Deriving Place of Residence, Modified Rankin Scale, and EuroQol-5D Scores from the Medical Record for Stroke Survivors
dc.contributor.author | Sucharew, Heidi | |
dc.contributor.author | Kleindorfer, Dawn | |
dc.contributor.author | Khoury, Jane C. | |
dc.contributor.author | Alwell, Kathleen | |
dc.contributor.author | Haverbusch, Mary | |
dc.contributor.author | Stanton, Robert | |
dc.contributor.author | Demel, Stacie | |
dc.contributor.author | De Los Rios La Rosa, Felipe | |
dc.contributor.author | Ferioli, Simona | |
dc.contributor.author | Jasne, Adam | |
dc.contributor.author | Mistry, Eva | |
dc.contributor.author | Moomaw, Charles J. | |
dc.contributor.author | Mackey, Jason | |
dc.contributor.author | Slavin, Sabreena | |
dc.contributor.author | Star, Michael | |
dc.contributor.author | Walsh, Kyle | |
dc.contributor.author | Woo, Daniel | |
dc.contributor.author | Kissela, Brett M. | |
dc.contributor.department | Neurology, School of Medicine | |
dc.date.accessioned | 2024-04-01T12:21:19Z | |
dc.date.available | 2024-04-01T12:21:19Z | |
dc.date.issued | 2021 | |
dc.description.abstract | Introduction: We sought to determine the feasibility and validity of estimating post-stroke outcomes using information available in the electronic medical record (EMR) through comparison with outcomes obtained from telephone interviews. Methods: The Greater Cincinnati Northern Kentucky Stroke Study is a retrospective population-based epidemiology study that ascertains hospitalized strokes in the study region. As a sub-study, we identified all ischemic stroke patients who presented to a system of 4 hospitals during the study period 1/1/2015–12/31/2015 and were discharged alive. Enrolled subjects (or proxies for cognitively-disabled patients) were contacted by telephone at 3 and 6 months post-stroke to determine current place of residence and two functional outcomes—the modified Rankin Score (mRS) and the EuroQol (EQ-5D). Concurrently, the lead study coordinator, blinded to the telephone assessment outcomes, reviewed all available EMRs to estimate outcome status. Agreement between outcomes estimated from the EMR with “gold-standard” data obtained from telephone interviews was analyzed using the kappa statistic or interclass correlation (ICC), as appropriate. For each outcome, EMR-determined results were evaluated for added value beyond the information readily available from the stroke hospital stay. Results: Of 381 ischemic strokes identified, 294 (median [IQR] age 70 [60–79] years, 4% black, 52% female) were interviewed post-stroke. Agreement between EMR and telephone for 3-month residence was very good (kappa=0.84, 95% CI 0.74–0.94), good for mRS (weighted kappa=0.75, 95% CI 0.70–0.80), and good for EQ-5D (ICC=0.74, 95% CI 0.68–0.79). Similar results were observed at 6 months post stroke. At both 3 and 6 months post stroke, EMR-determined outcomes added value in predicting the gold standard telephone results beyond the information available from the stroke hospitalization; the added fraction of new information ranged from 0.25 to 0.59. Conclusions: Determining place of residence, mRS, and EQ-5D outcomes derived from information recorded in the EMR post-stroke, without patient contact, is feasible and has good agreement with data obtained from direct contact. However, we note that the level of agreement for mRS and EQ-5D was higher for proxy interviews and that the EMR often reflects health care providers’ judgments that tend to overestimate disability and underestimate quality of life. | |
dc.eprint.version | Author's manuscript | |
dc.identifier.citation | Sucharew H, Kleindorfer D, Khoury JC, et al. Deriving Place of Residence, Modified Rankin Scale, and EuroQol-5D Scores from the Medical Record for Stroke Survivors. Cerebrovasc Dis. 2021;50(5):567-573. doi:10.1159/000516571 | |
dc.identifier.uri | https://hdl.handle.net/1805/39642 | |
dc.language.iso | en_US | |
dc.publisher | Karger | |
dc.relation.isversionof | 10.1159/000516571 | |
dc.relation.journal | Cerebrovascular Diseases | |
dc.rights | Publisher Policy | |
dc.source | PMC | |
dc.subject | Electronic medical record | |
dc.subject | EuroQol | |
dc.subject | Ischemic stroke | |
dc.subject | Modified Rankin score | |
dc.subject | Outcome | |
dc.subject | Residence | |
dc.subject | Telephone assessment | |
dc.title | Deriving Place of Residence, Modified Rankin Scale, and EuroQol-5D Scores from the Medical Record for Stroke Survivors | |
dc.type | Article |