缺血性卒中TOAST亚型分析的信度检验

目的检验TOAST分型法应用于临床研究时的信度值。方法2002年7月至2003年2月期间因首发缺血性卒中在我科住院治疗患者300例,进行MRI、磁共振血管造影及弥散加权成像等影像学检查及其他病因学检查。通过不同医师对其进行TOAST分型,对分型结果进行统计学分析。结果本信度研究的Kappa值为0.81,P=0.028。结论TOAST分型标准的信度令人满意,医师专业知识水平的提高和诊断学技术的发展有助于进一步提高其信度值。

The reliability of ischemic stroke subtype classification using the TOAST criteria

OBJECTIVE: The aim of this study was to assess the reliability of the classification of acute cerebral infarction based on the TOAST system. METHODS: 300 patients with ischemic stroke were recruited into this study. Ischemic stroke was classified into five subtypes according on clinical manifestations, MRI, MRA and DSA. The investigators classified all the patients into five etiologic subtypes. The data was analyzed by the statistics software of SPSS 11.5. RESULTS: The value of Kappa about the classification's reliability was 0.8, P = 0.028. CONCLUSIONS: The reliability for the classification of acute cerebral was excellent. This value could be improved with the development of the diagnosis tools and the physicians' recognition.