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Development of a Telephone Interview Version of the Chedoke-McMaster Stroke Assessment Activity Inventory.

ABSTRACT: Purpose: To develop a telephone version of the Chedoke-McMaster Stroke Assessment Activity Inventory (CMSA-AI) and estimate the test-retest reliability, interrater reliability (between participant and proxy), and construct validity of the scores for individuals with stroke. Methods: Adults with stroke and their caregivers or proxies were included. Participants were assessed with the CMSA-AI at discharge from a stroke rehabilitation unit and interviewed using the telephone version (TCMSA-AI). Two months after discharge, participants were evaluated with the CMSA-AI and interviewed over the phone using the TCMSA-AI on two occasions 2-3 days apart. Proxies were interviewed with the TCMSA-AI within another 2-3 days. Results: The mean age of the 53 participants with stroke was 62 years; 59% were male; 43% had right-side hemiparesis; 42 completed follow-up interviews; and 18 had proxies who also participated. Test-retest reliability showed an intra-class correlation coefficient of 0.98 (95% CI: 0.96, 0.99) for the total score, 0.96 (95% CI: 0.91, 0.98) for the Gross Motor Function Index, and 0.96 (95% CI: 0.91, 0.98) for the Walking Index, and an interrater reliability (between participant and proxy) of 0.75 (95% CI: 0.28, 0.90) for total score. Spearman's rho correlation between CMSA-AI and TCMSA-AI total scores was 0.62 (lower-sided 95% CI: 0.42) at discharge and 0.90 (lower-sided 95% CI: 0.82) at 2 months after discharge. Correlations between the change scores of the CMSA-AI and TCMSA-AI were 0.50 or lower. Conclusion: There is potential for remote evaluation of the functional mobility of individuals with stroke in research and clinical settings.

SUBMITTER: Barclay R

PROVIDER: S-EPMC5125464 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundReliable, valid, and easy-to-administer instruments to identify possible caseness and to provide proxies for clinical diagnoses are needed in epidemiological research on child and adolescent mental health.The aim of this study is to provide further validity data for a parent telephone interview focused on Autism--Tics, Attention-deficit/hyperactivity disorder (AD/HD), and other Comorbidities (A-TAC), for which reliability and preliminary validation data have been previously reported.MethodsParents of 91 children clinically diagnosed at a specialized Child Neuropsychiatric Clinic, 366 control children and 319 children for whom clinical diagnoses had been previously assigned were interviewed by the A-TAC over the phone. Interviewers were blind to clinical information. Different scores from the A-TAC were compared to the diagnostic outcome.ResultsAreas under ROC curves for interview scores as predictors of clinical diagnoses were around 0.95 for most disorders, including autism spectrum disorders (ASDs), attention deficit/hyperactivity disorder (AD/HD), tic disorders, developmental coordination disorders (DCD) and learning disorders, indicating excellent screening properties. Screening cut-off scores with sensitivities above 0.90 (0.95 for ASD and AD/HD) were established for most conditions, as well as cut-off scores to identify proxies to clinical diagnoses with specificities above 0.90 (0.95 for ASD and AD/HD).ConclusionsThe previously reported validity of the A-TAC was supported by this larger replication study using broader scales from the A-TAC-items and a larger number of diagnostic categories. Short versions of algorithms worked as well as larger. Different cut-off levels for screening versus identifying proxies for clinical diagnoses are warranted. Data on the validity for mood problems and oppositional defiant/conduct problems are still lacking. Although the A-TAC is principally intended for epidemiological research and general investigations, the instrument may be useful as a tool to collect information in clinical practice as well.

Project description:BackgroundFor a trial of supportive self-management for people with chronic headache we needed to develop and validate a telephone classification interview that can be used by a non-headache specialist to classify common chronic headache types in primary care. We aimed to specifically: exclude secondary headaches other than medication overuse, exclude primary headache disorders other than migraine and tension type headache (TTH), distinguish between chronic migraine and chronic TTH, and identify medication overuse headache.MethodsWe held a headache classification consensus conference to draw on evidence and expertise to inform the content of a logic model underpinning the classification interview. Nurses trained to use the logic model did telephone classification interviews with participants recruited from primary care. Doctors specialising in headache did a second validation interview.ResultsTwenty-six delegates attended the headache classification conference including headache specialist doctors, nurses and lay representatives (with chronic headache). We trained six nurses to do the classification interviews and completed 107 paired interviews, median days between interviews was 32 days (interquartile range 21-48 days). We measured level of agreement between the nurse and doctor interviews using proportion of concordance, simple kappa and prevalence-adjusted bias-adjusted kappa (PABAK). Proportion of concordance of agreement between nurse and doctor interviews was 0.76, simple kappa coefficient κ 0.31 (95% CI, 0.09 to 0.52), and PABAK 0.51 (95% CI, 0.35 to 0.68), a moderate agreement. In a sensitivity test following review of headache characteristics recorded, concordance was 0.91, κ = 0.53 (95% CI, 0.28 to 0.79), and PABAK = 0.81 (95% CI, 0.70 to 0.92), a very good agreement.ConclusionWe developed and validated a new evidence-based telephone classification interview that can be used by a non-headache specialist to classify common chronic headache types in primary care.

Project description:BackgroundStandardised translation and cross-cultural adaptation (TCCA) procedures are vital to describe language translation, cultural adaptation, and to evaluate quality factors of transformed outcome measures. No TCCA procedure for objectively-assessed outcome (OAO) measures exists. Furthermore, no official German version of the Canadian Chedoke Arm and Hand Activity Inventory (CAHAI) is available.MethodsAn eight-step for TCCA procedure for OAO was developed (TCCA-OAO) based on the existing TCCA procedure for patient-reported outcomes. The TCCA-OAO procedure was applied to develop a German version of the CAHAI (CAHAI-G). Inter-rater reliability of the CAHAI-G was determined through video rating of CAHAI-G. Validity evaluation of the CAHAI-G was assessed using the Chedoke-McMaster Stroke Assessment (CMSA). All ratings were performed by trained, independent raters. In a cross-sectional study, patients were tested within 31 hours after the initial CAHAI-G scoring, for their motor function level using the subscales for arm and hand of the CMSA. Inpatients and outpatients of the occupational therapy department who experienced a cerebrovascular accident or an intracerebral haemorrhage were included.ResultsPerformance of 23 patients (mean age 69.4, SD 12.9; six females; mean time since stroke onset: 1.5 years, SD 2.5 years) have been assessed. A high inter-rater reliability was calculated with ICCs for 4 CAHAI-G versions (13, 9, 8, 7 items) ranging between r = 0.96 and r = 0.99 (p < 0.001). Correlation between the CAHAI-G and CMSA subscales for hand and arm was r = 0.74 (p < 0.001) and r = 0.67 (p < 0.001) respectively. Internal consistency of the CAHAI-G for all four versions ranged between α = 0.974 and α = 0.979.ConclusionsThe TCCA-OAO procedure was validated regarding its feasibility and applicability for objectively-assessed outcome measures. The resulting German CAHAI can be used as a valid and reliable assessment for bilateral upper limb performance in ADL in patients after stroke.

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Development of a Telephone Interview Version of the Chedoke-McMaster Stroke Assessment Activity Inventory.

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