scholarly journals Minimal Clinically Important Differences for Measures of Pain, Lung Function, Fatigue, and Functionality in Spinal Cord Injury

2020 ◽  
Author(s):  
Margarida Sobreira ◽  
Miguel P Almeida ◽  
Ana Gomes ◽  
Marlene Lucas ◽  
Ana Oliveira ◽  
...  
Keyword(s):  
Rating Scale ◽  
Rehabilitation Programme ◽  
Minimal Detectable Change ◽  
Global Rating ◽  
Receiver Operating Characteristic Curves ◽  
Cord Injury ◽  
Fatigue Severity ◽  
Standard Error Of Measurement ◽  
Pain Rating Scale ◽  
Error Of Measurement

Abstract Objective The objective of this study was to determine the MCIDs for the numerical pain rating scale (NPRS), peak cough flow (PCF), peak expiratory flow (PEF), fatigue severity scale (FSS), and London chest activities of daily living scale (LCADL) in patients with SCI after rehabilitation. Methods Inpatients with SCI from two rehabilitation centres participating in a daily rehabilitation programme were recruited. The NPRS, PCF, PEF, FSS, and LCADL were collected at baseline and discharge. The global rating of change (GRC) scale was performed at discharge. MCIDs were calculated using anchor (linear regression, mean change and receiver operating characteristic curves) and distribution-based methods (0.5 times the baseline standard deviation, standard error of measurement (SEM), 1.96 times SEM, and minimal detectable change) and pooled using arithmetic weighted mean. Results Sixty inpatients with SCI (36 males; 54.5 (15.9) years) participated. On average their rehabilitation programme lasted 7.3 (1.7) weeks. Pooled MCID estimates were − 1.6 points for the NPRS, 69.8 L/min for the PCF, 77.4 L/min for the PEF, 1.1 points for the FSS, and 1.4 points for the LCADL. Conclusion Established MCIDs for NPRS, PCF, PEF, FSS, and LCADL will help health professionals to interpret results and guide rehabilitation interventions in patients with SCI.

scholarly journals Relative and Absolute Reliability of a Vertical Numerical Pain Rating Scale Supplemented With a Faces Pain Scale After Stroke

2014 ◽  
Vol 94 (1) ◽  
pp. 129-138 ◽  
Author(s):  
Li-ling Chuang ◽  
Ching-yi Wu ◽  
Keh-chung Lin ◽  
Ching-ju Hsieh
Keyword(s):  
Rating Scale ◽  
Intraclass Correlation ◽  
Pain Scale ◽  
Repeated Measurements ◽  
Limits Of Agreement ◽  
Numerical Pain Rating Scale ◽  
Standard Error Of Measurement ◽  
Pain Rating Scale ◽  
Absolute Reliability ◽  
Error Of Measurement

BackgroundPain is a serious adverse complication after stroke. The combination of a vertical numerical pain rating scale (NPRS) and a faces pain scale (FPS) has been advocated to measure pain after stroke.ObjectiveThis study was conducted to investigate whether an NPRS supplemented with an FPS (NPRS-FPS) would show good test-retest reliability in people with stroke. The relative and absolute reliability of the NPRS-FPS were examined.DesignA test-retest design was used for this study.MethodsFifty people (>3 months after stroke) participating in an outpatient occupational therapy program were recruited through medical centers to rate current pain intensity twice, at a 1-week interval, with the NPRS-FPS (on a scale from 0 to 10). The relative reliability of the NPRS-FPS was analyzed with the intraclass correlation coefficient for determining the degree of consistency and agreement between 2 measures. The standard error of measurement, the smallest real difference, and Bland-Altman limits of agreement were the absolute reliability indexes used to quantify measurement errors and determine systematic biases of repeated measurements.ResultsThe relative reliability of the NPRS-FPS was substantial (intraclass correlation coefficient=.82). The standard error of measurement and the smallest real difference at the 90% confidence interval of the NPRS-FPS were 0.81 and 1.87, respectively. The Bland-Altman analyses revealed no significant systematic bias between repeated measurements for the NPRS-FPS. The range of the limits of agreement for the NPRS-FPS was narrow (−2.50 to 1.90), indicating a high level of stability and little variation over time.LimitationsThe pain intensity of the participants ranged from no pain to a moderate level of pain.ConclusionsThese findings suggest that the NPRS-FPS is a reliable measure of pain in people with stroke, with good relative and absolute reliability.

scholarly journals Reliability of three-dimensional kinematic gait data in adults with spinal cord injury

2017 ◽  
Vol 4 ◽  
pp. 205566831772999 ◽  
Author(s):  
Pia Wedege ◽  
Kathrin Steffen ◽  
Vegard Strøm ◽  
Arve Isak Opheim
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Intraclass Correlation ◽  
Three Dimensional ◽  
Minimal Detectable Change ◽  
Detectable Change ◽  
Cord Injury ◽  
Hip Rotation ◽  
Standard Error Of Measurement ◽  
Error Of Measurement

Objectives Three-dimensional gait analysis has been recommended as part of standardized gait assessment in people with spinal cord injury. The aim was to investigate inter- and intra-session reliabilities of gait kinematics in people with spinal cord injury. Methods Fifteen adults with spinal cord injury performed two test sessions on separate days. Six infrared cameras, 16 reflective markers and the Plug-in gait model were used. For each subject, five gait trials from both sessions were included. The Gait Profile Score and the Gait Variable Score were used as kinematic outcome measures. Reliability was assessed with intraclass correlation coefficient, standard error of measurement, minimal detectable change, and Bland–Altman plots. Results Inter-session intraclass correlation coefficient for all variables was >0.82 and standard error of measurement <1.8°, except for hip rotation. Intra-session reliability was found to be high (≥0.78) and slightly better than that for inter-session. Minimal detectable change for all variables was <4.7°, except for hip rotation. Conclusions The high inter- and intra-session reliabilities indicate small intrinsic variation of gait. Thus, three-dimensional gait analysis seems to be a reliable tool to evaluate kinematic gait in adults with spinal cord injury, but caution is warranted especially for hip rotation evaluation.

scholarly journals Validity and Reliability of the Standardized Orthopedic Assessment Tool (SOAT): A Variation of the Traditional Objective Structured Clinical Examination

2014 ◽  
Vol 49 (3) ◽  
pp. 373-380 ◽  
Author(s):  
Mark R. Lafave ◽  
Larry Katz
Keyword(s):  
Correlation Coefficient ◽  
Standard Error ◽  
Clinical Competence ◽  
Concurrent Validity ◽  
Assessment Tool ◽  
Global Rating ◽  
Validity And Reliability ◽  
Pearson Product Moment Correlation ◽  
Standard Error Of Measurement ◽  
Error Of Measurement

Context: Health care professions have replaced traditional multiple choice tests or essays with structured and practical, performance-based examinations with the hope of eliminating rater bias and measuring clinical competence. Objective: To establish the validity and reliability of the Standardized Orthopedic Assessment Tool (SOAT) as a measure of clinical competence of orthopaedic injury evaluation. Design: Descriptive laboratory study. Setting: University. Patients or Other Participants: A total of 60 undergraduate students and 11 raters from 3 Canadian universities and 1 standardized patient. Intervention(s): Students were required to complete a 30-minute musculoskeletal evaluation in 1 of 2 randomly assigned mock scenarios involving the knee (second-degree medial collateral ligament sprain) or the shoulder (third-degree supraspinatus muscle strain). Main Outcome Measure(s): We measured interreliability with an intraclass correlation coefficient (ICC) (2,k) and stability of the tool with standard error of measurement and confidence intervals. Agreement was measured using Bland-Altman plots. Concurrent validity was measured using a Pearson product moment correlation coefficient whereby the raters' global rating of a student was matched to the cumulative mean grade score. Results: The ICCs were 0.75 and 0.82 for the shoulder and knee cases, respectively. Bland-Altman plots indicated no systematic bias between raters. In addition, Pearson product moment correlation analysis demonstrated a strong relationship between the overall cumulative mean grade score and the global rating score of the examinees' performances. Conclusions: This study demonstrated good interrater reliability of the SOAT with a standard error of measurement that indicated very modest stability, strong agreement between raters, and correlation indicative of concurrent validity.

Cross-institutional OSCE Quality Assurance in Europe using a mutual assessment strategy; are we equipped for it?

2020 ◽  
Author(s):  
Thomas JB Kropmans ◽  
Eirik Søfteland ◽  
Anneke Wijnalda ◽  
Marie Thoresen ◽  
Magnus Hultin ◽  
...  
Keyword(s):  
Quality Assurance ◽  
Standard Error ◽  
Generalizability Theory ◽  
Global Rating ◽  
Cronbach’S Alpha ◽  
Cronbach's Alpha ◽  
Electronic Assessment ◽  
Criterion Referenced ◽  
Standard Error Of Measurement ◽  
Error Of Measurement

Abstract BackgroundUntil 2008, Objective Structured Clinical Examinations (OSCE) were well researched, laborious and costly paper based method of exam delivery restricting international comparison. Cross-institutional comparison of OSCE Quality Assurance in Europe has never been done and due to wide spread electronic assessment analysis is now available.MethodsTwenty educational institutions across Europe using an electronic OSCE Management Information System where invited of which 8 confirmed to join a mutual comparison of Quality Assurance outcome. Two theories evaluate the quality of the observed test scores, the Classical psychometric theory (Cronbach’s alpha) and the Generalizability theory. Outcomes for both were compared for all universities including the Standard Error of Measurement (SEM) as well as cut-scores, Pass/Fail score and Global Rating Scores, Cronbach’s Alpha and related SEM (68% and 95% CI) and G-theory Coefficients with related absolute and relative SEM (68% and 95% CI). ResultsOutcomes differ between participating universities and observed marks contradict global rating of fail, borderline and excellent performance. G-theory coefficients and Standard Error of Measurement were lower and smaller compared to the classical approach using Cronbach’s Alpha as measure of reliability. The Classical psychometric based SEM varies from 2.8% to 11.2% respectively whereas the 95% CI equivalent varied from 9.2% up to 22% (on a 0 - 100% scale). The relative SEM from G-theory analysis varied from 3.1% to 7.0% for criterion-referenced marks, and the absolute SEM for norm-referenced marks varied from 3.8% to 7.8% respectively. The 95% CI around the relative and absolute SEMs values varied from 7.3% to 15.3%. More students failed the examination if the 95% CI is applied to the observed scores.ConclusionTo protect society and to improve educational decision making, the Standard Error of Measurement and associated confidence intervals needs to be embedded in EU assessment strategies to rule out ‘false positive Pass decisions’.

Determining Meaningful Changes in Pelvic-On-Femoral Position during the Trendelenburg Test

2007 ◽  
Vol 16 (4) ◽  
pp. 326-335 ◽  
Author(s):  
James W. Youdas ◽  
Sara T. Mraz ◽  
Barbara J. Norstad ◽  
Jennifer J. Schinke ◽  
John H. Hollman
Keyword(s):  
Outcome Measures ◽  
Simple Procedure ◽  
Minimal Detectable Change ◽  
Detectable Change ◽  
Lower Extremity Injuries ◽  
Single Leg Stance ◽  
Hip Abductor ◽  
Extremity Injuries ◽  
Standard Error Of Measurement ◽  
Error Of Measurement

Context:Hip abductor muscle weakness is related to many lower extremity injuries. A simple procedure, the Trendelenburg test, may be used to assess hip abductor performance in patient populations.Objective:To describe the minimal detectable change (MDC) in pelvic-on-femoral (P-O-F) position of the stance limb during the Trendelenburg test.Setting:Laboratory.Participants:45 healthy women (28 ± 8 years) and 45 healthy men (33 ± 11 years).Main Outcome Measures:P-O-F position in degrees in single-leg stance. Results: Baseline P-O-F position (hip adduction) was 83° ± 3° with a range from 76° to 94°. The intratester reliability (ICC3,1 for measurement of P-O-F position using a universal goniometer was 0.58 with a standard error of measurement (SEM) of 2°. The minimal detectable change (MDC) was calculated to be 4°.Conclusions:If a person’s P-O-F position changes less than 4° between measurements, then the P-O-F position is within measurement error and it can be determined that there has been no change in the performance of the hip abductor muscles when examined by the Trendelenburg test.

scholarly journals Cross-cultural adaptation and psychometric evaluation of the Yoruba version of Oswestry disability index

2019 ◽  
Author(s):  
Chidozie Emmanuel Mbada ◽  
Oluwabunmi Esther Oguntoyinbo ◽  
Francis Oluwafunso Fasuyi ◽  
Opeyemi Ayodiipo Idowu ◽  
Adesola Christiana Odole ◽  
...  
Keyword(s):  
Back Pain ◽  
Psychometric Properties ◽  
Factor Structure ◽  
Minimal Detectable Change ◽  
Low Back ◽  
Detectable Change ◽  
Intra Class Correlation ◽  
Test Retest Reliability ◽  
Standard Error Of Measurement ◽  
Error Of Measurement

AbstractIntroductionLow Back Pain is a common public health problem worsened by maladaptive beliefs and incongruent back pain behaviour. It is imperative to develop outcome measures to assess these beliefs among patients with chronic LBP. This study aimed to cross-culturally adapt and determine the psychometric properties of the Yoruba version of the ODI (ODI-Y).MethodsThe ODI-Y was cross-culturally adapted following the process involving forward translation, synthesis, backward translation, expert review, and pilot testing. One hundred and thirty-six patients with chronic LBP took part in the validation of the ODI-Y; 86 of these individuals took part in the test-retest reliability (within 1-week interval) of the translated instrument. Internal consistency and test-retest reliability of the ODI-Y were determined using the Cronbach’s alpha and intra-class correlation. Other psychometric properties explored included the factor structure and fit, convergent validity, standard error of measurement and the minimal detectable change.ResultsThe mean age of the respondents was 50.5±10.6years. The ODI-Y showed a high internal consistency, with a Cronbach’s alpha (α) of 0.81. Test-retest of the Yoruba version of the ODI within 1-week interval yielded an Intra-Class Correlation coefficient of 0.89. The ODI-Y yielded a two-factor structure which accounted for 51.7% of the variance but showed poor fit. Convergent of ODI-Y with the visual analogue scale was moderate (r=0.30; p=0.00). The standard error of measurement and minimal detectable change of the ODI-Y were 2.0 and 5.5.ConclusionsThe ODI was adapted into the Yoruba language and proved to have a good factor structure and psychometric properties that replicated the results of other obtainable versions. We recommend it for use among Yoruba speaking patients with low-back pain.

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