Reliability and validity of telephonic Barthel Index: an experience from multi-centric randomized control study

Area of Science:

• Rehabilitation Medicine
• Neurology
• Health Services Research

Background:

• Telephonic Barthel Index (BI) assessment is a feasible and less time-consuming method compared to face-to-face interviews.
• Evaluating the validity and reliability of telephonic BI is crucial for its widespread adoption in clinical practice.

Purpose of the Study:

• To assess the validity and reliability of the Barthel Index (BI) when administered via telephone compared to traditional face-to-face assessments.
• To compare telephonic BI with other stroke scales like the modified Rankin Scale (mRS) and NIH Stroke Scale (NIHSS).

Main Methods:

• A multi-centric study involving 120 subacute stroke patients from five Indian teaching hospitals.
• Trained researchers conducted both telephonic and face-to-face assessments of BI and mRS at 3 and 6 months.
• Statistical analysis included Kappa (wK) for agreement, sensitivity, specificity, and correlation with mRS and NIHSS.

Main Results:

• Telephonic BI demonstrated high sensitivity and specificity across various cutoff levels.
• Moderate to substantial agreement was found between telephonic and face-to-face BI at 6 months (wK = 0.72).
• Item-wise and center-wise kappa values also indicated substantial agreement.

Conclusions:

• Telephonic assessment of activities of daily living using the BI is a valid and reliable method for moderate to severely disabled stroke patients.
• Telephonic BI assessment is more efficient, potentially requiring a smaller sample size than face-to-face assessments.