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The pediatric stroke outcome measure: a validation and reliability study.

Lisa Kitchen1, Robyn Westmacott, Sharon Friefeld

  • 1Children’s Stroke Program, The Hospital for Sick Children, Toronto, Canada.

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The Pediatric Stroke Outcome Measure (PSOM) is a valid and reliable tool for assessing neurological deficits in pediatric stroke survivors. This measure is suitable for both prospective and retrospective scoring in clinical trials.

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Area of Science:

  • Neurology
  • Pediatric Medicine
  • Clinical Outcomes Research

Background:

  • The Pediatric Stroke Outcome Measure (PSOM) is a comprehensive tool designed to assess neurological deficits and functional outcomes in individuals from infancy to adulthood.
  • It comprises 115 test items across five subscales: right sensorimotor, left sensorimotor, language production, language comprehension, and cognitive/behavior, yielding a final deficit score.

Purpose of the Study:

  • To evaluate the construct validity of the PSOM in assessing neurological outcomes in pediatric stroke survivors.
  • To determine the interrater reliability (IRR) of the PSOM for both prospective and retrospective scoring methods.

Main Methods:

  • Construct validity was assessed by correlating PSOM subscale scores with domain-matched standardized neuropsychological measures.
  • Prospective IRR was evaluated by comparing same-day PSOM scores from two independent raters in 10 children.
  • Retrospective IRR was assessed by comparing PSOM scores derived from medical dictations by five independent raters in another 10 children.

Main Results:

  • Analysis of PSOM scores from 203 children with ischemic stroke revealed good construct validity (ρ=0.2-0.4; P<0.05).
  • PSOM subscale scores demonstrated strong agreement with domain-matched neuropsychology scores.
  • Excellent prospective IRR (intraclass correlation coefficient=0.93) and strong retrospective IRR (intraclass correlation coefficient=0.77) were observed.

Conclusions:

  • The PSOM is confirmed as a valid and reliable outcome measure for pediatric stroke.
  • The PSOM is effective for retrospective scoring from health records and for prospective longitudinal assessments.
  • The PSOM is highly suitable for use in prospective clinical trials involving pediatric stroke patients.