Assessing the Inter-Rater and Inter-Trial Reliability of the NeurOptics Pupillary Light Response-3000 Pupillometer.
Deborah A Jehu, Lori A Bolgla, Samantha Armas and 1 others
PMID 39906054WHAT IT FOUND
Seven of eight pupillometer measures showed good to excellent reliability between raters and trials in healthy adults.
The T75 recovery time measure was unreliable, showing poor consistency and bias, meaning it should not be used for clinical decisions without further testing.
Key findings
01Inter-rater reliability was excellent for initial pupil size, end pupil size, average constriction velocity, and maximum constriction velocity, with ICCs exceeding 0.90.
02The T75 recovery time parameter failed to meet the minimum acceptable reliability threshold of 0.70 for both inter-rater and inter-trial comparisons.
03Bland-Altman analysis indicated bias for the T75 measure, where differences between raters increased as the score magnitude increased, unlike the other seven measures.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for SLPs
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What it does not show
The study used only one specific light stimulus intensity and duration, which may have contributed to the poor reliability of the T75 measure. Participants were healthy adults aged 18-40, so findings may not generalize to pediatric populations or those with existing neurological injuries. Eye dominance was not determined, which may explain why T75 bias was more pronounced in the right eye. Findings apply only to the NeurOptics PLR-3000 model and may not extend to other pupillometer devices.
Declared interests
No conflicts of interest or funding sources are explicitly declared in the provided text.
The easy way to misread this
Do not assume all pupillometer metrics are equally reliable. While pupil size and velocity are consistent, the T75 recovery time is not. Using T75 to track recovery or diagnose injury could lead to errors because the measurement varies significantly between raters and trials.