858: A Comparison of Two Grading Systems in Predicting Stage

2004 ◽  
Vol 171 (4S) ◽  
pp. 227-227
Author(s):  
Bungo Furusato ◽  
Isabell A. Sesterhenn ◽  
Emiko Furusato ◽  
William F. McCarthy ◽  
Judd W. Maul ◽  
...  
Keyword(s):  
Grading Systems

Is the Deductive Falsification Approach a Better Basis for Clinical Trial Appraisal?

2019 ◽  
Vol 14 (3) ◽  
pp. 224-228
Author(s):  
Steffen Mickenautsch
Keyword(s):  
Clinical Trial ◽  
Decision Making ◽  
Empirical Evidence ◽  
Clinical Decision Making ◽  
Inductive Reasoning ◽  
Clinical Decision ◽  
Future Trial ◽  
Grading Systems ◽  
Component Scores ◽  
Current Clinical Trial

Background: Inductive reasoning relies on an infinite regress without sufficient factual basis and verification is at any time vulnerable to single contrary observation. Thus, appraisal based on inductive verification, as applied in current clinical trial appraisal scales, checklists or grading systems, cannot prove or justify trial validity. Discussion: Trial appraisal based on deductive falsification can identify invalid trials and give evidence for the recommendation to exclude these from clinical decision-making. Such appraisal remains agnostic towards corroborated trials that pass all appraisal criteria. The results of corroborated trials cannot be considered more robust than falsified trials since nothing within a particular set of complied trial criteria can give certainty for trial compliance with any other appraisal criterion in future. A corroborated trial may or may not reflect therapeutic truth and may thus be the basis for clinical guidance, pending results of any future trial re-appraisal. Conclusion: Trial grading following appraisal based on deductive falsification should be binary (0 = Invalid or 1 = Unclear) and single component scores should be multiplied. Appraisal criteria for the judgment of trial characteristics require a clear rationale, quantification of such rationale and empirical evidence concerning the effect of trial characteristics on trial results.

The Primacy of Experience

2019 ◽  
pp. 64-81
Author(s):  
Andrea Schiavio
Keyword(s):  
Ecological Factors ◽  
Assessment Practices ◽  
Flexible Systems ◽  
Phenomenological Philosophy ◽  
The Core ◽  
Learning Contexts ◽  
Grading Systems ◽  
Recent Developments ◽  
Core Issue ◽  
Event Based

This chapter explores a possible alternative to traditional “paper-and-pencil” assessment practices in music classes. It argues that an approach based on phenomenological philosophy and inspired by recent developments in cognitive science may shed new light on learning and help educators reconsider grading systems accordingly. After individuating the core issue in an unresolved tension between subjective-objective methodologies relevant to certain learning contexts, the chapter proposes a possible remedy by appealing to three principles central to “embodied” approaches to cognition. Such principles may help educators reframe cognitive phenomena (learning described as a measurable event based on “information processing”) in terms of cognitive ecosystems (learning understood as a negotiating and transformative activity codetermined by diverse embodied and ecological factors connected in recurrent fashion). Accommodating this shift implies transforming assessment practices into more open and flexible systems that take seriously the challenge of cooperative learning and phenomenological reflections.

scholarly journals Prospective Validation of Indocyanine Green Lymphangiography Staging of Breast Cancer-Related Lymphedema

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1540
Author(s):  
Mads Gustaf Jørgensen ◽  
Navid Mohamadpour Toyserkani ◽  
Frederik Christopher Gulmark Hansen ◽  
Jørn Bo Thomsen ◽  
Jens Ahm Sørensen
Keyword(s):  
Breast Cancer ◽  
Indocyanine Green ◽  
Clinical Severity ◽  
Serious Adverse Events ◽  
Disease Information ◽  
Grading Systems ◽  
Breast Cancer Related Lymphedema ◽  
Disease Stratification ◽  
Md Anderson ◽  
Clinical Measurements

Indocyanine green lymphangiography (ICG-L) allows real-time investigation of lymphatics. Plastic surgeons performing lymphatic reconstruction use the ICG-L for patient selection and stratification using the MD Anderson (MDA) and the Arm Dermal Backflow (ADB) grading systems. However, the applicability of ICG-L in evaluating breast cancer-related lymphedema (BCRL) is sparse and not well established. This study comprehensively examines the usability of ICG-L in the assessment of BCRL. We prospectively performed ICG-L in 237 BCRL patients between January 2019 and February 2020. The aim of this study was to assess the interrater and intrarater agreement and interscale consensus of ratings made using the MDA and ADB scales. Three independent raters performed a total of 2607 ICG-L assessments. The ICG-L stage for each grading system was correlated to the lymphedema volume to assess the agreement between the ICG-L stage and clinical severity. The interrater agreement was near perfect for the MDA scale (kappa 0.82–0.90) and the ADB scale (kappa 0.80–0.91). Similarly, we found a near-perfect intrarater agreement for the MDA scale (kappa 0.84–0.94) and the ADB scale (kappa 0.88–0.89). The agreement between the MDA and the ADB scales was substantial (kappa 0.65–0.68); however, the ADB scale systematically overestimated lower ICG-L stages compared to the MDA scale. The volume of lymphedema correlated slightly with MDA stage (Spearmans rho = 0.44, p < 0.001) and ADB stage (rs = 0.35, p < 0.001). No serious adverse events occurred. The staging of BCRL with ICG-L is reliable, safe, and provides unique disease information unobtainable with clinical measurements alone. The MDA scale seems to provide better disease stratification compared to the ADB scale.

Systematic review of radiological cervical foraminal grading systems

2021 ◽  
Author(s):  
James Meacock ◽  
Moritz Schramm ◽  
Senthil Selvanathan ◽  
Stuart Currie ◽  
Deborah Stocken ◽  
...  
Keyword(s):  
Systematic Review ◽  
Grading Systems

scholarly journals Comparison of numerical and standard sarnat grading using the NICHD and SIBEN methods

2021 ◽  
Author(s):  
Brian H. Walsh ◽  
Chelsea Munster ◽  
Hoda El-Shibiny ◽  
Edward Yang ◽  
Terrie E. Inder ◽  
...  
Keyword(s):  
Predictive Ability ◽  
Roc Curves ◽  
Cerebral Injury ◽  
Neonatal Encephalopathy ◽  
Minimum Threshold ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Grading Systems ◽  
Good Agreement

Abstract Objective The NICHD and SIBEN assessments are adapted from the Sarnat grade, and used to determine severity of neonatal encephalopathy (NE). We compare NICHD and SIBEN methods, and their ability to define a minimum threshold associated with significant cerebral injury. Study design Between 2016 and 2019, 145 infants with NE (77-mild; 65-moderate; 3-severe) were included. NICHD and SIBEN grade and numerical scores were assigned. Kappa scores described agreement between methods, and ROC curves their ability to predict MR injury. Results Good agreement existed between grading systems (K = 0.86). SIBEN defined more infants as moderate, and less as mild, than NICHD (p < 0.001). Both numerical scores were superior to standard grades in predicting MR injury. Conclusion Despite good agreement between methods, SIBEN defines more infants as moderate NE. Both numerical scores were superior to standard grade, and comparable to each other, in defining a minimum threshold for cerebral injury. Further assessment contrasting their predictive ability for long-term outcome is required.

scholarly journals Early Detection of Cancer: Evaluation of MR Imaging Grading Systems in Patients with Suspected Nasopharyngeal Carcinoma

2020 ◽  
Vol 41 (3) ◽  
pp. 515-521 ◽  
Author(s):  
A.D. King ◽  
J.K.S. Woo ◽  
Q.-Y. Ai ◽  
F.K.F. Mo ◽  
T.Y. So ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Early Detection ◽  
Mr Imaging ◽  
Early Detection Of Cancer ◽  
Grading Systems

scholarly journals Automated feature-based grading and progression analysis of diabetic retinopathy

Eye ◽  
2021 ◽  
Author(s):  
Lutfiah Al-Turk ◽  
James Wawrzynski ◽  
Su Wang ◽  
Paul Krause ◽  
George M. Saleh ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Diabetic Macular Oedema ◽  
Large Datasets ◽  
Image Analysis System ◽  
Learning Approaches ◽  
External Evaluation ◽  
Severity Scale ◽  
Grading Systems ◽  
Feature Based ◽  
Analysis System

Abstract Background In diabetic retinopathy (DR) screening programmes feature-based grading guidelines are used by human graders. However, recent deep learning approaches have focused on end to end learning, based on labelled data at the whole image level. Most predictions from such software offer a direct grading output without information about the retinal features responsible for the grade. In this work, we demonstrate a feature based retinal image analysis system, which aims to support flexible grading and monitor progression. Methods The system was evaluated against images that had been graded according to two different grading systems; The International Clinical Diabetic Retinopathy and Diabetic Macular Oedema Severity Scale and the UK’s National Screening Committee guidelines. Results External evaluation on large datasets collected from three nations (Kenya, Saudi Arabia and China) was carried out. On a DR referable level, sensitivity did not vary significantly between different DR grading schemes (91.2–94.2.0%) and there were excellent specificity values above 93% in all image sets. More importantly, no cases of severe non-proliferative DR, proliferative DR or DMO were missed. Conclusions We demonstrate the potential of an AI feature-based DR grading system that is not constrained to any specific grading scheme.

Is intervertebral disc degeneration related to segmental instability? An evaluation with two different grading systems based on clinical imaging

2017 ◽  
Vol 59 (3) ◽  
pp. 327-335 ◽  
Author(s):  
David Volkheimer ◽  
Fabio Galbusera ◽  
Christian Liebsch ◽  
Sabine Schlegel ◽  
Friederike Rohlmann ◽  
...  
Keyword(s):  
Intervertebral Disc Degeneration ◽  
Statistical Significance ◽  
Axial Rotation ◽  
Spinal Motion ◽  
X Ray ◽  
Grading Systems ◽  
Flexion Extension ◽  
The Difference ◽  
Magnetic Resonance Imaging Mri

Background Several in vitro studies investigated how degeneration affects spinal motion. However, no consensus has emerged from these studies. Purpose To investigate how degeneration grading systems influence the kinematic output of spinal specimens. Material and Methods Flexibility testing was performed with ten human T12-S1 specimens. Degeneration was graded using two different classifications, one based on X-ray and the other one on magnetic resonance imaging (MRI). Intersegmental rotation (expressed by range of motion [ROM] and neutral zone [NZ]) was determined in all principal motion directions. Further, shear translation was measured during flexion/extension motion. Results The X-ray grading system yielded systematically lesser degeneration. In flexion/extension, only small differences in ROM and NZ were found between moderately degenerated motion segments, with only NZ for the MRI grading reaching statistical significance. In axial rotation, a significant increase in NZ for moderately degenerated segments was found for both grading systems, whereas the difference in ROM was significant only for the MRI scheme. Generally, the relative increases were more pronounced for the MRI classification compared to the X-ray grading scheme. In lateral bending, only relatively small differences between the degeneration groups were found. When evaluating shear translations, a non-significant increase was found for moderately degenerated segments. Motion segment segments tended to regain stability as degeneration progressed without reaching the level of statistical significance. Conclusion We found a fair agreement between the grading schemes which, nonetheless, yielded similar degeneration-related effects on intersegmental kinematics. However, as the trends were more pronounced using the Pfirrmann classification, this grading scheme appears superior for degeneration assessment.

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