 0.99 (95% CI, 0.97 to 0.99); precision measured by Pearson ρ of 0.97; and accuracy measured by the bias correction factor of 1.0.
CONCLUSIONS: There was excellent IRR of the pediatric adaptation of the National Institutes of Health Stroke Scale in a multicenter prospective cohort performed by trained child neurologists.
Authors:
Rebecca N Ichord; Rachel Bastian; Lisa Abraham; Rand Askalan; Susan Benedict; Timothy J Bernard; Lauren Beslow; Gabrielle Deveber; Michael Dowling; Neil Friedman; Heather Fullerton; Lori Jordan; Li Kan; Adam Kirton; Catherine Amlie-Lefond; Daniel Licht; Warren Lo; Chalmer McClure; Steve Pavlakis; Sabrina E Smith; Marilyn Tan; Scott Kasner; Abbas F Jawad
Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-02-11
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  42     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-21     Completed Date:  2011-04-19     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  613-7     Citation Subset:  IM    
Affiliation:
Department of Neurology, Children's Hospital of Philadelphia, Colket Translational Research Building 10th Floor, 3501 Civic Center Blvd, Philadelphia, PA 19104, USA. ichord@email.chop.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Child
Child, Preschool
Cohort Studies
Female
Humans
Male
National Institutes of Health (U.S.) / standards*
Observer Variation
Pilot Projects
Prospective Studies
Reproducibility of Results
Severity of Illness Index*
Stroke / diagnosis*,  epidemiology*
United States / epidemiology
Grant Support
ID/Acronym/Agency:
K02-NS053883/NS/NINDS NIH HHS; K12 NS049453/NS/NINDS NIH HHS; K12-NS049453/NS/NINDS NIH HHS; K23-HL096895/HL/NHLBI NIH HHS; K23-NS062110/NS/NINDS NIH HHS; K23-NS52380/NS/NINDS NIH HHS; KL2-RR024983/RR/NCRR NIH HHS; R01 NS050488-01A1/NS/NINDS NIH HHS; R01-NS050488/NS/NINDS NIH HHS; R01-NS062820/NS/NINDS NIH HHS; T32 NS007413/NS/NINDS NIH HHS; T32-NS007413/NS/NINDS NIH HHS
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