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Neurology India, Vol. 54, No. 3, July-September, 2006, pp. 316 Letter To Editor Is the knowledge about stroke among Indians poor? Nehra Ashima Clinical Psychology, Neuroscience Centre, AIIMS, New Delhi - 110 029 Date of Acceptance: 04-Aug-2006 Code Number: ni06104 Sir, The paper authored by Pandian et al stimulated my curiosity.[1] I was especially intrigued by the questionnaire which was used for the study. The questionnaire was adapted and modified from a previous survey conducted among general public in Northwest India but there was no mention of standardization with reliability and validity. Before adapting a questionnaire one needs to translate it and back translate the same to know which questions are sensitive to assessing what the original questionnaire proposed to assess. A copy of the new questionnaire in this regard would have been helpful. Similarly the questionnaire of socio-demographic information is not clear. The educational and social structure in India is very different from the West. Hence any such information can′t be adapted in Toto from the western culture. A large percentage of the population in our country is illiterate. Hence it would be unfair to club the illiterate and up to primary category. It was not very clear in the methodology if the educational status noted was of the patient or of the relatives. What I understand is that the questionnaire was filled up by asking questions from the significant relative. Hence, the education of the patient, in such a case is not important. A self-report measure to be filled out by patients judged capable of subjectively identifying and reporting on specific information would be different from a form intended as a more objective measure, to be filled out by an individual closest to the patient.[2] The paper suffers a few flaws that the questionnaire was filled up by trained nurses and medical interns conducted a standardized structured interview with open-ended questionnaire. If any research is done with more than one rater there is always a chance of a rater over estimating or under estimating the information given to him/her. Hence an inter-rater reliability is needed along with establishing the validity of the test. Minor criticism apart, the investigators deserve congratulations and more such studies need to be done to know the sensitive areas where awareness program need to be organized. References
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