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Interobserver reliability of the Mallet score
Johannes A van der Sluijs1, Mirjam H van Doorn-Loogman, Marco J P F Ritt
1Departments of aOrthopedic Surgery bRehabilitation cPlastic and Reconstructive Surgery, VU Medical Centre, Amsterdam, The Netherlands. ja.vandersluijs@vumc.nl
Journal of Pediatric Orthopedics. Part B
|August 8, 2006
Summary
The Mallet score shows good interobserver reliability for assessing shoulder function in children with obstetric brachial plexus injuries. Reliability varied across different shoulder movements and observer pairs.
Area of Science:
- Pediatric Orthopedics
- Neurology
- Rehabilitation Medicine
Background:
- Obstetric brachial plexus lesions (OBPL) significantly impact shoulder function in children.
- The Mallet score is a common clinical tool for evaluating active shoulder function in OBPL.
- Assessing the reliability of clinical assessment tools is crucial for consistent patient management.
Purpose of the Study:
- To evaluate the interobserver reliability of the Mallet score for active shoulder function.
- To determine the consistency of Mallet score assessments among experienced clinicians.
- To identify which aspects of shoulder function show the highest and lowest reliability using the Mallet score.
Main Methods:
- A group of 30 children diagnosed with obstetric brachial plexus lesions participated.
- Three experienced observers independently assessed active shoulder function using the Mallet score.
- Interobserver reliability was quantified using weighted kappa statistics.
Main Results:
- Overall interobserver reliability for the Mallet score was found to be good (weighted kappa range: 0.37–0.84).
- Reliability varied across different Mallet score components: abduction (0.75), hand to neck (0.73), hand to spine (0.67), external rotation (0.60), and hand to mouth (0.53).
- Variability in reliability was also observed between different pairs of observers.
Conclusions:
- The Mallet score demonstrates acceptable to good interobserver reliability for assessing shoulder function in children with OBPL.
- Specific Mallet score items, such as abduction and hand-to-neck movements, exhibit higher reliability.
- Clinicians should be aware of potential variability in Mallet score assessments, particularly for certain movements and observer combinations.
