Assuring interrater reliability for the UPDRS motor section: Utility of the UPDRS teaching tape
Assuring interrater reliability for the UPDRS motor section: Utility of the UPDRS teaching tape
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DOI：
10.1002/mds.20220
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发表时间：
2004-12-01
影响因子：
8.6
通讯作者：
Stebbins, GT
中科院分区：
文献类型：
--
作者：
Goetz, CG;Stebbins, GT
我们评估了使用帕金森氏病统一评定量表（UNIFIER Sm）教学磁带培训后，运动部分的成功认证率。PD最常用的临床量表是PDRS，大多数临床试验依赖于运动检查作为主要结局指标。尽管运动障碍协会的《运动障碍综合征教学磁带》已被广泛用作培训形式，但缺乏结果数据。我们检查了来自四项多中心研究的数据集，这些研究要求评分者通过CITRRS教学磁带的认证练习。评分员观看了显示所有项目所有评分水平示例的教学磁带（38分钟），然后进行认证练习，对4名受试者进行PD评分（20分钟）。认证要求所有4个科目的分数在三位专家确定的95%置信区间范围内。我们计算了在一次或多次评级尝试后成功认证的评级者数量。在226名参与评估的人员中，只有一半在第一次尝试时成功完成认证，但所有人都在第三次尝试时完成了认证。北美评分者的得分高于欧洲评分者。最难评定的病例是损伤最小的受试者。标准化的量表应用培训方法对于确保评分员统一使用量表至关重要。评分员在最轻微的损伤方面有最大的困难，这使得培训对早期PD的研究尤为重要。(C)2004年，《运动障碍协会》。
We assessed rates of successful certification on the motor section of the Unified Parkinson's Disease Rating Scale (UPDRSm) after training with the UPDRS Teaching Tape. The most frequently used clinical scale for PD is the UPDRS, and most clinical trials rely on the motor examination as the primary outcome measure. Whereas the Movement Disorder Society's UPDRS Teaching Tape has been used widely as a training format, outcome data are lacking. We examined data sets from four multicenter studies that required raters to pass the certification exercise of the UPDRS Teaching Tape. Raters viewed the Teaching Tape showing examples of all rating levels for all items (38 minutes), and then took the certification exercise, rating 4 subjects with PD (20 minutes). Certification required scores on all 4 subjects that fit within the 95% confidence interval range established by three experts. We calculated the numbers of raters successfully certified after one or more rating attempts. Only one-half of 226 raters that participated successfully completed certification on their first attempt, but all completed by the third attempt. North American raters scored better than Europeans raters. The most difficult case to rate was the subject with the least impairment. Standardized methods for training UPDRSm application are essential to ensure that raters use the scale uniformly. Raters have the greatest difficulty with the mildest impairment, making training especially important to studies of early PD. (C) 2004 Movement Disorder Society.