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Interrater Agreement of an Observational Tool to Code Knockouts and Technical Knockouts in Mixed Martial Arts

Lawrence, David W. MD*; Hutchison, Michael G. PhD; Cusimano, Michael D. MD, PhD; Singh, Tanveer§; Li, Luke§

Clinical Journal of Sport Medicine: September 2014 - Volume 24 - Issue 5 - p 397–402
doi: 10.1097/JSM.0000000000000047
Original Research

Objective: Interrater agreement evaluation of a tool to document and code the situational factors and mechanisms of knockouts (KOs) and technical knockouts (TKOs) in mixed martial arts (MMA).

Design: Retrospective case series.

Setting: Professional MMA matches from the Ultimate Fighting Championship—2006-2012.

Participants: Two nonmedically trained independent raters.

Main Outcome Measures: The MMA Knockout Tool (MMA-KT) consists of 20 factors and captures and codes information on match characteristics, situational context preceding KOs and TKOs, as well as describing competitor states during these outcomes. The MMA-KT also evaluates the mechanism of action and subsequent events surrounding a KO.

Results: The 2 raters coded 125 unique events for a total of 250 events. The 8 factors of Part A had an average κ of 0.87 (SD = 0.10; range = 0.65-0.98); 7 were considered “substantial” agreement and 1 “moderate.” Part B consists of 12 factors with an average κ of 0.84 (SD = 0.16; range = 0.59-1.0); 7 classified as “substantial” agreement, 4 “moderate,” and 1 “fair.” The majority of the factors in the MMA-KT demonstrated substantial interrater agreement, with an average κ of 0.86 (SD = 0.13; range = 0.59-1.0).

Conclusions: The MMA-KT is a reliable tool to extract and code relevant information to investigate the situational factors and mechanism of KOs and TKOs in MMA competitions.

*Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada;

David L. MacIntosh Sport Medicine Clinic, Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada;

Division of Neurosurgery, Injury Prevention Research Office, Keenan Research Centre, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; and

§University of Toronto, Toronto, Ontario, Canada.

Corresponding Author: Michael G. Hutchison, PhD, David L. MacIntosh Sport Medicine Clinic, Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord St, Toronto, ON M5S 2W6, Canada (

This study received funding by Canadian Institutes of Health Research Strategic Teams in Applied Injury Research. The organizations that contributed funds to the research had no role in the design of the study, the collection, analysis, and interpretation of the data.

The authors report no conflicts of interest.

Received April 01, 2013

Accepted September 17, 2013

© 2014 by Lippincott Williams & Wilkins