The Inter-rater Variability of Clinical Assessment in Post-anoxic Myoclonus

Jonathan C van Zijl; Martijn Beudel; Jan-Willem J Elting; Bauke M de Jong; Joukje van der Naalt; Walter M van den Bergh; Andrea O Rossetti; Marina A J Tijssen; Janneke Horn

doi:10.7916/D81R6XBV

The Inter-rater Variability of Clinical Assessment in Post-anoxic Myoclonus

Jonathan C van Zijl, Martijn Beudel, Jan-Willem J Elting, Bauke M de Jong, Joukje van der Naalt, Walter M van den Bergh, Andrea O Rossetti, Marina A J Tijssen, Janneke Horn

Onderzoeksoutput: Article › Academic › peer review

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BACKGROUND: 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.

METHODS: 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)).

RESULTS: 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).

DISCUSSION: 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.

Originele taal-2	English
Aantal pagina's	6
Tijdschrift	Tremor and other hyperkinetic movements (New York, N.Y.)
Volume	7
DOI's	https://doi.org/10.7916/D81R6XBV
Status	Published - 2017

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The Inter-rater Variability of Clinical Assessment in Post-anoxic MyoclonusFinal publisher's version, 1,2 MBLicentie: CC BY-NC-ND

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@article{3ad15e26e9fd4af9b91db7d195250059,

title = "The Inter-rater Variability of Clinical Assessment in Post-anoxic Myoclonus",

abstract = "BACKGROUND: 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.METHODS: 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)).RESULTS: 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).DISCUSSION: 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 = "Journal Article",

author = "{van Zijl}, {Jonathan C} and Martijn Beudel and Elting, {Jan-Willem J} and {de Jong}, {Bauke M} and {van der Naalt}, Joukje and {van den Bergh}, {Walter M} and Rossetti, {Andrea O} and Tijssen, {Marina A J} and Janneke Horn",

year = "2017",

doi = "10.7916/D81R6XBV",

language = "English",

volume = "7",

journal = "Tremor and other hyperkinetic movements (New York, N.Y.)",

issn = "2160-8288",

publisher = "COLUMBIA UNIV LIBRARIES, CENTER DIGITAL RESEARCH & SCHOLARSHIP",

}

TY - JOUR

T1 - The Inter-rater Variability of Clinical Assessment in Post-anoxic Myoclonus

AU - van Zijl, Jonathan C

AU - Beudel, Martijn

AU - Elting, Jan-Willem J

AU - de Jong, Bauke M

AU - van der Naalt, Joukje

AU - van den Bergh, Walter M

AU - Rossetti, Andrea O

AU - Tijssen, Marina A J

AU - Horn, Janneke

PY - 2017

Y1 - 2017

N2 - BACKGROUND: 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.METHODS: 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)).RESULTS: 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).DISCUSSION: 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.

AB - BACKGROUND: 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.METHODS: 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)).RESULTS: 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).DISCUSSION: 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.

KW - Journal Article

U2 - 10.7916/D81R6XBV

DO - 10.7916/D81R6XBV

M3 - Article

C2 - 28966876

SN - 2160-8288

VL - 7

JO - Tremor and other hyperkinetic movements (New York, N.Y.)

JF - Tremor and other hyperkinetic movements (New York, N.Y.)

ER -

The Inter-rater Variability of Clinical Assessment in Post-anoxic Myoclonus

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