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Derivation and Validation of a Modified Short Form of the Stroke Impact Scale

Lookup NU author(s): Emerita Professor Helen Rodgers



This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


Background-The Stroke Impact Scale (SIS) is a stroke-specific, quality of life measure recommended for research and clinical practice. Completion rates are suboptimal and could relate to test burden. We derived and validated a short form SIS (SF-SIS).Methods and Results-We examined data from the Virtual International Stroke Trial Archive, generating derivation and validation populations. We derived an SF-SIS by selecting 1 item per domain of SIS, choosing items most highly correlated with total domain score. Our validation described agreement of SF-SIS with original SIS and the SIS-16 and correlation with Barthel Index, modified Rankin Scale, National Institutes of Health Stroke Scale, and Euro-QoL 5 dimensions visual analog scales. We assessed discriminative validity (associations between SF-SIS and factors known to influence outcome [age, physiological parameters, and comorbidity]). We assessed face validity and acceptability by sharing the SF-SIS with a focus group of stroke survivors and multidisciplinary stroke healthcare staff. From 5549 acute study patients (mean age 68.5 [SD 13] years, mean SIS 64 [SD 32]) and 332 rehabilitation patients (mean age 65.7 [SD 11] years, mean SIS 61 [SD 11]), we derived an 8-item SF-SIS that demonstrated good agreement with original SIS and good correlation with our chosen functional and quality of life measures (all rho>0.70, P<0.0001). Significant associations were seen with our chosen predictors of stroke outcome in the acute group (P<0.0001). The focus group agreed with the choice of items for SF-SIS across 7 of 8 domains.Conclusions-Using multiple, complementary methods, we have derived an SF-SIS and demonstrated content, convergent, and discriminant validity. This shortened SIS should allow collection of robust quality of life data with less associated test burden.

Publication metadata

Author(s): MacIsaac R, Ali M, Peters M, English C, Rodgers H, Jenkinson C, Lees KR, Quinn TJ, VISTA Collaboration

Publication type: Article

Publication status: Published

Journal: Journal of the American Heart Association

Year: 2016

Volume: 5

Issue: 5

Online publication date: 20/05/2016

Acceptance date: 02/04/2016

Date deposited: 07/08/2017

ISSN (print): 2047-9980

Publisher: Wiley-Blackwell Publishing Ltd.


DOI: 10.1161/JAHA.115.003108


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