Louis E D, Barnes L, Wendt K J, Ford B, Sangiorgio M, Tabbal S, Lewis L, Kaufmann P, Moskowitz C, Comella C L, Goetz C C, Lang A E
Department of Neurology, Columbia University, New York, New York, USA.
Mov Disord. 2001 Jan;16(1):89-93. doi: 10.1002/1531-8257(200101)16:1<89::aid-mds1001>3.0.co;2-l.
Teaching videotapes, developed to aid in the evaluation of several movement disorders, have not been used in essential tremor research. As part of the Washington Heights-Inwood Genetic Study of Essential Tremor (WHIGET), we developed a reliable and valid tremor rating scale. Because this rating scale is currently being used by investigators at other centers, we developed a teaching videotape to aid in the consistent application of this scale.
To develop a teaching videotape for a revised version of the WHIGET Tremor Rating Scale and to assess the interrater agreement among raters who used this videotape to rate tremor.
The revised WHIGET Tremor Rating Scale was used to rate action tremor from 0 to 4 during six tests: arm extension, pouring, drinking, using a spoon, finger-to-nose, and drawing spirals. A 22-minute teaching videotape was developed that includes a 29-item educational section and a self-assessment section consisting of 20 examples of tremor ratings chosen by the two WHIGET study neurologists. Eight raters, including senior movement disorder specialists, movement disorder fellows, general neurologists, and a movement disorder nurse practitioner, independently viewed the videotape and rated tremor during the self-assessment section. Interobserver reliability was assessed with weighted kappa statistics (kappa(w)).
Eight raters each rated 20 items (160 ratings total). Total kappa(w) was 0.97 (nearly perfect agreement). Interrater reliability was as follows: kappa(w) = 0.99 (movement disorder specialists), kappa(w) = 0.98 (movement disorder fellows), and kappa(w) = 0.97 (general neurologists); all kappa(w) were nearly perfect.
This teaching videotape may be used to improve the uniform application of the revised WHIGET Tremor Rating Scale by raters with various levels of experience in movement disorders.
为辅助评估多种运动障碍而制作的教学录像带尚未用于特发性震颤研究。作为华盛顿高地 - 因伍德特发性震颤基因研究（WHIGET）的一部分，我们制定了一个可靠且有效的震颤评定量表。由于该评定量表目前正被其他中心的研究人员使用，我们制作了一盘教学录像带，以帮助一致地应用此量表。
为修订版的WHIGET震颤评定量表制作一盘教学录像带，并评估使用该录像带对震颤进行评分的评估者之间的评分者间一致性。
修订版的WHIGET震颤评定量表用于在六项测试中对动作性震颤从0到4进行评分：手臂伸展、倒水、饮水、使用勺子、指鼻试验和画螺旋线。制作了一盘22分钟的教学录像带，其中包括一个29项的教育部分和一个自我评估部分，该自我评估部分由WHIGET研究的两位神经科医生挑选的20个震颤评分示例组成。八名评估者，包括资深运动障碍专家、运动障碍研究员、普通神经科医生和一名运动障碍护士从业者，独立观看录像带并在自我评估部分对震颤进行评分。使用加权kappa统计量（kappa(w)）评估观察者间的可靠性。
八名评估者每人对20项进行评分（共160次评分）。总kappa(w)为0.97（几乎完全一致）。评分者间的可靠性如下：kappa(w) = 0.99（运动障碍专家），kappa(w) = 0.98（运动障碍研究员），kappa(w) = 0.97（普通神经科医生）；所有kappa(w)均几乎完全一致。
这盘教学录像带可用于提高不同运动障碍经验水平的评估者对修订版WHIGET震颤评定量表的统一应用。
