The Inter-rater Variability of Clinical Assessment in Post-anoxic Myoclonus

• DOI: 10.5334/tohm.343
• Publication Date: 2020-06-24T11:19:36Z
• Authors: Jonathan C. Van Zijl; Martijn Beudel; Jan-Willem J. Elting; Bauke M. De Jong; Joukje Van der Naalt; Walter M. Van den...; Andrea O. Rossetti; Marina A.J. Tijssen; Janneke Horn
• Keywords: Clinical Global Impression; Inter-Rater Reliability

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