Cipriany-Dacko L M, Innerst D, Johannsen J, Rude V
Physical Therapy Department of Beaver College, Glenside, PA 19038, USA.
Arch Phys Med Rehabil. 1997 Oct;78(10):1160-4. doi: 10.1016/s0003-9993(97)90145-3.
To examine interrater agreement of scores by physical therapy novices and experienced clinicians on videotaped and live performances of the balance portion of Tinetti's Performance Oriented Mobility Assessment (BPOMA).
A reliability design was used to assess the interrater agreement and consistency of the BPOMA scores in an elderly population.
General community hospital and skilled nursing facility.
Twenty-six residents of a skilled nursing home, ranging in age from 66 to 99 yrs (mean = 80.4, SD = 6.8), participated in Phase 1. Twenty-four hospital inpatients and five residents of a skilled nursing home, ranging in age from 60 to 92 yrs (mean = 74.7, SD = 7.9), participated in Phase 2. RATERS: Three student physical therapists scored the patients in Phase 1. One student was designated the administrating rater (AR). The AR instructed, guarded, and scored the subjects. The other two students were the observing raters (ORs), whose role was to observe and score the subject's performances. Nine physical therapy clinicians, ranging from 0 to 6 years of experience, rated subjects in Phase 2.
Consistency and agreement of BPOMA scores were compared between clinicians with varying levels of experience. In Phase I, BPOMA was scored on-site by three student physical therapists. In Phase 2, videotaped performances were scored by five physical therapists, one physical therapist assistant, and three student physical therapists.
Phase 1 demonstrated fair to excellent kappa coefficients (.40-1.00) in all maneuvers across all raters. The ORs had higher agreement compared with the AR, ranging from good to excellent (.75-1.00). Phase 2 demonstrated fair to good kappa coefficients (.40-.75) in 5 of 8 maneuvers across all nine raters. When comparing proportion of observed agreement to evaluate the years of experience on rater agreement, there was no significant difference between clinician groups.
Fair to good reliability of BPOMA scores occurred across many rates of varied experience with a small amount of training.
研究物理治疗新手和经验丰富的临床医生对蒂内蒂性能导向移动性评估（BPOMA）平衡部分的录像和现场表现评分的评分者间一致性。
采用可靠性设计评估老年人群中BPOMA评分的评分者间一致性和一致性。
综合社区医院和专业护理机构。
26名专业护理院居民，年龄在66至99岁之间（平均 = 80.4，标准差 = 6.8），参与了第一阶段。24名医院住院患者和5名专业护理院居民，年龄在60至92岁之间（平均 = 74.7，标准差 = 7.9），参与了第二阶段。
三名物理治疗专业学生在第一阶段对患者进行评分。一名学生被指定为执行评分者（AR）。AR指导、监护并对受试者进行评分。另外两名学生是观察评分者（OR），其职责是观察并对受试者的表现进行评分。九名经验在0至6年之间的物理治疗临床医生在第二阶段对受试者进行评分。
比较不同经验水平的临床医生之间BPOMA评分的一致性和一致性。在第一阶段，三名物理治疗专业学生在现场对BPOMA进行评分。在第二阶段，录像表现由五名物理治疗师、一名物理治疗师助理和三名物理治疗专业学生进行评分。
第一阶段在所有评分者的所有动作中显示出中等至优秀的kappa系数（0.40 - 1.00）。与AR相比，OR的一致性更高，范围从良好到优秀（0.75 - 1.00）。第二阶段在所有九名评分者的8个动作中的5个动作中显示出中等至良好的kappa系数（0.40 - 0.75）。在比较观察到的一致性比例以评估评分者一致性的经验年限时，临床医生组之间没有显著差异。
经过少量培训，不同经验水平的众多评分者对BPOMA评分的可靠性中等至良好。
