期刊
NEUROCRITICAL CARE
卷 24, 期 2, 页码 251-257出版社
HUMANA PRESS INC
DOI: 10.1007/s12028-015-0182-1
关键词
Pupillometry; Interrater reliability; Neurological illness; Traumatic brain injury; Pupil assessment
Background Subjective scoring of pupil reactivity is a fundamental element of the neurological examination for which the pupillometer provides an objective measure. Methods This single-blinded observational study examined interrater reliability of pupil exam findings between two practitioners and between practitioners and a pupillometer. Results From 2329 paired assessments, the interrater reliability between practitioners was only moderate for pupil size (k = 0.54), shape (k = 0.62), and reactivity (k = 0.40). Only 33.3 % of pupils scored as non-reactive by practitioners were scored as non-reactive by pupillometry. Conclusions Despite the strong emphasis placed on the traditional pupil examination, especially for patients with a neurological illness, there is limited interrater reliability for subjective scoring of pupillary assessments. Thus, the use of automated pupillometers should be examined as a potential method to increase the reliability of measuring of pupil reactivity.
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