Interrater Reliability of Pupillary Assessments - NeurOptics
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28 Feb Interrater Reliability of Pupillary Assessments

Posted at 01:28h in Critical Care by

Interrater Reliability of Pupillary Assessments

 

Category: Critical Care

 

Olson D, Stutzman S, Saju C, Wilson M, Zhao, W., Aiyagari V. Interrater Reliability of Pupillary Assessments. Neurocrit Care. Published online: 17 September 2015. http://link.springer.com/article/10.1007/s12028-015-0182-1/fulltext.html

 

Abstract

Background

Subjective scoring of pupil reactivity is a fundamental element of the neurological examination for which the pupillometer provides an objective measure.

Methods

This single-blinded observational study examined interrater reliability of pupil exam findings between two practitioners and between practitioners and a pupillometer.

Results

From 2329 paired assessments, the interrater reliability between practitioners was only moderate for pupil size (k = 0.54), shape (k = 0.62), and reactivity (k = 0.40). Only 33.3 % of pupils scored as non-reactive by practitioners were scored as non-reactive by pupillometry.

Conclusions

Despite the strong emphasis placed on the traditional pupil examination, especially for patients with a neurological illness, there is limited interrater reliability for subjective scoring of pupillary assessments. Thus, the use of automated pupillometers should be examined as a potential method to increase the reliability of measuring of pupil reactivity.

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