多动性运动障碍儿童运动障碍分类的评分者间一致性
Inter-rater Agreement for Movement Disorder Classification in Children with Hyperkinetic Movement Disorders.
作者信息
Yilmaz Sanem, Vermilion Jennifer, Dean Shannon, Pourdeyhimi Roxanna, Mink Jonathan W
机构信息
Division of Pediatric Neurology, Department of Pediatrics, Ege University Faculty of Medicine, Izmir, Turkiye.
Division of Child Neurology, Department of Neurology, University of Rochester, Rochester, New York, USA.
出版信息
Mov Disord Clin Pract. 2024 Dec;11(12):1598-1603. doi: 10.1002/mdc3.14252. Epub 2024 Oct 26.
BACKGROUND
Accurate classification is essential for addressing childhood movement disorders (MD), but the common coexistence of multiple MDs complicates this process.
OBJECTIVE
The aim was to assess inter-rater agreement on classifying hyperkinetic MDs among pediatric neurologists with expertise in MDs.
METHODS
Five pediatric neurologists were requested to examine 112 videos of 66 pediatric patients. Based on the Movement Disorder-Childhood Rating Scale, 3 queries were posed: (Q1) Is there more than 1 MD? (Q2) What is the (predominant) MD? (Q3) What is the other MD (if present)?
RESULTS
The final agreement rates were 57.5% for Q1, 66.6% for Q2, and 43.9% for absolute agreement. All videos with absolute agreement at the first evaluation featured 1 MD, whereas only 2 videos with multiple MDs could totally agree in the final review.
CONCLUSIONS
This study reveals significant discordance in classification even among pediatric neurologists with expertise in MDs and highlights the necessity for a standardized approach.
背景
准确分类对于解决儿童运动障碍（MD）至关重要，但多种运动障碍常并存使这一过程变得复杂。
目的
旨在评估在儿童运动障碍方面具有专业知识的儿科神经科医生对多动性运动障碍进行分类时的评分者间一致性。
方法
要求五位儿科神经科医生检查66名儿科患者的112段视频。基于儿童运动障碍评定量表，提出了3个问题：（问题1）是否存在不止一种运动障碍？（问题2）（主要的）运动障碍是什么？（问题3）另一种运动障碍（如果存在）是什么？
结果
问题1的最终一致率为57.5%，问题2为66.6%，绝对一致性为43.9%。在首次评估时具有绝对一致性的所有视频均显示有一种运动障碍，而在最终复查中，只有2段存在多种运动障碍的视频能够完全达成一致。
结论
本研究表明，即使在儿童运动障碍方面具有专业知识的儿科神经科医生中，分类也存在显著差异，并强调了采用标准化方法的必要性。
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