Institutional members access full text with Ovid®

Simple and Reliable Determination of the Modified Rankin Scale Score in Neurosurgical and Neurological Patients: The mRS-9Q

Patel, Nihar BA; Rao, Vivek A. MD; Heilman-Espinoza, Elizabeth R. MD; Lai, Raymond DO; Quesada, Ramon A. MD; Flint, Alexander C. MD, PhD

doi: 10.1227/NEU.0b013e31826a8a56
Research-Human-Clinical Studies

BACKGROUND: The modified Rankin Scale (mRS) is a 6-level outcome scale used to assess level of function in neurological disease.

OBJECTIVE: We examined the interobserver reliability and intraobserver reliability of the mRS-9Q, a 9-question “yes/no” survey that measures the mRS score in neurosurgical and neurological patients.

METHODS: The mRS-9Q was administered in person or by telephone, and a Web-based tool was used to calculate the mRS score and to perform error checking. Part 1 compared the mRS-9Q with an mRS structured interview (n = 80). Part 2 compared mRS-9Q administration by telephone and by hard copy (n = 80). Part 3 compared mRS-9Q administration by an expert interviewer with administration by a nonexpert (n = 83). Part 4 examined reproducibility of the mRS-9Q over a 2-week period (n = 84).

RESULTS: Agreement was very good in all study parts. In Part 1 (mRS-9Q vs mRS with structured interview), κ = 0.80 and κw = 0.96. In Part 2 (mRS-9Q telephone vs hard copy), κ = 0.83 and κw = 0.95. In Part 3 (mRS-9Q expert vs nonexpert), κ = 0.73 and κw = 0.93. In Part 4 (mRS-9Q reproducibility), κ = 0.76 and κw = 0.93.

CONCLUSION: The mRS-9Q is a simple, easy-to-administer survey with a custom Web-based mRS calculation and error-checking tool. The mRS-9Q can reliably determine the mRS by hard copy survey or by telephone and can be administered by experts or nonmedical study personnel. The mRS-9Q can be used to measure functional outcome in a broad population of patients with neurosurgical and neurological diseases.

ABBREVIATIONS: CI, confidence interval

mRS, modified Rankin Scale

mRS-SI, modified Rankin Scale structured expert interview

smRSq, simplified mRS questionnaire

Department of Neuroscience, Kaiser Permanente, Redwood City, California

Correspondence: Alexander C. Flint, MD, PhD, Department of Neuroscience, Kaiser Permanente, 1150 Veterans Blvd., Redwood City, CA 94063. E-mail: alexander.c.flint@kp.org

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.neurosurgery-online.com).

Received April 4, 2012

Accepted July 5, 2012

Copyright © by the Congress of Neurological Surgeons