HomeStrokeVol. 41, No. 12Response to Letter by Quinn et al Free AccessLetterPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessLetterPDF/EPUBResponse to Letter by Quinn et al Jeffrey L. Saver, MD, Bogdan Filip, MD, Scott Hamilton, PhD, Anna Yanes, RN, Sharon Craig, RN, Michelle Cho, BS, Robin Conwit, MD and Sidney Starkman, MD Jeffrey L. SaverJeffrey L. Saver For the FAST-MAG Investigators and Coordinators Search for more papers by this author , Bogdan FilipBogdan Filip For the FAST-MAG Investigators and Coordinators Search for more papers by this author , Scott HamiltonScott Hamilton For the FAST-MAG Investigators and Coordinators Search for more papers by this author , Anna YanesAnna Yanes For the FAST-MAG Investigators and Coordinators Search for more papers by this author , Sharon CraigSharon Craig For the FAST-MAG Investigators and Coordinators Search for more papers by this author , Michelle ChoMichelle Cho For the FAST-MAG Investigators and Coordinators Search for more papers by this author , Robin ConwitRobin Conwit For the FAST-MAG Investigators and Coordinators Search for more papers by this author and Sidney StarkmanSidney Starkman For the FAST-MAG Investigators and Coordinators Search for more papers by this author Originally published28 Oct 2010https://doi.org/10.1161/STROKEAHA.110.591214Stroke. 2010;41:e603Other version(s) of this articleYou are viewing the most recent version of this article. Previous versions: October 28, 2010: Previous Version 1 Response:We are grateful for the interest of Dr Quinn et al1 in our work and are pleased that none of the criticisms advanced in their letter apply to the Rankin focused assessment (RFA) that was the subject of our report.The RFA does not seek to reduce the time spent in deriving a Rankin score. By requiring formal assessment of several domains of function, the RFA actually precludes overly rapid, snap judgments that can occur with holistic assessments.The RFA is not inflexibly reductionist, although it is operationalized. For many patients, use of the RFA forces a multi-domain assessment that structurally counteracts overly reductionist tendencies that can occur in less ordered encounters.The design of the RFA recognizes that patients may occasionally struggle to answer a categorical question regarding their capacities and activities. In such instances, the RFA takes the approach recommended by Quinn et al,1 explicitly directing raters to obtain information from all available sources, including other informants and the medical record, to arrive at a final assessment regarding each line item.We concur with Quinn et al1 that additional studies comparing the RFA against traditional and alternative Rankin assessment techniques would be most welcome. We also agree that additional benefits may be gained by combining a focused assessment with central adjudicator panel scoring, but we emphasize the importance of making available to the central review committee not only the video of an interview with a single patient informant but also all other available salient data, including physician, nursing, and rehabilitation therapist assessments in the medical record, the concurrent neurological examination, and interviews with family and caretakers.DisclosureNone.1 Quinn TJ, McArthur K, Dawson J, Walters MR, Lees KR. Reliability of structured modified Rankin scale assessment. Stroke. 2010; 41: e602.LinkGoogle Scholar Previous Back to top Next FiguresReferencesRelatedDetails December 2010Vol 41, Issue 12 Advertisement Article InformationMetrics https://doi.org/10.1161/STROKEAHA.110.591214 Originally publishedOctober 28, 2010 PDF download Advertisement