583 THE INTER- AND INTRA-OBSERVER RELIABILITY OF A NOVEL VIDEO-FLUOROSCOPY PROTOCOL FOR GASTRO-ESOPHAGEAL JUNCTION ANATOMY POST-FUNDOPLICATION

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
S Gan ◽  
N Lee ◽  
S Tan ◽  
S Edwards ◽  
G Kiroff ◽  
...  
Keyword(s):  
Clinical Utility ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Mixed Effects ◽  
Partial Fundoplication ◽  
Anatomical Changes ◽  
Intraclass Correlation Coefficients ◽  
Observer Reliability ◽  
Swallow Study ◽  
Video Fluoroscopy

Abstract   Despite modifications in surgical technique, the occurrence of troublesome dysphagia after fundoplication remains difficult to predict. Objective measurements on video-fluoroscopy swallow study (VFSS) may hold the key to understanding post-fundoplication dysphagia. This study reports the inter- and intra-observer reliability of video-fluoroscopic anatomical measurements of the post-fundoplication gastro-esophageal junction (GEJ). Methods Thirty-one patients underwent structured VFSS 6–12 months after laparoscopic total or partial fundoplication. VFSS protocol included six views: standing AP, 2x standing oblique, 2x prone oblique (POb), and prone oblique with continuous drinking. The primary observer recorded two sets of 11 variables of GEJ anatomy (3 mo interval between set 1- set 2). Further datasets (one each) were obtained from two medical students trained in two 2-hour sessions. Inter-observer reliability was determined from datasets of three observers and intra-observer reliability from primary observer. Intraclass correlation coefficients (ICC) two-way mixed-effects model was used (ICC agreement: 0.40–0.59 “fair”; 0.60–0.74 “good”; 0.75–1.00 “excellent”). Results ICC for inter-observer reliability was good-excellent in 47/66 measurements. All measures of maximal esophageal diameter, maximal esophageal diameter cf. wrap opening diameter and posterior distal esophageal angulation were good-excellent (ICC range 0.74–0.78; 0.84–0.91; 0.68–0.80 respectively). Four parameters recorded 83% good-excellent ICC: wrap closing diameter, minimal wrap diameter, GEJ anterior displacement and degree of axis deviation (GEJ cf. esophagus) (ICC range 0.50–0.85; 0.58–0.93; 0.56–0.79; 0.41–0.77 respectively). Absolute and axial wrap length showed low reproducibility: “good” ICC in 25% of measurements. POb measurements were most reliable: good-excellent ICC 86% of times. Intra-observer reliability was excellent in 98% of measurements (ICC range 0.74–0.99). Conclusion Following a structured protocol, VFSS measurements of GEJ post-fundoplication anatomy are reliable between observers except for measures of absolute and axial wrap length. Measures from the POb view showed the greatest inter-observer reliability and may have higher clinical utility. Further studies using structured VFSS are warranted to determine the correlation between troublesome dysphagia and anatomical changes of the gastro-esophageal junction post-fundoplication.

scholarly journals The reliability of the augmented Lehnert-Schroth and Rigo classification in scoliosis management

2021 ◽  
Vol 77 (2) ◽  
Author(s):  
Burçin Akçay ◽  
Tuğba Kuru Çolak ◽  
Adnan Apti ◽  
İlker Çolak ◽  
Önder Kızıltaş
Keyword(s):  
Treatment Plan ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Error Measurement ◽  
X Rays ◽  
X Ray ◽  
Intraclass Correlation Coefficients ◽  
Observer Reliability ◽  
The Individual ◽  
Curve Patterns

Background: In pattern-specific scoliosis exercises and bracing, the corrective treatment plan differs according to different curve patterns. There are a limited number of studies investigating the reliability of the commonly used classifications systems.Objective: To test the reliability of the augmented Lehnert-Schroth (ALS) classification and the Rigo classification.Methods: X-rays and posterior photographs of 45 patients with scoliosis were sent by the first author to three clinicians twice at 1-week intervals. The clinicians classified images according to the ALS and Rigo classifications, and the data were analysed using SPSS V-16. Intraclass correlation coefficients (ICCs) and standard error measurement (SEM) were calculated to evaluate the inter- and intra-observer reliability.Results: The inter-observer ICC values were 0.552 (ALS), 0.452 (Rigo) for X-ray images and 0.494 (ALS), 0.518 (Rigo) for the photographs. The average intra-observer ICC value was 0.720 (ALS), 0.581 (Rigo) for the X-ray images and 0.726 (ALS) and 0.467 (Rigo) for the photographs.Conclusions: The results of our study indicate moderate inter-observer reliability for X-ray images using the ALS classification and clinical photographs using the Rigo classification. Intra-observer reliability was moderate to good for X-ray images and clinical photographs using the ALS classification and poor to moderate for X-ray and clinical photographs using the Rigo classification.Clinical implications: Pattern classifications assist in creating a plan and indication of correction in specific scoliosis physiotherapy and pattern-specific brace applications and surgical treatment. More sub-types are needed to address the individual patterns of curvature. The optimisation of curve classification will likely reduce failures in diagnosis and treatment.

The choice of chromogen and reliability of contact rhinoscopy in the irradiated nasopharynx

2007 ◽  
Vol 122 (2) ◽  
pp. 177-180 ◽  
Author(s):  
Martin W Pak ◽  
Samuel Chow ◽  
C A van Hasselt
Keyword(s):  
Methylene Blue ◽  
Squamous Metaplasia ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Cross Sectional ◽  
Vital Stain ◽  
Intraclass Correlation Coefficients ◽  
Observer Reliability ◽  
Blue Stain ◽  
The Mean

AbstractA cross-sectional randomised single blind study was conducted to assess how concentrations of chromogen (vital stain) and the characteristics of the assessors affect the assessment of contact rhinoscopy. Twenty-eight patients who had undergone external radiotherapy for nasopharyngeal carcinoma were assessed by contact rhinoscopy using 0.5 per cent and 1 per cent methylene blue stain on opposite sides of the nasopharynx. Three independent observers assessed the visual clarity of the 45 contact endoscopic images showing squamous metaplasia according to a visual analogue scale. The intraclass correlation coefficients were 0.916 to 0.957 and 0.839 to 0.964 for intra-observer reliability of assessors in the groups of 0.5 per cent and 1 per cent stains, respectively. The intraclass correlation coefficients for inter-observer reliability of assessors were 0.884 and 0.885 in the groups of 0.5 per cent and 1 per cent stains, respectively. The mean scores of clarity of the cellular details were statistically higher in the group of 1 per cent stain among all assessors. These results showed that the assessment of squamous metaplasia by contact endoscopy is highly reliable irrespective of the clinical experience and knowledge of histopathology of the assessors. One per cent methylene blue should be the vital stain of choice in contact endoscopy.

Development and Reliability and Validity Testing of an Audit Tool for Trail/Path Characteristics: The Path Environment Audit Tool (PEAT)

2006 ◽  
Vol 3 (s1) ◽  
pp. S158-S175 ◽  
Author(s):  
Philip J. Troped ◽  
Ellen K. Cromley ◽  
Maren S. Fragala ◽  
Steven J. Melly ◽  
Hope H. Hasbrouck ◽  
...  
Keyword(s):  
Gold Standard ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Correlation Coefficients ◽  
Audit Tool ◽  
Validity Testing ◽  
Intraclass Correlation Coefficients ◽  
Observer Reliability ◽  
Acceptable Reliability

Background:To determine how trail characteristics may influence use, reliable and valid audit tools are needed.Methods:The Path Environment Audit Tool (PEAT) was developed with design, amenity, and aesthetics/maintenance items. Two observers independently audited 185 trail segments at 6 Massachusetts facilities. GPS-derived items were used as a “gold standard.” Kappa (k) statistics, observed agreement and intraclass correlation coefficients (ICCs) were calculated to assess inter-observer reliability and validity.Results:Fifteen of 16 primary amenity items had k-values ≥ 0.49 (“moderate”) and all had observed agreement ≥ 81%. Seven binary design items had k-values ranging from 0.19 to 0.71 and three of 5 ordinal items had ICCs ≥ 0.52. Only two aesthetics/maintenance items (n = 7) had moderate ICCs. Observed agreement between PEAT and GPS items was ≥ 0.77; k-values were ≥ 0.57 for 7 out of 10 comparisons.Conclusions:PEAT has acceptable reliability for most of its primary items and appears ready for use by researchers and practitioners.

Quantification of fluoroscopic fundoplication anatomy: inter- and intraobserver reliability

2021 ◽  
Author(s):  
Siang Wei Gan ◽  
Natalie Lee ◽  
Siao En Tan ◽  
Suzanne M Edwards ◽  
George K Kiroff ◽  
...  
Keyword(s):  
Interobserver Agreement ◽  
Interobserver Reliability ◽  
Gastroesophageal Junction ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Barium Swallow ◽  
Anatomical Features ◽  
Intraclass Correlation Coefficients ◽  
Objectively Measured ◽  
Video Fluoroscopy

SUMMARY The etiology of postfundoplication dysphagia remains incompletely understood. Subtle changes of gastroesophageal junction (GEJ) anatomy may be contributory. Barium swallows have potential for standardization to evaluate postsurgical anatomical features. Using structured barium swallows, we aim to identify reproducible, objectively measured postfundoplication anatomical features that will permit future comparison between patients with/without dysphagia. At 6–12 months of postfundoplication, 31 patients underwent structured barium swallow with video–fluoroscopy recording: standing anteroposterior; standing oblique (×2); prone oblique (×2); and prone oblique with continuous free drinking. A primary observer recorded 11 variables of GEJ anatomy for each view, repeated 3 months later, forming two datasets to assess intraobserver consistency. Interobserver reliability was determined using a dataset each from the primary observer and two medical students (after training). Intraclass correlation coefficients (ICC) were based on two-way mixed-effects model (ICC agreement: 0.40–0.59 ‘fair’; 0.60–0.74 ‘good’; 0.75–1.00 ‘excellent’). Interobserver reliability was good–excellent for 47 of 66 measurements. Measures of maximal esophageal diameter cf. wrap opening diameter and posterior esophageal angle showed high interobserver reproducibility on all views (ICC range 0.84–0.91; 0.68–0.80, respectively). Interobserver agreement was good–excellent for 5/6 views when measuring anterior GEJ displacement and axis deviation (ICC range 0.56–0.79; 0.41–0.77, respectively). Measures of wrap length showed lower reproducibility. Prone oblique measurements showed highest reproducibility (good–excellent agreement in 19/22 measurements). Intraobserver consistency was excellent for 98% of measurements (ICC range 0.74–0.99). Objective measurements of postfundoplication GEJ anatomy using structured barium swallow are reproducible and may allow further interrogation of anatomical features contributing to postfundoplication dysphagia.

scholarly journals The accuracy and reliability of preoperative digital 2D templating in prosthesis size prediction in uncemented versus cemented total hip arthroplasty: a systematic review and meta-analysis

2021 ◽  
Vol 6 (11) ◽  
pp. 1020-1039
Author(s):  
Joshua B.V. Smith ◽  
Habeeb Bishi ◽  
Chao Wang ◽  
Vipin Asopa ◽  
Richard E. Field ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Intraclass Correlation ◽  
Case Series ◽  
Correlation Coefficients ◽  
Group Differences ◽  
Digital Templating ◽  
Intraclass Correlation Coefficients ◽  
Observer Reliability ◽  
Randomised Controlled ◽  
High Level

The purpose of this study was to compare the accuracy and the inter- and intra-observer reliability of preoperative digital 2D templating in prosthesis size prediction for the planning of cemented or uncemented THA. This study was registered in the NIHR PROSPERO database (ID: CRD420BLINDED) and conducted according to the PRISMA guidelines. A search of electronic databases in March 2021 found 29 papers overall. The quality of evidence was assessed using the IHE Quality Appraisal of Case Series Studies Checklist and the CASP Randomised Controlled Trials Checklist. A meta-analysis was conducted, and the accuracy was presented as proportions and the inter- and intra-observer reliability were measured using intraclass correlation coefficients (ICC). Accuracy within one prosthesis size (±1) for cemented stems was 0.89 (95% confidence interval (CI) 0.83–0.95), cemented cups 0.78 (95% CI 0.67–0.89), uncemented stems 0.74 (95% CI 0.66–0.82) and uncemented cups 0.73 (95% CI 0.67–0.79) (test of group differences: p = 0.010). Inter-observer reliability (ICC) for uncemented cups was 0.88 (95% CI 0.85–0.91), uncemented stems 0.86 (95% CI 0.81–0.91), cemented stems 0.69 (95% CI 0.54–0.84) and cemented cups 0.68 (95% CI 0.55–0.81) (test of group differences: p = 0.004). Due to lack of data, intra-observer reliability (ICC) could only be calculated for uncemented prostheses, which for the stems was 0.90 (95% CI 0.88–0.92) and for the cups was 0.87 (95% CI 0.83–0.90) (test of group differences: p = 0.124). The accuracy of preoperative digital templating is greater for cemented prostheses, but the inter-observer reliability is greater for uncemented prostheses. The intra-observer reliability showed a high level of agreement for uncemented prostheses. Cite this article: EFORT Open Rev 2021;6:1020-1039. DOI: 10.1302/2058-5241.6.210048

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

1991 ◽  
Vol 34 (5) ◽  
pp. 989-999 ◽  
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.

scholarly journals Is there a relationship between the overhead press and split jerk maximum performance? Influence of sex

2021 ◽  
pp. 174795412110204
Author(s):  
Marcos A Soriano ◽  
G Gregory Haff ◽  
Paul Comfort ◽  
Francisco J Amaro-Gahete ◽  
Antonio Torres-González ◽  
...  
Keyword(s):  
Confidence Intervals ◽  
Body Mass ◽  
Upper Limb ◽  
High Reliability ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Training Experience ◽  
Maximum Performance ◽  
Repetition Maximum ◽  
Intraclass Correlation Coefficients

The aims of this study were to (I) determine the differences and relationship between the overhead press and split jerk performance in athletes involved in weightlifting training, and (II) explore the magnitude of these differences in one-repetition maximum (1RM) performances between sexes. Sixty-one men (age: 30.4 ± 6.7 years; height: 1.8 ± 0.5 m; body mass 82.5 ± 8.5 kg; weightlifting training experience: 3.7 ± 3.5 yrs) and 21 women (age: 29.5 ± 5.2 yrs; height: 1.7 ± 0.5 m; body mass: 62.6 ± 5.7 kg; weightlifting training experience: 3.0 ± 1.5 yrs) participated. The 1RM performance of the overhead press and split jerk were assessed for all participants, with the overhead press assessed on two occasions to determine between-session reliability. The intraclass correlation coefficients (ICC) and 95% confidence intervals showed a high reliability for the overhead press ICC = 0.98 (0.97 – 0.99). A very strong correlation and significant differences were found between the overhead press and split jerk 1RM performances for all participants (r = 0.90 [0.93 – 0.85], 60.2 ± 18.3 kg, 95.7 ± 29.3 kg, p ≤ 0.001). Men demonstrated stronger correlations between the overhead press and split jerk 1RM performances (r = 0.83 [0.73-0.90], p ≤ 0.001) compared with women (r = 0.56 [0.17-0.80], p = 0.008). These results provide evidence that 1RM performance of the overhead press and split jerk performance are highly related, highlighting the importance of upper-limb strength in the split jerk maximum performance.

scholarly journals Patient-Reported Dysphagia in Adults with Eosinophilic Esophagitis: Translation and Validation of the Swedish Eosinophilic Esophagitis Activity Index

Dysphagia ◽  
2021 ◽  
Author(s):  
Sofie Albinsson ◽  
Lisa Tuomi ◽  
Christine Wennerås ◽  
Helen Larsson
Keyword(s):  
Eosinophilic Esophagitis ◽  
Activity Index ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Control Group ◽  
Cronbach’S Alpha ◽  
Intraclass Correlation Coefficients ◽  
Cronbach's Alpha ◽  
Patient Reported ◽  
Eortc Qlq

AbstractThe lack of a Swedish patient-reported outcome instrument for eosinophilic esophagitis (EoE) has limited the assessment of the disease. The aims of the study were to translate and validate the Eosinophilic Esophagitis Activity Index (EEsAI) to Swedish and to assess the symptom severity of patients with EoE compared to a nondysphagia control group. The EEsAI was translated and adapted to a Swedish cultural context (S-EEsAI) based on international guidelines. The S-EEsAI was validated using adult Swedish patients with EoE (n = 97) and an age- and sex-matched nondysphagia control group (n = 97). All participants completed the S-EEsAI, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Oesophageal Module 18 (EORTC QLQ-OES18), and supplementary questions regarding feasibility and demographics. Reliability and validity of the S-EEsAI were evaluated by Cronbach’s alpha and Spearman correlation coefficients between the domains of the S-EEsAI and the EORTC QLQ-OES18. A test–retest analysis of 29 patients was evaluated through intraclass correlation coefficients. The S-EEsAI had sufficient reliability with Cronbach’s alpha values of 0.83 and 0.85 for the “visual dysphagia question” and the “avoidance, modification and slow eating score” domains, respectively. The test–retest reliability was sufficient, with good to excellent intraclass correlation coefficients (0.60–0.89). The S-EEsAI domains showed moderate correlation to 6/10 EORTC QLQ-OES18 domains, indicating adequate validity. The patient S-EEsAI results differed significantly from those of the nondysphagia controls (p < 0.001). The S-EEsAI appears to be a valid and reliable instrument for monitoring adult patients with EoE in Sweden.

scholarly journals Diagnosis of left ventricular hypertrophy using non-ECG-gated 15O-water PET

2021 ◽  
Author(s):  
Jens Sörensen ◽  
Jonny Nordström ◽  
Tomasz Baron ◽  
Stellan Mörner ◽  
Sven-Olof Granstam ◽  
...  
Keyword(s):  
Method Development ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Roc Curves ◽  
Left Ventricular ◽  
Intraclass Correlation Coefficients ◽  
Concentric Hypertrophy ◽  
2D Echocardiography ◽  
Positron Emission ◽  
Septal Wall Thickness

Abstract Aim To develop a method for diagnosing left ventricular (LV) hypertrophy from cardiac perfusion 15O-water positron emission tomography (PET). Methods We retrospectively pooled data from 139 subjects in four research cohorts. LV remodeling patterns ranged from normal to severe eccentric and concentric hypertrophy. 15O-water PET scans (n = 197) were performed with three different PET devices. A low-end scanner (66 scans) was used for method development, and remaining scans with newer devices for a blinded evaluation. Dynamic data were converted into parametric images of perfusable tissue fraction for semi-automatic delineation of the LV wall and calculation of LV mass (LVM) and septal wall thickness (WT). LVM and WT from PET were compared to cardiac magnetic resonance (CMR, n = 47) and WT to 2D-echocardiography (2DE, n = 36). PET accuracy was tested using linear regression, Bland–Altman plots, and ROC curves. Observer reproducibility were evaluated using intraclass correlation coefficients. Results High correlations were found in the blinded analyses (r ≥ 0.87, P < 0.0001 for all). AUC for detecting increased LVM and WT (> 12 mm and > 15 mm) was ≥ 0.95 (P < 0.0001 for all). Reproducibility was excellent (ICC ≥ 0.93, P < 0.0001). Conclusion 15O-water PET might detect LV hypertrophy with high accuracy and precision.

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