ESOC 2021 | Assessing the performance of the modified rankin scale in stroke trials

Jesse Dawson, MD, Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, UK, discusses the performance and validity of the modified rankin scale (mRS) used to assess the extent of disability in patients after stroke. Multiple studies have investigated whether the scale effectively measures functional recovery after stroke, and how it correlates with other relevant measures like resource utilization in hospitals and quality of life. Prof. Dawson highlights the strengths of the mRS, specifically its ability to measure the breadth of recovery following stroke. However, this may be limited by its inability to inform on the smaller differences in outcomes. A further drawback is the reliability of the scale, due to disagreements between physicians on a patient’s score. Although other scales exist, these do not perform as well as the mRS; for example, the Barthel Index (BI) tends to have a ‘floor and ceiling effect’, and other less used scales may have poor reliability due to unfamiliarity. This interview took place at the European Stroke Organisation Conference (ESOC), 2021.