Comparison Between the Original and Shortened Versions of the National Institutes of Health Stroke Scale in Ischemic Stroke Patients of Intermediate Severity
Author:
Lee Chun Fan1, Venketasubramanian Narayanaswamy1, Wong K.S. Lawrence1, Chen Christopher L.H.1, Navarro Jose C.2, Gan Herminigildo H.2, Lao Annabelle2, Baroque Alejandro2, Lokin Johnny2, Hiyadan John Harold B.2, Sarfati Ma. Socorro2, Fangonillo Randolph John2, Ambasing Neil2, Chua Carlos2, San Jose Ma. Cristina2, Advincula Joel2, Berame Eli John2, Canete Maria Teresa2, Young Sherry H.3, Mamauag Marlie Jane3, Tay San San3, Pande Shrikant3, Thirugnanam Umapathi3, Singh Rajinder3, Chang Hui Meng3, De Silva Deidre Anne3, Chan Bernard P.L.3, Sharma Vijay3, Luen Teoh Hock3, Poungvarin Niphon4, Muengtaweepongsa Sombat4, Towanabut Somchai4, Suwanwela Nijasri4, Chotickanuchit Songkram4, Chankrachang Siwaporn4, Nitinun Samart4, de Silva H. Asita5, Ranawake Udaya5, Wijekoon Nirmala5, Eow Gaik Bee6, ,
Affiliation:
1. From the Department of Biostatistics, Singapore Clinical Research Institute, Singapore (C.F.L.); Raffles Neuroscience Centre, Raffles Hospital, Singapore (N.V.); Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories (K.S.L.W.); and Department of Pharmacology, National University of Singapore, Clinical Research Centre, Singapore (C.L.H.C.). 2. Philippines 3. Singapore 4. Thailand 5. Sri Lanka 6. Malaysia
Abstract
Background and Purpose—
The 15-item National Institutes of Health Stroke Scale (NIHSS) has been critiqued for its complexity and variability, and shortened versions have been proposed. This study aimed to compare the measurement properties of the original version with 3 shortened versions with 11, 8, and 5 items, respectively.
Methods—
Analyses were performed using data from an international, double-blind randomized controlled trial investigating the efficacy of MLC601 on stroke recovery in patients with ischemic stroke of intermediate severity (Chinese Medicine Neuroaid Efficacy on Stroke recovery [CHIMES]). To compare discriminative ability and responsiveness to change, the effect sizes of the NIHSS scores in relation to modified Rankin Scale, mini-mental status examination, and Barthel index were estimated using regression analysis.
Results—
For both discriminative ability and responsiveness to change, the original version exhibited a larger effect size (0.55 and 0.84) in relation to modified Rankin Scale than the other 3 shortened versions (0.35–0.46 and 0.74–0.78).
Conclusions—
The original 15-item NIHSS retained information that made it more discriminative and responsive to change than the shortened versions. We recommend future clinical researchers to use the full version NIHSS to evaluate patients’ stroke severity.
Clinical Trial Registration Information—
URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00554723.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Advanced and Specialized Nursing,Cardiology and Cardiovascular Medicine,Neurology (clinical)
Cited by
5 articles.
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