Clinicians' Tendencies to Under-Rate XXXX in the Less Affected Hand.

@entity1 @entity400 @entity191
UNASSIGNED: The standard assessment method for @entity400 severity in @entity191 is visual observation by neurologists using clinical rating scales. This is, therefore, a subjective rating that is dependent on clinical expertise. The objective of this study was to report clinicians' tendencies to under-rate Parkinsonian @entity400 in the less affected hand. This was observed through objective @entity400 measurement with accelerometers. @entity400 amplitudes were measured objectively using tri-axis-accelerometers for both hands simultaneously in 53 @entity1 with @entity191 during resting and postural @entity400 . The videotaped @entity400 was rated by neurologists using clinical rating scales. The @entity400 measured by accelerometer was compared with clinical ratings. Neurologists tended to under-rate the less affected hand in resting @entity400 when the contralateral hand had severe @entity400 in Session I. The participating neurologists corrected this tendency in Session II after being informed of it. The under-rating tendency was then repeated by other uninformed neurologists in Session III. Kappa statistics showed high inter-rater agreements and high agreements between estimated scores derived from the accelerometer signals and the mean Clinical @entity400 Rating Scale evaluated in every session. Therefore, clinicians need to be aware of this under-rating tendency in visual inspection of the less affected hand in order to make accurate @entity400 severity assessments.
