Department of Medicine, University of Otago, PO Box 913, Dunedin, New Zealand.
J Clin Neurosci. 2012 Sep;19(9):1246-51. doi: 10.1016/j.jocn.2011.12.007. Epub 2012 Jun 15.
There is a paucity of information on the inter-rater reliability and predictive value of components of the neurological examination. Selected tests of upper limb motor function were studied in 34 patients with Parkinson's disease, upper motor neuron disease or cerebellar disease and in 25 control participants. Video recordings were independently evaluated and scored by two clinicians to determine inter-rater reliability (kappa) and predictive values. Kappa values ranged from 0.00 to 0.73. Highest positive predictive values (PPV) were obtained for the Barré test, arm raise, forearm rolling and finger nose tests. Negative predictive values (NPV) were mostly low, with highest values for unimanual sequential finger tap and rhythmic tap. The combined tests had PPV of 0.58 and NPV of 0.73. This study demonstrates that these clinical tests have poor inter-rater reliability and low negative predictive value when used in isolation.
关于神经系统检查的各个组成部分的评价者间信度和预测值的信息十分有限。研究纳入了 34 例帕金森病、上运动神经元病或小脑疾病患者和 25 名对照参与者，对上肢运动功能的部分特定测试进行了研究。录像由两位临床医生独立进行评估和评分，以确定评价者间信度（kappa）和预测值。kappa 值范围为 0.00 至 0.73。Barré 试验、手臂抬高、前臂滚动和指鼻试验的阳性预测值（PPV）最高。阴性预测值（NPV）大多较低，单手连续指敲和节奏敲击的 NPV 最高。联合检查的 PPV 为 0.58，NPV 为 0.73。本研究表明，这些临床检查在单独使用时评价者间信度差，阴性预测值低。
