Interdisciplinary Consensus in Evaluating the Severity Subscale of the Original and Revised Toronto Western Spasmodic Torticollis Rating Scale Through Video‐Based Assessment: An Inter‐Rater Reliability Study.

Background: Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) is widely employed for cervical dystonia (CD) evaluation. Objective: To assess the inter‐rater reliability of the severity subscale of the original and revised TWSTRS using video recordings. Methods: Three raters, a PhD student with a nursing degree, a physiotherapist specialized in CD, and a neurologist‐in‐training independently rated all videos. The inter‐rater reliability was assessed with the intra‐class correlation coefficient (ICC). Results: The total severity score of both tools demonstrated a good inter‐rater reliability (ICC = 0.87 to 0.88). The inter‐rater reliability of individual sub‐items varied from poor (ICC = 0.29) to excellent (ICC = 0.9). Conclusions: The total severity score of both TWSTRS showed good inter‐rater reliability in a multidisciplinary team, indicating their applicability for online patients' assessment. We recommend using the total subscale for outcome comparison. Furthermore, there is a need for more accurate definitions of duration factor and shoulder elevation. [ABSTRACT FROM AUTHOR]