A validation study of the Bahasa Malaysia version of the National Institute of Health Stroke Scale

Najma Kori; Wan Asyraf Wan Zaidi; Rabani Remli; Azman Ali Raymond; Norlinah Mohamed Ibrahim; Hui Jan Tan; Syed Zulkifli Syed Zakaria; Zhe Kang Law; Kartini Ahmad; Wan Nafisah Wan Yahya; Ramesh Sahathevan

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A validation study of the Bahasa Malaysia version of the National Institute of Health Stroke Scale

Author: Najma Kori ¹ ; Wan Asyraf Wan Zaidi ¹ ; Rabani Remli ¹ ; Azman Ali Raymond ¹ ; Norlinah Mohamed Ibrahim ¹ ; Hui Jan Tan ¹ ; Syed Zulkifli Syed Zakaria ² ; Zhe Kang Law ¹ ; Kartini Ahmad ³ ; Wan Nafisah Wan Yahya ¹ ; Ramesh Sahathevan ^{4
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Author Information

1. Department of Medicine
2. Department of Clinical Epidemiology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur
3. Department of Audiology and Speech Sciences, Faculty of Allied Health Sciences, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
4. Internal Medicine Service, Ballarat Health Services, Ballarat
5. 5 Florey Institute of Neuroscience and Mental Health, Melbourne
6. 6 Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
Publication Type:Journal Article
Keywords: NIHSS; stroke; Bahasa Malaysia; validation
From:Neurology Asia 2018;23(3):225-232
CountryMalaysia
Language:English
Abstract: Background & Objectives: The National Institute of Health Stroke Scale (NIHSS) provides a valid and quick assessment of stroke severity in hyperacute stroke management. Stroke patients who are eligible for reperfusion therapy require prompt assessment. There is no validated Bahasa Malaysia (BM) version of the NIHSS that allows easier assessment by BM-speaking health professionals. This study aimed to translate and validate a BM version of the NIHSS. Methods: The English NIHSS was translated to BM, then back translated to ensure linguistic accuracy. We also adapted the language assessment of the NIHSS to be more culturally appropriate. Training and certification videos were downloaded from the NIH website and dubbed into BM. We determined intra-class correlation and unweighted kappa as the best measure of reliability. Median scores were used in the analysis for language items. Results: One hundred and one raters participated in the test-retest reliability study. Agreement between the original NIHSS and our translated version of the BM-NIHSS was good (ICC = 0.738, 95% CI: 0.611 to 0.823). Fair to moderate agreement was found on item-by-item analysis (unweighted κ=0.20-0.50) despite high observed agreement. Fifty patients participated in the language assessment arm. Scores were better in BM for reading, naming objects and repetition (Mdn = 100, p < 0.001). There was no difference in the median scores for the description component. Conclusions: The BM-NIHSS is a valid translation of the NIHSS, and may be used in clinical practice by BM-speaking healthcare professionals.
Full text:7.2018.my004.pdf