Interobserver Agreement for the Assessment of Handicap in Stroke Patients

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Interobserver agreement for the assessment of handicap in stroke patients was investigated in a group of 10 senior neurologists and 24 residents from two centers. One hundred patients were separately interviewed by two physicians in different combinations. The degree of handicap was recorded by each observer on the modified Ran kin scale, which has six grades (0–5). The agreement rates were corrected for chance (K statistics). Both physicians agreed on the degree of handicap in 65 patients; they differed by one grade in 32 patients and by two grades in 3 patients, K for all pairwise observations was 0.56; the value for weighted K (with quadratic disagreement weights) was 0.91. Our results confirm the value of the modified Rankin scale in the assessment of handicap in stroke patients; nevertheless, further improvements are possible. (Stroke 1988;19:604–607)

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