Assessment Scales Article

Question 1

Clinimetrics

Answer 1

Study of properties of clinical assessment tools

Derived from theory of psychometrics

Question 2

NIHSS - how many items

Answer 2

15 item scale - standardizes and quantifies a neuro exam

Question 3

NIHSS - what type of measure

Answer 3

ordinal, nonlinear measure - assigns numerical value to aspects of neuro function

Question 4

NIHSS assesses what

Answer 4

Language, motor function, sensory loss, consciousness, visual fields, extraocular movements, coordination, neglects, speech

Question 5

NIHSS - scored from

Answer 5

0 to 42
0 = no impairment
21+ = severe impairment

Question 6

NIHSS - Commonly used how clinically

Answer 6

in clinical acute stroke practice

Question 7

Modified NIHSS

Answer 7

11 point scale
improved reliability - not used often though
Also a pediatric one

Question 8

Advantages of NIHSS

Answer 8

straightforward
6 min to perform 
No equipment
Scores reliable across observers - non specialists can use it too
Reliable with telemedicine
High content validity

Question 9

NIHSS clinically relevant - score change of what

Answer 9

more than 2 points is clinically relevant

Question 10

Criticism of NIHSS

Answer 10

Validity in non dominant hemisphere stroke has been questioned

Question 11

Barthel Index - adapted from what

Answer 11

maryland disability index

Question 12

Barthel index - used for what in studies

Answer 12

studies looking at basic ADLs

Question 13

Barthel index - developed wh

Answer 13

to assist in discharge planning from longterm care wards

Question 14

Barthel index - most commonly used functional measure in what

Answer 14

stroke rehab settings and 2nd most used functional outcome measure across stroke trials

Question 15

Barthel index - assesses what

Answer 15

10 functional tasks (ADLs)

Scoring the individual based on independence in each task

Question 16

Barthel index - scores range from

Answer 16

0 to 100

Higher score = greater independence

Question 17

Barthel index - common interpretation

Answer 17

Over 80 = ind and should be able to return home

less than 40 = very dependent

Question 18

Barthel index - common interpretation of score for outcome

Answer 18

95 - excellent outcome

75 - poor outcome

Question 19

Barthel index - valid prognositc tool following stroke for predicting what

Answer 19

recovery, level of care needed, and duration of rehab needed after stroke

Question 20

Barthel index - strengths

Answer 20

Interobserver reliability

Question 21

Barthel index - limitations

Answer 21

Does not reflect burden of communication and cognitive deficits
Lacks a result to represent stroke mortality
Responsiveness to change - floor and ceiling effects!

Question 22

Barthel index - best suited for who

Answer 22

stroke survivors requiring inpatient rehab

Question 23

Barthel index - considered a measure of

Answer 23

basic ADLs (self care and mobility)

Question 24

Modified Rankin Scale (mRS) - how many points

Answer 24

6 point

0 to 5

Question 25

Modified rankin scale - what type of scale

Answer 25

ordinal, hierarchical scale

Question 26

Modified rankin scale describes what

Answer 26

global disability with a focus on mobility

Question 27

Modified rankin scale - most commonly used functional measure in what

Answer 27

stroke trials | AND the primary or coprimary outcome in large scale stroke trials

Question 28

Modified rankin scale - used to measure

Answer 28

premorbid ability to assist in selection of patients and as a final outcome measure (for stroke trials) Used for global disability

Question 29

Strengths of modified rankin scale

Answer 29

5 min to complete

Question 30

Modified rankin scale - score of 6

Answer 30

denotes death

Question 31

Modified rankin scale - limitations

Answer 31

reliability - potential for substantial interobserver variability

Question 32

Modified rankin scale - clinically relevant change

Answer 32

Less responsive to change than some scales but a single point change on mRS will always be clinically relevant

Question 33

QOL measure - short form 36

Answer 33

Geriatric scale that assesses 8 domains of health | Validated for stroke pts, noncompletion bias and floor/ceiling effects

Question 34

QOL measure - EuroQOL

Answer 34

Self completed questionairre Assess 5 domains with visual analog scale Validated for use in stroke populations Noncompletion bias present

Question 35

QOL measure - Stroke specific QOL scale

Answer 35

Developed based on interviews with stroke survivors Validated for use in stroke pts Values for minimal detectable change and clinical important differences are established