ArticleRasch analysis of a new stroke-specific outcome scale: the stroke impact scale1☆,
Section snippets
Study data set
The psychometric characteristics of the SIS were assessed among participants enrolled in the Glycine Antagonist in Neuroprotection (GAIN) Americas Trial,21 a multicenter randomized double blind placebo-controlled clinical trial. A total of 1605 individuals with ischemic or hemorrhagic stroke from 132 centers in the United States and Canadian were randomized and treated. The SIS substudy began after the main trial was in progress and included 696 patients. Participants had a stroke that caused
Results
A total of 696 subjects completed an SIS questionnaire at 1 or both time points. A total of 1264 SIS questionnaires (640 month 1 assessments, 624 month 3 assessments) were included in the Rasch analysis. Table 2 summarizes the baseline characteristics of the subjects.
Discussion
Rasch analysis had been widely used for the validation of self-report outcome measures. This study used Rasch analysis to assess further the validity of a new stroke-specific outcome measure, the SIS. This is the first study that has validated a stroke outcome measure on a large group of stroke survivors with a broad range of stroke severity (National Institute of Health Stroke Scale score range, 2–20). It included individuals with both ischemic and hemorrhagic stroke from a variety of clinical
Conclusions
Based on this analysis, we deleted 5 items in the SIS, version 2.0, and have created SIS, version 3.0. The ADL/IADL, mobility, strength, composite physical, and participation domains have the most robust psychometric characteristics. The domains are unidimensional, have good reliability, and have a wide range of items that capture the difficulties that most individuals with stroke experience in physical and role functions. Clearly, the composite physical domain is the most robust. In other
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Supported by the University of Kansas Medical Center Claude D Pepper Older Americans Independence Center (grant no. AG-96-003), and the American Heart Association Pharmaceutical Roundtable for Outcomes Research. Financial and material support for the GAIN Americas trial (protocol GLYA3OO2) was also provided by GlaxoWellcome Inc.
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No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.