Clinical correlates and implications of the reliability of the frailty index in the Canadian Longitudinal Study on Aging

2021 ◽  
Author(s):  
Quoc Dinh Nguyen ◽  
Erica M Moodie ◽  
Mark R Keezer ◽  
Christina Wolfson
Keyword(s):  
Odds Ratio ◽  
Frailty Index ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Community Dwelling ◽  
Deficit Accumulation ◽  
Intraclass Correlation Coefficients ◽  
Reliability Estimates ◽  
Predicted Probability ◽  
The Impact

Abstract Background Deficit-accumulation frailty indices (FIs) are widely used to characterize frailty. FIs vary in number and composition of items; the impact of this variation on reliability and clinical applicability is unknown. Methods We simulated 12,000 studies using a set of 70 candidate deficits in 12,080 community-dwelling participants 65 years and older. For each study, we varied the number (5, 10, 15, 25, 35, 45) and composition (random selection) of items defining the FI and calculated descriptive and predictive estimates: frailty score, prevalence, frailty cut-off, mortality odds ratio, predicted probability of mortality for FI=0.28 (prevalence threshold), and FI cut-off predicting 10% mortality over the follow-up. We summarized the estimates’ medians and spreads (0.025-0.975 quantiles) by number of items and calculated intraclass correlation coefficients (ICC). Results Medians of frailty scores were 0.11-0.12 with decreasing spreads from 0.04-0.24 to 0.10-0.14 for 5-item and 45-item FIs. The median cut-offs identifying 15% as frail was 0.19-0.20 and stable; the spreads decreased with more items. However, medians and spreads for the prevalence of frailty (medians: 11% to 3%), mortality odds ratio (medians:1.24 to 2.19), predicted probability of mortality (medians: 8% to 17%), and FI cut-off predicting 10% mortality (medians: 0.38 to 0.20) varied markedly. ICC increased from 0.19 (5-item FIs) to 0.84 (45-item FIs). Conclusions Variability in the number and composition of items of individual FIs strongly influences their reliability. Estimates using FIs may not be sufficiently stable for generalizing results or direct application. We propose avenues to improve the development, reporting, and interpretation of FIs.

scholarly journals An Electromyographic Analysis of the Deep Cervical Flexor Muscles in Performance of Craniocervical Flexion

2003 ◽  
Vol 83 (10) ◽  
pp. 899-906 ◽  
Author(s):  
Deborah Falla ◽  
Gwendolen Jull ◽  
Paul Dall'Alba ◽  
Alberto Rainoldi ◽  
Roberto Merletti
Keyword(s):  
Muscle Activity ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Bipolar Electrodes ◽  
Intraclass Correlation Coefficients ◽  
Reliability Estimates ◽  
Flexor Muscles ◽  
The Mean ◽  
Electromyographic Analysis ◽  
Electromyographic Signals

Abstract Background and Purpose. This study evaluated an electromyographic technique for the measurement of muscle activity of the deep cervical flexor (DCF) muscles. Electromyographic signals were detected from the DCF, sternocleidomastoid (SCM), and anterior scalene (AS) muscles during performance of the craniocervical flexion (CCF) test, which involves performing 5 stages of increasing craniocervical flexion range of motion—the anatomical action of the DCF muscles. Subjects. Ten volunteers without known pathology or impairment participated in this study. Methods. Root-mean-square (RMS) values were calculated for the DCF, SCM, and AS muscles during performance of the CCF test. Myoelectric signals were recorded from the DCF muscles using bipolar electrodes placed over the posterior oropharyngeal wall. Reliability estimates of normalized RMS values were obtained by evaluating intraclass correlation coefficients and the normalized standard error of the mean (SEM). Results. A linear relationship was evident between the amplitude of DCF muscle activity and the incremental stages of the CCF test (F=239.04, df=36, P<.0001). Normalized SEMs in the range 6.7% to 10.3% were obtained for the normalized RMS values for the DCF muscles, providing evidence of reliability for these variables. Discussion and Conclusion. This approach for obtaining a direct measure of the DCF muscles, which differs from those previously used, may be useful for the examination of these muscles in future electromyographic applications.

scholarly journals Deaminase associated single nucleotide variants in blood and saliva-derived exomes from healthy subjects

2019 ◽  
Author(s):  
Nathan E. Hall ◽  
Jared Mamrot ◽  
Christopher M.A. Frampton ◽  
Prue Read ◽  
Edward J. Steele ◽  
...  
Keyword(s):  
Exome Sequencing ◽  
Whole Exome Sequencing ◽  
Healthy Subjects ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Healthy Individuals ◽  
Intraclass Correlation Coefficients ◽  
Whole Exome ◽  
The Impact ◽  
Group 1

AbstractBackgroundDeaminases play an important role in shaping inherited and somatic variants. Disease related SNVs are associated with deaminase mutagenesis and genome instability. Here, we investigate the reproducibility and variance of whole exome SNV calls in blood and saliva of healthy subjects and analyze variants associated with AID, ADAR, APOBEC3G and APOBEC3B deaminase sequence motifs.MethodsSamples from twenty-four healthy Caucasian volunteers, allocated into two groups, underwent whole exome sequencing. Group 1 (n=12) analysis involved one blood and four saliva replicates. A single saliva sample was sequenced for Group 2 subjects (n=12). Overall, a total of 72 whole exome datasets were analyzed. Biological (Group 1 & 2) and technical (Group 1) variance of SNV calls and deaminase metrics were calculated and analyzed using intraclass correlation coefficients. Candidate somatic SNVs were identified and evaluated.ResultsWe report high blood-saliva concordance in germline SNVs from whole exome sequencing. Concordant SNVs, found in all subject replicates, accounted for 97% of SNVs located within the protein coding sequence of genes. Discordant SNVs have a 30% overlap with variants that fail gnomAD quality filters and are less likely to be found in dbSNP. SNV calls and deaminase-associated metrics were found to be reproducible and robust (intraclass correlation coefficients >0.95). No somatic SNVs were conclusively identified when comparing blood and saliva samples.ConclusionsSaliva and blood both provide high quality sources of DNA for whole exome sequencing, with no difference in ability to resolve SNVs and deaminase-associated metrics. We did not identify somatic SNVs when comparing blood and saliva of healthy individuals, and we conclude that more specialized investigative methods are required to comprehensively assess the impact of deaminase activity on genome stability in healthy individuals.

scholarly journals Assessment of a generalizable methodology to assess learning from manikin-based simulation technology*

2014 ◽  
Vol 28 (1) ◽  
pp. 16-20 ◽  
Author(s):  
Dominic A. Giuliano ◽  
Marion McGregor
Keyword(s):  
Learning Outcomes ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Wisdom Of Crowds ◽  
Diverse Range ◽  
Intraclass Correlation Coefficients ◽  
Significant Difference ◽  
Assessment Procedures ◽  
The Impact

Objective This study combined a learning outcomes-based checklist and salient characteristics derived from wisdom-of-crowds theory to test whether differing groups of judges (diversity maximized versus expertise maximized) would be able to appropriately assess videotaped, manikin-based simulation scenarios. Methods Two groups of 3 judges scored 9 videos of interns managing a simulated cardiac event. The first group had a diverse range of knowledge of simulation procedures, while the second group was more homogeneous in their knowledge and had greater simulation expertise. All judges viewed 3 types of videos (predebriefing, postdebriefing, and 6 month follow-up) in a blinded fashion and provided their scores independently. Intraclass correlation coefficients (ICCs) were used to assess the reliability of judges as related to group membership. Scores from each group of judges were averaged to determine the impact of group on scores. Results Results revealed strong ICCs for both groups of judges (diverse, 0.89; expert, 0.97), with the diverse group of judges having a much wider 95% confidence interval for the ICC. Analysis of variance of the average checklist scores indicated no significant difference between the 2 groups of judges for any of the types of videotapes assessed (F = 0.72, p = .4094). There was, however, a statistically significant difference between the types of videos (F = 14.39, p = .0004), with higher scores at the postdebrief and 6-month follow-up time periods. Conclusions Results obtained in this study provide optimism for assessment procedures in simulation using learning outcomes-based checklists and a small panel of judges.

scholarly journals Reliability of Sonoelastography Measurement of Tongue Muscles and Its Application on Obstructive Sleep Apnea

2021 ◽  
Vol 12 ◽  
Author(s):  
Cheng-An Chu ◽  
Yunn-Jy Chen ◽  
Ke-Vin Chang ◽  
Wei-Ting Wu ◽  
Levent Özçakar
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Muscle Stiffness ◽  
Tongue Muscle ◽  
Intraclass Correlation Coefficients ◽  
Obstructive Sleep

Few studies have explored the feasibility of shear-wave ultrasound elastography (SWUE) for evaluating the upper airways of patients with obstructive sleep apnea (OSA). This study aimed to establish a reliable SWUE protocol for evaluating tongue muscle elasticity and its feasibility and utility in differentiating patients with OSA. Inter-rater and intra-rater reliability of SWUE measurements were tested using the intraclass correlation coefficients. Submental ultrasound was used to measure tongue thickness and stiffness. Association between the ultrasound measurements and presence of OSA was analyzed using multivariate logistic regression. One-way analysis of variance was used to examine if the values of the ultrasound parameters varied among patients with different severities of OSA. Overall, 37 healthy subjects and 32 patients with OSA were recruited. The intraclass correlation coefficients of intra‐ and inter-rater reliability for SWUE for tongue stiffness ranged from 0.84 to 0.90. After adjusting for age, sex, neck circumference, and body mass index, the risk for OSA was positively associated with tongue thickness [odds ratio 1.16 (95% confidence interval 1.01–1.32)] and negatively associated with coronal imaging of tongue muscle stiffness [odds ratio 0.72 (95% confidence interval 0.54–0.95)]. There were no significant differences in tongue stiffness among OSA patients with varying disease severity. SWUE provided a reliable evaluation of tongue muscle stiffness, which appeared to be softer in patients with OSA. Future longitudinal studies are necessary to investigate the relationship between tongue softening and OSA, as well as response to treatment.

scholarly journals Reliability of Thoracic Spine Rotation Range-of-Motion Measurements in Healthy Adults

2012 ◽  
Vol 47 (1) ◽  
pp. 52-60 ◽  
Author(s):  
Katherine D. Johnson ◽  
Kyung-Min Kim ◽  
Byung-Kyu Yu ◽  
Susan A. Saliba ◽  
Terry L. Grindstaff
Keyword(s):  
Range Of Motion ◽  
Thoracic Spine ◽  
Measurement Techniques ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Minimal Detectable Change ◽  
Good Reliability ◽  
Intraclass Correlation Coefficients ◽  
Reliability Estimates ◽  
Standard Error Of Measurement

Context:The reliability of clinical techniques to quantify thoracic spine rotation range of motion (ROM) has not been evaluated.Objective:To determine the intratester and intertester reliability of 5 thoracic rotation measurement techniques.Design:Descriptive laboratory study.Setting:University research laboratory.Patients or Other Participants:Forty-six healthy volunteers (age = 23.6±4.3 years, height = 171.0±9.6 cm, mass = 71.4 ±16.7 kg).Main Outcome Measure(s):We tested 5 thoracic rotation ROM techniques over 2 days: seated rotation (bar in back and front), half-kneeling rotation (bar in back and front), and lumbar-locked rotation. On day 1, 2 examiners obtained 2 sets of measurements (sessions 1, 2) to determine the within-session intertester reliability and within-day intratester reliability. A single examiner obtained measurements on day 2 (session 3) to determine the intratester reliability between days. Each technique was performed 3 times per side, and averages were used for data analysis. Reliability was determined using intraclass correlation coefficients, standard error of measurement (SEM), and minimal detectable change (MDC). Differences between raters during session 1 were determined using paired t tests.Results:Within-session intertester reliability estimates ranged from 0.85 to 0.94. Ranges for the SEM were 1.0° to 2.3° and for the MDC were 2.8° to 6.3°. No differences were seen between examiners during session 1 for seated rotation (bar in front, both sides), half-kneeling rotation (bar in front, left side), or the lumbar locked position (both sides) (all values of P > .05). Within-day intratester reliability estimates ranged from 0.86 to 0.95. Ranges for the SEM were 0.8° to 2.1° and for the MDC were 2.1 ° to 5. 9°. Between-days intratester reliability estimates ranged from 0.84 to 0.91. Ranges for the SEM were 1.4° to 2.0° and for the MDC were 3.9° to 5.6°.Conclusions:All techniques had good reliability and low levels of measurement error. The seated rotation, bar in front, and lumbar-locked rotation tests may be used reliably when more than 1 examiner is obtaining measurements.

scholarly journals Pengaruh ukuran sampel dan intraclass correlation coefficients (ICC) terhadap bias estimasi parameter multilevel latent variable modeling: studi dengan simulasi Monte Carlo

2017 ◽  
Vol 21 (1) ◽  
pp. 34-50
Author(s):  
Muhammad Dwirifqi Kharisma Putra ◽  
Jahja Umar ◽  
Bahrul Hayat ◽  
Agung Priyo Utomo
Keyword(s):  
Monte Carlo ◽  
Markov Chain ◽  
Markov Chain Monte Carlo ◽  
Sample Size ◽  
Latent Variable ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Latent Variable Modeling ◽  
Intraclass Correlation Coefficients ◽  
The Impact

Studi ini menggunakan simulasi Monte Carlo dilakukan untuk melihat pengaruh ukuran sampel dan intraclass correlation coefficients (ICC) terhadap bias estimasi parameter multilevel latent variable modeling. Kondisi simulasi diciptakan dengan beberapa faktor yang ditetapkan yaitu lima kondisi ICC (0.05, 0.10, 0.15, 0.20, 0.25), jumlah kelompok (30, 50, 100 dan 150), jumlah observasi dalam kelompok (10, 20 dan 50) dan diestimasi menggunakan lima metode estimasi: ML, MLF, MLR, WLSMV dan BAYES. Jumlah kondisi keseluruhan sebanyak 300 kondisi dimana tiap kondisi direplikasi sebanyak 1000 kali dan dianalisis menggunakan software Mplus 7.4. Kriteria bias yang masih dapat diterima adalah < 10%. Hasil penelitian ini menunjukkan bahwa bias yang terjadi dipengaruhi oleh ukuran sampel dan ICC, penelitian ini juga menujukkan bahwa metode estimasi WLSMV dan BAYES berfungsi lebih baik pada berbagai kondisi dibandingkan dengan metode estimasi berbasis ML.Kata kunci: multilevel latent variable modeling, intraclass correlation coefficients, Metode Markov Chain Monte Carlo THE IMPACT OF SAMPLE SIZE AND INTRACLASS CORRELATION COEFFICIENTS (ICC) ON THE BIAS OF PARAMETER ESTIMATION IN MULTILEVEL LATENT VARIABLE MODELING: A MONTE CARLO STUDYAbstractA monte carlo study was conducted to investigate the effect of sample size and intraclass correlation coefficients (ICC) on the bias of parameter estimates in multilevel latent variable modeling. The design factors included (ICC: 0.05, 0.10, 0.15, 0.20, 0.25), number of groups in between level model (NG: 30, 50, 100 and 150), cluster size (CS: 10, 20 and 50) to be estimated with five different estimator: ML, MLF, MLR, WLSMV and BAYES. Factors were interegated into 300 conditions (4 NG  3 CS  5 ICC  5 Estimator). For each condition, replications with convergence problems were exclude until at least 1.000 replications were generated and analyzed using Mplus 7.4, we also consider absolute percent bias <10% to represent an acceptable level of bias. We find that the degree of bias depends on sample size and ICC. We also show that WLSMV and BAYES estimator performed better than ML-based estimator across varying sample sizes and ICC’s conditions.Keywords: multilevel latent variable modeling, intraclass correlation coefficients, Markov Chain Monte Carlo method

scholarly journals Measuring Frailty in Administrative Claims Data: Comparative Performance of Four Claims-Based Frailty Measures in the U.S. Medicare Data

2019 ◽  
Vol 75 (6) ◽  
pp. 1120-1125 ◽  
Author(s):  
Dae Hyun Kim ◽  
Elisabetta Patorno ◽  
Ajinkya Pawar ◽  
Hemin Lee ◽  
Sebastian Schneeweiss ◽  
...  
Keyword(s):  
Frailty Index ◽  
Correlation Coefficients ◽  
Community Dwelling ◽  
Administrative Claims ◽  
Fee For Service ◽  
Deficit Accumulation ◽  
Frailty Phenotype ◽  
Medicare Data ◽  
The U.S ◽  
Age And Sex

Abstract Background There has been increasing effort to measure frailty in the U.S. Medicare data. The performance of claims-based frailty measures has not been compared. Methods This cross-sectional study included 3,097 community-dwelling fee-for-service Medicare beneficiaries (mean age 75.6 years) who participated in the 2008 Health and Retirement Study examination. Four claims-based frailty measures developed by Davidoff, Faurot, Segal, and Kim were compared against frailty phenotype, a deficit-accumulation frailty index (FI), and activities of daily living (ADL) dependence using Spearman correlation coefficients and C-statistics. Results Claims-based frailty measures were positively associated with frailty phenotype (prevalence in ≤10th vs &gt;90th percentile: 8.0% vs 41.3% for Davidoff; 5.9% vs 53.1% for Faurot; 3.3% vs 48.0% for Segal; 2.9% vs 51.0% for Kim) and FI (mean in ≤10th vs &gt;90th percentile: 0.17 vs 0.33 for Davidoff; 0.13 vs 0.37 for Faurot; 0.12 vs 0.31 for Segal; 0.10 vs 0.37 for Kim). The age and sex-adjusted C-statistics for frailty phenotype for Davidoff, Faurot, Segal, and Kim indices were 0.73, 0.74, 0.73, and 0.78, respectively, and partial correlation coefficients with FI were 0.18, 0.32, 0.26, and 0.55, respectively. The results for ADL dependence were similar (prevalence in ≤10th vs &gt;90th percentile: 3.7% vs 50.5% for Davidoff; 2.3% vs 55.0% for Faurot; 3.0% vs 38.3% for Segal; 2.3% vs 50.8% for Kim). The age and sex-adjusted C-statistics for the indices were 0.79, 0.80, 0.74, and 0.81, respectively. Conclusions The choice of a claims-based frailty measure can influence the identification of older adults with frailty and disability in Medicare data.

scholarly journals Caregiving in schizophrenia: development, internal consistency and reliability of the Involvement Evaluation Questionnaire – European Version

2000 ◽  
Vol 177 (S39) ◽  
pp. s21-s27 ◽  
Author(s):  
Bob van Wijngaarden ◽  
Aart H. Schene ◽  
Maarten Koeter ◽  
José Luis Vázquez-Barquero ◽  
Helle Charlotte Knudsen ◽  
...  
Keyword(s):  
Internal Consistency ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Test Sample ◽  
Sample Sizes ◽  
Evaluation Questionnaire ◽  
Intraclass Correlation Coefficients ◽  
Reliability Estimates ◽  
Icd 10 ◽  
Test Retest Reliability

BackgroundIn international research on the consequences of psychiatric illnesses for relatives of patients, the need for an internationally standardised measure has been identified.AimsTo test the internal consistency and the test-retest reliability of the Involvement Evaluation Questionnaire (IEQ) in five European countries.MethodThe IEQ was administered twice to a sample of relatives or friends of patients with an ICD-10 diagnosis of schizophrenia. Reliability was tested using Cronbach's α, intraclass correlation coefficients and standard error of measurement. Reliability estimates were tested between sites.ResultsTest sample sizes ranged from 30 to 90 across sites, and retest sample sizes ranged from 21 to 77. Cronbach's α values of IEQ sub-scales and sumscore were substantial at most sites; but at two, α values were moderate. Intraclass correlation coefficients were substantial to high at all sites. The standard errors of measurement differed across sites, indicating differences in performance.ConclusionThe reliability of the IEQ in five languages varies across sites, but is sufficiently high in at least four out of five.

scholarly journals How to improve image quality of DWI of the prostate—enema or catheter preparation?

2021 ◽  
Author(s):  
Carolin Reischauer ◽  
Timmy Cancelli ◽  
Sonaz Malekzadeh ◽  
Johannes M. Froehlich ◽  
Harriet C. Thoeny
Keyword(s):  
Image Quality ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Observer Agreement ◽  
Strongly Correlated ◽  
Intraclass Correlation Coefficients ◽  
Single Center Study ◽  
The Impact ◽  
Gas Suction

Abstract Objectives To compare the impact of laxative enema preparation versus air/gas suction through a small catheter on image quality of prostate DWI. Methods In this single-center study, 200 consecutive patients (100 in each arm) with either enema or catheter preparation were retrospectively included. Two blinded readers independently assessed aspects of image quality on 5-point Likert scales. Scores were compared between groups and the influence of confounding factors evaluated using multivariable logistic regression. Prostate diameters were compared on DWI and T2-weighted imaging using intraclass correlation coefficients. Results Image quality was significantly higher in the enema group regarding the severity of susceptibility-related artifacts (reader 1: 0.34 ± 0.77 vs. 1.73 ± 1.34, reader 2: 0.38 ± 0.86 vs. 1.76 ± 1.39), the differentiability of the anatomy (reader 1: 3.36 ± 1.05 vs. 2.08 ± 1.31, reader 2: 3.37 ± 1.05 vs. 2.09 ± 1.35), and the overall image quality (reader 1: 3.66 ± 0.77 vs. 2.26 ± 1.33, Reader 2: 3.59 ± 0.87 vs. 2.23 ± 1.38) with almost perfect inter-observer agreement (κ = 0.92–0.95). In the enema group, rectal distention was significantly lower and strongly correlated with the severity of artifacts (reader 1: ρ = 0.79, reader 2: ρ = 0.73). Furthermore, there were significantly fewer substantial image distortions, with odds ratios of 0.051 and 0.084 for the two readers which coincided with a higher agreement of the prostate diameters in the phase-encoding direction (0.96 vs. 0.89). Conclusions Enema preparation is superior to catheter preparation and yields substantial improvements in image quality. Key Points • Enema preparation is superior to decompression of the rectum using air/gas suction through a small catheter. • Enema preparation markedly improves the image quality of prostate DWI regarding the severity of susceptibility-related artifacts, the differentiability of the anatomy, and the overall image quality and considerably reduces substantial artifacts that may impair a reliable diagnosis.

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.

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