Objective To assess the appropriateness of Barthel Index (BI) and Modified Rankin Scales (MRS) used as long-term outcome measures in a stroke data register and to investigate the correlation between cutoff points of the two scales in different stroke patients with and without disability. Methods Nine hundred and twelve patients were registered prospectively. BI and MRS were evaluated at the end of 1, 3, 6 and 12 months after stroke onset. The distribution, ceiling effects and floor effects of the two scales were evaluated. A logistic regression model was established to investigate correlation of cutoff points of BI and MRS. Results There were a total of 2 829 evaluation points of BI and MRS. The percentages of patients reaching the maximum scores of BI at the end of 3, 6 and 12 months (54.8％, 62.2％ and 68.3％, respectively) were higher than those of MRS. There was significant correlation between the two scales (Spearman’s correlation coefficient 0.887, P＜0.05), when MRS scores of ≤1 and ≤2 were taken as cutoff points, the corresponding cutoff points of BI score were ≥90 and ≥85, respectively. Conclusions BI has significant ceiling effects when used as long-term outcome measurement in a stroke data register. There was significant correlation between BI and MRS scores. In future clinical studies, an MRS score ≤2 or BI score ≥85 could be used as cutoff points in predicting stroke patients with and without disability.
ObjectiveTo systematically evaluate the types of interventions, the application of outcome measures, and the reporting quality of randomized controlled trials (RCTs) in medical education, and to provide evidence-based support for improving study design and optimizing evaluation frameworks in this field. MethodsPubMed, Embase, CBM, CNKI, and WanFang Data databases were systematically searched from inception to April 2025. A total of 340 medical education RCTs were included through stepwise random sampling and screening. Descriptive statistics were used to summarize publication characteristics, participant types, intervention classifications, and distributions of outcome measures. Regression analysis was conducted to identify factors associated with reporting quality. ResultsRCTs of medical education were included, with the majority originating from China (n=284). Participants were predominantly undergraduate clinical medical students, and sample sizes were mainly small to moderate (20-60 participants). Cognitive-oriented interventions accounted for the largest proportion (76.03%), and control group designs were highly homogeneous. A total of 843 outcome measures were identified, primarily focusing on short-term outcomes such as theoretical knowledge and clinical skills, whereas long-term outcomes (e.g., behavioral changes and patient-related outcomes) were markedly underrepresented. Overall reporting quality was suboptimal, with inadequate implementation of blinding and allocation concealment. Multivariable regression analysis indicated that explicit specification of primary outcomes, study region, and intervention type were significant determinants of reporting quality. ConclusionSignificant gaps remain in intervention design, outcome selection, and methodological reporting in medical education RCTs, particularly in the development of long-term outcome measures and adherence to key methodological standards. This study systematically synthesizes existing evidence and identifies key factors influencing reporting quality, providing empirical support for improving RCT design, standardizing outcome measure systems, and enhancing methodological rigor in medical education research. The findings also offer important implications for educational practice and policy-making.