title: Rater experience influences reliability and validity of the Brief International Classification of Functioning, Disability, and Health Core Set for Stroke.
abstract: OBJECTIVE
  To investigate how clinical experience and access to patient information regarding functional capability influence inter-rater reliability and validity of the Brief International Classification of Functioning, Disability, and Health Core Set for Stroke (ICF) assessment.
  
  
  METHODS
  Study 1 involved expert (clinical experience > 5 years) and novice (clinical experience < 2 years) rater-pairs, each evaluating the same post-stroke patients using the ICF assessment (n = 149). Study 2 involved novice raters separately evaluating a different cohort of post-stroke patients with the ICF assessment (n = 78). The novice raters had prior knowledge of patient functioning through conducting 6 clinical tests.
  
  
  RESULTS
  For Study 1, the expert rater-pairs (kappa=0.50-0.85 for categories; intra-class correlation (ICC)=0.76-0.96 for components) had higher reliability coefficients than novice rater-pairs (kappa=0.18-0.69 for categories; ICC=0.63-0.88 for components). For Study 2, the novice raters with prior knowledge of patient's functioning yielded significantly higher ICF component scores than those without prior knowledge. The former raters' component scores were comparable to those of the expert rater-pairs.
  
  
  CONCLUSIONS
  Clinical experience in post-stroke rehabilitation enhances inter-rater reliability of ICF assessment. Know-ledge of patient's functional capability, such as conducting common clinical tests in post-stroke rehabilitation, is useful for improving assessment validity.
authors.affiliation: College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China.
authors.forename: Shanjia
authors.initials: S
authors.lastname: Chen
authors.forename: Jing
authors.initials: J
authors.lastname: Tao
authors.forename: Qian
authors.initials: Q
authors.lastname: Tao
authors.forename: Yunhua
authors.initials: Y
authors.lastname: Fang
authors.forename: Xiaoxuan
authors.initials: X
authors.lastname: Zhou
authors.forename: Hongxia
authors.initials: H
authors.lastname: Chen
authors.forename: Zhuoming
authors.initials: Z
authors.lastname: Chen
authors.forename: Jia
authors.initials: J
authors.lastname: Huang
authors.forename: Lidian
authors.initials: L
authors.lastname: Chen
authors.forename: Chetwyn C H
authors.initials: CC
authors.lastname: Chan
mesh_terms: D000368:Aged; D002681:China; D002983:Clinical Competence; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation