BACKGROUND: The Oxfordshire Community Stroke Project (OCSP) and Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classifications are widely used for the assessment of major ischaemic stroke. We explored their intra- and inter-observer reliability in the classification of outpatient minor stroke. METHODS: Four physicians of differing seniority and training backgrounds classified minor stroke using clinical data from 90 patients. RESULTS: For both the OCSP and TOAST classifications, the intra-observer reliability varied from moderate to excellent (kappa = 0.48-0.83). The inter-observer reliability was good (kappa = 0.64) for the OCSP and moderate (kappa = 0.42) for the TOAST. Thus, neither classification was consistently reliable. CONCLUSIONS: Our results may reflect the limited validity of these classifications in a typical minor stroke outpatient population and variable observer expertise.
BACKGROUND: The Oxfordshire Community Stroke Project (OCSP) and Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classifications are widely used for the assessment of major ischaemic stroke. We explored their intra- and inter-observer reliability in the classification of outpatient minor stroke. METHODS: Four physicians of differing seniority and training backgrounds classified minor stroke using clinical data from 90 patients. RESULTS: For both the OCSP and TOAST classifications, the intra-observer reliability varied from moderate to excellent (kappa = 0.48-0.83). The inter-observer reliability was good (kappa = 0.64) for the OCSP and moderate (kappa = 0.42) for the TOAST. Thus, neither classification was consistently reliable. CONCLUSIONS: Our results may reflect the limited validity of these classifications in a typical minor strokeoutpatient population and variable observer expertise.
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Authors: Hakan Ay; Ethem Murat Arsava; Gunnar Andsberg; Thomas Benner; Robert D Brown; Sherita N Chapman; John W Cole; Hossein Delavaran; Martin Dichgans; Gunnar Engström; Eva Giralt-Steinhauer; Raji P Grewal; Katrina Gwinn; Christina Jern; Jordi Jimenez-Conde; Katarina Jood; Michael Katsnelson; Brett Kissela; Steven J Kittner; Dawn O Kleindorfer; Daniel L Labovitz; Silvia Lanfranconi; Jin-Moo Lee; Manuel Lehm; Robin Lemmens; Chris Levi; Linxin Li; Arne Lindgren; Hugh S Markus; Patrick F McArdle; Olle Melander; Bo Norrving; Leema Reddy Peddareddygari; Annie Pedersén; Joanna Pera; Kristiina Rannikmäe; Kathryn M Rexrode; David Rhodes; Stephen S Rich; Jaume Roquer; Jonathan Rosand; Peter M Rothwell; Tatjana Rundek; Ralph L Sacco; Reinhold Schmidt; Markus Schürks; Stephan Seiler; Pankaj Sharma; Agnieszka Slowik; Cathie Sudlow; Vincent Thijs; Rebecca Woodfield; Bradford B Worrall; James F Meschia Journal: Stroke Date: 2014-11-06 Impact factor: 7.914