title: Reliability of Semmes Weinstein monofilament and ballpoint sensory testing, and voluntary muscle testing in Bangladesh.
abstract: The reliability of methods of testing nerve function is important, since diagnostic decision making is a direct function of the quality of the test. Three methods of nerve function testing were investigated at the Danish Bangladesh Leprosy Mission (DBLM) in north Bangladesh, and assessed for inter-observer reliability. The three methods were 1) ballpoint pen test (BPT) for sensory function; 2) graded Semmes Weinstein monofilament test (SWM) for sensory function and 3) voluntary muscle testing (VMT) for motor function. The weighted kappa (kappa w) statistic was used to express inter-observer reliability. Using this statistic, 0 represents agreement no better than random, and 1.0 complete agreement. kappa w values of > or = 0.80 are reckoned to be adequate for monitoring and research. Fifty-three patients were tested, a Senior physiotechnician acting as 'gold standard' against whom four other staff physiotechnicians were assessed. All three testing methods were found to have minimal inter-observer variation, with the kappa w for inter-observer agreement using BPT being 0.86, the SWM 0.92, and VMT 0.94. It is concluded that in trained and experienced hands, all three methods are reliable and repeatable to a level allowing confident use of results obtained in monitoring and research.
authors.affiliation: INF RELEASE Project, Pokhara, Nepal.
authors.forename: A M
authors.initials: AM
authors.lastname: Anderson
authors.forename: R P
authors.initials: RP
authors.lastname: Croft
mesh_terms: D001459:Bangladesh; D005260:Female; D006801:Humans; D007916:Lepromin; D015440:Leprosy, Lepromatous / Q000150:complications; D015441:Leprosy, Tuberculoid / Q000150:complications / Q000175:diagnosis*; D008297:Male; D009135:Muscular Diseases / Q000175:diagnosis* / Q000209:etiology; D010147:Pain Measurement / Q000295:instrumentation* / Q000379:methods*; D015203:Reproducibility of Results; D012678:Sensation Disorders / Q000175:diagnosis* / Q000209:etiology; D012680:Sensitivity and Specificity; D012684:Sensory Thresholds; D012720:Severity of Illness Index; D013718:Tensile Strength
chemical_list: D007916:Lepromin