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Introducing Adam’s Scale of Posterior Stroke (ASPOS): A Novel Validated Tool to Assess and Predict Posterior Circulation Strokes

Background: Assessing the severity of posterior circulation strokes, due to the variety of symptoms, is a significant clinical problem. Current clinimetric scales show lower accuracy in the measurement of posterior stroke severity, compared with that of anterior strokes. The aim of the study was to...

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Autores principales: Wiśniewski, Adam, Filipska, Karolina, Piec, Katarzyna, Jaskólski, Filip, Ślusarz, Robert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8065750/
https://www.ncbi.nlm.nih.gov/pubmed/33810516
http://dx.doi.org/10.3390/brainsci11040424
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author Wiśniewski, Adam
Filipska, Karolina
Piec, Katarzyna
Jaskólski, Filip
Ślusarz, Robert
author_facet Wiśniewski, Adam
Filipska, Karolina
Piec, Katarzyna
Jaskólski, Filip
Ślusarz, Robert
author_sort Wiśniewski, Adam
collection PubMed
description Background: Assessing the severity of posterior circulation strokes, due to the variety of symptoms, is a significant clinical problem. Current clinimetric scales show lower accuracy in the measurement of posterior stroke severity, compared with that of anterior strokes. The aim of the study was to design a validated tool, termed Adam’s Scale of Posterior Stroke (ASPOS), for better assessment and prediction of posterior stroke. Methods: This prospective, observational study involved 126 posterior circulation ischemic stroke subjects. Four researchers, previously trained in ASPOS, randomized the stroke severity using a novel tool and other appropriate stroke scales (The National Institute of Health Stroke Scale—NIHSS, modified Rankin Scale—mRS, Glasgow Coma Scale, Barthel Index, or Israeli Vertebrobasilar Stroke Scale—IVBSS) to assess the psychometric properties, reliability, and validity of ASPOS and investigate its predictive value. Results: ASPOS reached a Cronbach’s alpha coefficient of 0.7449, indicating good internal consistency. The Bland–Altman analysis showed a good coefficient of repeatability (CR) of 0.46, a 95% confidence interval (CI) of 0.41–0.53, and excellent intraclass correlation coefficients or weighted kappa values (>0.90), reflecting high reliability and reproducibility. Highly significant correlations with other scales confirmed the construct and predictive validity of ASPOS. A total ASPOS score of three points indicated a significantly increased probability of severe stroke based on the NIHSS, compared to a total ASPOS of 1–2 points (odds ratio (OR) 141; 95% CI: 6.72–2977.66; p = 0.0014). Conclusions: We developed a novel, valid, and reliable tool to assess posterior circulation strokes. This can contribute to a more comprehensive estimation of posterior stroke and, additionally, due to its predictive properties, it can be used to more accurately select candidates for specific treatments.
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spelling pubmed-80657502021-04-25 Introducing Adam’s Scale of Posterior Stroke (ASPOS): A Novel Validated Tool to Assess and Predict Posterior Circulation Strokes Wiśniewski, Adam Filipska, Karolina Piec, Katarzyna Jaskólski, Filip Ślusarz, Robert Brain Sci Article Background: Assessing the severity of posterior circulation strokes, due to the variety of symptoms, is a significant clinical problem. Current clinimetric scales show lower accuracy in the measurement of posterior stroke severity, compared with that of anterior strokes. The aim of the study was to design a validated tool, termed Adam’s Scale of Posterior Stroke (ASPOS), for better assessment and prediction of posterior stroke. Methods: This prospective, observational study involved 126 posterior circulation ischemic stroke subjects. Four researchers, previously trained in ASPOS, randomized the stroke severity using a novel tool and other appropriate stroke scales (The National Institute of Health Stroke Scale—NIHSS, modified Rankin Scale—mRS, Glasgow Coma Scale, Barthel Index, or Israeli Vertebrobasilar Stroke Scale—IVBSS) to assess the psychometric properties, reliability, and validity of ASPOS and investigate its predictive value. Results: ASPOS reached a Cronbach’s alpha coefficient of 0.7449, indicating good internal consistency. The Bland–Altman analysis showed a good coefficient of repeatability (CR) of 0.46, a 95% confidence interval (CI) of 0.41–0.53, and excellent intraclass correlation coefficients or weighted kappa values (>0.90), reflecting high reliability and reproducibility. Highly significant correlations with other scales confirmed the construct and predictive validity of ASPOS. A total ASPOS score of three points indicated a significantly increased probability of severe stroke based on the NIHSS, compared to a total ASPOS of 1–2 points (odds ratio (OR) 141; 95% CI: 6.72–2977.66; p = 0.0014). Conclusions: We developed a novel, valid, and reliable tool to assess posterior circulation strokes. This can contribute to a more comprehensive estimation of posterior stroke and, additionally, due to its predictive properties, it can be used to more accurately select candidates for specific treatments. MDPI 2021-03-26 /pmc/articles/PMC8065750/ /pubmed/33810516 http://dx.doi.org/10.3390/brainsci11040424 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ).
spellingShingle Article
Wiśniewski, Adam
Filipska, Karolina
Piec, Katarzyna
Jaskólski, Filip
Ślusarz, Robert
Introducing Adam’s Scale of Posterior Stroke (ASPOS): A Novel Validated Tool to Assess and Predict Posterior Circulation Strokes
title Introducing Adam’s Scale of Posterior Stroke (ASPOS): A Novel Validated Tool to Assess and Predict Posterior Circulation Strokes
title_full Introducing Adam’s Scale of Posterior Stroke (ASPOS): A Novel Validated Tool to Assess and Predict Posterior Circulation Strokes
title_fullStr Introducing Adam’s Scale of Posterior Stroke (ASPOS): A Novel Validated Tool to Assess and Predict Posterior Circulation Strokes
title_full_unstemmed Introducing Adam’s Scale of Posterior Stroke (ASPOS): A Novel Validated Tool to Assess and Predict Posterior Circulation Strokes
title_short Introducing Adam’s Scale of Posterior Stroke (ASPOS): A Novel Validated Tool to Assess and Predict Posterior Circulation Strokes
title_sort introducing adam’s scale of posterior stroke (aspos): a novel validated tool to assess and predict posterior circulation strokes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8065750/
https://www.ncbi.nlm.nih.gov/pubmed/33810516
http://dx.doi.org/10.3390/brainsci11040424
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