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Interrater Reliability of the Unified Huntington's Disease Rating Scale-Total Motor Score Certification
- Source :
- Movement Disorders Clinical Practice. 5:290-295
- Publication Year :
- 2018
- Publisher :
- Wiley, 2018.
-
Abstract
- Background The clinical assessment of motor symptoms in Huntington's disease is usually performed with the Unified Huntington's Disease Rating Scale-Total Motor Score (UHDRS-TMS). A high interrater reliability is desirable to monitor symptom progression. Therefore, a teaching video and a system for annual online certification has been developed and implemented. Objectives The aim of this study is to investigate the interrater reliability of the UHDRS-TMS and of its subitems, and to examine the performance of raters in consecutive years. Methods Data from the online UHDRS-TMS certification were used. The interrater reliability was assessed for all first-time participants (n = 944) between 2009 and 2016. Intraclass correlation coefficients (ICC) were calculated for each year separately and the mean was taken as the total ICC. Results The UHDRS-TMS (ICC = 0.847), tandem walking (0.824), pronate/supinate hands left (0.713), and retropulsion pull test (0.706) showed good interrater reliability. Poor interrater reliability was found for maximal dystonia of the left and right upper extremity (0.187 and 0.322, respectively), maximal dystonia of the left and right lower extremity (0.200 and 0.256, respectively), and maximal dystonia of the trunk (0.389), tongue protrusion (0.266), and rigidity arms left (0.390). Raters performed significantly worse on follow-up certification compared to their first certification. Conclusions Our results suggest that the rating of dystonia (absent, slight, mild, moderate, or marked) is subjective and difficult to interpret, especially on video. Therefore, changing the dystonia items of the UHDRS-TMS should be explored. We also recommend that raters should watch the UHDRS-TMS teaching video before each certification.
- Subjects :
- 0301 basic medicine
Dystonia
medicine.medical_specialty
business.industry
Intraclass correlation
Certification
medicine.disease
Trunk
03 medical and health sciences
Inter-rater reliability
030104 developmental biology
0302 clinical medicine
Neurology
Huntington's disease
Rating scale
Physical therapy
Medicine
Neurology (clinical)
business
030217 neurology & neurosurgery
Motor score
Subjects
Details
- ISSN :
- 23301619
- Volume :
- 5
- Database :
- OpenAIRE
- Journal :
- Movement Disorders Clinical Practice
- Accession number :
- edsair.doi...........a03b7019334f0ff000ce4c4d51bfb432