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Departments of Neurology and Neurosurgery, McGill University, Montreal, Quebec (Drs. Côté and Wolfson)
Departments of Epidemiology and Biostatistics (Drs. Battista and Wolfson), McGill University, Montreal, Quebec
Divisions of Neurology, Montreal General Hospital, Montreal, Quebec (Dr. Côté)
Clinical Epidemiology, Montreal General Hospital, Montreal, Quebec (Drs. Côté and Battista, Ms. Boucher, and Ms. Adam)
Investigative Stroke Unit, University Hospital, London, Ontario, Canada (Dr. Hachinski).
The Canadian Neurological Scale (CNS) was designed to monitor mentation and motor functions in stroke patients. We assessed its validity and reliability on a group of 157 patients with a diagnosis of acute cerebrovascular accident. We determined validity by (1) correlating scale items and total score with the standard neurologic examination; (2) exploring the scale's predictive power with different end points at 6 months—the initial CNS was a significant predictor of outcome; (3) showing that the CNS had higher correlation coefficients with the initial neurologic examination than the Glasgow Coma Scale; and (4) assessing the responsiveness of the scale to change in the neurologic status of stroke patients. Interobserver reliability, measured by kappa statistics on each scale item, was good. Accordingly, we established the validity and reliability of the CNS for its use in clinical studies and in the care of stroke patients.
Address correspondence and reprint requests to Dr. Côté, Division of Clinical Epidemiology, Montreal General Hospital, 1650 Cedar Avenue, Montreal, PQ H3G 1A4, Canada.
Supported in part by the Fonds de la recherche en santé du Québec (FRSQ), and by the Québec Heart Foundation. Dr. Battista is a Research Scholar of the National Health Research and Development Program, Ottawa. Dr. Hachinski is a Career Investigator of the Heart and Stroke Foundation of Ontario.
Received August 31, 1988. Accepted for publication in final form November 28, 1988.
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