Performance Quality Rating Scale for Somatosensation After Stroke Version 3: Reliability, Feasibility.

Only four raters took part, and all were experienced in stroke somatosensory rehabilitation and trained in the SENSe approach and in this tool. The authors state it is unclear how novice or less experienced clinicians would score, so the reliability figures do not yet apply to them. Ratings were made from research trial videos rather than in a clinical setting, and the authors say the tool still needs testing in real clinical practice with clinicians of varying experience before it is recommended for routine use. Agreement between raters was calculated from the first rating session only; the two sessions were used to check whether each rater agreed with themselves over time. The 22 survivors whose videos were used were all right hand dominant and 19 of 22 were male, and all had touch discrimination impairment at least three months after stroke, so the sample is narrow. Two raters never used the top score of 10 and one never used the lowest score of 1, so not every rater used the whole scale.

The authors declared no conflicts of interest. The work was funded by Australian National Health and Medical Research Council project grants, a partnership grant and an ideas grant, a James S. McDonnell Foundation collaborative award, and an Australian Government Research Training Program scholarship plus a La Trobe University postgraduate research scholarship held by the first author.

Do not read the excellent 0.91 agreement figure as evidence that one clinician's score is precise. That figure comes from averaging four raters' scores; a single rater reached only 0.71, which the authors class as moderate, with a standard error of measurement of 1.22 points on a 10-point scale. A second trap is assuming this transfers to your own practice. All four raters were experienced clinicians trained in the SENSe approach and in the tool, so this study says nothing about how a less experienced therapist would score.