Comparison of outcome assessments of stroke convalescence by using multiple scales based on different dimensions
Lao Ying-rong1, Guo Xin-feng1,2, Lai Shi-long1,2, Liang Wei-xiong1,2, Wen Ze-huai1,2, Wang Qi1,2, Huang Pei-xin3, Huang Yan3, 1Research Institute of Applied Clinical Epidemiology, 3Department of Neurology, Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine(Guangzhou Provincial Hospital of Traditional Chinese Medicine), Guangzhou 510120, Guangdong Province, China; 2Center for DME, Guangzhou University of Traditional Chinese Medicine, Guangzhou 510405, Guangdong Province, China
AIM: To analyze the outcome assessments of the cases of stroke convalescence measured with different criteria consisting of various dimensions by a cross-sectional investigation of the condition of stroke convalescent patients. METHODS: Totally 194 stroke convalescent patients treated in the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from July 26, 2000 to February 28, 2001 were taken as subjects of the study. They were assessed by assessment methods including the following assessment instruments: diagnosis-treatment criteria of stroke(the second version), self-designed scale of traditional Chinese medicine(TCM) symptoms(28 symptoms and physical signs were scored as 0, 1, 2, 3 marks from none to severity), modified Edinburgh-Scandinavia stroke scale(a total of 45 marks, 0 to 15 marks as mild defect, 16 to 30 as moderate defect, 31 to 45 as severe defect), modified Barthel activities of daily life(ADL) index(a total of 100 marks, less than 60 marks as unable self-care), vitality and mental health(subscales derived from Health Survey Questionnaire, SF-36). The collected data from scales and inter-scale correlation were processed by the statistic methods mainly including descriptive analysis, Spearmen correlation analysis, factor analysis, etc. RESULTS: All of the patients completed the assessment, and analyzed in the result. ①The average scores of the scales and criteria: The average scores of diagnosis-treatment criteria of stroke(the second version), self-designed scale of TCM symptoms, modified Edinburgh-Scandinavia stroke scale, modified Barthel ADL index, vitality and mental health scales were 6.51±6.29, 13.73±6.97, 7.56±7.35, 63.58±23.68, 52.79±23.32 and 62.83 ±22.75 respectively. ②The Spearment correlation coefficients(R') of modified Edinburgh-Scandinavia stroke scale with diagnosis-treatment criteria of stroke, scale of TCM symptoms, modified Barthel ADL index, vitality scale and mental health scale were 0.885, 0.302, -0.824 -0.294 and -0.258 respectively. CONCLUSION: ①The modified Edinburgh-Scandinavia stroke scale and diagnosis-treatment criteria of stroke the second version shared the same assessment dimension, so they can be mutually alternated in some clinical practice. ②Discrepancy in measurements of health status was gained due to the diverse dimensions applied in outcome assessments. It is necessary to build up a multi-dimensional assessment criteria system for assessing the stroke convalescent cases in a more comprehensive scope and reflecting the efficacy of TCM treatment scientifically.
【Fund】： 国家“九五”科技攻关课题(96-903-01-11);; 国家中医药管理局资助课题(00-01LP16)~~
【CateGory Index】： R743.3
【CateGory Index】： R743.3