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Background: Knowing a patient’s premorbid functional status can aid in acute stroke management decisions. The often-adopted modified Rankin Scale is not suitable for prestroke assessment as it lacks a defined comparison state at lower scores. Methods: We designed a simple questionnaire for prestroke functional status assessment and tested its clinimetric properties in acute stroke patients. Five investigators took part in scoring the novel scale. For reliability testing, two raters independently administered the novel scale on two consecutive days to the patients or their caregivers, or both. For validity testing, one rater administered the Groningen activities scale and the other rater administered the Lawton activities scale on the two consecutive test days. Results: We tested 50 patients within 3 days of admission. The reliability kappa statistic between the paired raters was 0.36, and the weighted kappa (accounting for the degree of disagreements) was 0.53. Validity of the novel scale against the two validated function scales was moderate (correlation coefficients 0.65 and -0.56). Conclusion: We believe that misunderstandings of the novel questions by interviewees likely lead to weak reliability. These novel results inform the design of future research on this topic with clarified simple and unambiguous questions.
Gadipudi et al. (Thu,) studied this question.