How well do physicians, pharmacists, and psychologists assess tardive dyskinesia movements?

To measure and compare the tardive dyskinesia assessment ability of physicians, pharmacists, and psychologists prior to and after formal training.

One hundred twenty-two physicians, 82 pharmacists, and 78 psychologists participated in assessment training with the Dyskinesia Identification System Condensed User Scale (DISCUS). Participants were shown one of three videotapes as a pretest before training and as a posttest after training. Inter- and intraprofessional comparisons were made on total score, body area scores, and individual item scores. Multivariate analysis of variance (MANOVA) was used. If significant differences were found, analysis of variance (ANOVA) was conducted. To identify where significant effects occurred, the Tukey test was used.

The group as a whole improved from a pretest total point difference from criteria of 6.3 +/- 5.7 SD to a posttest difference of 2.8 +/- 2.8 SD (df = 2, f = 84.32, p < 0.001). This training effect occurred for six of the seven videotape testing sequences used. Physicians, pharmacists, and psychologists did not significantly differ from each other before or after training. All three professions significantly improved as a result of training. A subgroup of 39 psychiatrists within the physician group showed similar results.

Untrained raters, regardless of profession, are not necessarily accurate in quantifying dyskinetic movements. Brief but formal training significantly improves accuracy.