Inter-rater reliability and validity of two ataxia rating scales in children with brain tumours

Abstract

The SARA and BARS are reliable and valid measures and appear to be of equal value in determining the severity of ataxia in children with posterior fossa tumours.

Brief Ataxia Rating Scale: A Reliable Tool to Rate Ataxia in a Short Timeframe

“…However, BARS inter-rater reliability and validity have been demonstrated in other studies with SARA or ICARS totaling 146 patients (50 with SCA7, 44 children with brain tumor, and 52 healthy children). [5][6][7] BARS has also been used as the sole scale in few other studies so far, totaling 176 patients (17 with Niemann-Pick, 12 with SCA2, and 148 with multiple sclerosis). [8][9][10] We recommend BARS for use in clinical practice as a reliable tool to evaluate ataxia effectively and rapidly.…”

Current behavioral assessments of movement disorders in children

“…However, the reliability of the SARA remains controversial. Some studies have confirmed the validity of this scale for Friedreich's ataxia, spinocerebellar ataxia, and posterior fossa tumor . Although additional reports indicate that the SARA is age‐dependent and reliable in normal children, another author objected to this conclusion .…”

“…The BARS is concise and easy to use, and subsequent studies verified its reliability and validity. Despite its brief nature, it is as valuable as the more complicated SARS for the evaluation of ataxia severity in children with posterior fossa tumors …”

“…The maximum total BARS score is 30, with higher scores indicating more severe symptoms.The BARS is concise and easy to use, and subsequent studies verified its reliability and validity. Despite its brief nature, it is as valuable as the more complicated SARS for the evaluation of ataxia severity in children with posterior fossa tumors 79. The Friedreich Ataxia Rating Scale (FARS) includes the following measurements: a six-stage evaluation of ataxia and tests that targetthe upper limbs [finger-to-finger test (scores: 0-3), nose-finger test (0-4), dysmetria test (0-4), rapid alternating movements of hands (0-3), and finger taps (0-4)] and lower limbs [heel along shin slide (0-4)…”

Movement observation to identify ataxia: how well do experts agree?

“…Of the handful of semi‐quantitative ataxia scales available, the SARA has been recommended for adult populations due to its strong psychometric properties, ease of administration, and exclusion of oculomotor symptoms, which can result from cerebral rather than cerebellar pathology . In children who had undergone surgery for a posterior fossa tumor, the SARA was recently found to have convergent validity and high interrater reliability . However, this scale's test–retest reliability may not be sufficiently high to support clinical use, at least not in children with typical development .…”