Browsing by Author "Agunloye A."

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    Development and Reliability of a User-Friendly Multicenter Phenotyping Application for Hemorrhagic and Ischemic Stroke
    (Elsevier Inc., 2017) Owolabi M.; Ogbole G.; Akinyemi R.; Salaam K.; Akpa O.; Mongkolwat P.; Omisore A.; Agunloye A.; Efidi R.; Odo J.; Makanjuola A.; Akpalu A.; Sarfo F.; Owolabi L.; Obiako R.; Wahab K.; Sanya E.; Adebayo P.; Komolafe M.; Adeoye A. M.; Fawale M. B.
    "Background: Annotation and Image Markup on ClearCanvas Enriched Stroke– phenotyping Software (ACCESS) is a novel stand-alone computer software application that allows the creation of simple standardized annotations for reporting brain images of all stroke types. We developed the ACCESS application and determined its inter-rater and intra-rater reliability in the Stroke Investigative Research and Educational Network (SIREN) study to assess its suitability for multicenter studies. Methods: One hundred randomly selected stroke imaging reports from 5 SIREN sites were re-evaluated by 4 trained independent raters to determine the inter-rater reliability of the ACCESS (version 12.0) software for stroke phenotyping. To determine intra-rater reliability, 6 raters reviewed the same cases previously reported by them after a month of interval. Ischemic stroke was classified using the Oxfordshire Community Stroke Project (OCSP), Trial of Org 10172 in Acute Stroke Treatment (TOAST), and Atherosclerosis, Small-vessel disease, Cardiac source, Other cause (ASCO) protocols, while hemorrhagic stroke was classified using the Structural lesion, Medication, Amyloid angiopathy, Systemic disease, Hypertensive angiopathy and Undetermined (SMASH-U) protocol in ACCESS. Agreement among raters was measured with Cohen’s kappa statistics. Results: For primary stroke type, inter-rater agreement was .98 (95% confidence interval [CI], .94-1.00), while intra-rater agreement was 1.00 (95% CI, 1.00). For OCSP subtypes, inter-rater agreement was .97 (95% CI, .92-1.00) for the partial anterior circulation infarcts, .92 (95% CI, .76-1.00) for the total anterior circulation infarcts, and excellent for both lacunar infarcts and posterior circulation infarcts. Intra-rater agreement was .97 (.90-1.00), while inter-rater agreement was .93 (95% CI, .84-1.00) for TOAST subtypes. Inter-rater agreement ranged between .78 (cardioembolic) and .91 (large artery atherosclerotic) for ASCO subtypes and was .80 (95% CI, .56-1.00) for SMASH-U subtypes. Conclusion: The ACCESS application facilitates a con cordant and reproducible classification of stroke subtypes by multiple investigators, making it suitable for clinical use and multicenter research.
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    Multilingual Validation of the Questionnaire for Verifying Stroke-Free Status in West Africa
    (Lippincott Williams & Wilkins, 2016) Sarfo F.; Gebregziabher M.; Ovbiagele B.; Akinyemi R.; Owolabi L.; Obiako R.; Akpa O.; Armstrong K.; Akpalu A.; Adamu S.; Obese V.; Boa-Antwi N.; Appiah L.; Arulogun O.; Mensah Y.; Adeoye A.; Tosin A.; Adeleye O.; Tabi-Ajayi E.; Phillip I.; Sani A.; Isah S.; Tabari N.; Mande A.; Agunloye A.; Ogbole G.; Akinyemi J.; Laryea R.; Melikam S.; Uvere E.; Adekunle G.; Kehinde S.; Azuh P.; Dambatta A.; Ishaq N.; Saulson R.; Arnett D.; Tiwari H.; Jenkins C.; Lackland D.; Owolabi M.
    Background and Purpose—The Questionnaire for Verifying Stroke-Free Status (QVSFS), a method for verifying stroke-free status in participants of clinical, epidemiological, and genetic studies, has not been validated in low-income settings where populations have limited knowledge of stroke symptoms. We aimed to validate QVSFS in 3 languages, Yoruba, Hausa and Akan, for ascertainment of stroke-free status of control subjects enrolled in an on-going stroke epidemiological study in West Africa. Methods—Data were collected using a cross-sectional study design where 384 participants were consecutively recruited from neurology and general medicine clinics of 5 tertiary referral hospitals in Nigeria and Ghana. Ascertainment of stroke status was by neurologists using structured neurological examination, review of case records, and neuroimaging (gold standard). Relative performance of QVSFS without and with pictures of stroke symptoms (pictograms) was assessed using sensitivity, specificity, positive predictive value, and negative predictive value. Results—The overall median age of the study participants was 54 years and 48.4% were males. Of 165 stroke cases identified by gold standard, 98% were determined to have had stroke, whereas of 219 without stroke 87% were determined to be stroke-free by QVSFS. Negative predictive value of the QVSFS across the 3 languages was 0.97 (range, 0.93–1.00), sensitivity, specificity, and positive predictive value were 0.98, 0.82, and 0.80, respectively. Agreement between the questionnaire with and without the pictogram was excellent/strong with Cohen k=0.92. Conclusions—QVSFS is a valid tool for verifying stroke-free status across culturally diverse populations in West Africa.