Article

One important objective for clinical trialists in rehabilitation is
determining efficacy of interventions to enhance motor behavior. In part,
limitation in the precision of measurement presents a challenge. The few valid,
low-cost observational tools available to assess motor behavior cannot escape the
variability inherent in test administration and scoring. This is especially true
when there are multiple evaluators and raters, as in the case of multisite
randomized controlled trials (RCTs). One way to enhance reliability and reduce
variability is to implement rigorous quality control (QC) procedures. OBJECTIVE:
This article describes a systematic QC process used to refine the administration
and scoring procedures for the Wolf Motor Function Test (WMFT)-Functional Ability
Scale (FAS). METHODS: The QC process, a systematic focus-group collaboration, was
developed and used for a phase III RCT, which enlisted multiple evaluators and an
experienced WMFT-FAS rater panel. RESULTS: After 3 staged refinements to the
administration and scoring instructions, we achieved a sufficiently high
interrater reliability (weighted kappa = 0.8). CONCLUSIONS AND IMPLICATIONS: A
systematic focus-group process was shown to be an effective method to improve
reliability of observational assessment tools for motor behavior in
neurorehabilitation. A reduction in noise-related variability in performance
assessments will increase power and potentially lower the number needed to treat.
Improved precision of measurement can lead to more cost-effective and efficient
clinical trials. Finally, we suggest that improved precision in measures of motor
behavior may provide more insight into recovery mechanisms than a single measure
of movement time alone.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS