Mobile phone application for self-assessment of acute stroke patients: A tool for extended care and follow-up

We aimed to assess the accuracy of self-assessment for acute stroke patients via mobile phone application-based scales and determine the value and prospect of clinical use. A cross-sectional study was designed and acute stroke patients were enrolled. We pushed the modified Rankin scale (mRS) and activities of daily living (ADL) scale to patients via mobile phone application for self-assessment on the day before they were out of hospital. We compared the results from nurse assessment and self-assessment. Around 50 patients with the average age 51.72 ± 12.40 completed the self-assessment. A total of 27 patients self-assessed the scales, while caregivers of other 23 patients completed the assessment. In comparison with patient assessment and nurse assessment, significant difference was found in ADL score (P = .004), but was not found in mRS score (P > .05). When comparing caregiver assessment with nurse assessment, no significant difference could be found either in ADL score (P > .05) or in mRS score (P > .05). The kappa value for self-assessment and nurse agreement of ADL was 0.720 (P = .000), with sensitivity 96.8% and specificity 82.0%. The kappa value for self-assessment and nurse agreement of mRS was 0.718 (P = .000), with sensitivity 97.6% and specificity 92.4%. In summary, mobile phone application-based scales are generally accurate, economical and convenient for self-assessment of acute stroke patients with acceptable reliability in our small scale study. Caregivers can serve as the proper assessor when patients are out of hospital. Therefore, it is promising but still need to be further confirmed how practical to use this application in extended care and follow-up.