Determining the cut-off score for the Modified Barthel Index and the Modified Rankin Scale for assessment of functional independence and residual disability after stroke
Assessment of functional independence and residual disability is very important for measuring treatment outcome after stroke. The modified Rankin Scale (mRS) and the modified Barthel Index (MBI) are commonly used scales to measure disability or dependence in activities of daily living (ADL) of strok...
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| Veröffentlicht in: | PloS one 2020-01, Vol.15 (1), p.e0226324-e0226324 |
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| creator | Lee, Seung Yeol Kim, Deog Young Sohn, Min Kyun Lee, Jongmin Lee, Sam-Gyu Shin, Yong-Il Kim, Soo-Yeon Oh, Gyung-Jae Lee, Young Hoon Lee, Yang-Soo Joo, Min Cheol Lee, So Young Ahn, Jeonghoon Chang, Won Hyuk Choi, Ji Yoo Kang, Sung Hyun Kim, Il Yoel Han, Junhee Kim, Yun-Hee |
| description | Assessment of functional independence and residual disability is very important for measuring treatment outcome after stroke. The modified Rankin Scale (mRS) and the modified Barthel Index (MBI) are commonly used scales to measure disability or dependence in activities of daily living (ADL) of stroke survivors. Lack of consensus regarding MBI score categories has caused confusion in interpreting stroke outcomes. The purpose of this study was to identify the optimal corresponding MBI and modified Rankin scale (mRS) grades for categorization of MBI. The Korean versions of the MBI (K-MBI) and mRS were collected from 5,759 stroke patients at 3 months after onset of stroke. The sensitivity and specificity were calculated at K-MBI score cutoffs for each mRS grade to obtain optimally corresponding K-MBI scores and mRS grades. We also plotted receiver operating characteristic (ROC) curves of sensitivity and specificity and determined the area under the curve (AUC). The K-MBI cutoff points with the highest sum of sensitivity and specificity were 100 (sensitivity 0.940; specificity 0.612), 98 (sensitivity 0.904; specificity 0.838), 94 (sensitivity 0.885; specificity 0.937), 78 (sensitivity 0.946; specificity, 0.973), and 55 (sensitivity 937; specificity 0.986) for mRS grades 0, 1, 2, 3, and 4, respectively. From this result, the K-MBI cutoff score range for each mRS grade can be obtained. For mRS grade 0, the K-MBI cutoff score is 100, indicating no associated score range. For mRS grades 1, 2, 3, 4, and 5, the K-MBI score ranges is from 99 to 98, 97 to 94, 93 to 78, 77 to 55, and under 54, respectively.The AUC for the ROC curve was 0.791 for mRS grade 0, 0.919 for mRS grade 1, 0.970 for mRS grade 2, 0.0 for mRS grade 3, and 0.991 for mRS grade 4. The K-MBI cutoff score ranges for representing mRS grades were variable; mRS grades 0, 1, and 2 had narrow K-MBI score ranges, while mRS grades 3, 4, and 5 exhibited broad K-MBI score ranges. mRS grade seemed to sensitively differentiate mild residual disability of stroke survivors, whereas K-MBI provided more specific information of the functional status of stroke survivors with moderate to severe residual impairment. |
| doi_str_mv | 10.1371/journal.pone.0226324 |
| format | Article |
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The modified Rankin Scale (mRS) and the modified Barthel Index (MBI) are commonly used scales to measure disability or dependence in activities of daily living (ADL) of stroke survivors. Lack of consensus regarding MBI score categories has caused confusion in interpreting stroke outcomes. The purpose of this study was to identify the optimal corresponding MBI and modified Rankin scale (mRS) grades for categorization of MBI. The Korean versions of the MBI (K-MBI) and mRS were collected from 5,759 stroke patients at 3 months after onset of stroke. The sensitivity and specificity were calculated at K-MBI score cutoffs for each mRS grade to obtain optimally corresponding K-MBI scores and mRS grades. We also plotted receiver operating characteristic (ROC) curves of sensitivity and specificity and determined the area under the curve (AUC). The K-MBI cutoff points with the highest sum of sensitivity and specificity were 100 (sensitivity 0.940; specificity 0.612), 98 (sensitivity 0.904; specificity 0.838), 94 (sensitivity 0.885; specificity 0.937), 78 (sensitivity 0.946; specificity, 0.973), and 55 (sensitivity 937; specificity 0.986) for mRS grades 0, 1, 2, 3, and 4, respectively. From this result, the K-MBI cutoff score range for each mRS grade can be obtained. For mRS grade 0, the K-MBI cutoff score is 100, indicating no associated score range. For mRS grades 1, 2, 3, 4, and 5, the K-MBI score ranges is from 99 to 98, 97 to 94, 93 to 78, 77 to 55, and under 54, respectively.The AUC for the ROC curve was 0.791 for mRS grade 0, 0.919 for mRS grade 1, 0.970 for mRS grade 2, 0.0 for mRS grade 3, and 0.991 for mRS grade 4. The K-MBI cutoff score ranges for representing mRS grades were variable; mRS grades 0, 1, and 2 had narrow K-MBI score ranges, while mRS grades 3, 4, and 5 exhibited broad K-MBI score ranges. mRS grade seemed to sensitively differentiate mild residual disability of stroke survivors, whereas K-MBI provided more specific information of the functional status of stroke survivors with moderate to severe residual impairment.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0226324</identifier><identifier>PMID: 31995563</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Activities of Daily Living ; Aged ; Balances (scales) ; Chronic illnesses ; Computer and Information Sciences ; Data collection ; Disabilities ; Disability ; Disability Evaluation ; Disabled Persons - rehabilitation ; Disease control ; Disease prevention ; Disease Progression ; Female ; Hospitals ; Humans ; Logistic Models ; Male ; Medicine and Health Sciences ; Middle Aged ; Optimization ; Outcome Assessment, Health Care ; Patients ; People and Places ; Preventive medicine ; Quality ; Rehabilitation ; Research and Analysis Methods ; ROC Curve ; Sensitivity ; Severity of Illness Index ; Social Sciences ; Stroke ; Stroke - physiopathology ; Stroke Rehabilitation - methods ; Studies ; Survival ; Training ; Treatment Outcome</subject><ispartof>PloS one, 2020-01, Vol.15 (1), p.e0226324-e0226324</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Lee et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Lee et al 2020 Lee et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c758t-c5b73d86ecd062d68fbe69bf117133dc9a5089f6a569a051d4605ca6d7e459473</citedby><cites>FETCH-LOGICAL-c758t-c5b73d86ecd062d68fbe69bf117133dc9a5089f6a569a051d4605ca6d7e459473</cites><orcidid>0000-0002-0177-0192 ; 0000-0001-6101-8851 ; 0000-0002-2548-545X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6988933/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6988933/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31995563$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Seung Yeol</creatorcontrib><creatorcontrib>Kim, Deog Young</creatorcontrib><creatorcontrib>Sohn, Min Kyun</creatorcontrib><creatorcontrib>Lee, Jongmin</creatorcontrib><creatorcontrib>Lee, Sam-Gyu</creatorcontrib><creatorcontrib>Shin, Yong-Il</creatorcontrib><creatorcontrib>Kim, Soo-Yeon</creatorcontrib><creatorcontrib>Oh, Gyung-Jae</creatorcontrib><creatorcontrib>Lee, Young Hoon</creatorcontrib><creatorcontrib>Lee, Yang-Soo</creatorcontrib><creatorcontrib>Joo, Min Cheol</creatorcontrib><creatorcontrib>Lee, So Young</creatorcontrib><creatorcontrib>Ahn, Jeonghoon</creatorcontrib><creatorcontrib>Chang, Won Hyuk</creatorcontrib><creatorcontrib>Choi, Ji Yoo</creatorcontrib><creatorcontrib>Kang, Sung Hyun</creatorcontrib><creatorcontrib>Kim, Il Yoel</creatorcontrib><creatorcontrib>Han, Junhee</creatorcontrib><creatorcontrib>Kim, Yun-Hee</creatorcontrib><title>Determining the cut-off score for the Modified Barthel Index and the Modified Rankin Scale for assessment of functional independence and residual disability after stroke</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Assessment of functional independence and residual disability is very important for measuring treatment outcome after stroke. The modified Rankin Scale (mRS) and the modified Barthel Index (MBI) are commonly used scales to measure disability or dependence in activities of daily living (ADL) of stroke survivors. Lack of consensus regarding MBI score categories has caused confusion in interpreting stroke outcomes. The purpose of this study was to identify the optimal corresponding MBI and modified Rankin scale (mRS) grades for categorization of MBI. The Korean versions of the MBI (K-MBI) and mRS were collected from 5,759 stroke patients at 3 months after onset of stroke. The sensitivity and specificity were calculated at K-MBI score cutoffs for each mRS grade to obtain optimally corresponding K-MBI scores and mRS grades. We also plotted receiver operating characteristic (ROC) curves of sensitivity and specificity and determined the area under the curve (AUC). The K-MBI cutoff points with the highest sum of sensitivity and specificity were 100 (sensitivity 0.940; specificity 0.612), 98 (sensitivity 0.904; specificity 0.838), 94 (sensitivity 0.885; specificity 0.937), 78 (sensitivity 0.946; specificity, 0.973), and 55 (sensitivity 937; specificity 0.986) for mRS grades 0, 1, 2, 3, and 4, respectively. From this result, the K-MBI cutoff score range for each mRS grade can be obtained. For mRS grade 0, the K-MBI cutoff score is 100, indicating no associated score range. For mRS grades 1, 2, 3, 4, and 5, the K-MBI score ranges is from 99 to 98, 97 to 94, 93 to 78, 77 to 55, and under 54, respectively.The AUC for the ROC curve was 0.791 for mRS grade 0, 0.919 for mRS grade 1, 0.970 for mRS grade 2, 0.0 for mRS grade 3, and 0.991 for mRS grade 4. The K-MBI cutoff score ranges for representing mRS grades were variable; mRS grades 0, 1, and 2 had narrow K-MBI score ranges, while mRS grades 3, 4, and 5 exhibited broad K-MBI score ranges. mRS grade seemed to sensitively differentiate mild residual disability of stroke survivors, whereas K-MBI provided more specific information of the functional status of stroke survivors with moderate to severe residual impairment.</description><subject>Activities of Daily Living</subject><subject>Aged</subject><subject>Balances (scales)</subject><subject>Chronic illnesses</subject><subject>Computer and Information Sciences</subject><subject>Data collection</subject><subject>Disabilities</subject><subject>Disability</subject><subject>Disability Evaluation</subject><subject>Disabled Persons - rehabilitation</subject><subject>Disease control</subject><subject>Disease prevention</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Optimization</subject><subject>Outcome Assessment, Health Care</subject><subject>Patients</subject><subject>People and Places</subject><subject>Preventive medicine</subject><subject>Quality</subject><subject>Rehabilitation</subject><subject>Research and Analysis Methods</subject><subject>ROC Curve</subject><subject>Sensitivity</subject><subject>Severity of Illness Index</subject><subject>Social Sciences</subject><subject>Stroke</subject><subject>Stroke - physiopathology</subject><subject>Stroke Rehabilitation - methods</subject><subject>Studies</subject><subject>Survival</subject><subject>Training</subject><subject>Treatment Outcome</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk9tu1DAQhiMEoqXwBggsISG42MWOYye5QSrltFJRpRa4tRx7vOs2sRc7Qe0j8ZZ4d9Nqg3qBIuUw883vyW9Plj0neE5oSd5d-iE42c7X3sEc5zmnefEgOyQ1zWc8x_Th3vtB9iTGS4wZrTh_nB1QUteMcXqY_fkIPYTOOuuWqF8BUkM_88agqHwAZHzYRr95bY0FjT7IkL5btHAarpF0epo-l-7KOnShZLsrljFCjB24HnmDzOBUb31qG9kksIZ0cwq2OgGi1UPKaBtlY1vb3yBpUnMo9sFfwdPskZFthGfj8yj78fnT95Ovs9OzL4uT49OZKlnVzxRrSqorDkpjnmtemQZ43RhCSkKpVrVkuKoNl4zXEjOiC46ZklyXULC6KOlR9nKnu259FKPLUeS0qCjGmNaJWOwI7eWlWAfbyXAjvLRiG_BhKZJLVrUgCG5yQlmRA2EFLWVDsVS8KStec0VNkbTej6sNTQdaJaOCbCei04yzK7H0vwWvq6qmNAm8GQWC_zVA7EVno4K2lQ78sOu7wgQXLKGv_kHv_7uRWqY9FNYZn9ZVG1FxzEnOWUk5TtT8HipdGjqr0pE0NsUnBW8nBYnp4bpfyiFGsbg4_3_27OeUfb3HrkC2_Sr6dtgcszgFix2ogo8xgLkzmWCxmahbN8RmosQ4Uansxf4G3RXdjhD9CwMjHQ0</recordid><startdate>20200129</startdate><enddate>20200129</enddate><creator>Lee, Seung Yeol</creator><creator>Kim, Deog Young</creator><creator>Sohn, Min Kyun</creator><creator>Lee, Jongmin</creator><creator>Lee, Sam-Gyu</creator><creator>Shin, Yong-Il</creator><creator>Kim, Soo-Yeon</creator><creator>Oh, Gyung-Jae</creator><creator>Lee, Young Hoon</creator><creator>Lee, Yang-Soo</creator><creator>Joo, Min Cheol</creator><creator>Lee, So Young</creator><creator>Ahn, Jeonghoon</creator><creator>Chang, Won Hyuk</creator><creator>Choi, Ji Yoo</creator><creator>Kang, Sung Hyun</creator><creator>Kim, Il Yoel</creator><creator>Han, Junhee</creator><creator>Kim, Yun-Hee</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-0177-0192</orcidid><orcidid>https://orcid.org/0000-0001-6101-8851</orcidid><orcidid>https://orcid.org/0000-0002-2548-545X</orcidid></search><sort><creationdate>20200129</creationdate><title>Determining the cut-off score for the Modified Barthel Index and the Modified Rankin Scale for assessment of functional independence and residual disability after stroke</title><author>Lee, Seung Yeol ; Kim, Deog Young ; Sohn, Min Kyun ; Lee, Jongmin ; Lee, Sam-Gyu ; Shin, Yong-Il ; Kim, Soo-Yeon ; Oh, Gyung-Jae ; Lee, Young Hoon ; Lee, Yang-Soo ; Joo, Min Cheol ; Lee, So Young ; Ahn, Jeonghoon ; Chang, Won Hyuk ; Choi, Ji Yoo ; Kang, Sung Hyun ; Kim, Il Yoel ; Han, Junhee ; Kim, Yun-Hee</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c758t-c5b73d86ecd062d68fbe69bf117133dc9a5089f6a569a051d4605ca6d7e459473</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Activities of Daily Living</topic><topic>Aged</topic><topic>Balances (scales)</topic><topic>Chronic illnesses</topic><topic>Computer and Information Sciences</topic><topic>Data collection</topic><topic>Disabilities</topic><topic>Disability</topic><topic>Disability Evaluation</topic><topic>Disabled Persons - rehabilitation</topic><topic>Disease control</topic><topic>Disease prevention</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medicine and Health Sciences</topic><topic>Middle Aged</topic><topic>Optimization</topic><topic>Outcome Assessment, Health Care</topic><topic>Patients</topic><topic>People and Places</topic><topic>Preventive medicine</topic><topic>Quality</topic><topic>Rehabilitation</topic><topic>Research and Analysis Methods</topic><topic>ROC Curve</topic><topic>Sensitivity</topic><topic>Severity of Illness Index</topic><topic>Social Sciences</topic><topic>Stroke</topic><topic>Stroke - physiopathology</topic><topic>Stroke Rehabilitation - methods</topic><topic>Studies</topic><topic>Survival</topic><topic>Training</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Seung Yeol</creatorcontrib><creatorcontrib>Kim, Deog Young</creatorcontrib><creatorcontrib>Sohn, Min Kyun</creatorcontrib><creatorcontrib>Lee, Jongmin</creatorcontrib><creatorcontrib>Lee, Sam-Gyu</creatorcontrib><creatorcontrib>Shin, Yong-Il</creatorcontrib><creatorcontrib>Kim, Soo-Yeon</creatorcontrib><creatorcontrib>Oh, Gyung-Jae</creatorcontrib><creatorcontrib>Lee, Young Hoon</creatorcontrib><creatorcontrib>Lee, Yang-Soo</creatorcontrib><creatorcontrib>Joo, Min Cheol</creatorcontrib><creatorcontrib>Lee, So Young</creatorcontrib><creatorcontrib>Ahn, Jeonghoon</creatorcontrib><creatorcontrib>Chang, Won Hyuk</creatorcontrib><creatorcontrib>Choi, Ji Yoo</creatorcontrib><creatorcontrib>Kang, Sung Hyun</creatorcontrib><creatorcontrib>Kim, Il Yoel</creatorcontrib><creatorcontrib>Han, Junhee</creatorcontrib><creatorcontrib>Kim, Yun-Hee</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Seung Yeol</au><au>Kim, Deog Young</au><au>Sohn, Min Kyun</au><au>Lee, Jongmin</au><au>Lee, Sam-Gyu</au><au>Shin, Yong-Il</au><au>Kim, Soo-Yeon</au><au>Oh, Gyung-Jae</au><au>Lee, Young Hoon</au><au>Lee, Yang-Soo</au><au>Joo, Min Cheol</au><au>Lee, So Young</au><au>Ahn, Jeonghoon</au><au>Chang, Won Hyuk</au><au>Choi, Ji Yoo</au><au>Kang, Sung Hyun</au><au>Kim, Il Yoel</au><au>Han, Junhee</au><au>Kim, Yun-Hee</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Determining the cut-off score for the Modified Barthel Index and the Modified Rankin Scale for assessment of functional independence and residual disability after stroke</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2020-01-29</date><risdate>2020</risdate><volume>15</volume><issue>1</issue><spage>e0226324</spage><epage>e0226324</epage><pages>e0226324-e0226324</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Assessment of functional independence and residual disability is very important for measuring treatment outcome after stroke. The modified Rankin Scale (mRS) and the modified Barthel Index (MBI) are commonly used scales to measure disability or dependence in activities of daily living (ADL) of stroke survivors. Lack of consensus regarding MBI score categories has caused confusion in interpreting stroke outcomes. The purpose of this study was to identify the optimal corresponding MBI and modified Rankin scale (mRS) grades for categorization of MBI. The Korean versions of the MBI (K-MBI) and mRS were collected from 5,759 stroke patients at 3 months after onset of stroke. The sensitivity and specificity were calculated at K-MBI score cutoffs for each mRS grade to obtain optimally corresponding K-MBI scores and mRS grades. We also plotted receiver operating characteristic (ROC) curves of sensitivity and specificity and determined the area under the curve (AUC). The K-MBI cutoff points with the highest sum of sensitivity and specificity were 100 (sensitivity 0.940; specificity 0.612), 98 (sensitivity 0.904; specificity 0.838), 94 (sensitivity 0.885; specificity 0.937), 78 (sensitivity 0.946; specificity, 0.973), and 55 (sensitivity 937; specificity 0.986) for mRS grades 0, 1, 2, 3, and 4, respectively. From this result, the K-MBI cutoff score range for each mRS grade can be obtained. For mRS grade 0, the K-MBI cutoff score is 100, indicating no associated score range. For mRS grades 1, 2, 3, 4, and 5, the K-MBI score ranges is from 99 to 98, 97 to 94, 93 to 78, 77 to 55, and under 54, respectively.The AUC for the ROC curve was 0.791 for mRS grade 0, 0.919 for mRS grade 1, 0.970 for mRS grade 2, 0.0 for mRS grade 3, and 0.991 for mRS grade 4. The K-MBI cutoff score ranges for representing mRS grades were variable; mRS grades 0, 1, and 2 had narrow K-MBI score ranges, while mRS grades 3, 4, and 5 exhibited broad K-MBI score ranges. mRS grade seemed to sensitively differentiate mild residual disability of stroke survivors, whereas K-MBI provided more specific information of the functional status of stroke survivors with moderate to severe residual impairment.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>31995563</pmid><doi>10.1371/journal.pone.0226324</doi><tpages>e0226324</tpages><orcidid>https://orcid.org/0000-0002-0177-0192</orcidid><orcidid>https://orcid.org/0000-0001-6101-8851</orcidid><orcidid>https://orcid.org/0000-0002-2548-545X</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2020-01, Vol.15 (1), p.e0226324-e0226324 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2348300039 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Activities of Daily Living Aged Balances (scales) Chronic illnesses Computer and Information Sciences Data collection Disabilities Disability Disability Evaluation Disabled Persons - rehabilitation Disease control Disease prevention Disease Progression Female Hospitals Humans Logistic Models Male Medicine and Health Sciences Middle Aged Optimization Outcome Assessment, Health Care Patients People and Places Preventive medicine Quality Rehabilitation Research and Analysis Methods ROC Curve Sensitivity Severity of Illness Index Social Sciences Stroke Stroke - physiopathology Stroke Rehabilitation - methods Studies Survival Training Treatment Outcome |
| title | Determining the cut-off score for the Modified Barthel Index and the Modified Rankin Scale for assessment of functional independence and residual disability after stroke |
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