Reliability of a Caton-Deschamps-derived patella height index for knee arthroplasty

Abstract Purpose The original Caton-Deschamps index (oCDI) detects functional patella height. It cannot be used in knees with an implanted endoprosthesis. The “modified Caton-Deschamps index” (mCDI) for knee arthroplasty can miss pseudo-patella-infera (PPI), which is common after TKA. A derivate of the oCDI could be a simple analogue to the index published in 1982 using a modified tibial reference point at the anterior proximal point of the inlay, which can indirectly be located on the lateral knee radiograph. It was the aim of this study to determine the intra- and inter-rater agreement of a derived Caton-Deschamps index (dCDI) for knee arthroplasty. We hypothesized that the derived Caton-Deschamps index (dCDI) is a reliable radiological measure for patella height in knee arthroplasty. Methods Several patella height indices were measured by three independent raters in two passes. The second pass was performed after 6 weeks in random order. Intra- and inter-observer agreements were determined and analyzed using the intraclass correlation coefficient (ICC). For radiographic evaluation, digital lateral radiographs of 150 knees before and after primary TKA were used. Results We found high interrater reliability for all analyzed indices. We found the highest agreements for the ISI preop (ICC = 0.914) and postop (ICC = 0.920), respectively. We also found very good intra-rater reliability for the CDI (ICCpreop = 0.954), dCDI (ICCpostop = 0.945), ISI (ICCpreop = 0.960; ICCpostop=0.940) and BPI (ICCpreop = 0.969; ICCpostop = 0.955). Fourteen cases (9.3%) with insignificant PPI were found. Conclusion The derived Caton-Deschamps index (dCDI) can easily be used in knee arthroplasty and demonstrated high intra- and interrater agreement, which was similar to other commonly used and established patella height indices.

Download Full-text

Intrarater and Interrater Reliability of Infrared Image Analysis of Forearm Acupoints before and after Moxibustion

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2020/6328756 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Jiali Lou ◽

Yongliang Jiang ◽

Hantong Hu ◽

Xiaoyu Li ◽

Yajun Zhang ◽

...

Keyword(s):

Image Analysis ◽

Correlation Coefficient ◽

Temperature Change ◽

Intraclass Correlation Coefficient ◽

Interrater Reliability ◽

Intraclass Correlation ◽

Infrared Image ◽

Infrared Images ◽

Intrarater Reliability ◽

Before And After

The objective of this study was to determine the intrarater and interrater reliabilities of infrared image analysis of forearm acupoints before and after moxibustion. In this work, infrared images of acupoints in the forearm of 20 volunteers (M/F, 10/10) were collected prior to and after moxibustion by infrared thermography (IRT). Two trained raters performed the analysis of infrared images in two different periods at a one-week interval. The intraclass correlation coefficient (ICC) was calculated to determine the intrarater and interrater reliabilities. With regard to the intrarater reliability, ICC values were between 0.758 and 0.994 (substantial to excellent). For the interrater reliability, ICC values ranged from 0.707 to 0.964 (moderate to excellent). Given that the intrarater and interrater reliability levels show excellent concordance, IRT could be a reliable tool to monitor the temperature change of forearm acupoints induced by moxibustion.

Download Full-text

Assessing Balance Function in Patients With Total Knee Arthroplasty

Physical Therapy ◽

10.2522/ptj.20140486 ◽

2015 ◽

Vol 95 (10) ◽

pp. 1397-1407 ◽

Cited By ~ 21

Author(s):

Andy C.M. Chan ◽

Marco Y.C. Pang

Keyword(s):

Total Knee Arthroplasty ◽

Internal Consistency ◽

Knee Arthroplasty ◽

Convergent Validity ◽

Interrater Reliability ◽

Intraclass Correlation ◽

Cronbach Alpha ◽

Ceiling Effects ◽

Total Knee ◽

Abc Scale

BackgroundThe Balance Evaluation Systems Test (BESTest) is a relatively new balance assessment tool. Recently, the Mini-BESTest and the Brief-BESTest, which are shortened versions of the BESTest, were developed.ObjectiveThe purpose of this study was to estimate interrater and intrarater-interoccasion reliability, internal consistency, concurrent and convergent validity, and floor and ceiling effects of the 3 BESTests and other related measures, namely, the Berg Balance Scale (BBS), Functional Gait Assessment (FGA), and Activities-specific Balance Confidence (ABC) Scale, among patients with total knee arthroplasty (TKA).DesignThis was an observational measurement study.MethodsTo establish interrater reliability, the 3 BESTests were administered by 3 independent raters to 25 participants with TKA. Intrarater-interoccasion reliability was evaluated in 46 participants with TKA (including the 25 individuals who participated in the interrater reliability experiments) by repeating the 3 BESTests, BBS, and FGA within 1 week by the same rater. Internal consistency of each test also was assessed with Cronbach alpha. Validity was assessed in another 46 patients with TKA by correlating the 3 BESTests with BBS, FGA, and ABC. The floor and ceiling effects also were examined.ResultsThe 3 BESTests demonstrated excellent interrater reliability (intraclass correlation coefficient [ICC] [2,1]=.96–.99), intrarater-interoccasion reliability (ICC [2,1]=.92–.96), and internal consistency (Cronbach alpha=.96–.98). These values were comparable to those for the BBS and FGA. The 3 BESTests also showed moderate-to-strong correlations with the BBS, FGA, and ABC (r=.35–.81), thus demonstrating good concurrent and convergent validity. No significant floor and ceiling effects were observed, except for the BBS.LimitationsThe results are generalizable only to patients with TKA due to end-stage knee osteoarthritis.ConclusionsThe 3 BESTests have good reliability and validity for evaluating balance in people with TKA. The Brief-BESTest is the least time-consuming and may be more useful clinically.

Download Full-text

Validity evidence for Quality Improvement Knowledge Application Tool Revised (QIKAT-R) scores: consequences of rater number and type using neurology cases

BMJ Quality & Safety ◽

10.1136/bmjqs-2018-008689 ◽

2019 ◽

Vol 28 (11) ◽

pp. 925-933 ◽

Cited By ~ 1

Author(s):

Charles Kassardjian ◽

Yoon Soo Park ◽

Sherri Braksick ◽

Jeremy Cutsforth-Gregory ◽

Carrie Robertson ◽

...

Keyword(s):

Quality Improvement ◽

Interrater Reliability ◽

Intraclass Correlation ◽

Validity Evidence ◽

Knowledge Application ◽

Before And After ◽

The Mean ◽

Phi Coefficient ◽

The Impact ◽

Multiple Scenarios

ObjectivesTo develop neurology scenarios for use with the Quality Improvement Knowledge Application Tool Revised (QIKAT-R), gather and evaluate validity evidence, and project the impact of scenario number, rater number and rater type on score reliability.MethodsSix neurological case scenarios were developed. Residents were randomly assigned three scenarios before and after a quality improvement (QI) course in 2015 and 2016. For each scenario, residents crafted an aim statement, selected a measure and proposed a change to address a quality gap. Responses were scored by six faculty raters (two with and four without QI expertise) using the QIKAT-R. Validity evidence from content, response process, internal structure, relations to other variables and consequences was collected. A generalisability (G) study examined sources of score variability, and decision analyses estimated projected reliability for different numbers of raters and scenarios and raters with and without QI expertise.ResultsRaters scored 163 responses from 28 residents. The mean QIKAT-R score was 5.69 (SD 1.06). G-coefficient and Phi-coefficient were 0.65 and 0.60, respectively. Interrater reliability was fair for raters without QI expertise (intraclass correlation = 0.53, 95% CI 0.30 to 0.72) and acceptable for raters with QI expertise (intraclass correlation = 0.66, 95% CI 0.02 to 0.88). Postcourse scores were significantly higher than precourse scores (6.05, SD 1.48 vs 5.22, SD 1.5; p < 0.001). Sufficient reliability for formative assessment (G-coefficient > 0.60) could be achieved by three raters scoring six scenarios or two raters scoring eight scenarios, regardless of rater QI expertise.ConclusionsValidity evidence was sufficient to support the use of the QIKAT-R with multiple scenarios and raters to assess resident QI knowledge application for formative or low-stakes summative purposes. The results provide practical information for educators to guide implementation decisions.

Download Full-text

A new method for evaluation of patellar height and the position of the joint line before and after total knee arthroplasty

10.21203/rs.3.rs-38838/v2 ◽

2020 ◽

Author(s):

Hua Han ◽

Xiaohui Zhang

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Measurement Method ◽

Intraclass Correlation ◽

Patellar Height ◽

Joint Line ◽

New Method ◽

Line Position ◽

Before And After ◽

Total Knee

Abstract Background: The measurement of patellar height and restoration of the natural position of the joint line are crucial to total knee arthroplasty (TKA). However, there remains a lack of consensus on an optimal measurement method to associate the patellar height with the joint line position. The objective of this study was to introduce a new method and validate the application in TKA both preoperatively and postoperatively.Methods: Instead of taking marginal landmarks as the tibial references, the tibial shaft axis was used to construct the new measurement method, which comprises the axis-patella (AP), joint axis-patella (jAP) indices and joint line height (JLH). Patellar heights were measured using the Insall-Salvati (IS), modified Insall-Salvati (mIS), Blackburne-Peel (BP), Caton-Deschamps (CD) indices, and the new method in 175 knees both preoperatively and postoperatively. Intraclass correlation coefficients and Pearson’s correlation analyses were respectively used to evaluate the reliabilities and correlations.Results: There were good correlations between the proposed method and the mIS, CD, and BP indices. High inter-observer reproducibility was found for AP (preoperative and postoperative 0.83), jAP (preoperative 0.82; postoperative 0.86) indices and JLH (preoperative 0.88; postoperative 0.95). High intra-observer repeatability was also found for AP (preoperative 0.85; postoperative 0.87), jAP (preoperative 0.83; postoperative 0.87) indices and JLH (preoperative 0.80; postoperative 0.92).Conclusions: The new method is reliable for measuring patellar height before and after TKA, providing an alternative to distinguish between true and pseudo patella baja. Furthermore, JLH can be applied to assess and restore the joint line position in TKA.

Download Full-text

A new method for evaluation of patellar height and the position of the joint line before and after total knee arthroplasty

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03794-1 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Hua Han ◽

Xiaohui Zhang

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Measurement Method ◽

Intraclass Correlation ◽

Patellar Height ◽

Joint Line ◽

New Method ◽

Line Position ◽

Before And After ◽

Total Knee

Abstract Background The measurement of patellar height and restoration of the natural position of the joint line are crucial to total knee arthroplasty (TKA). However, there remains a lack of consensus on an optimal measurement method to associate the patellar height with the joint line position. The objective of this study was to introduce a new method and validate the application in TKA both preoperatively and postoperatively. Methods Instead of taking marginal landmarks as the tibial references, the tibial shaft axis was used to construct the new measurement method, which comprises the axis-patella (AP), joint axis-patella (jAP) indices and joint line height (JLH). Patellar heights were measured using the Insall-Salvati (IS), modified Insall-Salvati (mIS), Blackburne-Peel (BP), Caton-Deschamps (CD) indices, and the new method in 175 knees both preoperatively and postoperatively. Intraclass correlation coefficients and Pearson’s correlation analyses were respectively used to evaluate the reliabilities and correlations. Results There were good correlations between the proposed method and the mIS, CD, and BP indices. High inter-observer reproducibility was found for AP (preoperative and postoperative 0.83), jAP (preoperative 0.82; postoperative 0.86) indices and JLH (preoperative 0.88; postoperative 0.95). High intra-observer repeatability was also found for AP (preoperative 0.85; postoperative 0.87), jAP (preoperative 0.83; postoperative 0.87) indices and JLH (preoperative 0.80; postoperative 0.92). Conclusions The new method is reliable for measuring patellar height before and after TKA, providing an alternative to distinguish between true and pseudo patella baja. Furthermore, JLH can be applied to assess and restore the joint line position in TKA.

Download Full-text

A new method for evaluation of patellar height and the position of the joint line before and after total knee arthroplasty

10.21203/rs.3.rs-38838/v1 ◽

2020 ◽

Author(s):

Hua Han ◽

Xiaohui Zhang

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Measurement Method ◽

Intraclass Correlation ◽

Patellar Height ◽

Joint Line ◽

New Method ◽

Line Position ◽

Before And After ◽

Total Knee

Abstract Background: The measurement of patellar height and restoration of the natural position of the joint line are crucial to total knee arthroplasty (TKA). However, there remains a lack of consensus on an optimal measurement method to associate the patellar height with the joint line position. The objective of this study was to introduce a new method and validate the application in TKA both preoperatively and postoperatively.Methods: Instead of taking marginal landmarks as the tibial references, the tibial shaft axis was used to construct the new measurement method, which comprises the axis-patella (AP), joint axis-patella (jAP) indices and joint line height (JLH). Patellar heights were measured using the Insall-Salvati (IS), modified Insall-Salvati (mIS), Blackburne-Peel (BP), Caton-Deschamps (CD) indices, and the new method in 175 knees both preoperatively and postoperatively. Intraclass correlation coefficients and Pearson’s correlation analysis were respectively used to evaluate the reliabilities and correlations.Results: There was good correlation between the proposed method and the mIS, CD, and BP indices. High inter-observer reproducibility was found for AP (preoperative and postoperative 0.83), jAP (preoperative 0.82; postoperative 0.86) indices and JLH (preoperative 0.88; postoperative 0.95). High intra-observer repeatability was also found for AP (preoperative 0.85; postoperative 0.87), jAP (preoperative 0.83; postoperative 0.87) indices and JLH (preoperative 0.80; postoperative 0.92). Conclusions: The new method is reliable for measuring patellar height before and after TKA, providing an alternative to distinguish between true and pseudo patella baja. Furthermore, JLH can be applied to assess and restore the joint line position in TKA.

Download Full-text

Interobserver Reliability Using the Phonetic Level Evaluation With Severely and Profoundly Hearing-Impaired Children

Journal of Speech Language and Hearing Research ◽

10.1044/jshr.3405.989 ◽

1991 ◽

Vol 34 (5) ◽

pp. 989-999 ◽

Cited By ~ 6

Author(s):

Stephanie Shaw ◽

Truman E. Coggins

Keyword(s):

Interrater Reliability ◽

Interobserver Reliability ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Hearing Impaired ◽

Intraclass Correlation Coefficients ◽

Assessment Measure ◽

Impaired Children ◽

Speech Assessment ◽

Hearing Impaired Children

This study examines whether observers reliably categorize selected speech production behaviors in hearing-impaired children. A group of experienced speech-language pathologists was trained to score the elicited imitations of 5 profoundly and 5 severely hearing-impaired subjects using the Phonetic Level Evaluation (Ling, 1976). Interrater reliability was calculated using intraclass correlation coefficients. Overall, the magnitude of the coefficients was found to be considerably below what would be accepted in published behavioral research. Failure to obtain acceptably high levels of reliability suggests that the Phonetic Level Evaluation may not yet be an accurate and objective speech assessment measure for hearing-impaired children.

Download Full-text

CODEM Instrument

GeroPsych ◽

10.1024/1662-9647/a000100 ◽

2014 ◽

Vol 27 (1) ◽

pp. 23-31 ◽

Cited By ~ 4

Author(s):

Anne Kuemmel (This author contributed eq ◽

Julia Haberstroh (This author contributed ◽

Johannes Pantel

Keyword(s):

Convergent Validity ◽

Interrater Reliability ◽

Discriminant Validity ◽

Assessment Tool ◽

Intraclass Correlation ◽

Well Being ◽

Communication Behavior ◽

People With Dementia ◽

Pearson's R ◽

Pearson’S R

Communication and communication behaviors in situational contexts are essential conditions for well-being and quality of life in people with dementia. Measuring methods, however, are limited. The CODEM instrument, a standardized observational communication behavior assessment tool, was developed and evaluated on the basis of the current state of research in dementia care and social-communicative behavior. Initially, interrater reliability was examined by means of videoratings (N = 10 people with dementia). Thereupon, six caregivers in six German nursing homes observed 69 residents suffering from dementia and used CODEM to rate their communication behavior. The interrater reliability of CODEM was excellent (mean κ = .79; intraclass correlation = .91). Statistical analysis indicated that CODEM had excellent internal consistency (Cronbach’s α = .95). CODEM also showed excellent convergent validity (Pearson’s R = .88) as well as discriminant validity (Pearson’s R = .63). Confirmatory factor analysis verified the two-factor solution of verbal/content aspects and nonverbal/relationship aspects. With regard to the severity of the disease, the content and relational aspects of communication exhibited different trends. CODEM proved to be a reliable, valid, and sensitive assessment tool for examining communication behavior in the field of dementia. CODEM also provides researchers a feasible examination tool for measuring effects of psychosocial intervention studies that strive to improve communication behavior and well-being in dementia.

Download Full-text

Comparison of Two Tests to Determine the Maximal Aerobic Speed

Acta Facultatis Educationis Physicae Universitatis Comenianae ◽

10.2478/afepuc-2020-0021 ◽

2020 ◽

Vol 60 (2) ◽

pp. 252-262

Author(s):

Benhammou Saddek ◽

Jérémy B.J. Coquart ◽

Laurent Mourot ◽

Belkadi Adel ◽

Mokkedes Moulay Idriss ◽

...

Keyword(s):

Physiological Responses ◽

Intraclass Correlation ◽

Lactate Concentration ◽

Blood Lactate Concentration ◽

Random Order ◽

Standard Test ◽

Maximal Heart Rate ◽

Distance Runners ◽

Gold Standard Test ◽

Maximal Aerobic Speed

SummaryThe aims of this study were (a): to compare maximal physiological responses (maximal heart rate: HRmax and blood lactate concentration: [La-]) and maximal aerobic speed (MAS) achieved during a gold standard test (T-VAM) to those during a new test entitled: the 150-50 Intermittent Test (150-50IT), and (b): to test the reliability of the 150-50IT. Eighteen middle-distance runners performed, in a random order, the T-VAM and the 150-50IT. Moreover, the runners performed a second 150-50IT (retest). The results of this study showed that the MAS obtained during 150-50IT were significantly higher than the MAS during the T-VAM (19.1 ± 0.9 vs. 17.9 ± 0.9 km.h−1, p < 0.001). There was also significant higher values in HRmax (193 ± 4 vs. 191 ± 2 bpm, p = 0.011), [La-] (11.4 ± 0.4 vs. 11.0 ± 0.5 mmol.L−1, p = 0.039) during the 150-50IT. Nevertheless, significant correlations were noted for MAS (r = 0.71, p = 0.001) and HRmax (r = 0.63, p = 0.007). MAS obtained during the first 150-50IT and the retest were not significantly different (p = 0.76) and were significantly correlated (r = 0.94, p < 0.001, intraclass correlation coefficient = 0.93 and coefficient of variation = 6.8 %). In conclusion, the 150-50IT is highly reproducible, but the maximal physiological responses derived from both tests cannot be interchangeable in the design of training programs.

Download Full-text

Reliability of a Modified Medication Appropriateness Index in Community Pharmacies

Annals of Pharmacotherapy ◽

10.1177/106002800303700101 ◽

2003 ◽

Vol 37 (1) ◽

pp. 40-46

Author(s):

Rosemin Kassam ◽

Linda G Martin ◽

Karen B Farris ◽

Homero A Monsanto ◽

Jean-Marie Kaiser

Keyword(s):

Community Pharmacy ◽

Interrater Reliability ◽

Intraclass Correlation ◽

Community Setting ◽

Medication Appropriateness Index ◽

Paired Samples ◽

Psychometric Data ◽

Ambulatory Patients ◽

Pharmacy Setting ◽

Medication Appropriateness

Background The medication appropriateness index (MAI) has demonstrated reliability in selected outpatient clinics where medical data were easily accessible from medical charts. However, its use in the community setting where patient data may be limited has not been examined. Objective To evaluate the usefulness of a modified MAI for use in the community pharmacy setting by testing interrater reliability using 3 different rating schemes. Methods Two raters evaluated 160 medications for 32 elderly ambulatory patients. Patient information was acquired using community pharmacist-collected medication histories. A summated MAI score, percent agreement, κ, positive agreement, negative agreement, and intraclass correlation coefficient were calculated for each criterion using 3 scoring schemes. A paired samples t-test (95% CI) was used to test interrater reliability. Results The κ statistics were >0.75 for indication and effectiveness, but good (0.41–0.66) for the remaining criteria using the Hanlon scoring scheme. The intraclass coefficients (0.82, 0.86, 0.87) and overall κ (0.65, 0.66, 0.61) were similar for the 3 schemes. Conclusions This study suggests that the modified MAI has the potential to detect medication appropriateness and inappropriateness in the community pharmacy setting; however, it is not without limitations. Because the MAI has the most clinimetric and psychometric data available, the instrument should be studied further to increase its reliability and generalizability.

Download Full-text