Abstract
{\it Objectives:} This study examined the validity of hand therapists' self-report of cumulative trauma disorder (CTD) risk factors by comparing the self-report to observations performed by the raters. Inter-rater reliability was also analyzed between the raters who observed the hand therapists. {\it Study Design:} Two raters simultaneously observed each hand therapist during a splinting task at a therapy facility. Following this task, the raters and the hand therapist independently completed an identical assessment tool. Thirteen therapists were observed and a total of six raters observed the therapists. Responses from two categories of the self-assessment, ``posture'' and ``mechanical stress'', were compared. Percentage of agreement was calculated by dividing the number of like responses by the total number of possible responses for each category. {\it Results:} Overall inter-rater reliability was 72%, significantly above the accepted minimum standard of 60--70%, and validity was 39%, significantly below the accepted minimum. {\it Conclusion:} The high percentage of inter-rater reliability established consistency and accuracy among the raters in their observations. However, the low percentage of validity should prompt hand therapists to investigate the accuracy of a patient's self-report before relying on it for treatment.
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