Abstract
Telephonic Barthel Index (BI) assessment is less time-consuming and more feasible than a face-to-face interview. The aim of this study was to test the validity as well as reliability of the BI administered by telephone in comparison with face-to-face assessment in a multi-centric study. The study was conducted during the course of a randomized controlled trial in which 120 patients with subacute strokes from five teaching hospitals from different parts of India were recruited. Central telephonic follow-up and face-to-face assessment of BI and modified Rankin Scale (mRS) at 3 and 6 months were done by trained and certified blinded researchers. Kappa or weighted kappa (wK) was estimated. Sensitivity and specificity at various cutoff levels of telephonic BI were calculated. Concurrent validity of the telephonic BI was assessed by correlating it with the mRS and National Institutes of Health Stroke Scales (NIHSS) at 3 and 6 months. We observed high sensitivity and specificity at various cutoff levels of BI. Moderate to substantial agreement was observed between the two methods at 6 months wK 0.72 (95% CI 0.70–0.77). Item-wise and center-wise kappa also reflected substantial agreement. The study shows that telephonic assessment of activities of daily living with the BI in moderate to severely disabled stroke patients is valid and reliable compared to face-to-face assessment. Our study shows that telephonic assessment requires smaller sample size compared to face-to-face assessment of BI.
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Mahoney FI, Barthel DW (1965) Functional evaluation: the Barthel Index. Md State Med J 14:61–65
Title of measure: Barthel Index of Activities of Daily Living (ADLs). https://www.rtog.org/LinkClick.aspx?fileticket=WFmhDMpabFE%3D&tabid=118. 3 December 2010. Accessed Sept 10, 2016
Wade DT, Hewer RL (1987) Functional abilities after stroke: measurement, natural history and prognosis. J Neurol Neurosurg Psychiatry 50:177–182
Gosman-Hedström G, Svensson E (2000) Parallel reliability of the functional independence measure and the Barthel ADL Index. Disabil Rehabil 22:702–715
Wolfe CD, Taub NA, Woodrow EJ, Burney PJ (1991) Assessment of scales of disability and handicap for stroke patients. Stroke J Cereb Circ 22:1242–1244
Richards SH, Peters TJ, Coast J, Gunnell DJ, Darlow MA, Pounsford J (2000) Inter-rater reliability of the Barthel ADL Index: how does a researcher compare to a nurse? Clin Rehabil 14:72–78
van Bennekom CA, Jelles F, Lankhorst GJ, Bouter LM (1996) Responsiveness of the rehabilitation activities profile and the Barthel Index. J Clin Epidemiol 49:39–44
Hsueh IP, Lee MM, Hsieh CL (2001) Psychometric characteristics of the Barthel activities of daily living Index in stroke patients. J Formos Med Assoc Taiwan Yi Zhi 100:526–532
Della Pietra GL, Savio K, Oddone E, Reggiani M, Monaco F, Leone MA (2011) Validity and reliability of the Barthel Index administered by telephone. Stroke J Cereb Circ 42:2077–2079
Shinar D, Gross CR, Bronstein KS, Licata-Gehr EE, Eden DT, Cabrera AR, Fishman IG, Roth AA, Barwick JA, Kunitz SC (1987) Reliability of the activities of daily living scale and its use in telephone interview. Arch Phys Med Rehabil 68:723–728
Yeo D, Faleiro R, Lincoln NB (1995) Barthel ADL Index: a comparison of administration methods. Clin Rehabil 9:34–39
Korner-Bitensky N, Wood-Dauphinee S (1995) Barthel Index information elicited over the telephone. Is it reliable? Am J Phys Med Rehabil Assoc Acad Physiatr 74:9–18
Prasad K, Sharma A, Garg A et al (2014) Intravenous autologous bone marrow mononuclear stem cell therapy for ischemic stroke: a multicentric, randomized trial. Stroke J Cereb Circ 45:3618–3624
Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174
Rumsey DJ. How to interpret correlation coefficient R. Dummies a Wiley Brand. http://www.dummies.com/how-to/content/how-to-interpret-a-correlation-coefficient-r. Accessed Sept 10, 2016
Languages of India. Wikipedia. https://en.wikipedia.org/wiki/Languages_of_India. Accessed Sept 10, 2016
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KP—conceptualized the study, drafted and written the final manuscript, AK—helped in writing the manuscript and did statistical analysis, SM—helped in statistical analysis and data extraction, AKY—conducted statistical tests and helped in data interpretation, PK—data extraction and designing the manuscript
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This study was approved by each centre's local institutional ethics committee.
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Prasad, K., Kumar, A., Misra, S. et al. Reliability and validity of telephonic Barthel Index: an experience from multi-centric randomized control study. Acta Neurol Belg 118, 53–59 (2018). https://doi.org/10.1007/s13760-017-0843-2
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DOI: https://doi.org/10.1007/s13760-017-0843-2