Reliability of Head, Neck, and Trunk Anthropometric Measurements Used for Predicting Segment Tissue Masses in Living Humans

2017 ◽  
Vol 33 (5) ◽  
pp. 373-378
Author(s):  
Nicole C. George ◽  
Charles Kahelin ◽  
Timothy A. Burkhart ◽  
David M. Andrews
Keyword(s):  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Prediction Equation ◽  
Anthropometric Measurements ◽  
Good Reliability ◽  
Tissue Mass ◽  
Upper And Lower Extremities ◽  
The Right ◽  
Relative Differences ◽  
Head Neck

Soft and rigid tissue mass prediction equations have been previously developed and validated for the segments of the upper and lower extremities in living humans using simple anthropometric measurements. The reliability of these measurements has been found to be good to excellent for all measurement types (segment lengths, circumferences, breadths, skinfolds). However, the reliability of the measurements needed to develop corresponding equations for the head, neck, and trunk has yet to be determined. The purpose of this study was to quantify the inter- and intrameasurer reliability of 34 surface anthropometric measurements of the head, neck, and trunk segments. Measurements (11 lengths, 7 circumferences, 11 breadths, 5 skinfolds) were taken twice separately on 50 healthy, university-age individuals using standard anthropometric tools. The mean inter- and intrameasurer measurement differences were fairly small overall, with 64.7% and 67.6% of the relative differences less than 5%, respectively. All measurements, except for the right lateral trunk, had intraclass correlation coefficients (ICCs) greater than 0.75, and coefficients of variation (CVs) less than 10%, indicating good reliability overall. These results are consistent with previous work for the extremities and provide support for the use of the defined surface measurements for future tissue mass prediction equation development.

scholarly journals Reliability and Change in Erosion Measurements by High-Resolution peripheral Quantitative Computed Tomography in a Longitudinal Dataset of Rheumatoid Arthritis Patients

2020 ◽  
pp. jrheum.191391 ◽  
Author(s):  
Stephanie Finzel ◽  
Sarah L. Manske ◽  
Cheryl Barnabe ◽  
Andrew J. Burghardt ◽  
Hubert Marotte ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Computed Tomography ◽  
High Resolution ◽  
Intraclass Correlation ◽  
Quantitative Computed Tomography ◽  
Correlation Coefficients ◽  
Peripheral Quantitative Computed Tomography ◽  
Good Reliability ◽  
Change Over Time ◽  
Over Time

Objective The aim of this multi-reader exercise was to assess the reliability and change over time of erosion measurements in rheumatoid arthritis (RA) patients using high-resolution peripheral quantitative computed tomography (HR-pQCT). Methods HR-pQCT scans of 23 patients with RA were assessed at baseline and 12 months. Four experienced readers examined the dorsal, palmar, radial, and ulnar surfaces of the metacarpal head (MH) and phalangeal base (PB) of the 2nd and 3rd digits, blinded to time order. In total, 368 surfaces (23 patients x16 surfaces) were evaluated per time point to characterize cortical breaks as pathological (erosion) or physiological, and to quantify erosion width and depth. Reliability was evaluated by intraclass correlation coefficients (ICC), percentage agreement, and Light’s kappa; change over time was defined by means ± SD of erosion numbers and dimensions. Results ICCs for the mean measurements of width and depth of the pathological breaks ranged between 0.819 - 0.883, and 0.771 - 0.907 respectively. Most physiological cortical breaks were found at the palmar PB, whereas most pathological cortical breaks were located at the radial MH. There was a significant increase in both the numbers and the dimensions of erosions between baseline and follow-up (p=0.0001 for erosion numbers, width, and depth in axial plane, and p=0.001 for depth in perpendicular plane). Conclusion This exercise confirmed good reliability of HR-pQCT erosion measurements and their ability to detect change over time.

scholarly journals Using Smart Bracelets to Assess Heart Rate Among Students During Physical Education Lessons: Feasibility, Reliability, and Validity Study (Preprint)

2020 ◽  
Author(s):  
Jiangang Sun ◽  
Yang Liu
Keyword(s):  
Heart Rate ◽  
Physical Education ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Correlation Coefficients ◽  
Left Wrist ◽  
Intraclass Correlation Coefficients ◽  
Estimate Reliability ◽  
Left And Right ◽  
The Right

BACKGROUND An increasing number of wrist-worn wearables are being examined in the context of health care. However, studies of their use during physical education (PE) lessons remain scarce. OBJECTIVE We aim to examine the reliability and validity of the Fizzo Smart Bracelet (Fizzo) in measuring heart rate (HR) in the laboratory and during PE lessons. METHODS In Study 1, 11 healthy subjects (median age 22.0 years, IQR 3.75 years) twice completed a test that involved running on a treadmill at 6 km/h for 12 minutes and 12 km/h for 5 minutes. During the test, participants wore two Fizzo devices, one each on their left and right wrists, to measure their HR. At the same time, the Polar Team2 Pro (Polar), which is worn on the chest, was used as the standard. In Study 2, we went to 10 schools and measured the HR of 24 students (median age 14.0 years, IQR 2.0 years) during PE lessons. During the PE lessons, each student wore a Polar device on their chest and a Fizzo on their right wrist to measure HR data. At the end of the PE lessons, the students and their teachers completed a questionnaire where they assessed the feasibility of Fizzo. The measurements taken by the left wrist Fizzo and the right wrist Fizzo were compared to estimate reliability, while the Fizzo measurements were compared to the Polar measurements to estimate validity. To measure reliability, intraclass correlation coefficients (ICC), mean difference (MD), standard error of measurement (SEM), and mean absolute percentage errors (MAPE) were used. To measure validity, ICC, limits of agreement (LOA), and MAPE were calculated and Bland-Altman plots were constructed. Percentage values were used to estimate the feasibility of Fizzo. RESULTS The Fizzo showed excellent reliability and validity in the laboratory and moderate validity in a PE lesson setting. In Study 1, reliability was excellent (ICC>0.97; MD<0.7; SEM<0.56; MAPE<1.45%). The validity as determined by comparing the left wrist Fizzo and right wrist Fizzo was excellent (ICC>0.98; MAPE<1.85%). Bland-Altman plots showed a strong correlation between left wrist Fizzo measurements (bias=0.48, LOA=–3.94 to 4.89 beats per minute) and right wrist Fizzo measurements (bias=0.56, LOA=–4.60 to 5.72 beats per minute). In Study 2, the validity of the Fizzo was lower compared to that found in Study 1 but still moderate (ICC>0.70; MAPE<9.0%). The Fizzo showed broader LOA in the Bland-Altman plots during the PE lessons (bias=–2.60, LOA=–38.89 to 33.69 beats per minute). Most participants considered the Fizzo very comfortable and easy to put on. All teachers thought the Fizzo was helpful. CONCLUSIONS When participants ran on a treadmill in the laboratory, both left and right wrist Fizzo measurements were accurate. The validity of the Fizzo was lower in PE lessons but still reached a moderate level. The Fizzo is feasible for use during PE lessons.

scholarly journals Action Boundary Proximity Effects on Perceptual-Motor Judgments

2019 ◽  
Vol 90 (12) ◽  
pp. 1000-1008
Author(s):  
Caleb D. Johnson ◽  
Alice D. LaGoy ◽  
Gert-Jan Pepping ◽  
Shawn R. Eagle ◽  
Anne Z. Beethe ◽  
...  
Keyword(s):  
Intraclass Correlation ◽  
Reaction Times ◽  
Correlation Coefficients ◽  
Proximity Effects ◽  
Testing Time ◽  
Good Reliability ◽  
Intraclass Correlation Coefficients ◽  
Coefficients Of Variation ◽  
Time Required ◽  
Action Coupling

INTRODUCTION: Designed as a more ecological measure of reaction times, the Perception-Action Coupling Task (PACT) has shown good reliability and within-subject stability. However, a lengthy testing period was required. Perceptual-motor judgments are known to be affected by proximity of the stimulus to the action boundary. The current study sought to determine the effects of action boundary proximity on PACT performance, and whether redundant levels of stimuli, eliciting similar responses, can be eliminated to shorten the PACT.METHODS: There were 9 men and 7 women who completed 4 testing sessions, consisting of 3 familiarization cycles and 6 testing cycles of the PACT. For the PACT, subjects made judgments on whether a series of balls presented on a tablet afford “posting” (can fit) through a series of apertures. There were 8 ratios of ball to aperture size (B-AR) presented, ranging from 0.2 to 1.8, with each ratio appearing 12 times (12 trials) per cycle. Reaction times and judgment accuracy were calculated, and averaged across all B-ARs. Ratios and individual trials within each B-AR were systematically eliminated. Variables were re-averaged, and intraclass correlation coefficients (ICC) and coefficients of variation (CVTE) were calculated in an iterative manner.RESULTS: With elimination of the 0.2 and 1.8 B-ARs, the PACT showed good reliability (ICC = 0.81–0.99) and consistent within-subject stability (CVTE = 2.2–14.7%). Reliability (ICC = 0.81–0.97) and stability (CVTE = 2.6–15.6%) were unaffected with elimination of up to 8 trials from each B-AR.DISCUSSION: The shortened PACT resulted in an almost 50% reduction in total familiarization/testing time required, significantly increasing usability.Johnson CD, LaGoy AD, Pepping G-J, Eagle SR, Beethe AZ, Bower JL, Alfano CA, Simpson RJ, Connaboy C. Action boundary proximity effects on perceptual-motor judgments. Aerosp Med Hum Perform. 2019; 90(12):1000–1008.

Reproducibility of 24-h energy expenditure and macronutrient oxidation rates in an indirect calorimeter

1996 ◽  
Vol 80 (1) ◽  
pp. 133-139 ◽  
Author(s):  
M. D. White ◽  
G. Bouchard ◽  
B. Buemann ◽  
N. Almeras ◽  
J. P. Despres ◽  
...  
Keyword(s):  
Energy Expenditure ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Whole Body ◽  
Tissue Mass ◽  
Intraclass Correlation Coefficients ◽  
Oxidation Rates ◽  
Coefficients Of Variation ◽  
Habitual Diet ◽  
Adipose Tissue Mass

The maintenance of weight and adipose tissue mass in humans appears to be related to a balance between the rates of oxidation and consumption of macronutrients; yet, little evidence is available on the reproducibility of 24-h macronutrient oxidation rates and how this relates to diet in the days preceding a chamber session. This study examined the reproducibility of 24-h macronutrient oxidation rates, 24-h energy expenditure (EE), and respiratory quotient (RQ) in 30 adults who ate their habitual diets before two 24-h whole body indirect calorimeter sessions. Results showed that the within-subject coefficients of variation (CVws) for 24-h EE and RQ were 2.8 and 2.6%, respectively. CVws for macronutrient oxidations ranged from approximately 15 to 25%. Means comparisons of 24-h EE, RQ, and macronutrient oxidation rates between sessions showed no significant differences, and all variables had significant positive intraclass correlation coefficients (P < 0.05). In conclusion, macronutrient oxidations all showed significant reproducibility for the group and a significant but lower reproducibility for individuals when habitual diet and activity preceded the experimental sessions.

The Reproducibility of Cephalic Pain Pressure Thresholds in Control Subjects and Headache Patients

Cephalalgia ◽  
1997 ◽  
Vol 17 (7) ◽  
pp. 748-755 ◽  
Author(s):  
T Sand ◽  
JA Zwart ◽  
G Helde ◽  
G Bovim
Keyword(s):  
Pain Intensity ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Cervicogenic Headache ◽  
Tension Type Headache ◽  
Control Subjects ◽  
Cephalic Pain ◽  
Type Headache ◽  
The Right ◽  
Headache Patients

Pain pressure thresholds (PPT) were measured at 13 cephalic points bilaterally in 30 headache patients (10 with tension-type headache, 10 with migraine and 10 with cervicogenic headache) and 10 control subjects on three different days. During the sessions, the subjects reported their pain intensity on the right and left sides of the head on a visual analogue scale (VAS). The variability between days was estimated as a coefficient of repeatability (CR=2 standard deviations of intraindividual differences). The mean CR across all 13 locations was larger in headache patients (2.0 kg/cm2) than in controls (1.68 kg/cm2). Variability (CR) was larger in headache patients as compared to control subjects for 11 of the 13 points (p=0.02). Reliability was better in controls (intraclass correlation coefficients (ICC) ranging from 0.55 to 0.85) than in headache patients (ICC ranging from 0.43 to 0.78). A moderate negative association between PPT and pain intensity was demonstrated. The intraindividual PPT difference (PPT on the most painful occasions-PPT on the least painful occasions) was negative at 12 of 13 cephalic points (p=0.003, across-location mean difference: -0.20 kg/cm2). The PPT differed significantly from one day to the next. A part of this variation was presumably related to the circumstances around the procedure; thresholds were lower when the subjects came directly to algometry without any preceding medical examination at all 13 points (p=0.0002). These results have implications for the planning of future algometer studies. The sample size that is required in studies of headache patients is greater than that in studies of healthy subjects, especially when patients suffer from pain during the PPT session. Particular attention should be paid to circumstances (e.g. preceding medical investigations) around the algometry procedure in order to reduce variability.

Reliability of Dermatologists in Acne Lesion Counts and Global Assessments

2006 ◽  
Vol 10 (4) ◽  
pp. 160-165 ◽  
Author(s):  
Jerry K.L. Tan ◽  
Karen Fung ◽  
Lynne Bulger
Keyword(s):  
Intraclass Correlation ◽  
Training Session ◽  
Correlation Coefficients ◽  
Good Reliability ◽  
Inflammatory Lesions ◽  
Acne Lesion ◽  
Intraclass Correlation Coefficients ◽  
Outcome Measurements ◽  
Group A ◽  
Group B

Background: There is a paucity of data on the reliability of dermatologists in acne lesion counting and global severity assessments. The effects of training and practice on reliability are also uncertain. The objective of this study was to determine the reliability of these outcome measurements when performed by trained dermatologists. Methods: Eleven dermatologists were divided into two groups that evaluated the same six acne subjects twice on the same day. A training session was provided either after (group A) or before (group B) the first patient evaluation sessions. Reliability of raters in lesion counting and global severity assessment was determined by calculation of intraclass correlation coefficients (ICCs). ICC values close to 1.0 indicate excellent reliability, whereas values less than 0.75 are considered unacceptable. Results: Intrarater ICCs ranged from 0.37 to 0.99 for noninflammatory lesions, 0.26 to 0.97 for inflammatory lesions, and 0.56 to 0.83 for global assessments for group A (trained after); corresponding values for group B (trained before) were 0.84 to 0.98, 0.61 to 0.95, and 0.43 to 0.91. ICC values ≥ 0.75 for all three outcome parameters were observed in one of six group A and three of five group B raters. Interrater ICCs for groups A and B after the first evaluation session were 0.17 versus 0.68 for noninflammatory counts, 0.84 versus 0.72 for inflammatory counts, and 0.71 versus 0.65 for global assessments, respectively. Corresponding values after session 2 were 0.79 and 0.77 for noninflammatory, 0.81 and 0.90 for inflammatory, and 0.61 and 0.77 for global assessments. Conclusion: Dermatologists tended to be reliable in acne lesion counting but somewhat less so in global assessments. Training tended to improve group reliability in noninflammatory lesion counts and increased the proportion of raters with good reliability in all three outcome measures. Practice enhanced reliability in all outcome measurements.

scholarly journals Convergent Validity of the Fitbit Charge 2 to Measure Sedentary Behavior and Physical Activity in Overweight and Obese Adults

2020 ◽  
pp. 1-8
Author(s):  
Joanne A. McVeigh ◽  
Jennifer Ellis ◽  
Caitlin Ross ◽  
Kim Tang ◽  
Phoebe Wan ◽  
...  
Keyword(s):  
Physical Activity ◽  
Confidence Interval ◽  
Sedentary Behavior ◽  
Convergent Validity ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Living Environment ◽  
Step Count ◽  
Activity Trackers ◽  
Relative Differences

Activity trackers provide real-time sedentary behavior (SB) and physical activity (PA) data enabling feedback to support behavior change. The validity of activity trackers in an obese population in a free-living environment is largely unknown. This study determined the convergent validity of the Fitbit Charge 2 in measuring SB and PA in overweight adults. The participants (n = 59; M ± SD: age = 48 ± 11 years; body mass index = 34 ± 4 kg/m2) concurrently wore a Charge 2 and ActiGraph GT3X+ accelerometer for 8 days. The same waking wear periods were analyzed, and standard cut points for GT3X+ and proprietary algorithms for the Charge 2, together with a daily step count, were used. Associations between outputs, mean difference (MD) and limits of agreement (LOA), and relative differences were assessed. There was substantial association between devices (intraclass correlation coefficients from .504, 95% confidence interval [.287, .672] for SB, to .925, 95% confidence interval [.877, .955] for step count). In comparison to the GT3X+, the Charge 2 overestimated SB (MD = 37, LOA = −129 to 204 min/day), moderate to vigorous PA (MD = 15, LOA = −49 to 79 min/day), and steps (MD = 1,813, LOA = −1,066 to 4,691 steps/day), and underestimated light PA (MD = −32, LOA = −123 to 58 min/day). The Charge 2 may be a useful tool for self-monitoring of SB and PA in an overweight population, as mostly good agreement was demonstrated with the GT3X+. However, there were mean and relative differences, and the implications of these need to be considered for overweight adult populations who are already at risk of being highly sedentary and insufficiently active.

scholarly journals EXCELLENT RELIABILITY OF SEMI-QUANTITATIVE NAILFOLD CAPILLAROSCOPY IN PATIENTS WITH SYSTEMIC SCLEROSIS – A PILOT STUDY

2016 ◽  
Vol 25 (4) ◽  
pp. 194-198
Author(s):  
Ana Maria Gheorghiu ◽  
◽  
Raida Oneata ◽  
Mihai Bojinca ◽  
Rucsandra Dobrota ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Pilot Study ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Nailfold Capillaroscopy ◽  
Qualitative Assessment ◽  
Rater Agreement ◽  
Quality Of Data ◽  
Good Test ◽  
Good Reliability

Background. Semi-quantitative nailfold capillaroscopy (NFC) scoring represents a promising tool for assessing disease activity, severity and change in systemic sclerosis (SSc), however there is no consensus yet over which capillaroscopy abnormalities should be analyzed and how. Objective. Investigation of the reliability of the qualitative and semi-quantitative scoring of NFC assessment between two raters and test-retest for each rater in a SSc cohort. Methods. This is a single-center pilot study where 2 raters assessed the NFC images of 48 consecutive patients with SSc. Data were analyzed in 3 ways: 1. qualitatively by “normal”/“abnormal” category; 2. qualitatively by the following categories: “early”, “active”, “late” SSc patterns, “normal”, and unclassifiable in any pattern, and step; 3. Semi-quantitatively by calculating the mean score for capillary loss, disorganization of the microvascular array, giant capillaries, microhaemorrhages and capillary ramifications and combinations of giant capillaries and microhaemorrhages (as a surrogate for vascular activity). Disorganization and ramifications (surrogate for vascular damage) were also assessed. Variables for all steps were calculated for all fingers and for each finger. Inter-rater/intra-rater agreement was assessed by Cohen’s kappa coefficients for qualitative variables and by intraclass correlation coefficients (ICC) for mean score values of abnormalities. Results. Inter-rater reliability ranged from good to excellent agreement for mean score values of abnormalities in all fingers (ICC coefficients 0.745 to 0.897) and was excellent for activity (ICC coefficient of 0.923) and damage combinations (ICC coefficient of 0.918). Assessment of abnormalities in a qualitative manner (normal/abnormal or with capillaroscopy patterns) showed weaker inter-rater agreement than the semi-quantitative assessment (k coefficient <0.7). Intra-rater variability was good to excellent for mean score values of abnormalities and activity and damage combinations in all fingers and separate fingers for both raters; for qualitative assessment, only one of the raters had good test-retest reliability. Conclusion. Reliability of NFC assessment is essential in SSc trials/clinical practice to ensure quality of data. This pilot study demonstrates very good reliability between raters of the semi-quantitative NFC assessment in a SSc cohort. Combinations of NFC abnormalities had very good reliability and might be preferred because they are less time consuming.

scholarly journals Test–Retest Reliability of a New Device Versus a Long-Arm Goniometer to Evaluate Knee Proprioception

2021 ◽  
pp. 1-6
Author(s):  
Fei Tian ◽  
Yaqi Zhao ◽  
Jixin Li ◽  
Wenjin Wang ◽  
Danni Wu ◽  
...  
Keyword(s):  
Standard Error ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Joint Position Sense ◽  
Repeated Measurements ◽  
Good Reliability ◽  
Retest Reliability ◽  
New Device ◽  
Intraclass Correlation Coefficients ◽  
Test Retest Reliability

Context: Many methods used to evaluate knee proprioception have shortcomings that limit their use in clinical settings. Based on an inexpensive 3D camera, a new portable device was recently used to evaluate the joint position sense (JPS) of the knee joint. However, the test–retest reliability of the new method remains unclear. This study aimed to evaluate the test–retest reliability of the new device and a long-arm goniometer for assessing knee JPS, and to compare the variability of the 2 methods. Design: Prospective observational study of the test–retest reliability of knee JPS measurements. Methods: Twenty-one healthy adults were tested in 2 sessions with a 1-week interval. Three target knee flexion angles (30°, 45°, and 60°) were reproduced in each session. Target and reproduced angles were measured with both methods. Intraclass correlation coefficients, standard error of the measurement, and Bland–Altman plots were used to quantify test–retest reliability. Paired t tests were used to compare knee JPS (absolute error of the target-reproduced angle) between the methods. Results: The new device (good to excellent intraclass correlation coefficients .74–.80; standard error of the measurement 0.52°–0.61°) demonstrated better test–retest reliability than the goniometer (poor to fair intraclass correlation coefficients .23–.43; standard error of the measurement 0.89°–2.07°) and better test–retest agreement (respective mean differences for the 30°, 45°, and 60° knee angles: 0.11°, 0.13°, and 0.41° for the new system; 0.84°, 1.52°, and 1.18° for the goniometer). The measurements (absolute errors of the target-reproduced angles) with the goniometer were significantly greater than those with the new device (P < .05); the SDs of repeated measurements with the goniometer (1.50°–2.41°) were greater than with the new device (1.08°–1.38°). Conclusions: Given that the new device has good reliability and sufficient precision, it is the better alternative for evaluating knee JPS. Goniometers should be used with caution to assess knee JPS.

Relative validity and reliability of a novel diet quality assessment tool for athletes: the Athlete Diet Index

2020 ◽  
pp. 1-13
Author(s):  
Louise Capling ◽  
Janelle A. Gifford ◽  
Kathryn L. Beck ◽  
Victoria M. Flood ◽  
Fiona Halar ◽  
...  
Keyword(s):  
Diet Quality ◽  
Assessment Tool ◽  
Intraclass Correlation ◽  
Rank Correlation ◽  
Correlation Coefficients ◽  
Systematic Bias ◽  
Validity And Reliability ◽  
Food Record ◽  
Good Reliability ◽  
Relative Validity

Abstract Diet quality indices are a practical, cost-effective method to evaluate dietary patterns, yet few have investigated diet quality in athletes. This study describes the relative validity and reliability of the recently developed Athlete Diet Index (ADI). Participants completed the electronic ADI on two occasions, 2 weeks apart, followed by a 4-d estimated food record (4-dFR). Relative validity was evaluated by directly comparing mean scores of the two administrations (mAdm) against scores derived from 4-dFR using Spearman’s rank correlation coefficient and Bland–Altman (B–A) plots. Construct validity was investigated by comparing mAdm scores and 4-dFR-derived nutrient intakes using Spearman’s coefficient and independent t test. Test–retest reliability was assessed using paired t test, intraclass correlation coefficients (ICC) and B–A plots. Sixty-eight elite athletes (18·8 (sd 4·2) years) from an Australian sporting institute completed the ADI on both occasions. Mean score was 84·1 (sd 15·2; range 42·5–114·0). The ADI had good reliability (ICC = 0·80, 95 % CI 0·69, 0·87; P < 0·001), and B–A plots (mean 1·9; level of agreement −17·8, 21·7) showed no indication of systematic bias (y = 4·57–0·03 × x) (95 % CI −0·2, 0·1; P = 0·70). Relative validity was evaluated in fifty athletes who completed all study phases. Comparison of mAdm scores with 4-dFR-derived scores was moderate (rs 0·69; P < 0·001) with no systematic bias between methods of measurement (y = 6·90–0·04 × x) (95 % CI −0·3, 0·2; P = 0·73). Higher scores were associated with higher absolute nutrient intake consistent with a healthy dietary pattern. The ADI is a reliable tool with moderate validity, demonstrating its potential for application to investigate the diet quality of athletes.

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