BACKGROUND: The National Institutes of Health @entity64 Scale (NIHSS) was not intended to be used to determine the @entity64 's vascular distribution. The aim of this study was to develop, assess the reliability, and validate a computer algorithm based on the NIHSS for this purpose. METHODS: Two cohorts of @entity1 with @entity385 having similar distributions of Oxfordshire localizations (total anterior, partial anterior, lacunar, and posterior circulation) based on neuroimaging were identified. The first cohort (n   =   40) was used to develop a computer algorithm for vascular localization using a modified version of the NIHSS (NIHSS-Localization [NIHSS-Loc]) that included the laterality of selected deficits; the second (n   =   20) was used to assess the reliability of algorithm-based localizations compared to those of 2 vascular neurologists. The validity of the algorithm-based localizations was assessed in comparison to neuroimaging. Agreement was assessed using the unweighted kappa (k) statistic. RESULTS: Agreement between the 2 raters using the standard NIHSS was slight to moderate (k   =   .36, 95% confidence interval [CI] .10-.61). Inter-rater agreement significantly improved to the substantial to almost perfect range using the NIHSS-Loc (k   =   .88, 95% CI .73-1.00). Agreement was perfect when the 2 raters entered the data into the NIHSS-Loc computer algorithm (k   =   1.00, 95% CI 1.00-1.00). Agreement between the algorithm localization and neuroimaging results was fair to moderate (k   =   .59, 95% CI .35-.84) and not significantly different from the localizations of either rater using the NIHSS-Loc. CONCLUSION: A computerized, modified version of the standard NIHSS can be used to reliably and validly assign the vascular distribution of an acute @entity385 .

Development and Assessment of a Computer Algorithm for @entity64 Vascular Localization Using Components of the National Institutes of Health XXXX Scale.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke', 'Stroke'] @entity385 :: ('MESH:D002544', 'Disease') :: ['ischemic stroke']
@entity64 :: (MESH:D020521,Disease) :: ['Stroke']
