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Supplemental File: The Interrater Variability of Clinical Assessment in Post-anoxic Myoclonus

van Zijl, Jonathan C.; Beudel, Martijn; Elting, Jan-Willem J.; de Jong, Bauke M.; van der Naalt, Joukje; van den Bergh, Walter M.; Rossetti, Andrea O.; Tijssen, Marina A. J.; Horn, Janneke

Background: Acute post-anoxic myoclonus (PAM) can be divided into an unfavorable (generalized/subcortical) and more favorable ((multi)focal/cortical) outcome group which could support prognostication in post-anoxic encephalopathy, however the interrater variability of clinically assessing these PAM subtypes is unknown.
Methods: We prospectively examined PAM patients using a standardized video protocol. Videos were rated by three neurologists who classified PAM phenotype (generalized/(multi)focal), stimulus sensitivity, localization (proximal/distal/both), and severity (Clinical Global Impression-Severity scale (CGI-S) and Unified Myoclonus Rating Scale (UMRS)).
Results: Poor interrater agreement was found for phenotype and stimulus sensitivity
(κ=-0.05), moderate agreement for localization (κ=0.46). Substantial agreement was obtained for the CGI-S (intraclass correlation coefficient (ICC)=0.64) and almost perfect agreement for the UMRS (ICC=0.82).
Discussion: Clinical assessment of PAM is not reproducible between physicians, and should therefore not be used for prognostication. PAM severity measured by the UMRS appears to be reliable, however the relation between PAM severity and outcome is unknown.

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More About This Work

Academic Units
Center for Parkinson's Disease and Other Movement Disorders
Published Here
July 12, 2017

Notes

This supplemental file is associated with the Brief Report, "The Interrater Variability of Clinical Assessment in Post-anoxic Myoclonus" published in Tremor and Other Hyperkinetic Movements and available at http://dx.doi.org/10.7916/D81R6XBV

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