Different measures for assessing stroke outcome: an analysis from the International Stroke Trial in Italy

We sought to assess the relationship between 2 simple questions on recovery (question 1: do you feel that you have made a complete recovery from your stroke?) and dependency (question 2: do you require help from another person for everyday activities?) and the Barthel Index (BI) and Oxford Handicap Scale (OHS), as well as the relationship between BI and OHS, in a large number of Italian stroke survivors who participated in the International Stroke Trial (IST).

We used data from 2423 patients interviewed by telephone at 6 months after the event. The kappa statistic, sensitivity, and specificity were calculated for several comparisons. Internal consistency for BI was calculated.

The reliability of the dependency question compared with BI=20 (kappa=0.93) and the reliability of the recovery question compared with OHS=0 (kappa=0.89) were good. Sensitivity of the dependency question in predicting whether patients scored BI >18 was 0.98; sensitivity of the recovery question in predicting whether patients scored OHS=0 was 0.99. The reliability of BI=20 compared with OHS <3 was good (kappa=0.87). Internal consistency of BI was very high (Cronbach's alpha=0.96).

The 2 simple questions are a good means of evaluating outcome from a patient's view and of dichotomizing the stroke survivor in a time-effective and reliable way.