Saint Louis University School of Nursing, St Louis, Missouri, USA.
J Adv Nurs. 2010 Jun;66(6):1382-7. doi: 10.1111/j.1365-2648.2010.05313.x.
This paper is a report of a study to establish the inter-rater reliability of advanced practice nurse and neurologist neurological assessments which included ratings with the Unified Parkinson's Disease Rating Scale-Motor Exam.
Around the world, advanced practice nurses are performing tasks once completed only by physicians. To promote consumer and provider confidence, it is important to establish that nurse and physician ratings using assessment tools are similar. In addition in research settings, when different raters are used, establishment of inter-rater reliability for study assessments is needed.
Advanced practice nurses and neurologists independently recorded findings on neurological examinations of 46 participants in a study conducted between August 2007 and January 2008. An intraclass correlation coefficient was calculated to estimate overall agreement between the nurse and neurologist ratings. Agreement for individual items measured on a dichotomous scale was assessed by calculating Cohen's kappa.
There was substantial agreement between advanced practice nurses and neurologists on the mean Unified Parkinson's Disease Rating Scale-Motor Exam ratings (intraclass correlation coefficient = 0.65) and the U.S. National Alzheimer's Coordinating Center Uniform Data Set neurological examination ratings of unremarkable findings (kappa = 0.74) and of gait disorder (kappa = 0.73). Moderate agreement (kappa = 0.53) was reached for the rating of whether all Unified Parkinson's Disease Rating Scale-Motor Exam items were normal.
These findings are consistent with studies of the inter-rater agreement of the Unified Parkinson's Disease Rating Scale-Motor Exam and support the conduct of neurological assessments by advanced practice nurses.
本文报告了一项研究，旨在建立高级实践护士和神经科医生进行神经评估的评分者间信度，其中包括使用统一帕金森病评定量表-运动检查进行的评分。
在全球范围内，高级实践护士正在执行以前仅由医生完成的任务。为了增强消费者和提供者的信心，重要的是要确定使用评估工具的护士和医生的评分是相似的。此外，在研究环境中，当使用不同的评分者时，需要建立研究评估的评分者间信度。
高级实践护士和神经科医生在 2007 年 8 月至 2008 年 1 月期间独立记录了 46 名参与者的神经检查结果。通过计算组内相关系数来估计护士和神经科医生评分之间的总体一致性。通过计算 Cohen 的 kappa 值来评估二分类量表上各个项目的一致性。
高级实践护士和神经科医生在统一帕金森病评定量表-运动检查的平均评分（组内相关系数=0.65）以及美国国家阿尔茨海默病协调中心统一数据集中正常发现（kappa=0.74）和步态障碍（kappa=0.73）的神经检查评分方面具有显著一致性。对于所有统一帕金森病评定量表-运动检查项目是否正常的评分，达到了中度一致性（kappa=0.53）。
这些发现与统一帕金森病评定量表-运动检查评分者间一致性的研究结果一致，并支持高级实践护士进行神经评估。
