Reliability of the Severity subscale of the revised Toronto Spasmodic Torticollis Rating Scale (TWSTRS-2) (S15.001)
Bibliographic record
Abstract
OBJECTIVE:To test the inter- and intra-rater reliability of the motor severity subscale of the revised Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS-2) in cervical dystonia (CD) in a multicenter study. BACKGROUND: The TWSTRS scale is used as the standard scale to evaluate the severity of CD. The TWSTRS-2 was developed using a modified Delphi methodology to address the limitations of the standard TWSTRS. METHODS:Subjects with isolated CD were videotaped using a standardized protocol. Subjects were rated by the principal investigator (CLC) using a global scale from 0 (no dystonia) to 10 (severe dystonia). The subject videotapes were stratified for severity using this global scale and randomly assigned to blocks of 20 unique subjects and 5 repeated subjects. Raters included 11 dystonia experts. Each rated 2 blocks for a total of 45 unique and 5 repeat subjects. Intraclass correlation coefficients were used to assess rater agreement given the ordinal nature of the data. RESULTS: 209 CD subjects (73[percnt] women, age 59+10 years) were included from 10 sites. Inter-rater agreement for the total TWSTR-2 score was good (ICC = 0.70 [95th CI: 0.62-0.78]). Fair to excellent inter-rater agreement (ICC > 0.40) was found for rotation, laterocolis, anterocolis, retrocollis, lateral shift, tremor, shoulder elevation, range of motion and time at midline. Poor inter-rater agreement was found for sagittal shift, duration and sensory trick (ICC < 0.40). Intra-rater agreement for total TWSTRS-2 score was excellent (ICC = 0.75 [95th CI: 0.51-0.87]). Intra-rater agreement was fair to excellent for all items except sagittal shift and duration ( ICCs < 0.40). CONCLUSIONS: The overall agreement among and within raters is acceptable for the severity subscale of the TWSTR-2 scale. Examination of individual item agreement suggests either item modification or improved training may be required for sagittal shift, duration and sensory trick. Study Supported by: U54 NS065701
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".