OBJECTIVE The Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) is widely applied to assess disease severity and progression in patients with motor neuron disease (MND). The objective of the study is to assess the inter-rater and intra-rater reproducibility, i.e., the inter-rater and intra-rater reliability and agreement, of a self-administration version of the ALSFRS-R for use in apps, online platforms, clinical care and trials. METHODS The self-administration version of the ALSFRS-R was developed based on both patient and expert feedback. To assess the inter-rater reproducibility, 59 patients with MND filled out the ALSFRS-R online and were subsequently assessed on the ALSFRS-R by three raters. To assess the intra-rater reproducibility, patients were invited on two occasions to complete the ALSFRS-R online. Reliability was assessed with intraclass correlation coefficients, agreement was assessed with Bland-Altman plots and paired samples t-tests, and internal consistency was examined with Cronbach's coefficient alpha. RESULTS The self-administration version of the ALSFRS-R demonstrated excellent inter-rater and intra-rater reliability. The assessment of inter-rater agreement demonstrated small systematic differences between patients and raters and acceptable limits of agreement. The assessment of intra-rater agreement demonstrated no systematic changes between time points; limits of agreement were 4.3 points for the total score and ranged from 1.6 to 2.4 points for the domain scores. Coefficient alpha values were acceptable. DISCUSSION The self-administration version of the ALSFRS-R demonstrates high reproducibility and can be used in apps and online portals for both individual comparisons, facilitating the management of clinical care and group comparisons in clinical trials.

中文翻译：

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开发和评估ALSFRS-R自我管理版本的评估者之间和评估者内部的可重复性。

目的修订肌萎缩性侧索硬化功能评分量表（ALSFRS-R），以评估运动神经元疾病（MND）患者的疾病严重程度和病情进展。这项研究的目的是评估ALSFRS-R自管理版本在应用程序，在线平台中使用的评估者之间和评估者内部的可重复性，即评估者之间和评估者内部的可靠性和一致性。 ，临床护理和试验。方法ALSFRS-R的自我管理版本是根据患者和专家的反馈而开发的。为了评估评估者之间的可重复性，共有59名MND患者在线填写了ALSFRS-R，随后由三名评估者对ALSFRS-R进行了评估。为了评估评估者内的可重复性，两次邀请患者在线完成ALSFRS-R。使用组内相关系数评估可靠性，使用Bland-Altman图和配对样本t检验评估一致性，并使用Cronbach系数α检验内部一致性。结果ALSFRS-R的自我管理版本显示出出色的评估者间和评估者内可靠性。评估者之间协议的评估表明，患者与评估者之间的系统性细微差异以及协议的可接受范围。评估者内部协议的评估表明，各时间点之间没有系统的变化；协议限制的总分数为4.3分，领域分数的分数范围为1.6至2.4分。系数α值是可以接受的。