Health of the Nation Outcome Scales

Gowers, S.G., Harrington, R.C., Whitton, A., Lelliott, P., Beevor, A., Wing, J., and Jezzard, R. (1999) Brief scale for measuring the outcomes of emotional and behavioural disorders in children. Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA). Br ] Psychiatry 174 413—416. 

Outcome measures, e.g. Health of the Nation Outcome Scales (HONOS) - rates symptoms and problems, often linked to PbR. HONOS is usually completed at initial assessment, transfer between services, and discharge. 

HONOS (Health Of the Nation Outcome Scales scores symptoms and disability)... 

The primary outcome of NINDS part I was early clinical improvement by 24 hours, dehned as complete resolution of the stroke symptoms or an improvement in the National Instimte of Health Stroke Scale (NIHSS) score by 4 or more points. There was no difference in early clinical improvement in the rt-PA group compared to the placebo group (relative risk 1.2, 95% Cl 0.9-1.6, p = 0.21). 

The severity of the neurological deficit at the time of stroke onset is a major predictor of stroke outcome. In an analysis of the placebo-treated patients in the National Institute of Neurological Disorders and Stroke (NINDS) recombinant tissue-plasminogen activator (rt-PA) study, the best acute predictor of a poor outcome at 1 year was an National Institute of Health Stroke Scale (NIHSS) score >17 for patients over 70 years. These criteria had a high specificity (98%), but sensitivity was only 31%. The low sensitivity of the acute NIHSS score alone in predicting... 

Stroke outcomes are measured based on the neurologic status and functioning of the patient after the acute event. The National Institutes of Health Stroke Scale (NIHSS) is a measure of daily functioning and is used to assess patient status following a stroke. 

The FASTER randomized controlled pilot trial studied the benefit of clopidogrel versus placebo and simvastatin versus placebo initiated within 24-hours of symptom onset in patients with TIA or minor stroke, all of whom were treated with aspirin (Kennedy et al. 2007). The primary outcome was any stroke (ischemic and hemorrhagic) within 90 days. Minor stroke was defined as a score < 3 on the National Institutes of Health Stroke Scale (NIHSS) at the time of randomization and TIA was defined in the usual way. In addition, patients were excluded if they did not have weakness or speech disturbance or if symptom duration was less than five minutes. 

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