Interrater agreement in the assessment of motor manifestations of Huntington's disease
Identifieur interne : 003E63 ( Main/Exploration ); précédent : 003E62; suivant : 003E64Interrater agreement in the assessment of motor manifestations of Huntington's disease
Auteurs : Penelope Hogarth [États-Unis] ; Elise Kayson [États-Unis] ; Karl Kieburtz [États-Unis] ; Karen Marder [États-Unis] ; David Oakes [États-Unis] ; Diana Rosas [États-Unis] ; Ira Shoulson [États-Unis] ; Nancy S. Wexler [États-Unis] ; Anne B. Young [États-Unis] ; HONGWEI ZHAO [États-Unis]Source :
- Movement disorders [ 0885-3185 ] ; 2004.
Descripteurs français
- Pascal (Inist)
English descriptors
Abstract
With prospects improving for experimental therapeutics aimed at postponing the onset of illness in preclinical carriers of the Huntington's disease (HD) gene, we assessed agreement among experienced clinicians with respect to the motor manifestations of HD, a relevant outcome measure for preventive trials in this population. Seventy-five clinicians experienced in the evaluation of patients with early HD and six non-clinicians were shown a videotape compiled from the film archives of the United States-Venezuela Collaborative HD Research Project. Observers were asked to rate a 2-3-minute segment of the motor examination for each of 17 at-risk subjects. The rating scale ranged from 0 (normal) to 4 (unequivocal extrapyramidal movement disorder characteristic of HD). As measured by a weighted K statistic, there was substantial agreement among the 75 clinicians in the judgment of unequivocal motor abnormalities comparing scale ratings of 4 with ratings that were not 4 (weighted K = 0.67; standard error (SE) = 0.09). Agreement among the non-clinicians was only fair (weighted K = 0.28; SE = 0.10). Even under the artificial conditions of a videotape study, experienced clinicians show substantial agreement about the signs that constitute the motor manifestations of illness in subjects at risk for HD. We expect these findings to translate to a similar level of interobserver agreement in the clinical trial setting involving experienced investigators examining live patients.
Affiliations:
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Wexler</name><affiliation wicri:level="4"><inist:fA14 i1="03"><s1>Columbia University</s1><s2>New York, New York</s2><s3>USA</s3><sZ>4 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">État de New York</region><settlement type="city">New York</settlement></placeName><orgName type="university">Université Columbia</orgName></affiliation></author><author><name sortKey="Young, Anne B" sort="Young, Anne B" uniqKey="Young A" first="Anne B." last="Young">Anne B. Young</name><affiliation wicri:level="2"><inist:fA14 i1="04"><s1>Massachusetts General Hospital</s1><s2>Boston, Massachusetts</s2><s3>USA</s3><sZ>6 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Hongwei Zhao" sort="Hongwei Zhao" uniqKey="Hongwei Zhao" last="Hongwei Zhao">HONGWEI ZHAO</name><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>University of Rochester</s1><s2>Rochester, New York</s2><s3>USA</s3><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">État de New York</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2004">2004</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Clinical trial</term><term>Huntington disease</term><term>Interrater agreement</term><term>Nervous system diseases</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Système nerveux pathologie</term><term>Accord interjuge</term><term>Essai clinique</term><term>Chorée Huntington</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">With prospects improving for experimental therapeutics aimed at postponing the onset of illness in preclinical carriers of the Huntington's disease (HD) gene, we assessed agreement among experienced clinicians with respect to the motor manifestations of HD, a relevant outcome measure for preventive trials in this population. Seventy-five clinicians experienced in the evaluation of patients with early HD and six non-clinicians were shown a videotape compiled from the film archives of the United States-Venezuela Collaborative HD Research Project. Observers were asked to rate a 2-3-minute segment of the motor examination for each of 17 at-risk subjects. The rating scale ranged from 0 (normal) to 4 (unequivocal extrapyramidal movement disorder characteristic of HD). As measured by a weighted K statistic, there was substantial agreement among the 75 clinicians in the judgment of unequivocal motor abnormalities comparing scale ratings of 4 with ratings that were not 4 (weighted K = 0.67; standard error (SE) = 0.09). Agreement among the non-clinicians was only fair (weighted K = 0.28; SE = 0.10). Even under the artificial conditions of a videotape study, experienced clinicians show substantial agreement about the signs that constitute the motor manifestations of illness in subjects at risk for HD. We expect these findings to translate to a similar level of interobserver agreement in the clinical trial setting involving experienced investigators examining live patients.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Massachusetts</li><li>Oregon</li><li>État de New York</li></region><settlement><li>New York</li></settlement><orgName><li>Université Columbia</li></orgName></list><tree><country name="États-Unis"><region name="Oregon"><name sortKey="Hogarth, Penelope" sort="Hogarth, Penelope" uniqKey="Hogarth P" first="Penelope" last="Hogarth">Penelope Hogarth</name></region><name sortKey="Hongwei Zhao" sort="Hongwei Zhao" uniqKey="Hongwei Zhao" last="Hongwei Zhao">HONGWEI ZHAO</name><name sortKey="Kayson, Elise" sort="Kayson, Elise" uniqKey="Kayson E" first="Elise" last="Kayson">Elise Kayson</name><name sortKey="Kieburtz, Karl" sort="Kieburtz, Karl" uniqKey="Kieburtz K" first="Karl" last="Kieburtz">Karl Kieburtz</name><name sortKey="Marder, Karen" sort="Marder, Karen" uniqKey="Marder K" first="Karen" last="Marder">Karen Marder</name><name sortKey="Oakes, David" sort="Oakes, David" uniqKey="Oakes D" first="David" last="Oakes">David Oakes</name><name sortKey="Rosas, Diana" sort="Rosas, Diana" uniqKey="Rosas D" first="Diana" last="Rosas">Diana Rosas</name><name sortKey="Shoulson, Ira" sort="Shoulson, Ira" uniqKey="Shoulson I" first="Ira" last="Shoulson">Ira Shoulson</name><name sortKey="Wexler, Nancy S" sort="Wexler, Nancy S" uniqKey="Wexler N" first="Nancy S." last="Wexler">Nancy S. Wexler</name><name sortKey="Young, Anne B" sort="Young, Anne B" uniqKey="Young A" first="Anne B." last="Young">Anne B. Young</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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