Vizcarra Joaquin A, Casey Hannah L, Hamedani Ali G, Gomez Christopher M
Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Parkinson's Disease Research, Education and Clinical Center, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA; Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, PA, USA.
Department of Neurology, The University of Chicago Pritzker School of Medicine, Chicago, IL, USA.
Parkinsonism Relat Disord. 2025 Mar;132:107278. doi: 10.1016/j.parkreldis.2025.107278. Epub 2025 Jan 13.
The Scale for Assessment and Rating of Ataxia (SARA) is a widely used clinical rating scale in ataxia. Remote video assessments of SARA examinations are increasingly used to reduce variability through centralized ratings. Remote video assessments have a high agreement with in-person ratings, but the intra- and inter-rater reliability of remote video ratings has not been examined. In this study, we compared the performance of live versus video SARA ratings and evaluated intra- and inter-rater reliability of SARA ratings via video review in patients with spinocerebellar ataxia (SCA) type 1, 2, 3, and 6.
We calculated the Bland-Altman analysis for average measures to assess the agreement between live and video ratings and the Intraclass Correlation Coefficient (ICC) for intra- and inter-rater reliability of video ratings.
In all 15 participants, we found high agreement between live and video for all SARA items, with less than 0.5 point overestimation of video compared to live SARA total score, and excellent intra- and inter-rater reliability for the SARA total score rated by video revision, with an ICC of 0.98 and 0.95, respectively.
Our study highlights the ability to adopt SARA video ratings in clinical practice and research.
共济失调评估与评分量表（SARA）是共济失调领域广泛使用的临床评分量表。通过集中评分，对SARA检查进行远程视频评估越来越多地用于减少变异性。远程视频评估与现场评分具有高度一致性，但远程视频评分的评分者内和评分者间信度尚未得到检验。在本研究中，我们比较了脊髓小脑共济失调（SCA）1、2、3和6型患者现场与视频SARA评分的表现，并通过视频回顾评估了SARA评分的评分者内和评分者间信度。
我们计算了平均测量值的Bland-Altman分析，以评估现场评分与视频评分之间的一致性，以及视频评分的评分者内和评分者间信度的组内相关系数（ICC）。
在所有15名参与者中，我们发现所有SARA项目的现场评分与视频评分之间高度一致，与现场SARA总分相比，视频评分高估不到0.5分，视频修订后的SARA总分具有出色的评分者内和评分者间信度，ICC分别为0.98和0.95。
我们的研究突出了在临床实践和研究中采用SARA视频评分的能力。
