scholarly journals Preoperative measurement of the hiatal surface with MDCT: impact on surgical planning

Author(s):  
Marco Rengo ◽  
Cristian E. Boru ◽  
Stefano Badia ◽  
Angelo Iossa ◽  
Davide Bellini ◽  
...  

Abstract Objective To evaluate the accuracy and reproducibility of hiatal surface area (HSA) measurement on dedicated multidetector computed tomography (MDCT) acquisition, in patients, previously subjected to laparoscopic sleeve gastrectomy (LSG), and affected by gastroesophageal reflux disease (GERD). Intraoperative HSA measurement was considered the reference standard. Methods Fifty-two candidates for laparoscopic hiatal hernia repair were prospectively included in the study. MDCT images were acquired during swallowing of oral iodinated contrast media and during strain. Measurements were performed by nine readers divided into three groups according to their experience. Results were compared with intraoperative measurements by means of Spearman correlation coefficient. Reproducibility was evaluated with intra- and interreader agreement by means of weighted Cohen’s kappa and intraclass correlation coefficient (ICC). Results Significant differences between MDCT and intraoperative HSA measurements were observed for swallowing imaging for less experienced readers (p = 0.037, 0.025, 0.028 and 0.019). No other statistically significant differences were observed (p > 0.05). The correlation between HSA measured intraoperatively and on MDCT was higher for strain imaging compared to swallowing (r = 0.94—0.92 vs 0.94—0.89). The overall reproducibility of MDCT HSA measurement was excellent (ICC of 0.95; 95% CI 0,8993 to 0,9840) independently of reader’s experience Conclusion HSA can be accurately measured on MDCT images. This method is reproducible and minimally influenced by reader experience. The preoperative measurement of HSA has potential advantages for surgeons in terms of correct approach to hiatal defects in obese patient.

2019 ◽  
Vol 160 (16) ◽  
pp. 619-628
Author(s):  
Ian O’Sullivan ◽  
Ádám Tibor Schlégl ◽  
Péter Varga ◽  
Kamilla Kerekes ◽  
Csaba Vermes ◽  
...  

Abstract: Introduction: Hand and wrist bone age assessment methods cannot be performed when using the recommended patient position within the EOS scanner. Aim: We aimed to assess alternative methods for use with the EOS. Method: After investigating 9 alternatives, five methods were selected – cervical vertebra (Hassel–Farman), iliac crest (Risser ‘plus’), hip (Oxford), knee (O’Connor), calcaneus (Nicholson) – and applied to EOS scans of 114, 2–21-year-old normal individuals. Intraclass correlation coefficient tests for reliability and Spearman correlation with calendar age were assessed. Results: Intra- and interobserver reliabilities were all excellent, except with the knee method (0.865 – ‘good’). Calcaneal and cervical methods were the fastest to apply (mean 17.5 s, 33.4 s per evaluation), however, calcanei were unassessable in 14% of scans (versus 1% of cervical). All methods correlated significantly with calendar age (r>0.829, p<0.05). Difficulties were principally absent (12%) or obscured (23%) landmarks. Conclusion: Bone age assessment is possible with all 5 methods, however, the Hassel–Farman method proved to be easily useable, fast and reliable. Orv Hetil. 2019; 160(16): 619–628.


Author(s):  
Marieke Ruessink ◽  
Lenie van den Engel-Hoek ◽  
Marjo van Gerven ◽  
Bea Spek ◽  
Bert de Swart ◽  
...  

PURPOSE: The Radboud Dysarthria Assessment (RDA) was published in 2014. Adaptation into a pediatric version (p-RDA) was required because of relevant differences between children and adults. The purpose of this study was to assess the feasibility of the p-RDA and to test intra-rater and inter-rater reliability as well as the validity of the two severity scales (function and activity level). METHODS: Video recordings were made of 35 participants with (suspected) dysarthria (age 4 to 17 years) while being assessed using the p-RDA. Intra-rater reliability was assessed by one, and inter-rater reliability by two experiments using the Intraclass Correlation Coefficient (ICC). Validity of the severity scales was tested by correlating the consensus scores with the independently rated scores on four communication scales, three mobility scales, and one self-care scale using Spearman correlation coefficients (r s). RESULTS: The assessment was applicable for 89% of the tested sample, with good intra-rater and inter-rater reliability (ICC = 0.88–0.98 and 0.83–0.93). The p-RDA severity scales (function and activity level) correlated from substantially to strongly with the communication scales (r s = 0.69–0.82 and 0.77–0.92) and self-care scale (r s = 0.76–0.71) and correlated substantially with the mobility scales (r s = 0.49–0.60). CONCLUSION: The feasibility, reliability and validity of the p-RDA are sufficient for clinical use.


2019 ◽  
Vol 33 (9) ◽  
pp. 1479-1491 ◽  
Author(s):  
Yulong Wang ◽  
Shanshan Guo ◽  
Jiejiao Zheng ◽  
Qing Mei Wang ◽  
Yuling Zhang ◽  
...  

Objective:The aim of this study was to validate a novel pictorial-based Longshi Scale for evaluating a patient’s disability by healthcare professionals and non-professionals.Design:Prospective study.Setting:Rehabilitation departments from a grade A, class 3 public hospital, a grade B, class 2 public hospital, and a private hospital and seven community rehabilitation centers.Subjects:A total of 618 patients and 251 patients with functional disabilities were recruited in a two-phase study, respectively.Main measures:Outcome measure: pictorial scale of activities of daily living (ADLs, Longshi Scale). Reference measure: Barthel Index. The Spearman correlation coefficient was used to analyze the validity of Longshi Scale against Barthel Index.Results:In phase 1 study, from March 2016 to August 2016, the results demonstrated that the Longshi Scale was both reliable and valid (intraclass correlation coefficient based on two-way random effect (ICC2,1) = 0.877–0.974 for intra-rater reliability; ICC2,1= 0.928–0.979; κ = 0.679–1.000 for inter-rater reliability; intraclass correlation coefficient based on one-way random effect (ICC1,1) = 0.921–0.984 for test–retest reliability and Spearman correlation coefficient = 0.836–0.899). In the second phase, in March 2018, results further demonstrated that the Longshi Scale had good inter-rater and intra-rater reliability among healthcare professionals and non-professionals including therapists, interns, and personal care aids (ICC1,1= 0.822–0.882 on Day 1; ICC1,1= 0.842–0.899 on Day 7 for inter-rater reliability). In addition, the Longshi Scale decreased assessment time significantly, compared with the Barthel Index assessment ( P < 0.01).Conclusion:The Longshi Scale could potentially provide an efficient way for healthcare professionals and non-professionals who may have minimal training to assess the ADLs of functionally disabled patients.


2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Bas A. de Vries ◽  
Stephan J. Breda ◽  
Bragi Sveinsson ◽  
Emily J. McWalter ◽  
Duncan E. Meuffels ◽  
...  

Abstract Background To assess diagnostic accuracy of quantitative double-echo in steady-state (qDESS) MRI for detecting synovitis in knee osteoarthritis (OA). Methods Patients with different degrees of radiographic knee OA were included prospectively. All underwent MRI with both qDESS and contrast-enhanced T1-weighted magnetic resonance imaging (CE-MRI). A linear combination of the two qDESS images can be used to create an image that displays contrast between synovium and the synovial fluid. Synovitis on both qDESS and CE-MRI was assessed semi-quantitatively, using a whole-knee synovitis sum score, indicating no/equivocal, mild, moderate, and severe synovitis. The correlation between sum scores of qDESS and CE-MRI (reference standard) was determined using Spearman’s rank correlation coefficient and intraclass correlation coefficient for absolute agreement. Receiver operating characteristic analysis was performed to assess the diagnostic performance of qDESS for detecting different degrees of synovitis, with CE-MRI as reference standard. Results In the 31 patients included, very strong correlation was found between synovitis sum scores on qDESS and CE-MRI (ρ = 0.96, p < 0.001), with high absolute agreement (0.84 (95%CI 0.14–0.95)). Mean sum score (SD) values on qDESS 5.16 (3.75) were lower than on CE-MRI 7.13 (4.66), indicating systematically underestimated synovitis severity on qDESS. For detecting mild synovitis or higher, high sensitivity and specificity were found for qDESS (1.00 (95%CI 0.80–1.00) and 0.909 (0.571–1.00), respectively). For detecting moderate synovitis or higher, sensitivity and specificity were good (0.727 (95%CI 0.393–0.927) and 1.00 (0.800–1.00), respectively). Conclusion qDESS MRI is able to, however with an underestimation, detect synovitis in patients with knee OA.


Author(s):  
Karl Spiteri ◽  
Kate Grafton ◽  
John Xerri de Caro ◽  
David Broom

The International Physical Activity Questionnaire (IPAQ) is a widely used self-reported physical activity (PA) measure developed to allow for international cross-country comparisons. Due to its unavailability, the aim of this study was to translate the IPAQ-long to Maltese and undertake reliability testing. The IPAQ-long English version was translated into Maltese following the IPAQ guidelines, which included backwards translation. Maltese-speaking participants, aged between 18 and 69 years, were recruited through convenience sampling (n = 170). Participants completed the IPAQ-long twice within an 8- to 48-hr period. PA was calculated in MET minutes per week, and reliability was calculated using the Spearman correlation, intraclass correlation coefficient, concordance correlation coefficient, and Bland–Altman plots. A total of 155 participants completed the questionnaire at two time points. Spearman correlation was .83 (.76–.88) for total PA and .84 (.77–.89) for total sitting time. The intraclass correlation coefficient was .83 (.76–.88) and the concordance correlation coefficient was .75–.87 for total PA. The lowest reliability was for total transport, with a concordance correlation coefficient of .21−.45. Bland–Altman plots highlight that 95% of the differences fell within 2 SDs from the mean. Since the Maltese IPAQ-long has similar reliability to the English version, the authors recommend that health care professionals and PA practitioners use this tool when examining population-level PA among Maltese-speaking individuals.


2015 ◽  
Vol 31 (3) ◽  
pp. 507-515 ◽  
Author(s):  
Laércio Lima Luz ◽  
Lívia Maria Santiago ◽  
João Francisco Santos da Silva ◽  
Inês Echenique Mattos

This study aims to assess the psychometric properties of the Brazilian version of the Vulnerable Elders Survey-13 (VES-13). Interviews were carried out with individuals aged 60 years and over receiving care at an ambulatory cancer centre. Test-retest reliability was assessed using the Spearman correlation coefficient, intraclass correlation coefficients and Cohen's kappa coefficient. Construct validity was assessed by testing convergent and discriminant validity using principal component analysis and Varimax rotation. The Spearman correlation coefficient value of the comparison between test and retest scores was 0.98 (p < 0.001). All intraclass correlation coefficient values were higher than 0.60 and kappa coefficients varied between 0.33 and 0.94. Three identified factors explained 72.6% of overall sample variance. VES-13 presented good convergent validity and reasonable discriminant validity. The psychometric properties of the adapted version of the VES-13 are consistent and adequate for use with the Brazilian population.


2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Bo Zhang ◽  
Jianjun Gu ◽  
Xiaoxiao Zhang ◽  
Bin Yang ◽  
Zheng Wang ◽  
...  

Purpose. To explore the probability and variation in biomechanical measurements of rabbit cornea by a modified Scheimpflug device.Methods. A modified Scheimpflug device was developed by imaging anterior segment of the model imitating the intact eye at various posterior pressures. The eight isolated rabbit corneas were mounted on the Barron artificial chamber and images of the anterior segment were taken at posterior pressures of 15, 30, 45, 60, and 75 mmHg by the device. The repeatability and reliability of the parameters including CCT, ACD, ACV, and CV were evaluated at each posterior pressure. All the variations of the parameters at the different posterior pressures were calculated.Results. All parameters showed good intraobserver reliability (Cronbach’s alpha; intraclass correlation coefficient,α, ICC > 0.96) and repeatability in the modified Scheimpflug device. With the increase of posterior pressures, the ratio of CCT decreased linearly and the bulk modulus gradually reduced to a platform. The increase of ACD was almost linear with the posterior pressures elevated.Conclusions. The modified Scheimpflug device was a valuable tool to investigate the biomechanics of the cornea. The posterior pressure 15–75 mmHg range produced small viscoelastic deformations and nearly linear pressure-deformation response in the rabbit cornea.


Cancers ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 2135
Author(s):  
Vincenza Granata ◽  
Damiano Caruso ◽  
Roberto Grassi ◽  
Salvatore Cappabianca ◽  
Alfonso Reginelli ◽  
...  

Background: Structured reporting (SR) in oncologic imaging is becoming necessary and has recently been recognized by major scientific societies. The aim of this study was to build MRI-based structured reports for rectal cancer (RC) staging and restaging in order to provide clinicians all critical tumor information. Materials and Methods: A panel of radiologist experts in abdominal imaging, called the members of the Italian Society of Medical and Interventional Radiology, was established. The modified Delphi process was used to build the SR and to assess the level of agreement in all sections. The Cronbach’s alpha (Cα) correlation coefficient was used to assess the internal consistency of each section and to measure the quality analysis according to the average inter-item correlation. The intraclass correlation coefficient (ICC) was also evaluated. Results: After the second Delphi round of the SR RC staging, the panelists’ single scores and sum of scores were 3.8 (range 2–4) and 169, and the SR RC restaging panelists’ single scores and sum of scores were 3.7 (range 2–4) and 148, respectively. The Cα correlation coefficient was 0.79 for SR staging and 0.81 for SR restaging. The ICCs for the SR RC staging and restaging were 0.78 (p < 0.01) and 0.82 (p < 0.01), respectively. The final SR version was built and included 53 items for RC staging and 50 items for RC restaging. Conclusions: The final version of the structured reports of MRI-based RC staging and restaging should be a helpful and promising tool for clinicians in managing cancer patients properly. Structured reports collect all Patient Clinical Data, Clinical Evaluations and relevant key findings of Rectal Cancer, both in staging and restaging, and can facilitate clinical decision-making.


2021 ◽  
pp. 026010602098235 ◽  
Author(s):  
Panchali Moitra ◽  
Preeti Verma ◽  
Jagmeet Madan

Background: Development of culturally appropriate and psychometrically sound instruments that measure knowledge and health behaviors of children will help to inform appropriate interventions. Aim: To develop and test the validity and reliability of a questionnaire measuring knowledge, attitudes, and practices to healthy eating and activity patterns in school children in India. Methods: Review of literature, focus-group discussions, and theoretical constructs of the Health Belief Model guided the development of an item pool. Face and content validity were assessed by children and a panel of experts and the item content validity, item difficulty, and discrimination indices were calculated. Construct validity was determined using the principal axis method of exploratory factor analysis among a cross-sectional sample of children ( n=252). Internal consistency (Cronbach α values >0.7) and test-retest reliability (intraclass correlation coefficient values >0.75) were estimated. Results: Item content validity index for clarity and relevance were satisfactory (>0.80) and internal consistency for knowledge (Kuder-Richardson 20 = 0.832), attitude (Cronbach’s α = 0.912), and practice items (Cronbach’s α = 0.769) were good. Four factors (children’s eating habits, family dietary practices, and consumption of healthy and unhealthy foods) and two factors (moderate to vigorous activities and sedentary activities) explained 67.7% and 48.2% of the total variance in practice items. Intraclass correlation coefficient estimates ranged from good to excellent (0.72–0.99). Conclusions: The results of the validity and reliability of the 84-item knowledge, attitudes, and practices to healthy eating and activity patterns in schoolchildren questionnaire were promising. The detailed description of the methodology employed may prove useful to researchers conducting similar studies in children.


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