Scale for the assessment and rating of ataxia

TLDR

The authors developed a reliable and valid clinical scale measuring the severity of ataxia. They devised and tested the Scale for the Assessment and Rating of Ataxia (SARA) in two trials of 167 and 119 spinocerebellar ataxia patients, with a mean administration time of 14.2 minutes. SARA demonstrated excellent reliability (ICC 0.98 inter‑rater, 0.90 test‑retest, Cronbach’s alpha 0.94), unidimensionality, strong linearity with global visual analogue scores (r² = 0.98), and significant correlations with disease stage, Barthel Index, and UHDRS‑IV, confirming it as a reliable and valid ataxia outcome measure.

Abstract

To develop a reliable and valid clinical scale measuring the severity of ataxia.The authors devised the Scale for the Assessment and Rating of Ataxia (SARA) and tested it in two trials of 167 and 119 patients with spinocerebellar ataxia.The mean time to administer SARA in patients was 14.2 +/- 7.5 minutes (range 5 to 40). Interrater reliability was high, with an intraclass coefficient (ICC) of 0.98. Test-retest reliability was high with an ICC of 0.90. Internal consistency was high as indicated by Cronbach's alpha of 0.94. Factorial analysis revealed that the rating results were determined by a single factor. SARA ratings showed a linear relation to global assessments using a visual analogue scale, suggesting linearity of the scale (p < 0.0001, r(2) = 0.98). SARA score increased with the disease stage (p < 0.001) and was closely correlated with the Barthel Index (r = -0.80, p < 0.001) and part IV (functional assessment) of the Unified Huntington's Disease Rating Scale (UHDRS-IV) (r = -0.89, p < 0.0001), whereas it had only a weak correlation with disease duration (r = 0.34, p < 0.0002).The Scale for the Assessment and Rating of Ataxia is a reliable and valid measure of ataxia, making it an appropriate primary outcome measure for clinical trials.