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Screening for action tremor in epidemiological field surveys: assessing the reliability of a semi-quantitative, visual, template-based scale for rating hand-drawn spirals.

Louis ED, Zhao Q, Meng H, Ding D - Tremor Other Hyperkinet Mov (N Y) (2012)

Bottom Line: Initial agreement (548 spirals) was good (r values ranged from 0.49 to 0.62, all p<0.001).Subsequent agreement (200 spirals and using visual template) improved (r values ranged from 0.67 to -0.91, all p<0.001).This tool will be useful to researchers who are attempting to rapidly assess action tremor in their field surveys.

View Article: PubMed Central - PubMed

Affiliation: G.H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, United States of America.

ABSTRACT

Background: Population-based epidemiological studies of essential and other tremors have need of a rapid yet accurate means to assess tremor, especially mild tremors. Handwriting is often affected by tremor, and a hand-drawn spiral can provide investigators with objective rather than self-reported data. We present a semi-quantitative, ordinal scale to rate hand-drawn spirals. The scale, which includes values for mild tremor, is accompanied by photographic examples of spirals of each rating, providing a visual template for guidance.

Methods: This study, conducted within the framework of a population-based epidemiological study of 5,000 individuals aged 60 and older in Shanghai, asked enrollees to draw an Archimedes spiral with each hand. Spirals were rated using an ordinal scale (0, 0.5, 1, 1.5, 2, and 3). Three raters rated an initial set of 548 spirals. Four raters rated a subsequent set of 200 spirals using a visual template for guidance.

Results: Initial agreement (548 spirals) was good (r values ranged from 0.49 to 0.62, all p<0.001). Subsequent agreement (200 spirals and using visual template) improved (r values ranged from 0.67 to -0.91, all p<0.001).

Discussion: This tool will be useful to researchers who are attempting to rapidly assess action tremor in their field surveys.

No MeSH data available.


Related in: MedlinePlus

(A, B) Two Spirals that Received Ratings of 2.
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f04: (A, B) Two Spirals that Received Ratings of 2.

Mentions: To further improve on the inter-rater reliability, the senior movement disorder neurologist carefully assembled visual examples of spirals that he had rated, including two examples each of the spirals rated as 0.5, 1.0, 1.5, 2, and 3 (Figures 1–5). These spirals were electronically scanned to produce a visual template to be used as a reference guide during the rating process. The investigative team in China was asked to assemble 200 spirals with a range of scores (0–3) so that they could be independently rated by the movement disorder neurologist, the two previous investigators on the Chinese team, and a new investigator (a second neurologist) on the Chinese team (H.M.). The new investigator did not have the benefit of the initial in-person training session in New York or experience with the prior 548 rated spirals. These 200 spirals were independently rated by the four investigators.


Screening for action tremor in epidemiological field surveys: assessing the reliability of a semi-quantitative, visual, template-based scale for rating hand-drawn spirals.

Louis ED, Zhao Q, Meng H, Ding D - Tremor Other Hyperkinet Mov (N Y) (2012)

(A, B) Two Spirals that Received Ratings of 2.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3368524&req=5

f04: (A, B) Two Spirals that Received Ratings of 2.
Mentions: To further improve on the inter-rater reliability, the senior movement disorder neurologist carefully assembled visual examples of spirals that he had rated, including two examples each of the spirals rated as 0.5, 1.0, 1.5, 2, and 3 (Figures 1–5). These spirals were electronically scanned to produce a visual template to be used as a reference guide during the rating process. The investigative team in China was asked to assemble 200 spirals with a range of scores (0–3) so that they could be independently rated by the movement disorder neurologist, the two previous investigators on the Chinese team, and a new investigator (a second neurologist) on the Chinese team (H.M.). The new investigator did not have the benefit of the initial in-person training session in New York or experience with the prior 548 rated spirals. These 200 spirals were independently rated by the four investigators.

Bottom Line: Initial agreement (548 spirals) was good (r values ranged from 0.49 to 0.62, all p<0.001).Subsequent agreement (200 spirals and using visual template) improved (r values ranged from 0.67 to -0.91, all p<0.001).This tool will be useful to researchers who are attempting to rapidly assess action tremor in their field surveys.

View Article: PubMed Central - PubMed

Affiliation: G.H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, United States of America.

ABSTRACT

Background: Population-based epidemiological studies of essential and other tremors have need of a rapid yet accurate means to assess tremor, especially mild tremors. Handwriting is often affected by tremor, and a hand-drawn spiral can provide investigators with objective rather than self-reported data. We present a semi-quantitative, ordinal scale to rate hand-drawn spirals. The scale, which includes values for mild tremor, is accompanied by photographic examples of spirals of each rating, providing a visual template for guidance.

Methods: This study, conducted within the framework of a population-based epidemiological study of 5,000 individuals aged 60 and older in Shanghai, asked enrollees to draw an Archimedes spiral with each hand. Spirals were rated using an ordinal scale (0, 0.5, 1, 1.5, 2, and 3). Three raters rated an initial set of 548 spirals. Four raters rated a subsequent set of 200 spirals using a visual template for guidance.

Results: Initial agreement (548 spirals) was good (r values ranged from 0.49 to 0.62, all p<0.001). Subsequent agreement (200 spirals and using visual template) improved (r values ranged from 0.67 to -0.91, all p<0.001).

Discussion: This tool will be useful to researchers who are attempting to rapidly assess action tremor in their field surveys.

No MeSH data available.


Related in: MedlinePlus