Objective: To measure the inter-rater reliability of the interview-administered version of the Frenchay Activities Index (FAI).
Design: Comparison of FAI score on the same person when administered by two raters (mean time between interviews 15.2 days).
Subjects: Fifty-nine Oxfordshire residents who either had had a stroke (n = 35) or were the main carer (n = 24).
Results: The 95% limits of agreement for the FAI totals were –9.9 to +8.4. The kappa statistic for nine of the 15 items showed a good level of agreement between the two research interviews (0.64–0.80). The other six items showed fair or moderate strength of agreement (0.26–0.52). Three items showed significant differences between the two raters p < 0.05 (Wilcoxon's sign paired rank sum test). The mean difference between the total scores was –0.76 (95% confidence interval from –1.98 to 0.46). Spearman's rho correlation coefficient for FAI totals of rater B against A was r(59) = 0.93 (p < 0.001).
Conclusion: The FAI is a reliable tool for measuring outcome following stroke. Suggestions are made to strengthen the reliability, and consequently the validity of the measure.
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References
1.
Holbrook M, Skilbeck CE. An activities index for use with stroke patients. Age Ageing1983; 12: 166–170.
2.
Schuling J, de Haan R, Limburg M, Groenier KH. The Frenchay Activities Index: assessment of functional status in stroke patients. Stroke1993; 24: 1173–1177.
3.
Carter J, Mant J, Wade D, Winner S. Comparison of postal version of the Frenchay Activities Index with interview-administered version for use in people with stroke. Clin Rehabil1997; 11: 131–138.
4.
Wade DT, Leigh-Smith J, Langton Hewer R. Social activities after stroke: measurement and natural history using the Frenchay Activities Index. Int Rehabil Med1985; 7: 176–181.
5.
Segal ME, Schall RR. Determining functional/health status and its relation to disability in stroke survivors. Stroke1994; 25: 2391–2397.
6.
Wyller TB, Sveen U, Bautz-Holter E. The Frenchay Activities Index in stroke patients: agreement between scores by patients and by relatives. Disabil Rehabil1996; 18: 454–459.
7.
Cockburn J, Smith PT, Wade DT. Influence of cognitive function on social, domestic, and leisure activities of community-dwelling older people. Int Disabil Stud1990; 12: 169–172.
8.
Bond MJ, Harris RD, Smith DS, Clark MS. An examination of the factor structure of the Frenchay Activities Index. Disabil Rehabil1991; 14: 27–29.
9.
Bond MJ, Clark MS, Smith DS, Harris RD. Lifestyle activities of the elderly: composition and determinants. Disabil Rehabil1995; 17: 63–69.
10.
Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical agreement. Lancet1986; i: 307–310.
11.
Brennan P, Silman A. Statistical methods for assessing observer variability in clinical measures. BMJ1992; 304: 1491–1494.
12.
de Haan R, Aaronson N, Limburg M, Langton Hewer R, van Crevel H. Measuring quality of life in stroke. Stroke1993; 24: 320–327.
13.
Chong DK-H. Measurement of instrumental activities of daily living in stroke. Stroke1995; 26: 1119–1122.
14.
Altman DG. Practical statistics for medical research. London: Chapman and Hall, 1991.
15.
Mant J, Winner S, Carter J, Wade DT. Informed consent: patients' knowledge that they are participating in trial may not bias results. BMJ1997; 315: 252–253.
