RELIABILITY AMONG NEUROLOGISTS IN THE SEVERITY ASSESSMENT OF BLEPHAROSPASM AND OROMANDIBULAR DYSTONIA - A MULTICENTER STUDY

The reliability of a scale of 0 to 4 (where 0 is normal) in rating the severity of blepharospasm (BS) and oromandibular dystonia (OMD) was e valuated by the concordance among six neurologists from different neur ological institutions. As expressed by k index, interobserver agreemen t was moderate either for BS or for OMD according to the Landis classi fication. Neurologists showed different rating attitude toward BS and OMD. In fact, the category analysis showed that raters were inclined t o overestimate BS and to underestimate OMD. The familiarity with dysto nia influenced reliability more than the length of professional experi ence in neurology. In fact, when examiners were subdivided into subgro ups (each of three raters) according to the former criteria, the level of interobserver agreement increased significantly. Almost perfect ag reement was obtained in intrarater comparisons. These results may be o f value with regard to the conduct of multicenter epidemiologic and cl inical studies on focal dystonias.