This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Maria Pia Amato, MD; Laura Fratiglioni, MD; Cinzia Groppi, MD; Gianfranco Siracusa, MD; Luigi Amaducci, MD

Arch Neurol. 1988;45(7):746-748.

Abstract
• Interexaminer agreement in the use of quantitative scales for the evaluation of neurological deficits is essential to the reliability of clinical data from cooperative studies on multiple sclerosis. In this study, four neurologists, arranged into six pairs, examined 24 patients with definite multiple sclerosis and assessed each functional system and disability on the Kurtzke scale. As expressed by the k index, interobserver agreement was rather low, ranging from 30% to 50%. Sensory and mental functions turned out to be the most variable. The k indexes reached values above 85%, when raters who differed by no more than one point were considered as agreeing. A point difference on the scale of, at most, two units seemed to be a reliable index of clinical change. Moreover, these results pointed to the necessity for a specific training program for raters and for periodic control of interobserver variability in multicenter surveys.

Author Affiliations
From the Department of Neurology, University of Florence (Italy).

Footnotes
Accepted for publication Dec 21, 1987.

Reprint requests to Department of Neurology, University of Florence, V.le Morgagni, n. 85, Florence 50134, Italy (Dr Amato).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Teleneurology in patients with multiple sclerosis: EDSS ratings derived remotely and from hands-on examination
Kane et al.
J Telemed Telecare 2008;14:190-194.
ABSTRACT | FULL TEXT  

How similar are commonly combined criteria for EDSS progression in multiple sclerosis?
Kragt et al.
Mult Scler 2006;12:782-786.
ABSTRACT  

The Six Spot Step Test: a new measurement for walking ability in multiple sclerosis
Nieuwenhuis et al.
Mult Scler 2006;12:495-500.
ABSTRACT  

Responsiveness of the Multiple Sclerosis Impairment Scale in comparison with the Expanded Disability Status Scale
Ravnborg et al.
Mult Scler 2005;11:81-84.
ABSTRACT  

The use of magnetic resonance imaging in multiple sclerosis: lessons learned from clinical trials
Boneschi et al.
Mult Scler 2004;10:341-347.
ABSTRACT  

Can the Expanded Disability Status Scale be assessed by telephone?
Lechner-Scott et al.
Mult Scler 2003;9:154-159.
ABSTRACT  

Factors related to agreement between self-reported and conventional Expanded Disability Status Scale (EDSS) scores
Cheng et al.
Mult Scler 2001;7:405-410.
ABSTRACT  

Quality of life in multiple sclerosis: the impact of depression, fatigue and disability
Amato et al.
Mult Scler 2001;7:340-344.
ABSTRACT  

Use of the Multiple Sclerosis Functional Composite as an Outcome Measure in a Phase 3 Clinical Trial
Cohen et al.
Arch Neurol 2001;58:961-967.
ABSTRACT | FULL TEXT  

Developing a disease-specific quality of life measure for people with multiple sclerosis
Ford et al.
Clin Rehabil 2001;15:247-258.
ABSTRACT  

MS-CANE: a computer-aided instrument for neurological evaluation of patients with multiple sclerosis: enhanced reliability of expanded disability status scale (EDSS) assessment
Cohen et al.
Mult Scler 2000;6:355-361.
ABSTRACT  

Kurtzke scales revisited: the application of psychometric methods to clinical intuition
Hobart et al.
Brain 2000;123:1027-1040.
ABSTRACT | FULL TEXT  

Intrarater and interrater reliability of the MS functional composite outcome measure
Cohen et al.
Neurology 2000;54:802-806.
ABSTRACT | FULL TEXT  

Quantification of impairment in MS: discussion of the scales in use
Amato and Ponziani
Mult Scler 1999;5:216-219.
ABSTRACT  

Design of a European multicenter study dedicated to the evaluation of the EDMUS system: EVALUED
Grimaud et al.
Mult Scler 1999;5:234-238.
 

The psychometric properties of clinical rating scales used in multiple sclerosis
Sharrack et al.
Brain 1999;122:141-159.
ABSTRACT | FULL TEXT  

Reliability and validity of two self-report measures of impairment and disability for MS
Schwartz et al.
Neurology 1999;52:63-63.
ABSTRACT | FULL TEXT  

A questionnaire to assess neurological impairment in multiple sclerosis
Goodin
Mult Scler 1998;4:444-451.
ABSTRACT  

The MS impairment scale: a pragmatic approach to the assessment of impairment in patients with multiple sclerosis
Ravnborgl et al.
Mult Scler 1997;3:31-41.
ABSTRACT  

Long-term and Short-term Outcome of Multiple Sclerosis: A 3-Year Follow-up Study
Weinshenker et al.
Arch Neurol 1996;53:353-358.
ABSTRACT  

Measuring Patient-Centered Outcomes in Neurologic Disease: Extending the Q-TWiST Method
Schwartz et al.
Arch Neurol 1995;52:754-762.
ABSTRACT  

An Assessment of Disability Rating Scales Used in Multiple Sclerosis
Francis et al.
Arch Neurol 1991;48:299-301.
ABSTRACT