The Inter-rater Variability of Clinical Assessment in Post-anoxic Myoclonus.
Details
State: Public
Version: Final published version
Serval ID
serval:BIB_B7FD1AE02250
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
The Inter-rater Variability of Clinical Assessment in Post-anoxic Myoclonus.
Journal
Tremor and other hyperkinetic movements
ISSN
2160-8288 (Electronic)
ISSN-L
2160-8288
Publication state
Published
Issued date
2017
Peer-reviewed
Oui
Volume
7
Pages
470
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Video-Audio Media
Publication Status: epublish
Publication Status: epublish
Abstract
Acute post-anoxic myoclonus (PAM) can be divided into an unfavorable (generalized/subcortical) and more favorable ((multi)focal/cortical) outcome group that could support prognostication in post-anoxic encephalopathy; however, the inter-rater variability of clinically assessing these PAM subtypes is unknown.
We prospectively examined PAM patients using a standardized video protocol. Videos were rated by three neurologists who classified PAM phenotype (generalized/(multi)focal), stimulus sensitivity, localization (proximal/distal/both), and severity (Clinical Global Impression-Severity Scale (CGI-S) and Unified Myoclonus Rating Scale (UMRS)).
Poor inter-rater agreement was found for phenotype and stimulus sensitivity (κ=-0.05), moderate agreement for localization (κ=0.46). Substantial agreement was obtained for the CGI-S (intraclass correlation coefficient (ICC)=0.64) and almost perfect agreement for the UMRS (ICC=0.82).
Clinical assessment of PAM is not reproducible between physicians, and should therefore not be used for prognostication. PAM severity measured by the UMRS appears to be reliable; however, the relation between PAM severity and outcome is unknown.
We prospectively examined PAM patients using a standardized video protocol. Videos were rated by three neurologists who classified PAM phenotype (generalized/(multi)focal), stimulus sensitivity, localization (proximal/distal/both), and severity (Clinical Global Impression-Severity Scale (CGI-S) and Unified Myoclonus Rating Scale (UMRS)).
Poor inter-rater agreement was found for phenotype and stimulus sensitivity (κ=-0.05), moderate agreement for localization (κ=0.46). Substantial agreement was obtained for the CGI-S (intraclass correlation coefficient (ICC)=0.64) and almost perfect agreement for the UMRS (ICC=0.82).
Clinical assessment of PAM is not reproducible between physicians, and should therefore not be used for prognostication. PAM severity measured by the UMRS appears to be reliable; however, the relation between PAM severity and outcome is unknown.
Keywords
Female, Humans, Hypoxia, Brain/complications, Hypoxia, Brain/diagnosis, Hypoxia, Brain/physiopathology, Male, Middle Aged, Myoclonus/diagnosis, Myoclonus/drug therapy, Myoclonus/etiology, Myoclonus/physiopathology, Neurologic Examination, Neurologists, Observer Variation, Phenotype, Physical Stimulation, Prospective Studies, Reproducibility of Results, Severity of Illness Index, Video Recording, Myoclonus, clinical neurology examination, critical care, post-anoxic encephalopathy, prognosis
Pubmed
Create date
09/10/2017 14:26
Last modification date
20/08/2019 15:26
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