scholarly journals An assessment of inter-rater agreement of the literature filtering process in the development of evidence-based dietary guidelines

2006 ◽  
Vol 9 (4) ◽  
pp. 494-500 ◽  
Author(s):  
Marcia Cooper ◽  
Wendy Ungar ◽  
Stanley Zlotkin
Keyword(s):  
False Negative ◽  
Consensus Meeting ◽  
Dietary Guidelines ◽  
Kappa Statistics ◽  
Evidence Based ◽  
Reference Standard ◽  
Percentage Agreement ◽  
Rater Agreement ◽  
Eligibility Criteria ◽  
Guideline Topic

AbstractObjectiveTo determine whether the literature filtering process, a vital initial component of a systematic literature review, could be successfully completed by nutrition professionals or non-professionals.DesignUsing a diet–disease relationship as the guideline topic, inter-rater agreement for the title and abstract filtering processes between and among professionals and non-professionals was assessed and compared with an expert reference standard. Predetermined eligibility criteria were applied by all raters to 185 titles and 90 abstracts. Filtering decisions were initially made independently and then revised after a within-pair consensus meeting.SubjectsThe raters were six dietitians (RD) and six nutrition graduate students (Grad). To assess inter-rater agreement (reliability), each group was divided into three pairs.ResultsWeighted and unweighted kappa statistics and percentage agreement were calculated to determine the inter-rater agreement within pairs. Sensitivity and specificity estimates were determined by comparing responses with those of an expert reference standard. Overall, Grad pairs demonstrated greater inter-rater agreement than RD pairs for title filtering (P < 0.05); no differences were observed for abstract filtering. Compared with the expert reference standard, every rater and pair had false-negative responses for both title and abstract filtering.ConclusionsAfter consensus meetings, both RDs and Grads were comparable in their agreement on title and abstract filtering, although important differences remained compared with the expert reference standard. This study provides preliminary findings on the value of utilising a non-expert pair in developing guidelines, and suggests that the literature filtering process is complex and quite subjective.

scholarly journals Toward an Evidence-Based Definition and Classification of Carbohydrate Food Quality: An Expert Panel Report

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2667
Author(s):  
Kevin B. Comerford ◽  
Yanni Papanikolaou ◽  
Julie Miller Jones ◽  
Judith Rodriguez ◽  
Joanne Slavin ◽  
...  
Keyword(s):  
Food Quality ◽  
Diet Quality ◽  
Expert Panel ◽  
Present Report ◽  
Food Group ◽  
Dietary Guidelines ◽  
Evidence Based ◽  
Carbohydrate Quality ◽  
Dietary Guidelines For Americans

Carbohydrate-containing crops provide the bulk of dietary energy worldwide. In addition to their various carbohydrate forms (sugars, starches, fibers) and ratios, these foods may also contain varying amounts and combinations of proteins, fats, vitamins, minerals, phytochemicals, prebiotics, and anti-nutritional factors that may impact diet quality and health. Currently, there is no standardized or unified way to assess the quality of carbohydrate foods for the overall purpose of improving diet quality and health outcomes, creating an urgent need for the development of metrics and tools to better define and classify high-quality carbohydrate foods. The present report is based on a series of expert panel meetings and a scoping review of the literature focused on carbohydrate quality indicators and metrics produced over the last 10 years. The report outlines various approaches to assessing food quality, and proposes next steps and principles for developing improved metrics for assessing carbohydrate food quality. The expert panel concluded that a composite metric based on nutrient profiling methods featuring inputs such as carbohydrate–fiber–sugar ratios, micronutrients, and/or food group classification could provide useful and informative measures for guiding researchers, policymakers, industry, and consumers towards a better understanding of carbohydrate food quality and overall healthier diets. The identification of higher quality carbohydrate foods could improve evidence-based public health policies and programming—such as the 2025–2030 Dietary Guidelines for Americans.

scholarly journals Diagnostic Performance of Ankle-Brachial Pressure Index in Lower Extremity Arterial Disease

2021 ◽  
Vol 07 (03) ◽  
pp. e132-e137
Author(s):  
Mohammed Alagha ◽  
Thomas M. Aherne ◽  
Ahmed Hassanin ◽  
Adeel S. Zafar ◽  
Doireann P. Joyce ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Sensitivity And Specificity ◽  
False Negative ◽  
Arterial Disease ◽  
Initial Assessment ◽  
Reference Standard ◽  
Lower Extremity Arterial Disease ◽  
Negative Results ◽  
Positive Results ◽  
Arterial Imaging

Abstract Introduction Ankle-brachial pressure indices (ABIs) continue to form the basis of diagnostics for lower extremity arterial disease (LEAD). However, there remains a paucity of data to support its accuracy. This study aims to evaluate its diagnostic sensitivity and specificity using established arterial-imaging modalities as a benchmark. Methods In this retrospective study, a regional, prospectively maintained, vascular laboratory database was interrogated to identify referred patients with arterial disease who underwent concomitant assessment with ABI and lower limb arterial duplex ultrasound (DUS). Duplex acted as the reference standard. Those who had peripheral computed tomography angiogram (CTA) within 3 months of initial assessment were included in a subgroup analysis to correlate ABI with CTA. The primary end point was the sensitivity and specificity of ABI compared with DUS as the reference standard. Results Concomitant assessment was performed in 438 limbs (250 patients) over a 27-month period. The ABI was normal (0.9 to 1.4) in 196 limbs (44.9%) and abnormal in the remaining 241 limbs (55.1%). False-positive results occurred in 83 out of 241 limbs (34.4%), and false-negative results occurred in 54 limbs out of 196 (27.5%). True-positive results were 158 out of 241 limbs (65.6%), whereas true-negative results were 142 out of 196 limbs (72.4%). ABI using DUS as a benchmark identified a sensitivity for peripheral artery disease of 72.3% and a specificity of 69.3%. Concomitant CTA imaging was available in 200 limbs. The sensitivity and specificity of ABI correlated with CTA were 65.5 and 68.8%, respectively. Conclusion ABIs have a moderate predictive value in the diagnosis of LEAD. Normal range outcomes cannot be taken to infer the absence of LEAD and, as such, further arterial imaging in the form of DUS or angiography should be strongly considered in those with suspected underlying disease requiring intervention. Further noninvasive tests such as exercise studies or pulse volume waveforms should be considered, if diagnostic uncertainty exists, in those requiring nonoperative intervention and risk factor control.

scholarly journals Comparison of 2D Fat Suppressed Proton Density (FS-PD) and 3D (WATS-c) MRI pulse sequences in evaluation of chondromalacia patellae

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Ahmed Ibrahim Tawfik ◽  
Wael Hamza Kamr ◽  
Saher Ebrahim Taman
Keyword(s):  
Diagnostic Performance ◽  
False Negative ◽  
Pulse Sequences ◽  
Proton Density ◽  
Grading System ◽  
Reference Standard ◽  
Mr Images ◽  
Arthroscopic Findings ◽  
Chondromalacia Patella ◽  
Sensitivity Specificity

Abstract Background Comparing the diagnostic performance of widely used 2D FSE technique (fat-suppressed proton density; FS-PD) and the 3D technique (water-selective cartilage scan; WATS-c) in evaluation of the chondromalacia patella by using arthroscopy as reference standard Results Seventy-five adult patients were enrolled in this study. They underwent MRI examinations then arthroscopy done in 2–4 days after it. MRI was done using 2D (FS-PD) and 3D (WATS-c) sequences and MR images were compared by two radiologists separately, then grading of the cartilage lesions was performed according to modified Noyes grading system and comparison between grade 0–1, 2, and 3 lesions was done using arthroscopic findings as a reference. A false-negative result is considered if there was undergrading of chondromalacia and false-positive result if chondromalacia was overgraded. Each sequence sensitivity, specificity, and accuracy was calculated by both readers. For reader 1, the sensitivity is 69% for WATS-c and 80% for FS-PD and the accuracy is 90% for WATS-c and 92% for FS-PD and for reader 2, the sensitivity is 56% for WATS-c and 84% for FS-PD and the accuracy is 88% for WATS-c and 94% for FS-PD. Conclusion 2D FS-PD images showed better diagnostic performance than 3D WATS-c images for evaluating chondromalacia patella.

Abstract WP418: A Systematic Comparison of Key Features of Ischaemic Stroke Prevention Guidelines in Low- and Middle-income vs High-income Countries

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Hernan O Bayona ◽  
Mayowa Owolabi ◽  
Wayne Feng ◽  
James R Sawers ◽  
Paul Olowoyo ◽  
...  
Keyword(s):  
Stroke Prevention ◽  
High Income ◽  
Evidence Based ◽  
Vascular Risk ◽  
Eligibility Criteria ◽  
Middle Income ◽  
Middle Income Countries ◽  
Prevention Guideline ◽  
Prevention Guidelines ◽  
Low And Middle Income

Introduction: Implementation of contextually appropriate, evidence-based, expert-recommended stroke prevention guideline is particularly important in Low- and Middle-Income Countries (LMICs), which bear disproportional larger burden of stroke while possessing fewer resources. Focus therefore, should be on approaches enabling healthcare systems to improve control of vascular risk factors. Objective: We aimed to compare important features of stroke prevention guidelines between LMICs and High Income Countries (HICs). Methods: We systematically searched PubMed, AJOL, SciELO, and LILACS databases for stroke prevention guidelines published between January 2005 and December 2015 by country. Primary search items included: “Stroke” and “Guidelines”. We critically appraised the articles for evidence level, issuance frequency and implementation aspects to clinical practice. Results: Among 45 stroke prevention guidelines published, 28 (62%) met eligibility criteria: 7 from LMICs (25%) and 21 from HICs (75%). LMIC-issued guidelines were less likely to have conflict of interest declarations (57% vs. 100%, p=0.01), involve high quality systematic reviews (57% vs. 95%, p= 0.03), had good dissemination channels (14% vs 71%, p=0.02). The patient views and preferences were the most significant stakeholder considerations in HICs (43%, p=0.04) compared with LMICs. Conclusion: The quality and quantity of stroke prevention guidelines in LMICs are less than those of HICs and need to be significantly improved upon.

Abstract WP282: Protecting Stroke Patients from Aspiration and Mortality through a Bedside Aspiration Screen

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Edith Matesic
Keyword(s):  
Organizational Learning ◽  
Aspiration Pneumonia ◽  
The Body ◽  
Kappa Statistics ◽  
Evidence Based ◽  
Stroke Patients ◽  
Rater Reliability ◽  
Stroke Treatment ◽  
Risk Of Death ◽  
The Impact

Background: Stroke patients initially experience dysphagia approximately 42-76% of the time, putting them at high risk for developing aspiration pneumonia and increasing the risk of death threefold in the first 30 days following onset of the condition. Interventions to identify risk for aspiration pneumonia are key to reducing mortality in hospitalized patients. However, no generally recognized bedside aspiration screen exists, and few have been rigorously tested. The Edith-Huhn-Matesic Bedside Aspiration Screen (EHMBAS) TM was developed as an evidence-based RN bedside aspiration screening protocol. Purpose: This study analyzed the sensitivity and inter-rater reliability of EHMBAS TM , assessed the efficacy of training methods, evaluated patient feedback, and looked at the impact of organizational learning. Methods: RNs were trained to apply the EHMBAS TM . An evaluation study assessed the sensitivity, specificity and predictability of the screen to detect aspiration in the stroke population study group. Cohen’s Kappa statistics was applied to test inter-rater reliability. Pre- and post-implementation Likert surveys examined patient and staff satisfaction on the education plan and screening process, respectively. Lastly, an analysis of organizational learning examined whether changes enhanced adherence to screening requirements. Results: Results showed that the EHMBAS TM demonstrated strong validity (94% sensitivity) and high inter-rater reliability (Kappa = .92, p<.001). Pre- and post- staff training survey results demonstrated a significant positive change in knowledge gained, feelings of preparedness, and satisfaction with teaching methods. Further, 92.3% of patients surveyed had positive screening experiences. The hospital received Silver recognition from The American Heart Association for following stroke treatment guidelines 85% of the time for at least 12 months, demonstrating the positive impact of the protocol on organizational change. Conclusions: This study contributes to the body of work aimed at establishing a reliable evidence-based, bedside aspiration screen. Patient safety is enhanced, because screen results help determine when patients can safely receive medication and nutrition by mouth.

scholarly journals Detection of Fracture Bones in X-ray Images Categorization

2020 ◽  
pp. 1-11
Author(s):  
Adigun Oyeranmi ◽  
Babatunde Ronke ◽  
Rufai Mohammed ◽  
Aigbokhan Edwin
Keyword(s):  
Feature Extraction ◽  
Performance Metrics ◽  
Confusion Matrix ◽  
False Negative ◽  
Support Vector ◽  
Kappa Statistics ◽  
Fracture Detection ◽  
True Negative ◽  
Research Attention ◽  
X Ray

Fractured bone detection and categorization is currently receiving research attention in computer aided diagnosis system because of the ease it has brought to doctors in classification and interpretation of X-ray images.  The choice of an efficient algorithm or combination of algorithms is paramount to accurately detect and categorize fractures in X-ray images, which is the first stage of diagnosis in treatment and correction of damaged bones for patients. This is what this research seeks to address. The research design involves data collection, preprocessing, segmentation, feature extraction, classification and evaluation of the proposed method. The sample dataset were x-ray images collected from the Department of Radiology, National Orthopedic Hospital, Igbobi-Lagos, Nigeria as well as Open Access Medical Image Repositories. The image preprocessing involves the conversion of images in RGB format to grayscale, sharpening and smoothing using Unsharp Masking Tool.  The segmentation of the preprocessed image was carried out by adopting the Entropy method in the first stage and Canny edge method in the second stage while feature extraction was performed using Hough Transformation. Detection and classification of fracture image employed a combination of two algorithms;  K-Nearest Neighbor (KNN) and Support Vector Machine (SVM) for detecting fracture locations based on four classification types: (normal, comminute, oblique and transverse).Two performance assessment methods were employed to evaluate the developed system. The first evaluation was based on confusion matrix which evaluates fracture and non-fracture on the basis of TP (True Positive), TN (True negative), FP (False Positive) and FN (False Negative). The second appraisal was based on Kappa Statistics which evaluates the type of fracture by determining the accuracy of the categorized fracture bone type. The result of first assessment for fracture detection shows that 26 out of 40 preprocessed images were fractured, resulting to the following three values of performance metrics: accuracy value of 90%, sensitivity of 87% and specificity of 100%. The Kappa coefficient error assessment produced accuracy of 83% during classification. The proposed method can find suitable use in categorization of fracture types on different bone images based on the results obtained from the experiment.

Which psychosocial interventions improve sex worker well-being? A systematic review of evidence from resource-rich countries

2021 ◽  
pp. bmjsrh-2021-201028
Author(s):  
Kevin Turner ◽  
Jane Meyrick ◽  
Danny Miller ◽  
Laura Stopgate
Keyword(s):  
Sex Workers ◽  
Real Life ◽  
Qualitative Evaluation ◽  
Psychosocial Interventions ◽  
Well Being ◽  
Evidence Base ◽  
Vulnerable Groups ◽  
Cochrane Library ◽  
Evidence Based ◽  
Eligibility Criteria

ObjectiveTo establish the state of the evidence base around psychosocial interventions that support well-being in sex workers in order to inform policy and practice within a resource-rich geographical context.MethodsPublished and unpublished studies were identified through electronic databases (PsychINFO, CINHAL Plus, MEDLINE, EMBASE, The Cochrane Library and Open Grey), hand searching and contacting relevant organisations and experts in the field. Studies were included if they were conducted in high-income settings with sex workers or people engaging in exchange or transactional sex, and evaluated the effect of a psychosocial intervention with validated psychological or well-being measures or through qualitative evaluation.ResultsA total of 19 202 studies were identified of which 10 studies met the eligibility criteria. The heterogeneity found dictated a narrative synthesis across studies. Overall, there was very little evidence of good quality to make clear evidence-based recommendations. Despite methodological limitations, the evidence as it stands suggests that peer health initiatives improve well-being in female street-based sex workers. Use of ecological momentary assessment (EMA), a diary-based method of collecting real-life behavioural data through the use of twice-daily questionnaires via a smartphone, increased self-esteem and behaviour change intentions.ConclusionsWork with sex workers should be based on an evidence-based approach. Limitations to the existing evidence and the constraints of this work with vulnerable groups are recognised and discussed.

Evaluation of a Rapid Immunochromatographic test kit to the Gold Standard Fluorescent Antibody test for diagnosis of rabies in animals in Bhutan 

2020 ◽  
Author(s):  
Tenzin Tenzin ◽  
Kelzang Lhamo ◽  
Purna B Rai ◽  
Dawa Tshering ◽  
Pema Jamtsho ◽  
...  
Keyword(s):  
Predictive Value ◽  
Fluorescent Antibody ◽  
False Negative ◽  
Rapid Test ◽  
Antibody Test ◽  
Reference Standard ◽  
Predictive Values ◽  
Percent Agreement ◽  
Test Kit ◽  
Resource Poor

Abstract Background: Rabies kills approximately 59,000 people in the world each year worldwide. Rapid and accurate diagnosis of rabies is important for instituting rapid containment measures and for advising the exposed people for postexposure treatment. The application of a rapid diagnostic tests in the field can greatly enhance disease surveillance and diagnostic activities, especially in resource poor settings. In this study, a total of 179 brain tissue samples collected from different rabies suspect animal species (113 dogs, 50 cattle, 10 cats, 3 goats, 2 horses, and 1 bear) were selected and tested using both rapid immunochromatographic kit and the reference standard fluorescent antibody test (FAT). We evaluated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of a rapid antigen detection test kit produced by BioNote, Inc. (Hwaseong-si, Korea) relative to a FAT for its fit-for-purpose for confirmation of clinical cases of rabies for early response and enhancing rabies surveillance. Results: Among 179 samples examined in this study, there was a concordance in results by the rapid test and FAT in 115 positive samples and 54 negative samples. Test results were discordant in 10 samples which were positive by FAT, but negative (false negative) by rapid kit. The rapid test kit showed a sensitivity of 92% (95% CI: 85.9 – 95.6) and specificity of 100% (95% CI: 93.4 – 100) using FAT as the reference standard. The positive and negative predictive values were found to be 100% (95% CI:96.7 – 100) and 84.4% (95% CI: 73.6 – 91.3), respectively. Overall, there was 94.4% (95% CI: 90 – 96.9) test agreement between rapid test and FAT (Kappa value = 0.874) with a positive percent agreement and negative percent agreement of 92 and 100%, respectively. Conclusions: Our finding demonstrated that the rapid test kit (BioNote) can be used for rabies surveillance and confirming clinical case of rabies in animals for making rapid decisions particularly controlling rabies outbreaks in resource poor settings.

scholarly journals Validity and Reliability of an Expanded Vegetable Questionnaire Among Elementary School Children

2019 ◽  
Vol 3 (8) ◽  
Author(s):  
M J Landry ◽  
N Ranjit ◽  
D M Hoelscher ◽  
F M Asigbee ◽  
S Vandyousefi ◽  
...  
Keyword(s):  
Vegetable Intake ◽  
Weighted Kappa ◽  
Fifth Grade ◽  
Kappa Statistics ◽  
Percentage Agreement ◽  
Validity And Reliability ◽  
Reliable Measure ◽  
Dietary Recall ◽  
Fifth Grade Students ◽  
Reliability Estimates

ABSTRACT Background The purpose of this study was to expand the School Physical Activity and Nutrition questionnaire to include a greater variety of vegetables and to evaluate the relative validity and reliability of these revised items. Objectives This study utilized 2 convenience samples of third to fifth graders for an analysis: validity (n = 70) and reliability (n = 76). Validity was assessed by comparing questionnaire items with vegetable intake reported from a 24-hour dietary recall covering the same reference period. Reliability estimates were assessed via same-day test-retest. Results Agreement correlations ranged from 0.35 to 0.71. Kappa statistics varied from 0.16 to 0.66. Percentage agreements ranged from 57% to 87%. Test-retest Spearman coefficients were greater than 0.50 for 6 items, weighted Kappa values were greater than 0.40 for all 7 items, and percentage agreement exceeded 75% for 5 items. Conclusions Results suggest that the questionnaire is a valid and reliable measure of the previous day's vegetable intake in third- to fifth-grade students. This trial was registered at ClinicalTrials.gov as NCT02668744.

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