测量NIHSS的异质性:一个系统的审查和元分析
Gianluca De Rubeis1, Seemant Chaturvedi2, Hooman Kamel3
1Department of Diagnostic, UOC of Diagnostic and Interventional Neuroradiology, San Camillo-Forlanini Hospital, Circonvallazione Gianicolense 87, 00152, Rome, Italy. derubeis.gianluca@gmail.com.
美国国立卫生研究院中风量表 (NIHSS) 显示出很好的一致性,但运动功能项目比非运动项目更一致. 语言和评估方法等因素对NIHSS得分异质性的影响最小.
科学领域:
- 神经学 神经学
- 临床评估 临床评估
- 生物统计学 生物统计学
背景情况:
- 国家卫生研究院中风量表 (NIHSS) 对急性中风评估至关重要.
- 在NIHSS的应用和解释中的变化是一个挑战.
- 这次审查系统地检查了NIHSS测量异质性.
研究的目的:
- 阐明国家卫生研究院中风量表 (NIHSS) 测量的异质性来源.
- 评估不同NIHSS项目之间的评审者间协议.
主要方法:
- 在PubMed,OVID和Cochrane CENTRAL (开始-2023) 的系统文献搜索.
- 包括21项涉及818名患者的研究和9666次NIHSS检查.
- 用随机效应模型进行元分析和元回归,以确定异质源.
主要成果:
- 运动功能项目表现出比非运动项目 (ICC 0.58-0.85) 的更高的评级者间可靠性 (ICC 0.85-0.90).
- 超回归揭示了语言版本,远程评估和对NIHSS分数的回顾分析的轻微影响.
- 在非运动功能评估中,异质性最高.
结论:
- 美国NIHSS评分通常表现出中等到优秀的评审者之间的一致性.
- 非运动功能项目更容易发生异质性.
- 诸如非英语版本,远程或回顾性评估等因素对NIHSS异质性的影响有限.
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