title: Video training and certification program improves reliability of postischemic neurologic deficit measurement in the rat.
abstract: Scoring systems are used to measure behavioral deficits in stroke research. Video-assisted training is used to standardize stroke-related neurologic deficit scoring in humans. We hypothesized that a video-assisted training and certification program can improve inter-rater reliability in assessing neurologic function after middle cerebral artery occlusion in rats. Three expert raters scored neurologic deficits in post-middle cerebral artery occlusion rats using three published systems having different complexity levels (3, 18, or 48 points). The system having the highest point estimate for the correlation between neurologic score and infarct size was selected to create a video-assisted training and certification program. Eight trainee raters completed the video-assisted training and certification program. Inter-rater agreement ( Κ: score) and agreement with expert consensus scores were measured before and after video-assisted training and certification program completion. The 48-point system correlated best with infarct size. Video-assisted training and certification improved agreement with expert consensus scores (pretraining = 65 ± 10, posttraining = 87 ± 14, 112 possible scores, P < 0.0001), median number of trainee raters with scores within ±2 points of the expert consensus score (pretraining = 4, posttraining = 6.5, P < 0.01), categories with Κ:  > 0.4 (pretraining = 4, posttraining = 9), and number of categories with an improvement in the Κ: score from pretraining to posttraining (n = 6). Video-assisted training and certification improved trainee inter-rater reliability and agreement with expert consensus behavioral scores in rats after middle cerebral artery occlusion. Video-assisted training and certification may be useful in multilaboratory preclinical studies.
authors.affiliation: Department of Anesthesiology, Duke University Medical Center, Durham, USA.
authors.forename: Hideki
authors.initials: H
authors.lastname: Taninishi
authors.affiliation: Department of Anesthesiology, Duke University Medical Center, Durham, USA.
authors.forename: Molly
authors.initials: M
authors.lastname: Pearlstein
authors.affiliation: Department of Anesthesiology, Duke University Medical Center, Durham, USA.
authors.forename: Huaxin
authors.initials: H
authors.lastname: Sheng
authors.affiliation: Department of Anesthesiology, Duke University Medical Center, Durham, USA.
authors.forename: Miwa
authors.initials: M
authors.lastname: Izutsu
authors.affiliation: Department of Anesthesiology, Duke University Medical Center, Durham, USA.
authors.forename: Rafael E
authors.initials: RE
authors.lastname: Chaparro
authors.affiliation: Department of Neurology, Kentucky Neuroscience Institute, University of Kentucky, Lexington, USA.
authors.forename: Larry B
authors.initials: LB
authors.lastname: Goldstein
authors.affiliation: Department of Anesthesiology, Duke University Medical Center, Durham, USA david.warner@duke.edu.|Department of Neurobiology, Duke University Medical Center, Durham, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Warner
mesh_terms: D000818:Animals; D002568:Certification / Q000592:standards*; D006801:Humans; D020244:Infarction, Middle Cerebral Artery; D009422:Nervous System Diseases / Q000175:diagnosis*; D009460:Neurologic Examination / Q000592:standards*; D015588:Observer Variation; D051381:Rats; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D013663:Teaching / Q000592:standards*; D014741:Video Recording
keywords: Animal models; behavior (rodent); behavioral neurology; brain ischemia; focal ischemia