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Inter-rater Agreement for Movement Disorder Classification in Children with Hyperkinetic Movement Disorders.

Sanem Yilmaz1, Jennifer Vermilion2, Shannon Dean2

  • 1Division of Pediatric Neurology, Department of Pediatrics, Ege University Faculty of Medicine, Izmir, Turkiye.

Movement Disorders Clinical Practice
|October 26, 2024
PubMed
Summary

Pediatric neurologists showed low agreement classifying childhood movement disorders (MD), even with expertise. This highlights the need for standardized diagnostic criteria for these complex neurological conditions.

Keywords:
childhoodclassificationhyperkineticinter‐rater agreementmovement disorder

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Area of Science:

  • Pediatric Neurology
  • Movement Disorders
  • Clinical Diagnostics

Background:

  • Accurate classification of childhood movement disorders (MD) is crucial for effective management.
  • The frequent co-occurrence of multiple MDs presents a significant diagnostic challenge.

Purpose of the Study:

  • To evaluate the inter-rater reliability among pediatric neurologists in classifying hyperkinetic movement disorders.
  • To identify challenges in diagnosing complex pediatric movement disorders.

Main Methods:

  • Five pediatric neurologists reviewed 112 videos from 66 pediatric patients.
  • The Movement Disorder-Childhood Rating Scale was used to assess the presence and type of MDs.
  • Specific queries addressed the existence of single versus multiple MDs and their classification.

Main Results:

  • Inter-rater agreement varied, with 57.5% for identifying multiple MDs and 66.6% for classifying the predominant MD.
  • Absolute agreement across all queries was only 43.9%.
  • Videos with absolute agreement predominantly featured a single MD, while those with multiple MDs showed lower consensus.

Conclusions:

  • Significant discordance exists in the classification of childhood movement disorders, even among specialists.
  • There is a clear need for standardized diagnostic tools and approaches for pediatric MDs.