ArticleMovement disorders clinical practice2021
Exploring Interrater Disagreement on Essential Tremor Using a Standardized Tremor Elements Assessment.
Article in Movement disorders clinical practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed.
- Defining the Clinical Phenotypic Ground Truth: Expert Interrater Agreement in Hyperkinetic Movement Disorders.Movement disorders clinical practice · 2026Article
- Kinetic-rest tremor dominance for differentiating dystonic tremor from Parkinson's disease.Journal of Parkinson's disease · 2026Article
- Signal-based differentiation of essential and dystonic tremor.Frontiers in neurology · 2026Article
- Defining the Rhythm: Developing a New Method to Describe Tremor and Myoclonus.Movement disorders : official journal of the Movement Disorder Society · 2025Article
- Subtle bradykinesia features are easier to identify and more prevalent than questionable dystonia in essential tremor.Journal of neural transmission (Vienna, Austria : 1996) · 2025Article
- Epidemiology and treatment patterns of essential tremor: a retrospective cohort analysis in Germany.Frontiers in neurology · 2025Article
- Clinical and kinematic characterization of parkinsonian soft signs in essential tremor.Journal of neural transmission (Vienna, Austria : 1996) · 2024Article
- Validation and application of computer vision algorithms for video-based tremor analysis.NPJ digital medicine · 2024Article
- Comparing Essential Tremor with and without Soft Dystonic Signs and Tremor Combined with Dystonia: The TITAN Study.Movement disorders clinical practice · 2024Article
- Effect of Thalamic versus Pallidal Deep Brain Stimulation on Head Tremor in Dystonic and Essential Tremor Patients-A Retrospective Video-Blinded Study.Movement disorders clinical practice · 2024Article
- Bedside clinical assessment of patients with common upper limb tremor and algorithmic approach.Asian biomedicine : research, reviews and news · 2024Review
- The Challenge of Choosing the Right Stimulation Target for Dystonic Tremor-A Series of Instructive Cases.Movement disorders clinical practice · 2023Article
- The Italian tremor Network (TITAN): rationale, design and preliminary findings.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2022Article
- Essential tremor plus rest tremor: current concepts and controversies.Journal of neural transmission (Vienna, Austria : 1996) · 2022Review
- Clinical features, pathophysiology, treatment, and controversies of tremor in dystonia.Journal of the neurological sciences · 2022Review
- Bayesian Interpretation of Essential Tremor Plus.Journal of clinical neurology (Seoul, Korea) · 2022Review
- Encouraging a Generation of Tremor Researchers: Macdonald Critchley's Paper on Essential Tremor.Movement disorders clinical practice · 2022Article
- A standardized accelerometry method for characterizing tremor: Application and validation in an ageing population with postural and action tremor.Frontiers in neuroinformatics · 2022Article
- Soft Signs in Essential Tremor Plus: A Prospective Study.Movement disorders clinical practice · 2021Article
Corrections and comments
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Authors and funding
7 authors.
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Abstract
backgroundPatients with upper limb action tremor frequently exhibit additional neurological signs of uncertain significance. Clinicians vary in their interpretation, and interrater agreement on the final diagnosis is poor.
objectivesA new clinical tool for assessing the presence or absence of clinical signs that are important in axis-1 classification of tremor patients is introduced: the Standardized Tremor Elements Assessment (STEA). Interrater agreement is determined, and signs leading to disagreement in the final diagnosis are identified.
methodsThree tremor-focussed and one dystonia-focussed movement disorder specialists rated 59 videos of patients with upper limb action tremor syndromes using STEA. Interrater agreements for final diagnosis and STEA items were calculated.
resultsInterrater agreement regarding the final diagnosis was higher within the group of tremor specialists and poor between dystonia and tremor specialists. Greater agreement was found for items characterizing tremor than for signs of dystonia.
conclusionsClinical signs leading to diagnostic disagreement were identified with STEA, and STEA should therefore be useful in future studies of diagnostic disagreement. The thresholds for considering neurological signs as soft versus significant for ataxia, parkinsonism, dystonia, etc. are critically important in tremor classification and must be studied across movement disorder subspecialties, not simply within a pool of tremor specialists.
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