Improving the reliability of stroke subgroup classification using the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) criteria

Stroke; a Journal of Cerebral Circulation
L B GoldsteinR D Horner

Abstract

We sought to improve the reliability of the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification of stroke subtype for retrospective use in clinical, health services, and quality of care outcome studies. The TOAST investigators devised a series of 11 definitions to classify patients with ischemic stroke into 5 major etiologic/pathophysiological groupings. Interrater agreement was reported to be substantial in a series of patients who were independently assessed by pairs of physicians. However, the investigators cautioned that disagreements in subtype assignment remain despite the use of these explicit criteria and that trials should include measures to ensure the most uniform diagnosis possible. In preparation for a study of outcomes and management practices for patients with ischemic stroke within Department of Veterans Affairs hospitals, 2 neurologists and 2 internists first retrospectively classified a series of 14 randomly selected stroke patients on the basis of the TOAST definitions to provide a baseline assessment of interrater agreement. A 2-phase process was then used to improve the reliability of subtype assignment. In the first phase, a computerized algorithm was developed to assign the TOAST diagnosti...Continue Reading

Citations

Jan 13, 2005·Journal of Neurology·J F VaronaJ A Molina
Sep 26, 2012·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Giovanni CorsoMassimo Veronese Morosini
Apr 29, 2010·Current Neurology and Neuroscience Reports·Hakan Ay
Dec 14, 2002·Journal of the Neurological Sciences·Joong-Seok KimJong-Won Kim
Nov 26, 2003·Lancet Neurology·David J Blacker
May 18, 2012·The New England Journal of Medicine·Stephen M Davis, Geoffrey A Donnan
Jul 14, 2011·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·V ReyP Michel
Sep 29, 2011·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·H S NamJ H Heo
Jul 14, 2012·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·S HorstmannR Veltkamp
Jul 19, 2006·Journal of Neurology, Neurosurgery, and Psychiatry·Y IguchiT Inoue
May 13, 2008·Journal of Health Care for the Poor and Underserved·Rebecca HanrattyUNKNOWN Latino Using Cardio Health Actions to Reduce Risk study investigators
Apr 6, 2006·Internal Medicine·Yuichiro InatomiMakoto Uchino
Mar 10, 2008·Nihon Naika Gakkai zasshi. The Journal of the Japanese Society of Internal Medicine·Norihiro Suzuki
Oct 29, 2014·Nature Reviews. Neurology·Hugh S Markus, Steve Bevan
Jun 26, 2014·The New England Journal of Medicine·David J GladstoneUNKNOWN EMBRACE Investigators and Coordinators
Mar 3, 2011·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Rosalba PatellaMaurizia Rasura
Jul 22, 2011·Stroke Research and Treatment·Sofia MarkoulaAthanassios P Kyritsis
Nov 12, 2014·Clinical Drug Investigation·Antonio SiniscalchiLuca Gallelli
Jun 21, 2013·Rinshō shinkeigaku = Clinical neurology·Jyunichi UemuraKazumi Kimura
May 23, 2015·The International Journal of Neuroscience·Yi-Jun ShenLe Zhang
Dec 9, 2014·Neurologia i neurochirurgia polska·Alicja WawrzynekGrażyna Michałowska-Wender
Oct 15, 2013·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Shoji HondaMakoto Uchino
Nov 17, 2012·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Junichi UemuraJunya Aoki
Dec 19, 2003·Annals of Neurology·José CastilloAntonio Dávalos
Oct 23, 2010·Neurología : publicación oficial de la Sociedad Española de Neurología·B TarazonaJ Pérez
Jun 24, 2010·Journal of the Neurological Sciences·Kazumi KimuraShinji Yamashita
Sep 1, 2009·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Paolo FalsettiLucia Lenzi
Aug 18, 2009·Pathophysiology : the Official Journal of the International Society for Pathophysiology·Kavian Ghandehari
Apr 30, 2008·Metabolism: Clinical and Experimental·Antonio PintoGiuseppe Licata
Nov 6, 2015·Neurology·Rajbeer S SanghaShyam Prabhakaran
Jun 26, 2007·Journal of the Neurological Sciences·Yasuyuki IguchiTakeshi Inoue
Aug 11, 2007·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Nikola SpriggUNKNOWN TAIST Investigators
Feb 3, 2007·Journal of the Neurological Sciences·Yasuyuki IguchiTakeshi Inoue
Nov 22, 2005·Radiologic Clinics of North America·Mark E Mullins
Oct 2, 2007·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·James F MeschiaUNKNOWN Siblings with Ischemic Stroke Study (SWISS) Investigators
Oct 30, 2013·International Journal of Stroke : Official Journal of the International Stroke Society·Rita KrishnamurthiUNKNOWN ARCOS IV Programme Group

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