title: Inter-rater reliability of physiotherapists using the Pirani scoring system for clubfoot: comparison with a modified five-point scale.
abstract: This study examines inter-rater reliability between physiotherapists using the Pirani scoring system for clubfoot, and whether the addition of two scale points to give a modified five-point severity scale improves reliability. A total of 65 infant feet were assessed by two raters, with 21 different rater combinations used. The Pirani scoring system was found to be a reliable assessment tool when used by physiotherapists to score clubfoot, with a minimum of fair to good inter-rater reliability demonstrated across all clinical signs. The modified five-point scale proved significantly more reliable than the three-point scale; however, the benefit is not sufficient to warrant varying the original three-point scale.
authors.affiliation: aDepartment of Physiotherapy, Sydney Children's Hospital, Sydney Children's Hospitals Network bDiscipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, Australia.
authors.forename: Nicole J
authors.initials: NJ
authors.lastname: Harvey
authors.forename: Anita J
authors.initials: AJ
authors.lastname: Mudge
authors.forename: Deborah T
authors.initials: DT
authors.lastname: Daley
authors.forename: Susan K
authors.initials: SK
authors.lastname: Sims
authors.forename: Roger D
authors.initials: RD
authors.lastname: Adams
mesh_terms: D003025:Clubfoot / Q000175:diagnosis* / Q000503:physiopathology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015588:Observer Variation; D026741:Physical Therapy Modalities / Q000592:standards*; D015203:Reproducibility of Results; D012720:Severity of Illness Index