A teaching videotape for the assessment of essential tremor

✍ Scribed by Elan D. Louis; Livia Barnes; Kristin J. Wendt; Blair Ford; Maria Sangiorgio; Samer Tabbal; Linda Lewis; Petra Kaufmann; Carol Moskowitz; Cynthia L. Comella; Christopher C. Goetz; Anthony E. Lang

• Publisher: John Wiley and Sons
• Year: 2001
• Tongue: English
• Weight: 38 KB
• Volume: 16
• Category: Article
• ISSN: 0885-3185
• DOI: 10.1002/1531-8257(200101)16:1<89::aid-mds1001>3.0.co;2-l

✦ Synopsis

Teaching videotapes, developed to aid in the evaluation of several movement disorders, have not been used in essential tremor research. As part of the Washington Heights-Inwood Genetic Study of Essential Tremor (WHIGET), we developed a reliable and valid tremor rating scale. Because this rating scale is currently being used by investigators at other centers, we developed a teaching videotape to aid in the consistent application of this scale.

OBJECTIVE: To develop a teaching videotape for a revised version of the WHIGET Tremor Rating Scale and to assess the interrater agreement among raters who used this videotape to rate tremor.

METHODS: The revised WHIGET Tremor Rating Scale was used to rate action tremor from 0 to 4 during six tests: arm extension, pouring, drinking, using a spoon, finger-to-nose, and drawing spirals. A 22-minute teaching videotape was developed that includes a 29-item educational section and a selfassessment section consisting of 20 examples of tremor ratings chosen by the two WHIGET study neurologists. Eight raters, including senior movement disorder specialists, movement disorder fellows, general neurologists, and a movement disorder nurse practitioner, independently viewed the videotape and rated tremor during the self-assessment section. Interobserver reliability was assessed with weighted kappa statistics ( w ).

RESULTS: Eight raters each rated 20 items (160 ratings total). Total w was 0.97 (nearly perfect agreement). Interrater reliability was as follows: w ‫ס‬ 0.99 (movement disorder specialists), w ‫ס‬ 0.98 (movement disorder fellows), and w ‫ס‬ 0.97 (general neurologists); all w were nearly perfect.

CONCLUSIONS: This teaching videotape may be used to improve the uniform application of the revised WHIGET Tremor Rating Scale by raters with various levels of experience in movement disorders.