Deriving modified rankin scores from medical records

Quinn, T.J., Ray, G., Atula, S., Walters, M.R., Dawson, J. and Lees, K.R. (2008) Deriving modified rankin scores from medical records. Stroke, 39(12), pp. 3421-3423. (doi:10.1161/STROKEAHA.108.519306)



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Background and Purpose: Modified Rankin score (mRS) is traditionally graded using a face-to-face or telephone interview. Certain stroke assessment scales can be derived from a review of a patient’s case-record alone. We hypothesized that mRS could be successfully derived from the narrative within patient case-records.

Methods: Sequential patients attending our cerebrovascular outpatient clinic were included. Two independent, blinded clinicians, trained in mRS, assessed case-records to derive mRS. They scored “certainty” of their grading on a 5-point Likert scale. Agreement between derived and traditional face-to-face mRS was calculated using attribute agreement analysis.

Results: Fifty patients with a range of disabilities were included. Case-record appraisers were poor at deriving mRS (k=0.34 against standard). Derived mRS grades showed poor agreement between observers (k=0.33). There was no relationship between certainty of derived mRS and proportion of correct grades (P=0.727).

Conclusion: Accurate mRS cannot be derived from standard hospital records. Direct mRS interview is still required for clinical trials.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Lees, Professor Kennedy and Ray, Dr Gautamananda and Dawson, Professor Jesse and Walters, Professor Matthew and Quinn, Dr Terence
Authors: Quinn, T.J., Ray, G., Atula, S., Walters, M.R., Dawson, J., and Lees, K.R.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Stroke
Publisher:American Heart Association
ISSN (Online):1524-4628
Copyright Holders:Copyright © 2008 American Heart Association
First Published:First published in Stroke 39(12):3421-3423
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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