We found the intra-rater agreement of nomas with respect to the diagnosis

to be fair to almost perfect Table 4 while the inter-rater agreement with

respect to the diagnosis was moderate to substantial Table 5. The reason

for the moderate inter-rater agreement possibly lay in the lack of agreement

in scoring the separate items and/or in the interpretation of some items

belonging to the diagnosis disorganization. It is remarkable that the items

that score lowest in Palmers study are the same items that caused confusion

and disagreement in our study. What struck us was that one assessor would

attach a different diagnosis to the same score than would the other assessor.

In particular, this was the case for the items inconsistent jaw degree and

arrhythmic jaw/tongue movements.