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The Burden of Stroke Scale (BOSS) provided valid, reliable, and responsive score estimates of functioning and well-being during the first year of recovery from stroke

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Abstract

Objectives

To examine the reliability, validity, and responsiveness of the Burden of Stroke Scale (BOSS).

Study design

A prospective cohort of stroke survivors were assessed at 3 (T1, T2), 6 (T3), and 12 (T4) months post onset (MPO) of stroke. Test-retest reliability was evaluated by calculating intra-class correlation coefficients (ICCs) between T1 and T2 scale scores. Convergent validity was evaluated by calculating Pearson product moment correlation coefficients between T1 BOSS, Stroke Impact Scale and MOS SF-36 scale scores assessing similar health concepts. Responsiveness was evaluated using a repeated measures ANOVA and the linear trend test in the full study sample and by calculating standardized response means (SRM) and a probability of change statistic, \( \hat{p} \) between T1, T3, and T4 scale scores in participants demonstrating change on external criteria.

Results

ICCs ranged from 0.78 to 0.94. Pearson coefficients ranged from −0.57 to −0.86. Moderate to high responsiveness estimates were obtained for 9 of 12 subscales with SRM (\( \hat{p} \)) values ranging from .497 (.690) to 1.161 (.877). Composite scale SRM (\( \hat{p} \)) values ranged from .661 (.746) to 1.192 (.883).

Conclusions

The BOSS provided valid and reliable score estimates that were responsive to positive changes in functioning and well-being during the first year of recovery from stroke.

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Notes

  1. A standardized performance-based measure requiring auditory comprehension of increasingly longer sentences comprised of from 3 (e.g., touch the red square) to 8 (e.g., put the little red square to the left of the big green circle) non-redundant linguistic elements.

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Acknowledgements

This work was supported by the Veterans Health Administration’s Rehabilitation Research and Development Service, and the VA Pittsburgh Healthcare System’s Geriatric Research Education and Clinical Center. The authors wish to acknowledge the assistance of Mary Ann Oakley and Marina Blocher of the VA Pittsburgh Healthcare System, Pittsburgh, PA; Lawrence Wexler, and Carol Barch, of the UPMC Stroke Institute, Pittsburgh, PA; Margaret Reidy, and Lynn O’Donnel, of the UPMC Rehabilitation Institute, Pittsburgh, PA; William Connor of the UPMC Passavant Hospital, Pittsburgh PA; Steve Larson of the Carl T. Hayden VA Medical Center, Phoenix AZ; Rosalea Cameron, Sandra Wright and Christina Nessler of VA Salt Lake City Healthcare System, Salt Lake City, UT; Janet Woodruff of the University of Utah Stroke Center.

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Authors and Affiliations

  1. Geriatric Research Education & Clinical Center, VA Pittsburgh Healthcare System, 7180 Highland Drive, Pittsburgh, PA, 15206, USA

    Patrick J. Doyle, Malcolm R. McNeil & William D. Hula

  2. Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA, USA

    Patrick J. Doyle, Malcolm R. McNeil & William D. Hula

  3. Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA

    James E. Bost

  4. Carl T. Hayden VA Medical Center, Phoenix, AZ, USA

    Katherine B. Ross

  5. VA Salt Lake City Healthcare System, Salt Lake City, UT, USA

    Julie L. Wambaugh

  6. Novum Pharmaceutical Research Services, Pittsburgh, PA, USA

    Joseph M. Mikolic

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  1. Patrick J. Doyle
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  2. Malcolm R. McNeil
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Correspondence to Patrick J. Doyle.

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Doyle, P.J., McNeil, M.R., Bost, J.E. et al. The Burden of Stroke Scale (BOSS) provided valid, reliable, and responsive score estimates of functioning and well-being during the first year of recovery from stroke. Qual Life Res 16, 1389–1398 (2007). https://doi.org/10.1007/s11136-007-9247-8

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