Interrater reliability of an etiologic classification of ischemic stroke

C. J. Johnson, C. J. Kittner, R. J. McCarter, R. J. Sloan, Barney Stern, David Buchholz, T. R. Price

Research output: Contribution to journalArticle

Abstract

Precise identification of the cause of stroke is critical to research and clinical practice. Published series of ischemic stroke show considerable variation in the proportion of cases classified as atherosclerotic large-vessel disease, lacunar infarct, cardioembolic stroke, stroke of other known cause, and stroke of undetermined etiology. We describe the development and use of an etiology-specific classification of ischemic stroke. The interrater reliability of the classification is then evaluated. Methods A total of 160 cases of ischemic strokes in young adults were reviewed by paired neurologists who assigned cases to prioritized categories. The results of paired ratings were evaluated for each of the potential causes. Interrater agreement was assessed by means of kappa, which is the chance-adjusted percent agreement. Results For standard pairs, kappa was fair to good for all causes except lacunar stroke (kappa = 0.31); however, pair-to-pair variation was greatest for lacunar strokes. Strokes of undetermined cause and hematologic/other cause were of borderline fair reliability. Conclusions The utility of a stroke classification system is dependent on its intended use. An etiologic classification is useful in studies of the epidemiology and pathophysiological basis of stroke. Fair to good reliability for an etiologic classification of stroke can be obtained when criteria are explicit.

Original languageEnglish (US)
Pages (from-to)46-51
Number of pages6
JournalStroke
Volume26
Issue number1
StatePublished - 1995

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Stroke
Lacunar Stroke
Young Adult
Epidemiology
Research

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing
  • Neuroscience(all)

Cite this

Johnson, C. J., Kittner, C. J., McCarter, R. J., Sloan, R. J., Stern, B., Buchholz, D., & Price, T. R. (1995). Interrater reliability of an etiologic classification of ischemic stroke. Stroke, 26(1), 46-51.

Interrater reliability of an etiologic classification of ischemic stroke. / Johnson, C. J.; Kittner, C. J.; McCarter, R. J.; Sloan, R. J.; Stern, Barney; Buchholz, David; Price, T. R.

In: Stroke, Vol. 26, No. 1, 1995, p. 46-51.

Research output: Contribution to journalArticle

Johnson, CJ, Kittner, CJ, McCarter, RJ, Sloan, RJ, Stern, B, Buchholz, D & Price, TR 1995, 'Interrater reliability of an etiologic classification of ischemic stroke', Stroke, vol. 26, no. 1, pp. 46-51.
Johnson CJ, Kittner CJ, McCarter RJ, Sloan RJ, Stern B, Buchholz D et al. Interrater reliability of an etiologic classification of ischemic stroke. Stroke. 1995;26(1):46-51.
Johnson, C. J. ; Kittner, C. J. ; McCarter, R. J. ; Sloan, R. J. ; Stern, Barney ; Buchholz, David ; Price, T. R. / Interrater reliability of an etiologic classification of ischemic stroke. In: Stroke. 1995 ; Vol. 26, No. 1. pp. 46-51.
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