scholarly journals Do Handcycling Time-Trial Velocities Achieved by Para-Cycling Athletes Vary Across Handcycling Classes?

2020 ◽  
Vol 37 (4) ◽  
pp. 461-480
Author(s):  
Rafael E.A. Muchaxo ◽  
Sonja de Groot ◽  
Lucas H.V. van der Woude ◽  
Thomas W.J. Janssen ◽  
Carla Nooijen
Keyword(s):  
Effect Size ◽  
Classification System ◽  
Average Velocity ◽  
Time Trial ◽  
Class Structure ◽  
Evidence Based ◽  
Multilevel Regression ◽  
Recumbent Position ◽  
Hierarchical Classes ◽  
Performance Differences

The classification system for handcycling groups athletes into five hierarchical classes, based on how much their impairment affects performance. Athletes in class H5, with the least impairments, compete in a kneeling position, while athletes in classes H1 to H4 compete in a recumbent position. This study investigated the average time-trial velocity of athletes in different classes. A total of 1,807 results from 353 athletes who competed at 20 international competitions (2014–2018) were analyzed. Multilevel regression was performed to analyze differences in average velocities between adjacent pairs of classes, while correcting for gender, age, and event distance. The average velocity of adjacent classes was significantly different (p < .01), with higher classes being faster, except for H4 and H5. However, the effect size of the differences between H3 and H4 was smaller (d = 0.12). Hence, results indicated a need for research in evaluating and developing evidence-based classification in handcycling, yielding a class structure with meaningful performance differences between adjacent classes.

scholarly journals The impact of impairment on kinematic and kinetic variables in Va’a paddling: Towards a sport-specific evidence-based classification system for Para Va’a

2019 ◽  
Vol 37 (17) ◽  
pp. 1942-1950 ◽  
Author(s):  
Johanna S. Rosén ◽  
Anton Arndt ◽  
Victoria L. Goosey-Tolfrey ◽  
Barry S. Mason ◽  
Michael J. Hutchinson ◽  
...  
Keyword(s):  
Classification System ◽  
Evidence Based ◽  
The Impact

scholarly journals Revisiting Statistics and Evidence-Based Medicine: On the Fallacy of the Effect Size Based on Correlation and Misconception of Contingency Tables

2021 ◽  
Author(s):  
Sergey Roussakow
Keyword(s):  
Effect Size ◽  
Evidence Based Medicine ◽  
Binary Data ◽  
Contingency Tables ◽  
Evidence Based ◽  
Mean Square ◽  
Bias Analysis ◽  
Contingency Coefficient ◽  
Meta Analyses ◽  
Based Medicine

Abstract BACKGROUND: Evidence-based medicine (EBM) is in crisis, in part due to bad methods, which are understood as misuse of statistics that is considered correct in itself. The correctness of the basic statistics related to the effect size (ES) based on correlation (CBES) was questioned. METHODS: Monte Carlo simulation of two paired binary samples, mathematical analysis, conceptual analysis, bias analysis. RESULTS: Actual effect size and CBES are not related. CBES is a fallacy based on misunderstanding of correlation and ES and confusion with 2 × 2 tables that makes no distinction between gross crosstabs (GCTs) and contingency tables (CTs). This leads to misapplication of Pearson’s Phi, designed for CTs, to GCTs and confusion of the resulting gross Pearson Phi, or mean-square effect half-size, with the implied Pearson mean square contingency coefficient. Generalizing this binary fallacy to continuous data and the correlation in general (Pearson’s r) resulted in flawed equations directly expressing ES in terms of the correlation coefficient, which is impossible without including covariance, so these equations and the whole CBES concept are fundamentally wrong. misconception of contingency tables (MCT) is a series of related misconceptions due to confusion with 2 × 2 tables and misapplication of related statistics. Problems arising from these fallacies are discussed and the necessary changes to the corpus of statistics are proposed resolving the problem of correlation and ES in paired binary data. CONCLUSIONS: Two related common misconceptions in statistics have been exposed, CBES and MCT. The misconceptions are threatening because most of the findings from contingency tables, including meta-analyses, can be misleading. Since exposing these fallacies casts doubt on the reliability of the statistical foundations of EBM in general, we urgently need to revise them.

Abstract 127: Cardiovascular Risk and Outcomes in Patients with Diabetes: Using Medical Education to Improve Care

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Amy Larkin ◽  
Colleen Healy
Keyword(s):  
Risk Factors ◽  
Medical Education ◽  
High Risk ◽  
Effect Size ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Glucose Lowering ◽  
Multi Media ◽  
And Performance ◽  
Selection Of

Introduction: Mortality rates due to cardiovascular disease (CVD) are 2-4 times higher among people with diabetes than in those without. Glucose control reduces the risk of any CVD event by 42% and the risk of heart attack, stroke, or death from CVD by 57%. We assessed the hypothesis that continuing medical education (CME) improves knowledge and performance of cardiologists in managing glycemic control and other CV risk factors in patients with type 2 diabetes (T2D). Methods: Cardiologists who treat patients with coronary artery disease participated in at least 1 of 2 online CME activities within a curriculum on CV risks and outcomes in patients with T2D. Participant responses to a case-based survey after activity completion were compared with responses from demographically similar control groups of nonparticipants. Educational effect size was calculated using Cohen’s d formula, with a value of <0.4 representing a small effect, 0.4-0.8 a medium effect, and >0.8 a large effect. Results: Participating cardiologists (n = 151) were more likely to make evidence-based practice choices than were nonparticipating cardiologists. Activity 1: Improving CV Outcomes in Patients with T2D Multi-media format Increased Likelihood to Make Evidence-Based Practice Choices Post-Education: 33.5% Effect Size: 0.51 (N = 78) Activity 1: Assessing CV Risk in Patients with T2D Multi-media format Increased Likelihood to Make Evidence-Based Practice Choices Post-Education: 50.3% Effect Size: 0.87 (N = 73) Domain 1: Managing Glycemic Control and Other CV Risk Factors in Patients with CVD and T2D. Participating cardiologists significantly improved their consideration of comorbid conditions when deciding on a glucose management strategy (73% pre vs. 85% post) and selection of treatment for early intervention (85% pre vs. 96% post). Domain 2: Identification of Outcomes Data on Glucose-Lowering Agents in Patients with T2D and CVD. Participating cardiologists significantly improved in the recognition of antihyperglycemic agents shown in clinical trials to be safe for high risk CV patients (36% pre vs. 79% post) and in identification of the effect of saxagliptin on CV events in high risk CV patients with T2D (SAVOR TIMI 53 trial) (55% pre vs. 86% post). Domain 3: Application of Outcomes Data on Glucose-Lowering Agents in Patients with T2D and CVD. Participating cardiologists significantly improved in their selection of a DPP-4 inhibitor as the most appropriate antihyperglycemic agent for patients with T2D and CV risk factors or previous CV events (59% pre vs. 81% post and 53% pre vs. 73% post, respectively). Conclusion: This study demonstrated the success of a curriculum-style educational intervention using multimedia technology on improving knowledge and performance of cardiologists which can lead to enhanced management of CV risks and, thus, improved outcomes in patients with T2D and CVD.

Stage 1 Registered Report: Stress regulation via being in nature and social support in adults - a meta-analysis

2021 ◽  
Author(s):  
Alessandro Sparacio ◽  
Ivan Ropovik ◽  
Gabriela M. Jiga-Boy ◽  
Hans IJzerman
Keyword(s):  
Social Support ◽  
Publication Bias ◽  
Effect Size ◽  
Meta Analysis ◽  
Multilevel Regression ◽  
Stress Regulation ◽  
Analysis Workflow ◽  
Affective Consequences ◽  
Emotional Social Support ◽  
Stage 1

This meta-analysis explored whether being in nature and emotional social support are effective in reducing levels of stress through a Registered Report. We retrieved all the relevant articles that investigated a connection between one of these two strategies and various components of stress (physiological, affective and cognitive) as well as affective consequences of stress. We followed a stringent analysis workflow (including permutation-based selection models and multilevel regression-based models) to provide publication bias-corrected estimates. We found [no evidence for the efficacy of either strategy/evidence for one of the two strategies/evidence for both strategies] with an estimated mean effect size of [xx/xx] and we recommend [recommendation will be provided if necessary].

scholarly journals Acceptance and efficacy of a metacognitive self-help intervention in an Arabic-speaking mixed patient sample with depression and/or obsessive–compulsive disorder: A randomized controlled trial

2019 ◽  
Vol 10 (1) ◽  
pp. 204380871882068 ◽  
Author(s):  
Steffen Moritz ◽  
Schaimaa Irshaid ◽  
Annabel Beiner ◽  
Marit Hauschildt ◽  
Franziska Miegel
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Effect Size ◽  
Retention Rates ◽  
Evidence Based ◽  
Completion Rates ◽  
Large Effect Size ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Self Help ◽  
Arabic Speaking

Objective: In Arabic-speaking countries, most individuals with depression or obsessive–compulsive disorder (OCD) do not seek or receive evidence-based treatment due to a dearth of facilities, shame/self-stigma, or religious concerns. The feasibility and effectiveness of “Western” psychotherapeutic concepts have rarely been evaluated for Arabic-speaking populations. The present study examined the efficacy of My Metacognitive Training (myMCT), a trans-therapeutic self-help manual, in a mixed sample of participants with depression and/or OCD. We considered both participants with depression and/or OCD because a number of cognitive biases and dysfunctional beliefs are shared by the two disorders. Method: The myMCT manual was translated into Arabic. A total of 160 individuals with either self-reported OCD and/or self-reported depression were recruited. Individuals were assessed at baseline and then randomized either to myMCT ( n = 84) or to a wait-list control condition ( n = 76). Six weeks later, individuals were invited to the post assessment. The Beck Depression Inventory (BDI-II) served here as the primary outcome. Secondary outcomes were the Obsessive–Compulsive Inventory–Revised (OCI-R) and the self-rating version of the Yale-Brown Obsessive Compulsive Scale (OCD patients only). Individuals were reimbursed with a 17€ voucher. Results: Completion rates were similarly low in the two groups (myMCT: 37%, controls: 35%). Presumably because of the high rate of noncompletion and nonadherence (29%), the intention-to-treat analyses failed to yield a significant effect. Those who had at least started the myMCT intervention improved significantly on the BDI-II at a large effect size. A significantly larger improvement among those who had started or completed the myMCT intervention was also seen on the OCI-R at a large effect size. Conclusions: Individuals who studied the myMCT manual showed large improvement on the BDI-II, irrespective of their primary symptomatology. However, the results are seriously compromised by the low completion rates in both conditions. Importantly, evaluations using the same manual in other language populations (and with other background cultures) produced good to excellent retention rates. The study demonstrates that self-help manuals may not represent a suitable medium for large-scale dissemination of evidence-based self-help material in an Arab population and corroborates prior findings suggesting low adherence in this population. Whether smartphone apps and Internet interventions represent more viable alternatives than self-help manuals needs to be tested, as well as specific barriers preventing dissemination and completion in this population.

Interrater Reliability of the New Sport-Specific Evidence-Based Classification System for Para Va'a

2020 ◽  
Vol 37 (3) ◽  
pp. 241-252
Author(s):  
Johanna S. Rosén ◽  
Victoria L. Goosey-Tolfrey ◽  
Keith Tolfrey ◽  
Anton Arndt ◽  
Anna Bjerkefors
Keyword(s):  
Classification System ◽  
Interrater Reliability ◽  
Intraclass Correlation ◽  
Test Battery ◽  
Evidence Based ◽  
Water Test ◽  
The Individual ◽  
New Evidence ◽  
Test Level ◽  
Total Agreement

The purpose of this study was to examine the interrater reliability of a new evidence-based classification system for Para Va'a. Twelve Para Va'a athletes were classified by three classifier teams each consisting of a medical and a technical classifier. Interrater reliability was assessed by calculating intraclass correlation for the overall class allocation and total scores of trunk, leg, and on-water test batteries and by calculating Fleiss’s kappa and percentage of total agreement in the individual tests of each test battery. All classifier teams agreed with the overall class allocation of all athletes, and all three test batteries exhibited excellent interrater reliability. At a test level, agreement between classifiers was almost perfect in 14 tests, substantial in four tests, moderate in four tests, and fair in one test. The results suggest that a Para Va'a athlete can expect to be allocated to the same class regardless of which classifier team conducts the classification.

Cluster analysis of novel isometric strength measures produces a valid and evidence-based classification structure for wheelchair track racing

2017 ◽  
Vol 52 (17) ◽  
pp. 1123-1129 ◽  
Author(s):  
Mark J Connick ◽  
Emma Beckman ◽  
Yves Vanlandewijck ◽  
Laurie A Malone ◽  
Sven Blomqvist ◽  
...  
Keyword(s):  
Cluster Analysis ◽  
Classification System ◽  
Scientific Evidence ◽  
Activity Limitation ◽  
Isometric Strength ◽  
Similar Degree ◽  
Evidence Based ◽  
Strength Tests ◽  
The Mean ◽  
Classification Structure

BackgroundThe Para athletics wheelchair-racing classification system employs best practice to ensure that classes comprise athletes whose impairments cause a comparable degree of activity limitation. However, decision-making is largely subjective and scientific evidence which reduces this subjectivity is required.AimTo evaluate whether isometric strength tests were valid for the purposes of classifying wheelchair racers and whether cluster analysis of the strength measures produced a valid classification structure.MethodsThirty-two international level, male wheelchair racers from classes T51–54 completed six isometric strength tests evaluating elbow extensors, shoulder flexors, trunk flexors and forearm pronators and two wheelchair performance tests–Top-Speed (0–15 m) and Top-Speed (absolute). Strength tests significantly correlated with wheelchair performance were included in a cluster analysis and the validity of the resulting clusters was assessed.ResultsAll six strength tests correlated with performance (r=0.54–0.88). Cluster analysis yielded four clusters with reasonable overall structure (mean silhouette coefficient=0.58) and large intercluster strength differences. Six athletes (19%) were allocated to clusters that did not align with their current class. While the mean wheelchair racing performance of the resulting clusters was unequivocally hierarchical, the mean performance of current classes was not, with no difference between current classes T53 and T54.ConclusionsCluster analysis of isometric strength tests produced classes comprising athletes who experienced a similar degree of activity limitation. The strength tests reported can provide the basis for a new, more transparent, less subjective wheelchair racing classification system, pending replication of these findings in a larger, representative sample. This paper also provides guidance for development of evidence-based systems in other Para sports.

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