Clinical meaning of the Stroke-Adapted Sickness Impact Profile-30 and the sickness impact profile-136

Background and Propose-Handicap or health-related quality of life (HRQL) me asures are seldom used in stroke trials, although the importance of these m easures has been stressed frequently. We studied the clinical meaning of th e Stroke-Adapted Sickness Impact Profile-30 (SA-SIP30) and the original SIP 136 for use in stroke research. Methods-We included 418 patients who had had a stroke 6 months earlier. We studied the associations between the SA-SIP30 and SIP136 scores versus othe r frequently used outcome measures from the International Classification of Impairments, Disabilities, and Handicaps (ICIDH) (Barthel Index, Rankin Sc ale) and the HRQL model (health perception items, Euroqol). To interpret th e continuous SA-SIP30 and SIP136 scores, we used receiver operating charact eristic curve analysis with the aforementioned measures as external criteri a. Results-The psychosocial dimension scores of both SIP versions remained lar gely unexplained. The physical dimension and total scores of both SIP versi ons were mainly associated with the disability measures derived from the IC IDH model, as well as with the physical HRQL domains. Most patients with an SA-SIP30 total score > 33 or an SIP136 total score > 22 had poor health pr ofiles. There were no major differences between the SA-SIP30 and the SIP136 , although the SA-SIP30 scores were less skewed toward the healthier outcom es than the SIP136. Conclusions-Our study showed that (I) both SIP total scores primarily repre sent aspects of physical functioning and not HRQL; (2) both SIP versions pr ovide more clinical information than the frequently used disability measure s; and (3) the SA-SIP30 should be preferred over the SIP136.