REPEATABILITY OF NERVE THICKNESS ASSESSMENT IN THE CLINICAL EXAMINATION FOR LEPROSY

The assessment of the thickness of the superficial peripheral nerve tr unks to document nerve involvement is an important aspect of clinical examination in case finding for leprosy, and is usually done by traine d paramedical workers (PMWs). This assessment is subject to variabilit y and has implications on the outcome of the survey. The present study proposes to quantify this variability. In this study, 242 individuals , consisting of 50 neuritic cases, 143 nonneuritic cases of leprosy an d 49 normal controls, selected from the records of the trial of BCG pr ophylaxis in leprosy in South India, were examined by a doctor and par amedical workers. Repeatability of nerve thickness assessment for ulna r and popliteal nerves between the medical officer (MO) and the PMWs w as quantified using Kappa statistics. The Kappa values for repeatabili ty between the MO and the PMWs ranged from 0.45 to 0.54 and 0.52 to 0. 69 for ulnar and popliteal nerves, respectively. The implications of t he variability in nerve assessment are discussed.