Variation in Cervical Length over Time during a Single Transvaginal Ultrasound Examination

Objective To quantify the degree of change in cervical length (CL) over a 3-minute transvaginal ultrasound. Study Design We conducted a prospective observational study of nulliparous patients who underwent routine transvaginal CL screening at the time of their second-trimester ultrasound. We recorded CL at four time points (0, 1, 2, 3 minutes) and compared these values to determine the minute-to-minute change within a single patient. Results A total of 771 patients were included. The mean gestational age was 20.8 weeks (±0.84). We used a linear mixed effect model to assess if each minute during the ultrasound is associated with a change in CL. The intraclass correlation coefficient between minute 0 to minute 3 was 0.82 (95% confidence interval: 0.80, 0.84). This indicates that there is a relatively high within-patient correlation in CL during their ultrasound. Additionally, we stratified patients based on their starting CL; the intraclass correlation coefficient remained high for all groups. We additionally compared CL at each minute. Although there is a statistically significant difference between several time points, the actual difference is small and not clinically meaningful. Conclusion The variation in CL over a 3-minute transvaginal ultrasound examination is not clinically significant. It may be reasonable to conduct this examination over a shorter period.

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Μελέτη της ποιότητας ζωής πριν και μετά από χειρουργική αντιμετώπιση της νοσογόνου παχυσαρκίας

10.12681/eadd/37963 ◽

2013 ◽

Author(s):

Βασίλειος Χαραλαμπάκης

Keyword(s):

Correlation Coefficient ◽

Intraclass Correlation Coefficient ◽

Intraclass Correlation ◽

Mixed Effect Model ◽

Mixed Effect ◽

Cronbach Alpha ◽

Effect Model ◽

Sf 36

Ο όρος «Ποιότητα Ζωής» (ΠΖ) αναφέρεται στη συνολική ευζωία του ατόμου η οποία περιλαμβάνει τη συναισθηματική, κοινωνική και φυσική συνιστώσα της ζωής. Όταν, όμως, ο όρος χρησιμοποιείται στο χώρο της ιατρικής και της περίθαλψης αναφέρεται στο κατά πόσο η ευζωία του ατόμου επηρεάζεται σε βάθος χρόνου από μια ασθένεια, αναπηρία ή διαταραχή.Η νοσογόνος παχυσαρκία επηρεάζει την ποιότητα ζωής. Η αξιολόγησή της έχει προσελκύσει σημαντική προσοχή και επιτυγχάνεται μέσω ειδικών εργαλείων μέτρησης, όπως είναι το ερωτηματολόγιο ΠΖ Moorehead-Ardelt II (MAII). Αποτελεί ένα ερωτηματολόγιο ειδικό για την παχυσαρκία που έχει δημιουργηθεί και σταθμιστεί στην Αγγλική γλώσσα και χρησιμοποιείται ευρέως στο χώρο της Βαριατρικής Χειρουργικής. Σύμφωνα με τα διεθνή δεδομένα των μελετών στάθμισης, η υιοθέτηση ενός ερωτηματολογίου σε μια άλλη από την αρχική γλώσσα, προϋποθέτει εφαρμογή προτυποποιημένης μεθοδολογίας για τη μετάφραση και τον έλεγχο της διατήρηση των ψυχομετρικών ιδιοτήτων του. Συνεπώς, η δημιουργία μιας έγκυρης μετάφρασης και η αξιολόγηση των ιδιοτήτων της Ελληνικής έκδοσης του ΜΑΙΙ, κρίθηκαν απαραίτητες πριν από την ευρεία εφαρμογή του ερωτηματολογίου σε βαριατρικούς ασθενείς. Αυτό επιτεύχθηκε μέσω της στάθμισής του με τη χρήση της Ελληνικής έκδοσης του υβριδικού ερωτηματολογίου ΠΖ SF-36 και μιας Οπτικής Αναλογικής Κλίμακας (VAS). Ο βαθμός ομοιογένειας εκτιμήθηκε με το συντελεστή συσχέτισης Cronbach alpha και η επαναληψιμότητα με το συντελεστή ενδοσυσχέτισης intraclass correlation coefficient (ICC). Η δομική εγκυρότητα του ερωτηματολογίου αξιολογήθηκε με τη χρήση δοκιμασίας Pearson μεταξύ των τιμών του ΜΑΙΙ και αυτών του SF-36 και της VAS.Συνολικά 175 ασθενείς εντάχθηκαν στη μελέτη. Η επαναληψιμότητα ελέγχθηκε σε δείγμα 40 ασθενών με μεσοδιάστημα 15 ημερών. Αναδείχθηκε ένας πολύ καλός βαθμός ομοιογένειας με συντελεστή Cronbach alpha της τάξης του 0,85. Παρατηρήθηκε εξαιρετική επαναληψιμότητα με συνολική ICC της τάξης του 0,981. Η σημαντική συσχέτιση μεταξύ της Ελληνικής έκδοσης του ΜΑΙΙ καθώς και κάθε ερώτησης αυτού και του SF-36 και της VAS αποδεικνύουν υψηλή δομική εγκυρότητα. Η αρνητική συσχέτιση μεταξύ της συνολικής βαθμολογίας του μεταφρασμένου ΜΑΙΙ και του ΔΜΣ επιβεβαίωσαν την υψηλή κλινική εγκυρότητά του.Μετά από αυτή την προσεκτική διαδικασία, δημιουργήθηκε η Ελληνική έκδοση του ερωτηματολογίου ΜΑΙΙ και αποδείχθηκε η εγκυρότητα και αξιοπιστία της, στη μέτρηση της ΠΖ σε νοσογόνα παχύσαρκους ασθενείς, πριν και μετά από βαριατρική επέμβαση.Το δεύτερο στάδιο αυτής της μελέτης περιελάμβανε την κλινική εφαρμογή του μεταφρασμένου ερωτηματολογίου για την προοπτική, διαχρονική αξιολόγηση της ΠΖ σε ασθενείς που επρόκειτο να υποβληθούν σε λαπαροσκοπική επιμήκη γαστρεκτομή (LSG). Η ΠΖ θεωρείται μείζον μέσο αξιολόγησης του βαριατρικού αποτελέσματος, όμως προοπτικά δεδομένα των αλλαγών της ΠΖ μετά από LSG σπανίζουν στη βιβλιογραφία.Στη μελέτη εντάχθηκαν προοπτικά, διαδοχικοί νοσογόνα παχύσαρκοι ασθενείς που προσήλθαν σε μια περίοδο 30 μηνών προκειμένου να υποβληθούν σε LSG. Το ερωτηματολόγιο ΜΑΙΙ και μια 10-βάθμια VAS προσφέρθηκαν στους ασθενείς προεγχειρητικά και στους 6, 12 και 24 μήνες μετεγχειρητικά. Τα πλήρη σωματομετρικά δεδομένα καθώς και οι συνοδές παθήσεις καταγράφηκαν σε όλα τα χρονικά σημεία.Στη μελέτη περιελήφθησαν συνολικά 111 ασθενείς (60 γυναίκες και 51 άνδρες, μέσης ηλικίας 36,8±9,2 έτη). Δεν σημειώθηκε κανένας θάνατος ενώ το συνολικό ποσοστό επιπλοκών ανήλθε στο 15,3%. Ο μέσος προεγχειρητικός ΔΜΣ ήταν 49,1±7,5kg/m2 και η % απώλεια του πλεονάζοντος ΔΜΣ (%EBL) ήταν 51,1±14,9% στους 6, 64,2±17,9% στους 12 και 66,4±18% στους 24 μήνες αντίστοιχα. Όλες οι σχετιζόμενες με την παχυσαρκία παθήσεις βελτιώθηκαν σημαντικά. Η μέση συνολική βαθμολογία του ΜΑΙΙ ήταν -0,40±1,30 προεγχειρητικά και αυξήθηκε σε 1,75±0,83, 2,18±0,80 και 1,95±0,71 στους 6, 12 και 24 μήνες μετεγχειρητικά (p<0.001). Η βαθμολογία της VAS αυξήθηκε από 2,8±1,4 προεγχειρητικά σε 9,1±1,1, 9,2±1,1 και 9,0±1,3 στους 6, 12 και 24 μήνες μετεγχειρητικά. Η βελτίωση της βαθμολογία του ΜΑΙΙ διατηρήθηκε καλύτερα στις γυναίκες στους 24 μήνες, παρά το γεγονός ότι ο τελικός ΔΜΣ ήταν συγκρίσιμος στα 2 φύλα. Ο ΔΜΣ δε σχετιζόταν σημαντικά με τη βαθμολογία ΜΑΙΙ σε κάθε χρονικό σημείο της μελέτης. Η %EBL, το γυναικείο φύλο, ο μικρότερος αριθμός συνοδών παθήσεων και η ίαση του ΣΔ2 και της υπνικής άπνοιας αποτέλεσαν σημαντικούς προγνωστικούς παράγοντες υψηλής ΠΖ στο τέλος της μελέτης, όπως προέκυψε από πολυπαραγοντική ανάλυση παλινδρόμησης και από την ανάλυση Mixed effect model. Ενδιαφέρον ήταν ότι οι ασθενείς που απαλλάχθηκαν από το σακχαρώδη διαβήτη, παρουσίασαν υψηλές τιμές ΠΖ παρά το γεγονός ότι η %EBL ήταν σημαντικά μικρότερη.Η LSG αποτελεί μια ασφαλή και αποτελεσματική βαριατρική επέμβαση με αποδεκτή νοσηρότητα, ικανοποιητική και διατηρούμενη απώλεια σωματικού βάρους καθώς και σημαντική βελτίωση της ΠΖ, ειδικά σε ασθενείς στους οποίους βελτιώνονται οι συνοδές παθήσεις. Το μεταβολικό αποτέλεσμα της Βαριατρικής Χειρουργικής φαίνεται οτι είναι περισσότερο σημαντικό από την απώλεια βάρους, όσον αφορά στη βελτίωση της ΠΖ. Η ανάλυση της ΠΖ είναι σημαντική για μια πλήρη αξιολόγηση του βαριατρικού αποτελέσματος, ενώ επιτρέπει την αναγνώριση υποομάδων ασθενών που θα ωφεληθούν τα μέγιστα από τη βαριατρική επέμβαση καθώς και εκείνων που θα χρειαστούν κάποιας μορφής παρέμβαση κατά τη μετεγχειρητική παρακολούθηση, προκειμένου να διατηρήσουν το βέλτιστο αποτέλεσμα ΠΖ. Η σημασία του μεταβολικού αποτελέσματος της LSG στην ΠΖ αποκαλύπτει ενδιαφέροντες δρόμους για το μέλλον της Βαριατρικής Χειρουργικής.

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Reproducibility of Toe Pressure Measurements

Journal for Vascular Ultrasound ◽

10.1177/154431670903300301 ◽

2009 ◽

Vol 33 (3) ◽

pp. 129-132 ◽

Cited By ~ 4

Author(s):

Neil Cloete ◽

Clare Kiely ◽

Mary Paula Colgan ◽

Naseem Haider ◽

Sean O'Neill ◽

...

Keyword(s):

Correlation Coefficient ◽

Intraclass Correlation Coefficient ◽

Carotid Artery Disease ◽

Intraclass Correlation ◽

Repeated Measurements ◽

Pressure Measurements ◽

Repeatability Coefficient ◽

Significant Difference ◽

Artery Disease ◽

Toe Pressure

Introduction Ankle/brachial indices are inaccurate in the presence of calcification, and physicians may rely on the measurement of digital pressures. As the population continues to age and with the escalation in type 2 diabetes, the importance of, and reliance on, toe pressure measurements will increase. The aim of this study was to assess the reproducibility of toe pressure measurements in a single vascular laboratory. Methods Repeated ankle/brachial indices and toe pressures were measured in 20 patients (10 with known peripheral vascular disease and 10 with aneurysmal or carotid artery disease but no history of PVD), and 10 control patients. Three measurements were made 48 hours apart. All measurements were made by a single vascular technologist. Reproducibility was assessed by the use of the repeatability coefficient and the intraclass correlation coefficient. Results Ankle/brachial indices ranged from 0.36 to 2.4, toe pressures from 18 mmHg to 173 mmHg, and toe/brachial indices from 0.11 to 1.1. The repeatability coefficient showed no significant difference between measurements ( p > 0.1) and the intraclass correlation coefficient estimates showed high agreement between repeated measurements (0.77–0.99). Bland-Altman plots indicated that the observer variability was equally distributed across the range of pressure measurements. Conclusion These results confirm the intraobserver reproducibility of toe pressure measurements; however, further work is required to demonstrate inter-observer reproducibility.

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Validity and reliability of badminton-specific Reactive Agility TestBadmintona özgü geliştirilen Reaktif Çeviklik Testinin geçerlik ve güvenirliği

Journal of Human Sciences ◽

10.14687/jhs.v15i1.5211 ◽

2018 ◽

Vol 15 (1) ◽

pp. 594

Author(s):

Mehmet Yıldız ◽

Uğur Fidan

Keyword(s):

Correlation Coefficient ◽

Intraclass Correlation Coefficient ◽

Linear Regression Analysis ◽

Intraclass Correlation ◽

T Test ◽

Validity And Reliability ◽

Test Protocol ◽

Significant Difference ◽

Reactive Agility ◽

The Difference

Many laboratory and field tests are used in the literature to measure agility. The aim of the present study was to investigate the reliability and validity of a new Reactive Agility Test developed for badminton. A total of fourty male [ 20 elites (age: 20.8 ± 2.98 year, height: 174.55 ± 12.03 cm, weight: 65.70 ± 14.41 kg) and 20 sub-elites (age: 22.20±1,51, height: 170.01 ± 05.80 cm, weight: 62.45 ± 6,45 kg)] badminton players took part in the present study. For validity, the difference and relationship between newly developed reactive agility and planned changing direction tests in terms of elit and sub-elit players was examined. In the reliability measurements of test-retest, The Reactive Agility Test at same route was performed twice. Independent sample t test was carried out in order to detect the difference among the groups in the search for validity. The identification of the relations between the two different tests was performed with linear regression analysis. The reliability of test-retest was tried to be estimated with the coefficient of variances and intraclass correlation coefficient, and the Bland Altman method. In addition, a systematic difference between the test and the retest was estimated with the paired t test. At the end of the study, while there was not a significant difference found in the rates of planned changing direction of the elit and sub-elit players, it was detected that reactive agility rates were better in the elit players (7.14±4.85 sec and 9.87±5.07 sec, respectively). Moreover, a high coefficient determination was revealed between two tests (r2: 0.63, p<0.01). In the comparison of test-retest, a high intraclass correlation coefficient (0.930) and a very low coefficient of variances (4.7) were found. Furthermore, it was observed in the Bland Altman graph that a 95% of concordance range of the data obtained between two measurements was a good and narrow concordance. In conclusion, it was determined that the new developed badminton specific Reactive Agility Test is a valid and reliable measurement method and it is suggested that this test protocol can be used to enhance and monitor reactive agility ability of badminton players.Extended English summary is in the end of Full Text PDF (TURKISH) file. ÖzetLiteratürde çevikliğin ölçülmesi amacıyla birçok laboratuvar ve saha testi kullanılmaktadır. Bu çalışmanın amacı badminton sporuna göre düzenlenmiş Reaktif Çeviklik Testinin güvenirlik ve geçerliğinin araştırılmasıdır. Araştırmaya toplam kırk erkek [20 elit (yaş: 20,8±2,98 yıl, boy uzunluğu: 174,55±12,03 cm, vücut ağırlığı:65,70±14,41 kg) ve 20 sub-elit (yaş: 22,20±1,51 yıl, boy uzunluğu: 170,01±05,80 cm, vücut ağırlığı:62,45±6,45 kg)] badminton oyuncusu katılmıştır. Geçerlik için yeni geliştirilen reaktif çeviklik ile planlı yön değiştirme testlerinin elit ve sub-elit katılımcılar arasındaki istatistiksel karşılaştırması ve ilişkisi analiz edilmiştir. Test-tekrar test güvenirlik ölçümlerinde aynı rotadaki reaktif çeviklik testi birer gün arayla iki kez uygulanmıştır. Geçerlik çalışmasında gruplar arası farkın belirlenmesi için bağımsız değişken t testi ve testler arası ilişkinin fonksiyonel olarak açıklanması ve bu ilişkinin bir modelle tanımlanması için basit doğrusal regresyon analizi yapılmıştır. Test-tekrar test güvenirliği varyasyon katsayısı, sınıf içi korelasyon katsayısı ve Bland Altman metodu ile kestirim edilmiştir. Ayrıca test- tekrar test arasında sistematik bir farkın olup olmadığı eşleştirilmiş t testi ile sınanmıştır. Çalışma sonunda elit ve sub-elit oyuncuların planlı yön değiştirme bulguları anlamlı bir fark bulunmazken, reaktif çeviklik derecelerinin elit oyuncularda istatistiksel olarak anlamlı farklı (sırasıyla 7,14±4.85 sn ve 9,87±5,07 sn) şekilde düşük olduğu tespit edilmiştir. Bununla beraber her iki test arasında yüksek düzeyde bir açıklayıcılık katsayısı tespit (r2: 0,63, p<0.01) edilmiştir. Test- tekrar test karşılaştırılmasında yüksek bir sınıf içi korelasyon katsayısı (0,930) ve çok düşük varyasyon katsayısı (4,7) belirlenmiştir. Ayrıca Bland-Altman grafiğinde iki ölçüm arasında elde edilen tüm verilerin %95 uyum aralığının dar ve iyi bir uyum gösterdiği gözlenmiştir. Sonuç olarak, badminton sporuna göre düzenlenmiş Reaktif Çeviklik Testinin geçerli ve güvenilir bir ölçüm yöntemi olduğu tespit edilmiştir ve badminton oyuncularının reaktif çeviklik becerilerinin geliştirilmesinde ve gelişimlerinin takibinde kullanılabileceği önerilmektedir.

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Progression of Beat-to-Beat Blood Pressure Variability Despite Best Medical Management

Hypertension ◽

10.1161/hypertensionaha.120.16290 ◽

2021 ◽

Vol 77 (1) ◽

pp. 193-201

Author(s):

Alastair J.S. Webb ◽

Amy Lawson ◽

Karolina Wartolowska ◽

Sara Mazzucco ◽

Peter M. Rothwell

Keyword(s):

Blood Pressure ◽

Cardiovascular Risk ◽

Pulse Wave Velocity ◽

Correlation Coefficient ◽

Wave Velocity ◽

Intraclass Correlation Coefficient ◽

Pulse Wave ◽

Intraclass Correlation ◽

Systolic Pressure ◽

Mixed Effect

Beat-to-beat variability in blood pressure (BP) is associated with recurrent stroke despite good control of hypertension. However, no study has identified rates of progression of beat-to-beat BP variability (BPV), its determinants, or which patient groups are particularly affected, limiting understanding of its potential as a treatment target. In consecutive patients one month after a transient ischaemic attack or nondisabling stroke (Oxford Vascular Study), continuous noninvasive BP was measured beat-to-beat over 5 minutes (Finometer). Arterial stiffness was measured by carotid-femoral pulse wave velocity (Sphygmocor). Repeat assessments were performed at the 5-year follow-up visit and agreement determined by intraclass correlation coefficient. Rates of progression of systolic BPV (SBPV) and diastolic BPV (DBPV) and their determinants were estimated by mixed-effect linear models, adjusted for age, sex, and cardiovascular risk factors. One hundred eighty-eight of 310 surviving, eligible patients had repeat assessments after a median of 5.8 years. Pulse wave velocity was highly reproducible but SBPV and DBPV were not (intraclass correlation coefficient: 0.71, 0.10, and 0.16, respectively), however, all 3 progressed significantly (pulse wave velocity, 2.39%, P <0.0001; SBPV, 8.36%, P <0.0001; DBPV, 9.7, P <0.0001). Rate of progression of pulse wave velocity, SBPV, and DBPV all increased significantly with age ( P <0.0001), with an increasingly positive skew and were particularly associated with female sex (pulse wave velocity P =0.00035; SBPV P <0.0001; DBPV P <0.0001) and aortic mean SBP (SBPV P =0.037, DBPV P <0.0001). Beat-to-beat BP variability progresses significantly in high-risk patients, particularly in older individuals with elevated aortic systolic pressure. Beat-to-beat BPV and its progression represent potential new therapeutic targets to reduce cardiovascular risk.

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Rising and Falling Trends in the Use of Chemotherapy and Targeted Therapy Near the End of Life in Older Patients With Cancer

Journal of Clinical Oncology ◽

10.1200/jco.18.02067 ◽

2019 ◽

Vol 37 (20) ◽

pp. 1721-1731 ◽

Cited By ~ 6

Author(s):

Penny Fang ◽

Reshma Jagsi ◽

Weiguo He ◽

Xiudong Lei ◽

Eric G. Campbell ◽

...

Keyword(s):

Targeted Therapy ◽

End Of Life ◽

Correlation Coefficient ◽

Intraclass Correlation Coefficient ◽

Intraclass Correlation ◽

Temporal Trends ◽

Logistic Models ◽

Time Points ◽

Patients With Cancer ◽

Oncology Practice

PURPOSE End-of-life (EOL) chemotherapy has been described as the most widespread, wasteful, and unnecessary practice in oncology, with benchmarking aimed to reduce physician use of chemotherapy within 14 days of EOL. We evaluated the recent transformation of EOL chemotherapy and targeted therapy practices nationally. METHODS In patients older than 65 years of age who died as a result of breast (n = 19,887), lung (n = 79,613), colorectal (n = 29,844), or prostate (n = 17,910) cancer between 2007 and 2013, we evaluated the guideline-benchmarked measure of chemotherapy use within 14 days of EOL in SEER-Medicare. Comparison outcomes were nonbenchmarked measures of chemotherapy and targeted therapy across time points within 6 months of EOL. Cochran-Armitage test was used to evaluate temporal trends. Multilevel logistic models and intraclass correlation coefficient was used to evaluate variation in EOL chemotherapy use at the physician level. RESULTS From 2007 to 2013, chemotherapy within 14 days of EOL declined from 6.7% to 4.9% of patients ( Ptrend < .001; ∆ = −1.8%). Similar declines occurred for chemotherapy within 1 month ( Ptrend < .001; ∆ = −1.8%) and 2 months ( Ptrend < .001; ∆ = −1.3%) of EOL. In contrast, chemotherapy within 4 to 6 months of EOL rose ( Ptrend ≤ .04; ∆ = 0.7% to 1.7%), and 43.0% of all patients received chemotherapy within 6 months of EOL. Frequency of targeted therapy use across all time points within 6 months of EOL was stable to marginally rising from 2007 to 2013 ( Ptrend = .09 to .82; ∆ = −0.2% to 1.8%); overall, 1.2% received targeted therapy within 14 days and 3.6% within 1 month of EOL. By 2013, 13.2% of patients received any targeted therapy within 6 months of EOL. In a multilevel model, 5.19% (intraclass correlation coefficient) of variation in 14-day EOL chemotherapy was attributed to the physician level. CONCLUSION With national benchmarking, chemotherapy within 14 days of EOL successfully declined to less than 5%, with comprehensive benchmark uptake by physicians. Results may inform current strategies to help to achieve high-value EOL oncology practice.

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Variability and Impact of Self-Selected Interset Rest Periods During Experienced Strength Training

Perceptual and Motor Skills ◽

10.1177/0031512519835976 ◽

2019 ◽

Vol 126 (3) ◽

pp. 546-558

Author(s):

P. Ibbott ◽

N. Ball ◽

M. Welvaert ◽

K. G. Thompson

Keyword(s):

Strength Training ◽

Correlation Coefficient ◽

Intraclass Correlation Coefficient ◽

Power Output ◽

Intraclass Correlation ◽

Rest Period ◽

Subjective Ratings ◽

Rest Periods ◽

Significant Difference ◽

Rest Time

We investigated the variability of strength trained athletes' self-selected rest periods between sets of heavy squat training. Sixteen strength-trained male athletes (Mage = 23, SD = 3 years) completed two squat training sessions 48 hours apart. Each training session consisted of five sets of 5RM squats, interspersed with self-selected interset rest periods. A Gymaware linear optical encoder collected kinetic data for each squat and temporal data for each interset rest period. The participants' subjective ratings of the experience were taken before (Readiness to Lift [RTL]) and after (Rating of Perceived Effort [RPE]) each set. Mean total rest time and mean power output differed significantly between sessions. For both sessions, interset rest period increased, and power output decreased between Sets 3, 4, and 5 (95% CI range [−101, −17]) compared with Set 1. In both sessions, RPE increased significantly in Set 3 compared with Set 1 (95% CI range = [0.68, 2.19]), while RTL decreased significantly from Set 3 (95% CI range [−2.99, −0.58]) compared to Set 1. Interset rest period and power output demonstrated fair reliability between sessions (mean intraclass correlation coefficient = 0.55), while RPE and RTL demonstrated good and excellent reliability, respectively (mean intraclass correlation coefficient = 0.63 and 0.80). In conclusion, highly trained strength athletes demonstrated a significant difference in their between session power output and total rest time when using self-selected interset rest periods, despite stability in their subjective ratings of fatigue and effort. Interset rest periods can be self-selected reliably to complete strength training in heavy squat protocol; however, power output may decline during the set.

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Reliability and Consistency of the Vestibular/Ocular Motor Screening (VOMS) Assessment Near Point of Convergence (NPC) Trials

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acz026.37 ◽

2019 ◽

Vol 34 (5) ◽

pp. 767-767

Author(s):

N Ernst ◽

A Sufrinko ◽

M Collins ◽

A Kontos

Keyword(s):

Correlation Coefficient ◽

Intraclass Correlation Coefficient ◽

Intraclass Correlation ◽

Ocular Motor ◽

Chi Square ◽

Mixed Effect ◽

Male Age ◽

Multiple Trials ◽

Absolute Agreement ◽

Chi Square Analysis

Abstract Purpose To examine the reliability of near point of convergence (NPC) across three trials and determine if one trial of NPC is adequate to identify receded NPC post-concussion. Methods Participants included 263 concussed patients (64.3% male; age=16.92±3.49 years) evaluated within 21 days of injury. NPC was measured in centimeters from the tip of the nose using a fixation stick and a Gulick anthropometric tape measure. A two-way, mixed effect, absolute agreement intraclass correlation coefficient (ICC 3,1) was conducted to evaluate reliability across the three trials. A chi-square analysis examined consistency of NPC classification (normal/abnormal) on the initial trial compared to average across three trials. Results Reliability of the three trials was high (.91 [95%CI, .89–.93]). Agreement between Trial 1 classification and classification based on average of all three trials was high (96.2%). Of the 10 participants who were classified differently for Trial 1 compared to average trials, 8 had borderline (e.g., 4–6 cm) measurements on the first trial. Conclusion NPC measurement across trials is reliable for the overall sample, but those who fell well below (i.e. 0–1cm) or well above (>8cm) clinical cutoffs on the first trial were almost always below or above respective cutoffs on the average convergence (>99%). Results suggest it is important to measure NPC across multiple trials for patients with initial borderline measurement.

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Reliability and Validity of the Kannada Version of the Consensus Auditory-Perceptual Evaluation of Voice

Journal of Speech Language and Hearing Research ◽

10.1044/2019_jslhr-19-00020 ◽

2020 ◽

Vol 63 (2) ◽

pp. 385-392 ◽

Cited By ~ 2

Author(s):

Dhanshree R. Gunjawate ◽

Rohit Ravi ◽

Srividya Bhagavan

Keyword(s):

Correlation Coefficient ◽

Intraclass Correlation Coefficient ◽

Function Analysis ◽

Intraclass Correlation ◽

Reliability And Validity ◽

Psychometric Validation ◽

Intrarater Reliability ◽

Perceptual Evaluation ◽

Significant Difference ◽

High Level

Purpose The purpose of this study was to evaluate the reliability and validity of the Kannada version of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V). Method The Kannada version of CAPE-V comprises six phrases that are phonetically designed as per the CAPE-V requirements. Sixty-five (21 individuals with dysphonia and 44 asymptomatic) participants were enrolled for the instrument psychometric validation. The interrater and intrarater reliability as well as validity were assessed. Results High level of agreement was noted between the three raters across all the CAPE-V parameters, highest for pitch (intraclass correlation coefficient value = .98) and lowest for loudness (intraclass correlation coefficient value = .96). High intrarater reliability agreement (intraclass correlation coefficient value > .97) was also noted for all the parameters. Among the correlation for parameters that are comparable between CAPE-V and the Grade, Roughness, Breathiness, Asthenia, and Strain scale, the highest correlation was noted for overall severity. There was a significant difference noted between the study and control groups for all parameters except loudness. The discriminant function analysis and classification revealed that 98% were correctly identified. Conclusion The Kannada version of CAPE-V has been proven to be a psychometrically reliable and valid tool to use for auditory-perceptual evaluation of voice.

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Development of a Tool Measuring Nurses’ Competence for Disaster Response

Prehospital and Disaster Medicine ◽

10.1017/s1049023x19002541 ◽

2019 ◽

Vol 34 (s1) ◽

pp. s119-s119

Author(s):

Sandra Mara Marin ◽

Regina Rigatto Witt

Keyword(s):

Correlation Coefficient ◽

Intraclass Correlation Coefficient ◽

Disaster Response ◽

Intraclass Correlation ◽

Cronbach’S Alpha ◽

Cronbach's Alpha ◽

Significant Difference ◽

Good Internal Consistency ◽

Assistance Service ◽

Two Stages

Introduction:Disasters are situations of complexity and unpredictability that require the performance of teams from various instances with preparation and qualification to assist the victims, recover the environment, and restore living conditions. Health services are essential in the response to a disaster, and nurses all over the world play a significant role in these disasters.Aim:To develop a valid and reliable scale to identify nursing competencies in disasters.Methods:Competencies were selected from those related to the framework developed by the International Council of Nurses. A methodological study was developed in two stages: I) validity of content and appearance verification and II) verification of applicability and reliability with test-retest. The participants of stage I were eight specialists in emergencies and disasters in Brazil. In stage II, 326 nurses from the Emergency Mobile Assistance Service in Southern Brazil participated. Data analysis utilized the Content Validity Index and Interest Reliability Index. Psychometric properties of the instrument were measured with Cronbach’s alpha coefficient; applicability and test-retest reliability with the use of the t-test and intraclass correlation coefficient and factorial validity.Results:Forty-one competencies of 51 were organized in three domains according to Factor Analysis. Cronbach’s alpha values showed good internal consistency. There was no significant difference between the test and retest scores. The intraclass correlation coefficient values were adequate. The instrument showed reproducibility and adequate applicability.Discussion:This tool will assess nurses’ competencies for disaster response and provide evidence for the development of educational policies in disasters, creating a reliable and prepared workforce to respond more effectively during a disaster.

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Inference for variance components in linear mixed-effect models with flexible random effect and error distributions

Statistical Methods in Medical Research ◽

10.1177/0962280220933909 ◽

2020 ◽

Vol 29 (12) ◽

pp. 3586-3604

Author(s):

Tom Chen ◽

Rui Wang

Keyword(s):

Correlation Coefficient ◽

Intraclass Correlation Coefficient ◽

Random Effects ◽

Bootstrap Method ◽

Intraclass Correlation ◽

Random Effect ◽

Correlated Data ◽

Parameter Distribution ◽

Mixed Effect ◽

Error Distributions

In many biomedical investigations, parameters of interest, such as the intraclass correlation coefficient, are functions of higher-order moments reflecting finer distributional characteristics. One popular method to make inference for such parameters is through postulating a parametric random effects model. We relax the standard normality assumptions for both the random effects and errors through the use of the Fleishman distribution, a flexible four-parameter distribution which accounts for the third and fourth cumulants. We propose a Fleishman bootstrap method to construct confidence intervals for correlated data and develop a normality test for the random effect and error distributions. Recognizing that the intraclass correlation coefficient may be heavily influenced by a few extreme observations, we propose a modified, quantile-normalized intraclass correlation coefficient. We evaluate our methods in simulation studies and apply these methods to the Childhood Adenotonsillectomy Trial sleep electroencephalogram data in quantifying wave-frequency correlation among different channels.

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