Inter-rater reliability of the Nottingham method of stereognosis assessment

Objective: To investigate the inter-rater reliability of stereognosis assessment in stroke patients, as measured by the Nottingham Sensory Assessment (NSA). Subjects: Twenty stroke patients consented to participate in the study. The subjects were aged between 40 and 93 years, and were no more than three months post stroke. Design: The stereognostic ability of the subjects was assessed by two of three examiners within a 24-hour period. The method laid out by the NSA was followed throughout the study. Analysis: Point to point agreement of scores and therefore reliability levels were assessed between examiners using the kappa coefficient of agreement. Results: The majority of subjects (n = 13) were found to have impaired stereognosis on their affected side. A good level of reliability was found for the majority of items (n = 32), with kappa values being rated as substantial or higher for most of the objects tested. In eight cases the reliability was fair or moderate. These cases included the glass, biro and 10p coin when the affected side was assessed by examiners 1 and 2, and the pencil when the same side was assessed by examiners 1 and 3. These levels of reliability were acceptable, but were not as high as the researchers had hoped. Conclusion: It is concluded that the Nottingham method of stereognosis assessment is a reliable assessment tool between raters.