Methodist Neurological Institute, Houston, TX, US.
Weill Cornell Medical School, US.
Tremor Other Hyperkinet Mov (N Y). 2021 Nov 16;11:50. doi: 10.5334/tohm.665. eCollection 2021.
Spiral drawings and handwriting tasks have long been used to assess the severity of essential tremor, but these motor tasks are somewhat less objective as the rules for scoring are not based on firm objective amplitude-based criteria. Publishing the best examples of each of the possible 0-4 ratings for these items could reduce scoring variance.
21 members of the Tremor Research Group each rated 94 spirals and 64 handwriting samples using TETRAS scoring criteria. For each sample, the most frequently reported score (mode; maximum of 21) was determined. Ratings not adjacent to the mode were subtracted from the number of mode scores, to calculate a total value. For each of the ratings (0, 1, 1.5, 2, 2.5, 3, 3.5, 4), the samples with the highest total value were selected as best examples.
In general, rater agreement was good for spirals but poor for handwriting samples. Nevertheless, examples with excellent agreement were identified for all spiral and handwriting ratings, and are presented.
Best examples for scoring spirals and handwritings are needed to reduce the variance of TETRAS scores in clinical trials and clinical practice.
螺旋绘图和手写任务长期以来一直被用于评估原发性震颤的严重程度，但这些运动任务的客观性较差，因为评分规则不是基于基于振幅的客观标准。发布这些项目每个可能的 0-4 评分的最佳示例可以减少评分差异。
震颤研究小组的 21 名成员使用 TETRAS 评分标准对 94 个螺旋和 64 个手写样本进行了评分。对于每个样本，确定了报告频率最高的分数（模式；最大值为 21）。将模式分数以外的评分从模式分数中减去，以计算总分。对于每个评分（0、1、1.5、2、2.5、3、3.5、4），选择总分最高的样本作为最佳示例。
总体而言，螺旋的评分者间一致性良好，但手写样本的一致性较差。然而，仍为所有螺旋和手写评分确定了具有良好一致性的示例，并进行了展示。
需要最佳示例来评分螺旋和手写，以减少临床试验和临床实践中 TETRAS 评分的变异性。
