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

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Version: Final published version
Serval ID
serval:BIB_B7FD1AE02250
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
The Inter-rater Variability of Clinical Assessment in Post-anoxic Myoclonus.
Journal
Tremor and other hyperkinetic movements
Author(s)
van Zijl J.C., Beudel M., Elting J.J., de Jong B.M., van der Naalt J., van den Bergh W.M., Rossetti A.O., Tijssen MAJ, Horn J.
ISSN
2160-8288 (Electronic)
ISSN-L
2160-8288
Publication state
Published
Issued date
2017
Peer-reviewed
Oui
Volume
7
Pages
470
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Video-Audio Media
Publication Status: epublish
Abstract
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.
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)).
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).
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
Female, Humans, Hypoxia, Brain/complications, Hypoxia, Brain/diagnosis, Hypoxia, Brain/physiopathology, Male, Middle Aged, Myoclonus/diagnosis, Myoclonus/drug therapy, Myoclonus/etiology, Myoclonus/physiopathology, Neurologic Examination, Neurologists, Observer Variation, Phenotype, Physical Stimulation, Prospective Studies, Reproducibility of Results, Severity of Illness Index, Video Recording, Myoclonus, clinical neurology examination, critical care, post-anoxic encephalopathy, prognosis
Pubmed
Create date
09/10/2017 14:26
Last modification date
20/08/2019 15:26
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