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Inter-rater reliability and validity of two ataxia rating scales in children with brain tumours

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Abstract

Objectives

This study aimed to investigate the inter-rater reliability and construct validity of the Scale for the Assessment and Rating of Ataxia (SARA) and Brief Ataxia Rating Scale (BARS) in children with posterior fossa tumours. These scales have been developed for adults with genetic ataxias, and the performance of these scales in children with brain tumours has not previously been described.

Methods

The participants, who had undergone surgical resection for a posterior fossa tumour (inclusion criteria age 4–18 years), were recruited from the neuro-oncology service at a tertiary children’s hospital. Children were assessed using the SARA, BARS and Paediatric Evaluation of Disability Index (PEDI) mobility domain, a measure of function. Children were independently rated by two therapists to determine the inter-rater reliability of the SARA and BARS. The construct validity was determined by assessing the correlation between the two scales with the PEDI.

Results

Forty-four children were recruited. Inter-rater reliability was good for both scales, demonstrating the strong correlations (SARA, r = 0.94; BARS, r = 0.91) and the good consistency (93 % of SARA and 90 % of BARS paired scores differing by less than 2 points) between two raters. Both ataxia scales demonstrated a strong negative correlation with the mobility domain of the PEDI (SARA, r = −0.77; BARS, r = −0.76), indicating that more severe ataxia was associated with worse mobility. The mean time for completion of the SARA was 4.5 and 2.7 min for the BARS.

Conclusions

The SARA and BARS are reliable and valid measures and appear to be of equal value in determining the severity of ataxia in children with posterior fossa tumours.

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Compliance with ethical standards

Conflict of interest

H. Hartley reports no conflicts of interest.

Prof. B. Pizer reports no conflicts of interest.

Dr. S. Lane reports no conflicts of interest.

C. Sneade reports no conflicts of interest.

R. Pratt reports no conflicts of interest.

Dr. A. Bishop is funded by a NIHR Research Professorship for Professor NE Foster (NIHR-RP-011-015) and reports no conflicts of interest.

Dr. R. Kumar reports no conflicts of interest.

Research involving human participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the local research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards

Informed consent

Informed consent was obtained from all individual participants (or parent/guardian) included in the study.

Author information

Authors and Affiliations

  1. Physiotherapy Department, Alder Hey Children’s NHS Foundation Trust, Eaton Road, Liverpool, L12 2AP, UK

    H. Hartley, C. Sneade & R. Pratt

  2. Oncology Department, Alder Hey Children’s NHS Foundation Trust, Eaton Road, Liverpool, L12 2AP, UK

    B. Pizer

  3. Department of Biostatistics, University of Liverpool, Liverpool, UK

    S. Lane

  4. Institute of Primary Care and Health Sciences, Keele University, Staffordshire, UK

    A. Bishop

  5. Department of Paediatric Neurology, Alder Hey Children’s NHS Foundation Trust, Eaton Road, Liverpool, L12 2AP, UK

    R. Kumar

Authors
  1. H. Hartley
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  2. B. Pizer
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  3. S. Lane
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  4. C. Sneade
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  5. R. Pratt
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  6. A. Bishop
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  7. R. Kumar
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Corresponding author

Correspondence to H. Hartley.

Additional information

Statistical analysis was completed by Dr. S. Lane of University of Liverpool.

Electronic supplementary material

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ESM 1

Threshold values of ataxia scales with GCI (includes three tables) (DOCX 16 kb)

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Hartley, H., Pizer, B., Lane, S. et al. Inter-rater reliability and validity of two ataxia rating scales in children with brain tumours. Childs Nerv Syst 31, 693–697 (2015). https://doi.org/10.1007/s00381-015-2650-5

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  • DOI: https://doi.org/10.1007/s00381-015-2650-5

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