DaiWai M Olson1, Sonja Stutzman2, Ciji Saju2, Margaret Wilson2, Weidan Zhao2, Venkatesh Aiyagari2,3. 1. Department of Neurology & Neurotherapeutics, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-8855, USA. daiwai.olson@utsouthwestern.edu. 2. Department of Neurology & Neurotherapeutics, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-8855, USA. 3. Department of Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
Abstract
BACKGROUND: Subjective scoring of pupil reactivity is a fundamental element of the neurological examination for which the pupillometer provides an objective measure. METHODS: This single-blinded observational study examined interrater reliability of pupil exam findings between two practitioners and between practitioners and a pupillometer. RESULTS: From 2329 paired assessments, the interrater reliability between practitioners was only moderate for pupil size (k = 0.54), shape (k = 0.62), and reactivity (k = 0.40). Only 33.3% of pupils scored as non-reactive by practitioners were scored as non-reactive by pupillometry. CONCLUSIONS: Despite the strong emphasis placed on the traditional pupil examination, especially for patients with a neurological illness, there is limited interrater reliability for subjective scoring of pupillary assessments. Thus, the use of automated pupillometers should be examined as a potential method to increase the reliability of measuring of pupil reactivity.
BACKGROUND: Subjective scoring of pupil reactivity is a fundamental element of the neurological examination for which the pupillometer provides an objective measure. METHODS: This single-blinded observational study examined interrater reliability of pupil exam findings between two practitioners and between practitioners and a pupillometer. RESULTS: From 2329 paired assessments, the interrater reliability between practitioners was only moderate for pupil size (k = 0.54), shape (k = 0.62), and reactivity (k = 0.40). Only 33.3% of pupils scored as non-reactive by practitioners were scored as non-reactive by pupillometry. CONCLUSIONS: Despite the strong emphasis placed on the traditional pupil examination, especially for patients with a neurological illness, there is limited interrater reliability for subjective scoring of pupillary assessments. Thus, the use of automated pupillometers should be examined as a potential method to increase the reliability of measuring of pupil reactivity.
Authors: Rose Du; Michele Meeker; Peter Bacchetti; Merlin D Larson; Martin C Holland; Geoffrey T Manley Journal: Neurosurgery Date: 2005-07 Impact factor: 4.654
Authors: Anthony Marmarou; Juan Lu; Isabella Butcher; Gillian S McHugh; Gordon D Murray; Ewout W Steyerberg; Nino A Mushkudiani; Sung Choi; Andrew I R Maas Journal: J Neurotrauma Date: 2007-02 Impact factor: 5.269
Authors: Kostas N Fountas; Eftychia Z Kapsalaki; Theofilos G Machinis; Angel N Boev; Joe S Robinson; E Christopher Troup Journal: Neurocrit Care Date: 2006 Impact factor: 3.210
Authors: Sonya E Zhou; Carolina B Maciel; Cora H Ormseth; Rachel Beekman; Emily J Gilmore; David M Greer Journal: Resuscitation Date: 2019-04-02 Impact factor: 5.262
Authors: Ehsan Dowlati; Kwadwo Sarpong; Stanley Kamande; Austin H Carroll; Jerome Murray; Alynna Wiley; Brendon Peterson; Jeffrey C Mai; Jason J Chang; Edward F Aulisi; Rocco A Armonda; Daniel R Felbaum Journal: Neurol Sci Date: 2021-03-29 Impact factor: 3.307
Authors: Claudio Sandroni; Sonia D'Arrigo; Sofia Cacciola; Cornelia W E Hoedemaekers; Marlijn J A Kamps; Mauro Oddo; Fabio S Taccone; Arianna Di Rocco; Frederick J A Meijer; Erik Westhall; Massimo Antonelli; Jasmeet Soar; Jerry P Nolan; Tobias Cronberg Journal: Intensive Care Med Date: 2020-09-11 Impact factor: 17.440
Authors: Jerry P Nolan; Claudio Sandroni; Bernd W Böttiger; Alain Cariou; Tobias Cronberg; Hans Friberg; Cornelia Genbrugge; Kirstie Haywood; Gisela Lilja; Véronique R M Moulaert; Nikolaos Nikolaou; Theresa Mariero Olasveengen; Markus B Skrifvars; Fabio Taccone; Jasmeet Soar Journal: Intensive Care Med Date: 2021-03-25 Impact factor: 17.440