Validation of the 8-item questionnaire for verifying stroke free status with and without pictograms in three West African languages

•This study seeks to evaluate the performance of the 8-item QVSFS in Akan, Yoruba and Hausa for the ascertainment of stroke-free status among West Africans.•A line pictogram has been developed to determine its impact on the relative performance of the 8-item QVSFS.

BackgroundThe Questionnaire for Verifying Stroke-free Status (QVSFS) has been validated in Western populations as a method for verifying stroke-free status in participants of clinical, epidemiological and genetic studies. This instrument has not been validated in low-income settings where populations have limited knowledge of stroke symptoms and literacy levels are low.ObjectiveTo simultaneously validate the 8-item QVSFS in 3 languages spoken in West Africa (Yoruba, Hausa and Akan) for ascertainment of stroke-free status of control subjects in SIREN.MethodsUsing a cross-sectional study design, 100 participants each from the 3 linguistic groups will be consecutively recruited from neurology and general medicine clinics of 5 tertiary referral hospitals in Nigeria and Ghana. Ascertainment of stroke status will be determined by neurologists using structured neurological examination, review of case records and neuro-imaging (Gold standard). The relative performance of QVSFS without and with pictures of stroke symptoms (pictograms) will be assessed using sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).ConclusionThe proposed study will provide valuable data on the performance of the QVSFS in resource-limited settings.