Quantifying variability in the measurement of control in intermittent XXXX .

@entity1 @entity5770
PURPOSE: To evaluate the performance of a series of summary measures of control and to assess reliability in quantifying exodeviation control in intermittent @entity5770 . METHODS: A large, simulated dataset of control scores for 10,000 hypothetical @entity1 with intermittent @entity5770 was created using Monte Carlo simulations. These data were based on @entity1 with intermittent @entity5770 in whom control was assessed twice during one clinical examination, using the office control score (0-5). Each simulated @entity1 had a baseline and 11 subsequent control scores. The repeatability of a series of summary measures of control (the mean of 2 vs the mean of 3 up to the mean of 6), was calculated using 95% limits of agreement (LOA). RESULTS: A total of 322 examinations in 152 @entity1 were used to provide representative distributions of control scores. From the resultant Monte Carlo simulations, the 95% LOAs were 2.60 for 1 distance control score measure, 1.76 for the average of 3, and 1.28 for the average of 6. Therefore using the average of 3 scores, a change of <1.76 would be consistent with short-term variability, whereas a change of >1.76 would suggest a real change in control. CONCLUSIONS: The large dataset of simulated control scores allowed us to assess the variability of specific summary measures of control. We recommend the average of 3 scores (a triple control score) as a new standard for assessing control, providing improved reliability over a single measure, while remaining implementable in clinical practice.
