Comparative interrater reliability of Asian Stroke Disability Scale, modified Rankin Scale and Barthel Index in patients with brain infarction

BACKGROUND: This study tried to develop an Asian Stroke Disability Scale (ASDS) and compared its interrater reliability with modified Rankin Scale (mRS) and Barthel Index (BI). METHODS: Three items including self-care, mobility, and daily activities were selected as variables for development of the ASDS. The variables were provisionally graded on a ۲- to ۴-point scale based on the importance of each item. Each of the variables was categorized into ۳ categories. Afterward, ۱۲۵ rater-patient assessments for each scale (mRS, BI, and ASDS) were performed on ۲۵ stroke patients by ۵ raters. For categorization of functional impairment as minor or major, the scores of mRS, BI and ASDS were categorized as ≤۲, >۲; ≥۹۰, <۹۰ and <۳, ≥۳, respectively. ۱۲۵ rater-patient assessments for each of the mRS, BI, and ASDS were performed on ۲۵ stroke patients by five raters. RESULTS: The quantitative variability of BI, mRS, and ASDS scores was not significant (P = ۰.۳۷۹; P = ۰.۷۸۰; and P = ۰.۸۳۵, respectively). Interrater variability of mRS, BI, and ASDS scores based on qualitative categorization was not significant (P = ۱.۰۰۰; P = ۰.۹۷۸; and P = ۰.۹۰۱, respectively). Paired interrater variability of mRS, BI, and ASDS scores based on qualitative categorization was not significant (P > ۰.۰۵). CONCLUSION: The ASDS is easy to use, requires less than ۱ minute to complete and is as valid as mRS and BI in assessment of functional impairment of patients with stroke. Keywords: Stroke, Disability, Scale, Validation