Inter-rater reliability of a clinical staging of HIV-associated cognitive impairment
Inter-rater reliability of a clinical staging of HIV-associated cognitive impairment
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DOI：
10.1212/01.wnl.0000064172.46685.82
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发表时间：
2003-05-13
期刊：
影响因子：
9.9
通讯作者：
Epstein, LG
中科院分区：
文献类型：
--
作者：
Marder, K;Albert, SM;Epstein, LG
目的：确定改良的纪念斯隆-凯特林(MSK)分期在HIV相关性认知功能障碍评定者间的可靠性。方法：在东北艾滋病痴呆(NEAD)联合队列研究的四个地点对100名个体的神经学、神经心理和功能状况进行数据提取，该研究是一项关于HIV感染者认知障碍预测因素的纵向研究。神经心理表现的定义是1)基于神经心理学家的总体印象，2)完全基于神经心理测试分数。每个地点的评分员使用提取的数据为每个受试者分配MSK阶段，而不考虑任何识别信息。使用kappa统计方法评估评分者之间的可靠性。还评估了计算机生成的评级和网站生成的评级之间的一致性。结果：关于MSK分期，各部位间配对一致性的Kappa统计范围为0.70-0.91，代表部位间的一致性良好到极好。计算机生成的评分和网站生成的评分之间的一致性在良好到优秀的范围内(0.62-0.79)。结论：作者对MSK评定量表进行了修订，并开发了一种可用于多中心研究的可靠工具。该仪器将在未来的纵向研究中用于HIV痴呆的分期，并将在提高临床病理研究的准确性方面具有价值。
Objective: To determine the inter-rater reliability of a modification of the Memorial Sloan-Kettering (MSK) Staging for HIV-associated cognitive impairment. Methods: Data were abstracted on neurologic, neuropsychological, and functional status on 100 individuals participating at four sites in the Northeast AIDS Dementia (NEAD) Consortium cohort study, a longitudinal study of predictors of cognitive impairment in HIV-infected individuals. Neuropsychological performance was defined 1) based on the neuropsychologist's global impression and 2) solely based on neuropsychological test scores. Raters at each site used the abstracted data to assign an MSK stage to each subject blind to any identifying information. Inter-rater reliability was assessed using kappa statistics. Agreement between computer-generated ratings and site-generated ratings was also assessed. Results: Kappa statistics for pair-wise agreement among the sites regarding MSK stage ranged from 0.70-0.91, representing good to excellent agreement between sites. Agreement between computer-generated ratings and site-generated ratings was in the good to excellent range (0.62-0.79). Conclusions: The authors have modified the MSK rating scale and developed a reliable instrument that can be used in multicenter studies. This instrument will be useful in staging HIV-dementia in future longitudinal studies and will be valuable in increasing accuracy of clinicopathologic studies.