Novice vs expert inter-rater reliability of the balance error scoring system in children between the ages of 5 and 14
•Non-clinicians or novices can achieve good reliability when administering the BESS.•Training in the BESS can increase reliability on the single leg, foam pad stance.•BESS reliability is best when an experienced clinician administers the test. The Balance Error Scoring System (BESS) is a tool to mea...
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| Published in: | Gait & posture Vol. 86; pp. 13 - 16 |
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| Main Authors: | , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
England
Elsevier B.V
01-05-2021
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | •Non-clinicians or novices can achieve good reliability when administering the BESS.•Training in the BESS can increase reliability on the single leg, foam pad stance.•BESS reliability is best when an experienced clinician administers the test.
The Balance Error Scoring System (BESS) is a tool to measure balance, however, no studies have shown its reliability between novice and expert raters.
What is the inter-rater reliability of BESS measurements when performed by novice raters compared to experts, and does completion of a focused, online training module increase the inter-rater reliability among novice raters?
In this reliability study, 5 novice volunteers were asked to independently rate BESS tests from 50 random prerecorded BESS videos of normal healthy subjects aged 5–14. Novice raters regraded the same 50 videos after receiving a formal training. The novices’ scores before and after the formal training were compared to one another and then the scores were compared to 4 expert scores. Intraclass correlation (ICC) with 95 % confidence intervals or percent agreements were calculated and compared across groups.
For the total BESS score, novice raters showed good reliability (ICC 0.845) which did not change with a formal training (ICC 0.846). Expert raters showed excellent reliability (ICC 0.929). Poor to moderate reliability was noted in the foam stance-single leg in the untrained novice and trained novice group (ICCs 0.452 and 0.64 L respectively).
BESS testing by novice raters with only written instruction and no formal training yields good inter-rater reliability. In contrast, BESS testing by expert raters yields excellent reliability. A focused training for novice raters conferred a small improvement in the reliability of the scoring of the single leg stance on foam condition but not a significant difference to the overall BESS score. While novices demonstrated promising reliability for overall BESS scores, optimizing clinical research using the BESS with expert raters show the highest reliability. |
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| Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| ISSN: | 0966-6362 1879-2219 |
| DOI: | 10.1016/j.gaitpost.2021.02.026 |