Comparative Evaluation of Telephone versus Face-to-Face Administration of the Indian Stroke Scale in Clinical Practice.

Abstract

The Indian Stroke Scale (ISS) measures limitations in everyday activities experienced by stroke patients in India. However, routine use of the ISS faces challenges, especially in remote areas, due to follow-up and accessibility issues, including logistical difficulties in arranging in-person visits, patient mobility issues, and the increased time and resources required for in-person assessments. We aimed to investigate whether the ISS produced equivalent scores when administered via telephone mode compared with face-to-face within clinical stroke rehabilitation settings. We administered the ISS face-to-face and by telephone to 104 stroke patients within a week. The order in which the modes of administration were administered was randomized. We evaluated the equivalence of modes of administration by calculating the intraclass correlation coefficient (ICC), the standard error of measurement (SEM), the minimal detectable change (MDC), and the limits of agreement using the Bland-Altman plot. Both modes of administration produced similar results. There was excellent reliability for total scores (ICC 2,1 = 0.95; 95% CI, 0.92 to 0.96); SEM was 1.45 and MDC was 4. The limits of agreement were narrow (-8.8 and 8.5) and within acceptable limits: 10 points. The ISS produced similar results when administered face-to-face and via telephone among patients with stroke. The study findings can benefit stroke rehabilitation researchers in recruiting patients living in geographically dispersed regions and remote locations who are often underrepresented in clinical trials and clinicians in conducting routine follow-up evaluations.