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

Mov Disord Clin Pract. 2024 Dec;11(12):1598-1603. doi: 10.1002/mdc3.14252. Epub 2024 Oct 26.

Abstract

Background: Accurate classification is essential for addressing childhood movement disorders (MD), but the common coexistence of multiple MDs complicates this process.

Objective: The aim was to assess inter-rater agreement on classifying hyperkinetic MDs among pediatric neurologists with expertise in MDs.

Methods: Five pediatric neurologists were requested to examine 112 videos of 66 pediatric patients. Based on the Movement Disorder-Childhood Rating Scale, 3 queries were posed: (Q1) Is there more than 1 MD? (Q2) What is the (predominant) MD? (Q3) What is the other MD (if present)?

Results: The final agreement rates were 57.5% for Q1, 66.6% for Q2, and 43.9% for absolute agreement. All videos with absolute agreement at the first evaluation featured 1 MD, whereas only 2 videos with multiple MDs could totally agree in the final review.

Conclusions: This study reveals significant discordance in classification even among pediatric neurologists with expertise in MDs and highlights the necessity for a standardized approach.

Keywords: childhood; classification; hyperkinetic; inter‐rater agreement; movement disorder.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Hyperkinesis* / classification
  • Hyperkinesis* / diagnosis
  • Male
  • Movement Disorders* / classification
  • Movement Disorders* / diagnosis
  • Movement Disorders* / physiopathology
  • Observer Variation
  • Video Recording