Fred Sarfo1, Mulugeta Gebregziabher2, Bruce Ovbiagele2, Rufus Akinyemi2, Lukman Owolabi2, Reginald Obiako2, Onoja Akpa2, Kevin Armstrong2, Albert Akpalu2, Sheila Adamu2, Vida Obese2, Nana Boa-Antwi2, Lambert Appiah2, Oyedunni Arulogun2, Yaw Mensah2, Abiodun Adeoye2, Aridegbe Tosin2, Osimhiarherhuo Adeleye2, Eric Tabi-Ajayi2, Ibinaiye Phillip2, Abubakar Sani2, Suleiman Isah2, Nasir Tabari2, Aliyu Mande2, Atinuke Agunloye2, Godwin Ogbole2, Joshua Akinyemi2, Ruth Laryea2, Sylvia Melikam2, Ezinne Uvere2, Gregory Adekunle2, Salaam Kehinde2, Paschal Azuh2, Abdul Dambatta2, Naser Ishaq2, Raelle Saulson2, Donna Arnett2, Hemnant Tiwari2, Carolyn Jenkins2, Dan Lackland2, Mayowa Owolabi2. 1. From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.). stephensarfo78@gmail.com. 2. From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
Abstract
BACKGROUND AND PURPOSE: The Questionnaire for Verifying Stroke-Free Status (QVSFS), a method for verifying stroke-free status in participants of clinical, epidemiological, and genetic studies, has not been validated in low-income settings where populations have limited knowledge of stroke symptoms. We aimed to validate QVSFS in 3 languages, Yoruba, Hausa and Akan, for ascertainment of stroke-free status of control subjects enrolled in an on-going stroke epidemiological study in West Africa. METHODS: Data were collected using a cross-sectional study design where 384 participants were consecutively recruited from neurology and general medicine clinics of 5 tertiary referral hospitals in Nigeria and Ghana. Ascertainment of stroke status was by neurologists using structured neurological examination, review of case records, and neuroimaging (gold standard). Relative performance of QVSFS without and with pictures of stroke symptoms (pictograms) was assessed using sensitivity, specificity, positive predictive value, and negative predictive value. RESULTS: The overall median age of the study participants was 54 years and 48.4% were males. Of 165 stroke cases identified by gold standard, 98% were determined to have had stroke, whereas of 219 without stroke 87% were determined to be stroke-free by QVSFS. Negative predictive value of the QVSFS across the 3 languages was 0.97 (range, 0.93-1.00), sensitivity, specificity, and positive predictive value were 0.98, 0.82, and 0.80, respectively. Agreement between the questionnaire with and without the pictogram was excellent/strong with Cohen k=0.92. CONCLUSIONS: QVSFS is a valid tool for verifying stroke-free status across culturally diverse populations in West Africa.
BACKGROUND AND PURPOSE: The Questionnaire for Verifying Stroke-Free Status (QVSFS), a method for verifying stroke-free status in participants of clinical, epidemiological, and genetic studies, has not been validated in low-income settings where populations have limited knowledge of stroke symptoms. We aimed to validate QVSFS in 3 languages, Yoruba, Hausa and Akan, for ascertainment of stroke-free status of control subjects enrolled in an on-going stroke epidemiological study in West Africa. METHODS: Data were collected using a cross-sectional study design where 384 participants were consecutively recruited from neurology and general medicine clinics of 5 tertiary referral hospitals in Nigeria and Ghana. Ascertainment of stroke status was by neurologists using structured neurological examination, review of case records, and neuroimaging (gold standard). Relative performance of QVSFS without and with pictures of stroke symptoms (pictograms) was assessed using sensitivity, specificity, positive predictive value, and negative predictive value. RESULTS: The overall median age of the study participants was 54 years and 48.4% were males. Of 165 stroke cases identified by gold standard, 98% were determined to have had stroke, whereas of 219 without stroke 87% were determined to be stroke-free by QVSFS. Negative predictive value of the QVSFS across the 3 languages was 0.97 (range, 0.93-1.00), sensitivity, specificity, and positive predictive value were 0.98, 0.82, and 0.80, respectively. Agreement between the questionnaire with and without the pictogram was excellent/strong with Cohen k=0.92. CONCLUSIONS: QVSFS is a valid tool for verifying stroke-free status across culturally diverse populations in West Africa.
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Authors: Fred Stephen Sarfo; Linda Meta Mobula; Titus Adade; Yvonne Commodore-Mensah; Martin Agyei; Collins Kokuro; Rexford Adu-Gyamfi; Christiana Duah; Bruce Ovbiagele Journal: J Neurol Sci Date: 2020-03-04 Impact factor: 3.181