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Tremor Research Group Essential Tremor Rating Scale (TETRAS): Assessing Impact of Different Item Instructions and Procedures.

ABSTRACT: Introduction:The Tremor Research Group Essential Tremor Rating Scale (TETRAS) is a well-validated instrument to assess essential tremor. However, similar to all other tremor rating scales, specific instructions for individual tasks are based mostly on expert opinion and tradition. Several tasks have multiple possible variations that have never been compared to determine if they impact score. Methods:Using blinded, randomized videotapes, a group of tremor experts evaluated multiple ET patients to determine: 1. whether assessments of spirals and writing samples are similar if the rater only sees the end result as opposed to actually watching the task, 2. whether arm tremor ratings (postural and wing-beating) are similar if the subjects hold both hands out concurrently vs. if they only hold one arm out at a time, 3. whether heal to shin tremor scores vary between supine and sitting, and 4. compared cursive vs script writing samples. Results:Intraclass correlation coefficients (ICC) were excellent (>0.95) for all arm assessments. Writing tremor was rated worse if only rating the spiral/writing photos (p < 0.05) rather than also viewing the writing process, arm tremor scores were higher if each arm was rated individually (p < 0.001), heal to shin scores were higher when done sitting (p = 0.01), and cursive writing tended to be rated higher than script (p = 0.08). Discussion:Minor procedure differences when administering the TETRAS can significantly alter results.

SUBMITTER: Ondo WG

PROVIDER: S-EPMC7546108 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Tremor Research Group Essential Tremor Rating Scale (TETRAS): Assessing Impact of Different Item Instructions and Procedures.

Ondo William G WG Pascual Belen B

Tremor and other hyperkinetic movements (New York, N.Y.) 20201005

<h4>Introduction</h4>The Tremor Research Group Essential Tremor Rating Scale (TETRAS) is a well-validated instrument to assess essential tremor. However, similar to all other tremor rating scales, specific instructions for individual tasks are based mostly on expert opinion and tradition. Several tasks have multiple possible variations that have never been compared to determine if they impact score.<h4>Methods</h4>Using blinded, randomized videotapes, a group of tremor experts evaluated multiple ...[more]

PMID: 33101762

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Project description:Essential tremor (ET) is among the most common neurological diseases and it often runs in families. How knowledgeable ET patients and their families are about their disease has been the subject of surprisingly little scholarship.To fill this gap in knowledge, we administered a comprehensive 32-item survey (i.e., questions about etiology, pathophysiology, symptoms and signs, natural history, and treatments) to 427 participants, including 76 ET probands, 74 affected relatives (AFRs), 238 unaffected relatives, and 39 spouses of unaffected relatives, all of whom were participating in two ET family studies. We hypothesized that there would be gaps in knowledge about ET and furthermore, that probands and AFRs would be the most knowledgeable, followed by unaffected relatives and then spouses of unaffected relatives, who would be the least knowledgeable.Overall, ET patients lacked knowledge about their disease. Nearly one-third of probands answered "yes" or "do not know" to the question, "is ET the same or different from the type of tremor that many normal people can get when they become old and frail?" A similar proportion did not know whether children could get ET or they responded "no." Nearly one-fourth of affecteds (i.e., probands and AFRs) did not know whether or to what degree (e.g., very well, moderately well, not well) the symptoms of ET could be medically controlled, and 38.0% either reported that there was no brain surgery for ET or reported that they did not know. Nearly 17% of affecteds did not endorse genes as a cause for ET, which was surprising given the fact that this was a family study of ET. Probands and AFRs were the most knowledgeable, followed by unaffected relatives. Spouses of unaffected relatives were the least knowledgeable.We targeted a large group of ET patients and their families, as this group is perhaps most likely to be informed about the disease. ET patients and their AFRs were more knowledgeable about the features of ET than their family members without ET. Overall, however, knowledge of ET was very limited and this lack of knowledge encompassed all aspects of the disease including its underlying causes, the nature of the symptoms and signs, its natural history and its treatment. Further ET awareness education and programs targeting both families of ET patients and the public would help alleviate this gap in knowledge.

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Tremor Research Group Essential Tremor Rating Scale (TETRAS): Assessing Impact of Different Item Instructions and Procedures.

Publications

Tremor Research Group Essential Tremor Rating Scale (TETRAS): Assessing Impact of Different Item Instructions and Procedures.

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