Text-message based assessment of 90-day modified Rankin Scale after Stroke

Author:

Abbasi Mohammad HosseinORCID,Yuan Kristy,Kasner Scott E.ORCID,McPartland Ellen,Owens Karrima C.,Sloane Kelly L.ORCID

Abstract

AbstractBackgroundThe modified Rankin scale (mRS) is commonly used to measure disability after stroke, traditionally assessed through telephone or in-person evaluation. Here, we investigated the validity of mRS assessment through automated text-messaging as an alternative method to traditional assessments.MethodsTwo hundred and fifty patients admitted to 3 hospitals within the University of Pennsylvania Health System with ischemic or hemorrhagic stroke were enrolled. Participants received automated text-messages sent 48 hours prior to their outpatient appointment at about 90-days post-stroke. The mRS scores were assigned based on participant responses to 2-4 text questions eliciting yes/no responses. The mRS was then evaluated in-person or by telephone interview for comparison. Responses were compared with kappa(κ).ResultsOne hundred and forty-two patients (57%) completed the study. Spontaneous response rate to text messages was 46% and up to 72% with an additional direct in-person or phone call reminder. Agreement was substantial (quadratic-weighted κ=0.87) between responses derived from the automated text messaging and traditional interviews. Agreement for distinguishing functional independence (mRS 0-2) from dependence (mRS 3-5) was substantial (unweighted κ=0.79).ConclusionAn automated text messaging system is a feasible and highly reliable for determining mRS and can serve as an alternative to traditional in-person or telephone assessment.

Publisher

Cold Spring Harbor Laboratory

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