KMID : 1130620120080030177
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Journal of Clinical Neurology 2012 Volume.8 No. 3 p.177 ~ p.183
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Validity and Reliability of a Korean Version of the National Institutes of Health Stroke Scale
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Oh Mi-Sun
Yu Kyung-Ho Lee Ju-Hun Jung San Ko Im-Suck Shin Joon-Hyun Cho Soo-Jin Choi Hui-Chul Kim Hyang-Hee Lee Byung-Chul
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Abstract
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Background and Purpose: The National Institutes of Health Stroke Scale (NIHSS) is a clinical assessment tool that is widely used in clinical trials and practice to evaluate stroke-related neurological deficits. The aim of this study was to determine the validity and reliability of the Korean version of the NIHSS (K-NIHSS) for evaluating Korean stroke patients.
Methods: The K-NIHSS was translated and adapted with regard to cultural and linguistic peculiarities. To examine its content validity, we quantified the Content Validity Index (CVI), which was rated by 11 stroke experts. The validity of the K-NIHSS was assessed by comparison with the Glasgow Coma Scale (GCS), the modified Rankin Scale (mRS), and the Barthel Index. The reliability of the K-NIHSS was evaluated using the unweighted kappa statistics for multiple raters and an intraclass correlation coefficient (ICC).
Results: The CVI of the K-NIHSS reached 0.91-1.00. The median K-NIHSS score at baseline was 3 (interquartile range, 2-7), and the mean¡¾SD score was 6.0¡¾6.6. The baseline K-NIHSS had a significantly negative correlation with the GCS at baseline and the Barthel Index after 90 days. The K-NIHSS also had a significantly positive correlation with the mRS after 90 days. Facial paresis and dysarthria had moderate interrater reliability (unweighted kappa, 0.41-0.60); kappa values were substantial to excellent (unweighted kappa, >0.60) for all the other items. The ICC for the overall K-NIHSS score was 0.998. The intrarater reliability was acceptable, with a median kappa range of 0.524-1.000.
Conclusions: The K-NIHSS is a valid and reliable tool for assessing neurological deficits in Korean acute stroke patients.
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KEYWORD
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NIH Stroke Scale, validity, reliability
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