The NIHSS is a valuable tool for assessing stroke severity, but its widespread use in clinical practice requires understanding its development history, clinimetric properties, and proper bedside administration.

Using the National Institutes of Health Stroke Scale: A Cautionary Tale

The National Institutes of Health Stroke Scale certification DVD is robust and surprisingly reliable for general users across multiple venues, with similar results between specialists and noncertified raters.

National Institutes of Health Stroke Scale Certification Is Reliable Across Multiple Venues

Video training and certification effectively standardizes the use of the NIH Stroke Scale, improving reliability in multicenter studies.

Improved Reliability of the NIH Stroke Scale Using Video Training

Mastery of the National Institutes of Health Stroke Scale scoring rules remains stable over time, and recertification intervals should be lengthened, with mandatory retraining only needed after unsuccessful recertifications.

Training and Certifying Users of the National Institutes of Health Stroke Scale

The mNIHSS, a modified version of the original NIHSS, shows good reliability and responsiveness in measuring acute stroke deficits in clinical trials, with potential for fewer patients and simpler use in clinical research trials.

A Modified National Institutes of Health Stroke Scale for Use in Stroke Clinical Trials: Preliminary Reliability and Validity

The new NIHSS certification DVD is reliable for NIHSS certification, with similar reliability scores among specialists and centers, and no differences between nurses and physicians.

NIHSS Training and Certification Using a New Digital Video Disk Is Reliable

The Italian translation of the NIHSS scale, supervised by experienced vascular neurologists, did not influence its clinimetric characteristics and supports its implementation in languages other than English.

Development of the Italian Version of the National Institutes of Health Stroke Scale: It-NIHSS

Our three-stage review process effectively selects reliable, valid, and responsive outcome measures for stroke rehabilitation studies.

Outcome Measurement in Stroke: A Scale Selection Strategy

The NIHSS is generally reliable for individual stroke elements, but overall scoring is inconsistent, potentially impacting clinical trial results.

NIH Stroke Scale Reliability in Ratings from a Large Sample of Clinicians

A multicenter clinical trial-based educational and certification program effectively enhances physician expertise and ensures reliability of outcome measures in acute ischemic stroke trials.

Ensuring Reliability of Outcome Measures in Multicenter Clinical Trials of Treatments for Acute Ischemic Stroke: The Program Developed for the Trial of ORG 10172 in Acute Stroke Treatment (TOAST)

Novice nurse users of the NIHSS-PE can accurately score stroke severity as well as trained users, making it a useful tool for facilities pursuing Acute Stroke-Ready certification.

National Institutes of Health Stroke Scale in Plain English Is Reliable for Novice Nurse Users with Minimal Training

The CPSS is a reliable and valid tool for identifying stroke patients who are candidates for thrombolytic therapy, especially those with anterior circulation strokes.

Cincinnati Prehospital Stroke Scale: reproducibility and validity.

Stroke scales, such as the NIHSS, mRS, and BI, can improve clinicians' understanding of stroke recovery and decision-making in acute stroke trials.

Clinical interpretation and use of stroke scales

The 15-item neurologic examination stroke scale shows high interrater reliability and test-retest reliability, with acceptable correlations to infarction size and clinical outcome in acute stroke therapy trials.

Measurements of acute cerebral infarction: a clinical examination scale.

The modified Rankin Scale (mRS) has been a reliable and valid outcome scale for acute stroke trials, but improvements in training and reproducibility are needed for optimal use in future trials.

Evolution of the Modified Rankin Scale and Its Use in Future Stroke Trials.

The modified NIHSS (mNIHSS) is a more reliable stroke scale, minimizing redundancy and eliminating poorly reliable items, making it the primary clinical and research scale for clinical and research purposes.

The Modified National Institutes of Health Stroke Scale: its Time has Come

Stroke and neuroscience nurses perceive certification as important for recognition of specialization, personal achievement, and professional accomplishment.

Results From the Perceived Value of Certification Tool-12 Survey: Analysis of the Perceived Value of Certification Among Stroke and Neuroscience Nurses

The Stroke Impact Scale (SIS) is a self-reported questionnaire that evaluates disability and health-related quality of life after stroke in eight domains, including strength, memory, thinking, emotion, communication, daily living, mobility, hand function, and participation.

Stroke Impact Scale

The Berg Balance Scale is a reliable and valid measure of balance impairment in poststroke assessment, but may need to be used in conjunction with other balance measures due to floor and ceiling effects.

Usefulness of the Berg Balance Scale in Stroke Rehabilitation: A Systematic Review

Death certification of stroke is inaccurate, with a 40% false negative rate and 21% false positive rate, questioning the accuracy of studies relying on this source of information.

Accuracy of death certification of stroke: the Framingham Study.

These studies suggest that NIHSS certification, including through video training and DVDs, is reliable and effective for both specialists and general users, with stable mastery over time and successful implementation in multiple languages.