Psychometric Evaluation of Commonly Used Measures in Stroke

Study Overview
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Brief Summary
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Purposes: The aim of this study is to examine the psychometric properties (e.g. test-retest reliability, random measurement error, practice effect, and responsiveness) of the commonly used measures in patients with stroke using medical record review. The investigators anticipate reviewing 1000 stroke patients' medical record from a medical center in Taiwan. The medical record will be reviewed by an experienced and well-trained occupational therapist.

Detailed Description
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The investigators anticipate reviewing 1000 stroke patients' medical record (from 2018/6/1 to 2021/6/30) from a medical center in Taiwan. The medical record will be reviewed by an experienced and well-trained occupational therapist. The study was approved by the local institutional review board. Because the targeted populations for examining the test-retest reliability and responsiveness were different, the inclusion criteria were listed separately below. Test-retest reliability Chronic stroke patients' data was reviewed to examine the test-retest reliability. The participants met the following criteria: (1) diagnosis of cerebral hemorrhage or cerebral infarction, (2) age ≥ 20 years, and (3) stroke onset ≥ 6 months (first and recurrent stroke included). Responsiveness Subacute stroke patients' data was reviewed to examine the responsiveness. The participants met the following criteria: (1) diagnosis of cerebral hemorrhage or cerebral infarction, (2) age ≥ 20 years, and (3) stroke onset < 3 months (first and recurrent stroke included).

Official Title
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Psychometric Evaluation of Commonly Used Measures in Patients With Stroke Using Medical Record Review

Conditions
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Stroke

Intervention / Treatment
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* Diagnostic Test: The Computerized Adaptive Testing system of the Functional Assessment of Stroke
* Diagnostic Test: The Barthel Index
* Diagnostic Test: The National Institutes of Health Stroke Scale


Participation Criteria
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Eligibility Criteria
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Inclusion criteria for test-retest reliability group (Chronic stroke patients' medical record was reviewed to examine the test-retest reliability) : Cerebral hemorrhage or cerebral infarction. Age ≥ 20 years. Stroke onset ≥ 6 months (first and recurrent stroke included). Inclusion criteria for responsiveness group (Subacute stroke patients' medical record was reviewed to examine the responsiveness): Cerebral hemorrhage or cerebral infarction. Age ≥ 20 years. Stroke onset < 3 months (first and recurrent stroke included). Exclusion criteria • Patients' diagnosis is not stroke.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Test-retest reliability and responsiveness group (All of the data was collected from medical record)<br>All the participants received conventional rehabilitation (e.g., occupational therapy, physical therapy, or speech therapy) or other interventions (e.g., acupuncture). | Diagnostic Test: The Computerized Adaptive Testing system of the Functional Assessment of Stroke<br>* The Computerized Adaptive Testing system of the Functional Assessment of Stroke comprises 58 items. The items were selected from four well-known physical function measures for patients with stroke: 26 items from the Fugl-Meyer Assessment-Upper limb, 11 items from the Fugl-Meyer Assessment-Lower limb, 12 items from the Postural Assessment Scale for Stroke Patients, and 9 items from the Barthel Index. These items evaluate motor control, postural control, and activity of daily living functions in patients with stroke. Results are automatically reported as Rasch scores (i.e., the minimum and maximum values are negative and positive infinity, respectively). A higher score indicates greater physical functions.<br>Diagnostic Test: The Barthel Index<br>* The Barthel Index has 10 items, and the total score ranges from 0 to 100. Higher score indicates less disability on activity of daily living functions.<br>Diagnostic Test: The National Institutes of Health Stroke Scale<br>* The National Institutes of Health Stroke Scale comprises 11 items and was used to monitor the severity in the patients with stroke. The total score ranges from 0 to 42, with a higher score indicating greater severity. A National Institutes of Health Stroke Scale score of 1-5 indicates mild severity; 6-14, mild to moderate severity; 15-24, severe severity; and equal to or greater than 25, very severe severity.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The computerized adaptive testing system of the functional assessment of stroke | The Computerized Adaptive Testing system of the Functional Assessment of Stroke comprises 58 items. The items were selected from four well-known physical function measures for patients with stroke: 26 items from the Fugl-Meyer Assessment-Upper limb, 11 items from the Fugl-Meyer Assessment-Lower limb, 12 items from the Postural Assessment Scale for Stroke Patients, and 9 items from the Barthel Index. These items evaluate motor control, postural control, and activity of daily living functions in patients with stroke. Results are automatically reported as Rasch scores (i.e., the minimum and maximum values are negative and positive infinity, respectively). A higher score indicates greater physical functions. | The repeated assessments were performed at an one-month interval. | 
| The Barthel Index | The Barthel Index has 10 items, and the total score ranges from 0 to 100. Higher score indicates less disability on activity of daily living functions. | The repeated assessments were performed at an one-month interval. | 
| The National Institutes of Health Stroke Scale | The National Institutes of Health Stroke Scale comprises 11 items and was used to monitor the severity in the patients with stroke. The total score ranges from 0 to 42, with a higher score indicating greater severity. A National Institutes of Health Stroke Scale score of 1-5 indicates mild severity; 6-14, mild to moderate severity; 15-24, severe severity; and equal to or greater than 25, very severe severity. | The repeated assessments were performed at an one-month interval. |