Jonsson M, Tollbäck A, Gonzales H, Borg J
Department of Physical Therapy, Karolinska Hospital, Stockholm, Sweden.
Spinal Cord. 2000 Nov;38(11):675-9. doi: 10.1038/sj.sc.3101067.
To determine the inter-rater reliability in scoring sensory and motor function and in defining sensory and motor levels in incomplete spinal cord injury, using the revised 1992 International Standards for Neurological and Functional Classification of Spinal Cord Injury (ISCSCI-92) and to determine the effect on raters agreement of one standardising assessment.
Two physicians and two physiotherapists at the Spinal Cord Injury Unit, Karolinska Hospital, classified 23 patients according to the ISCSCI-92. Kappa values were calculated.
Kappa values varied from 0 to 0.83 (poor to very good) for the pin-prick scores, from 0 to 1 for the light touch scores and from 0 to 0.89 for motor function after the standardising assessment. Kappa values for sensory and motor levels were fair to poor after the standardising assessment. The results showed improvement in degree of agreement in 35/46 dermatomes for scoring pin-prick, in 15/42 for light touch, in 14/19 segments for motor function and for three out of four sensory and motor levels.
This study indicates a weak inter-rater reliability for scoring incomplete SCI lesions using the ISCSCI-92.
采用修订的1992年脊髓损伤神经学和功能分类国际标准（ISCSCI - 92），确定在对不完全性脊髓损伤的感觉和运动功能评分以及定义感觉和运动平面时的评分者间信度，并确定一次标准化评估对评分者一致性的影响。
卡罗林斯卡医院脊髓损伤科的两名医生和两名物理治疗师根据ISCSCI - 92对23例患者进行分类。计算kappa值。
标准化评估后，针刺觉评分的kappa值在0至0.83之间（从差到非常好），轻触觉评分的kappa值在0至1之间，运动功能评分的kappa值在0至0.89之间。标准化评估后，感觉和运动平面的kappa值为中等至差。结果显示，在46个皮节中的35个皮节，针刺觉评分的一致性程度有所提高；在42个皮节中的15个皮节，轻触觉评分的一致性程度有所提高；在19个节段中的14个节段，运动功能评分的一致性程度有所提高；在四个感觉和运动平面中的三个平面，一致性程度有所提高。
本研究表明，使用ISCSCI - 92对不完全性脊髓损伤病变进行评分时，评分者间信度较低。
