scholarly journals Reliability of Measuring the Cervical Sagittal Translation Mobility with a Simple Method in a Clinical Setting

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Yvonne Severinsson ◽  
Lena Elisson ◽  
Olle Bunketorp
Keyword(s):  
Clinical Setting ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Practical Method ◽  
Systematic Difference ◽  
Reference Plane ◽  
Rank Test ◽  
Rater Agreement ◽  
Simple Method ◽  
The Difference

Introduction. The cervical sagittal translation mobility is related to neck pain. A practical method for measuring the specific cervical mobility is needed. The aim was to describe a simple method for measuring the cervical sagittal translation mobility and to evaluate its reliability in a clinical setting.Method. The head protraction and retraction ranges of thirty healthy seated subjects were measured from a dorsal reference plane by two physiotherapists utilizing a tape measure. A standard inclinometer/goniometer was used to minimize angular movements of the head during the translational movements. The measurements were made twice for each subject with a two-hours interval between each measurement. The inter-rater and intra-rater agreements were evaluated with intraclass correlation coefficients (ICCs) and with the distribution of the difference of the measurements. The systematic differences were analysed with the Wilcoxon signed rank test.Results. The intra-rater agreement was good. The inter-rater agreement was moderate in the first measurement and good in the second. A systematic difference was noted between raters in the first measurement but not in the second, possibly indicating a learning effect.Discussion. The method used in the study is simple and reliable and can be recommended for clinical use.

scholarly journals Assessment of reliability and validity of the 5-scale grading system of the point-of-care immunoassay for tear matrix metalloproteinase-9

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Minjeong Kim ◽  
Ja Young Oh ◽  
Seon Ha Bae ◽  
Seung Hyeun Lee ◽  
Won Jun Lee ◽  
...  
Keyword(s):  
Matrix Metalloproteinase ◽  
Calibration Curve ◽  
Point Of Care ◽  
Interobserver Reliability ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Correlation Coefficients ◽  
Grading System ◽  
Intraclass Correlation Coefficients ◽  
The Difference

AbstractWe evaluated the reliability and validity of the 5-scale grading system to interpret the point-of-care immunoassay for tear matrix metalloproteinase (MMP)-9. Six observers graded red bands of photographs of the readout window in MMP-9 immunoassay kit (InflammaDry) two times with 2-week interval based on the 5-scale grading system (i.e. grade 0–4). Interobserver and intraobserver reliability were evaluated using intraclass correlation coefficients. The interobserver agreements were analyzed according to the severity of tear MMP-9 expression. To validate the system, a concentration calibration curve was made using MMP-9 solutions with reference concentrations, then the distribution of MMP-9 concentrations was analyzed according to the 5-scale grading system. Both intraobserver and interobserver reliability was excellent. The readout grades were significantly correlated with the quantified colorimetric densities. The interobserver variance of readout grades had no correlation with the severity of the measured densities. The band density continued to increase up to a maximal concentration (i.e. 5000 ng/mL) according to the calibration curve. The difference of grades reflected the change of MMP-9 concentrations sensitively, especially between grade 2 and 4. Together, our data indicate that the subjective 5-scale grading system in the point-of-care MMP-9 immunoassay is an easy and reliable method with acceptable accuracy.

scholarly journals Navigation-assisted suture anchor insertion for arthroscopic rotator cuff repair

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Ivan Micic ◽  
Erica Kholinne ◽  
Hanpyo Hong ◽  
Hyunseok Choi ◽  
Jae-Man Kwak ◽  
...  
Keyword(s):  
Suture Anchor ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Rank Test ◽  
Subscapularis Tendon ◽  
Signed Rank ◽  
Original Target ◽  
Signed Rank Test ◽  
Arthroscopic Rotator Cuff ◽  
Anchor Fixation

Abstract Background Suture anchor placement for subscapularis repair is challenging. Determining the exact location and optimum angle relative to the subscapularis tendon direction is difficult because of the mismatch between a distorted arthroscopic view and the actual anatomy of the footprint. This study aimed to compare the reliability and reproducibility of the navigation-assisted anchoring technique with conventional arthroscopic anchor fixation. Methods Arthroscopic shoulder models were tested by five surgeons. The conventional and navigation-assisted methods of suture anchoring in the subscapularis footprint on the humeral head were tested by each surgeon seven times. Angular results and anchor locations were measured and compared using the Wilcoxon signed rank test. Interobserver intraclass correlation coefficients (ICCs) were analyzed among the surgeons. Results The mean angular errors of the targeted anchor fixation guide without and with navigation were 17° and 2° (p < 0.05), respectively, and the translational errors were 15 and 3 mm (p < 0.05), respectively. All participants showed a narrow range of anchor fixation angular and translational errors from the original target. Among the surgeons, the interobserver reliabilities of angular errors for ICCs of the navigation-assisted and conventional methods were 0.897 and 0.586, respectively, and the interobserver ICC reliabilities for translational error were 0.938 and 0.619, respectively. Conclusions The navigation system may help surgeons be more aware of the surrounding anatomy and location, providing better guidance for anchor orientation, including footprint location and anchor angle.

Development and assessment of the inter-rater and intra-rater reproducibility of a self-administration version of the ALSFRS-R

2019 ◽  
Vol 91 (1) ◽  
pp. 75-81 ◽  
Author(s):  
Leonhard A Bakker ◽  
Carin D Schröder ◽  
Harold H G Tan ◽  
Simone M A G Vugts ◽  
Ruben P A van Eijk ◽  
...  
Keyword(s):  
Rating Scale ◽  
Clinical Care ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
The Self ◽  
Coefficient Alpha ◽  
Rater Agreement ◽  
Self Administration ◽  
Limits Of Agreement ◽  
Rater Reliability

ObjectiveThe Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) is widely applied to assess disease severity and progression in patients with motor neuron disease (MND). The objective of the study is to assess the inter-rater and intra-rater reproducibility, i.e., the inter-rater and intra-rater reliability and agreement, of a self-administration version of the ALSFRS-R for use in apps, online platforms, clinical care and trials.MethodsThe self-administration version of the ALSFRS-R was developed based on both patient and expert feedback. To assess the inter-rater reproducibility, 59 patients with MND filled out the ALSFRS-R online and were subsequently assessed on the ALSFRS-R by three raters. To assess the intra-rater reproducibility, patients were invited on two occasions to complete the ALSFRS-R online. Reliability was assessed with intraclass correlation coefficients, agreement was assessed with Bland-Altman plots and paired samples t-tests, and internal consistency was examined with Cronbach’s coefficient alpha.ResultsThe self-administration version of the ALSFRS-R demonstrated excellent inter-rater and intra-rater reliability. The assessment of inter-rater agreement demonstrated small systematic differences between patients and raters and acceptable limits of agreement. The assessment of intra-rater agreement demonstrated no systematic changes between time points; limits of agreement were 4.3 points for the total score and ranged from 1.6 to 2.4 points for the domain scores. Coefficient alpha values were acceptable.DiscussionThe self-administration version of the ALSFRS-R demonstrates high reproducibility and can be used in apps and online portals for both individual comparisons, facilitating the management of clinical care and group comparisons in clinical trials.

Running Economy Following an Intense Cycling Bout in Female Duathletes and Triathletes

1995 ◽  
Vol 4 (1) ◽  
pp. 29-39 ◽  
Author(s):  
Tracy Danner ◽  
Sharon Ann Plowman
Keyword(s):  
Blood Lactate ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Systematic Difference ◽  
Running Economy ◽  
Vo2 Max ◽  
Intraclass Correlation Coefficients

The purpose of this study was to evaluate the influence of a preceding intense cycling bout on subsequent running economy in female duathletes and triathletes. Thirteen female duathletes and triathletes (age = 27.5 ± 3.36 yrs.) took part in three testing sessions: (a) measurement of running economy at 169, 177, 196, and 215 m·min−1 and running VO2 max; (b) remeasurement of running economy and measurement of cycling VO2 max; and (c) a 45 minute cycling bout at 70% of cycling VO2 max, immediately followed by measurement of running economy. Intraclass correlation coefficients between Day 1 and Day 2 running economy values ranged from 0.31 to 0.78. A systematic difference occurred at 169 m·min−1 only, with mean VO2 being higher on Day 1 than Day 2 (p<0.02). Based upon dependent t-tests, significantly higher running economy values (p<0.02) but not blood lactate concentrations (p>0.02) following the submaximal cycling bout compared to the control condition (mean of Day 1 and Day 2), at each of the four test velocities were found. Therefore we conclude that running economy was significantly impaired following a 45 minute intense cycling bout in female duathletes and triathletes, but lactate values remained constant.

scholarly journals Reproducibility and reliability of three-dimensional soft tissue landmark identification using three-dimensional stereophotogrammetry

2016 ◽  
Vol 86 (6) ◽  
pp. 1004-1009 ◽  
Author(s):  
Asli Baysal ◽  
Ahmet Oguz Sahan ◽  
Mehmet Ali Ozturk ◽  
Tancan Uysal
Keyword(s):  
Soft Tissue ◽  
Statistical Significance ◽  
Intraclass Correlation ◽  
Three Dimensional ◽  
Correlation Coefficients ◽  
Intraclass Correlation Coefficients ◽  
Paired Samples ◽  
Landmark Identification ◽  
The Difference ◽  
Intraexaminer Reliability

ABSTRACT Objective: To evaluate the intraexaminer repeatability and interexaminer reproducibility of soft tissue landmarks on three-dimensional (3-D) stereophogrammetric images. Materials and Methods: Thirty-four stereophotogrammetric images were taken and 19 soft tissue points were identified. The images were obtained using the 3-DMD Face (3-DMD TM Ltd, Atlanta, Ga) system. Two examiners marked 34 images manually with a mouse-driven cursor 4 weeks apart. Intraexaminer marking differences were calculated and classified as &lt;0.5 mm, 0.5–1 mm, and &gt;1 mm. Intraclass correlation coefficients were calculated for intraexaminer reliability. A paired-samples t-test was used to evaluate the difference between the examiners. Interexaminer reproducibility was evaluated by kappa analysis. Statistical significance was set at P &lt; .05. Results: Only one landmark (labiale superior) had an intraexaminer marking difference less than 0.5 mm. Existing landmarks had an intraexaminer difference less than 1 mm, but higher than 0.5 mm. The intraclass correlation coefficients (ICCs) indicated good intraexaminer repeatability for both observers. The ICC range for examiners 1 and 2 was 0.986–1.000 and 0.990–1.000, respectively. Kappa scores showed good interexaminer agreement, especially on the z-axis. Conclusions: Except labiale superior, the soft tissue landmarks used in this study were shown to have moderate reproducibility, but the difference between the landmarks was less than 1 mm, and they had clinically acceptable reproducibility.

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 Noninvasive quantitative estimation of hepatic steatosis by ultrasound: a comparison of the hepato-renal index and ultrasound attenuation index.

2016 ◽  
Vol 18 (4) ◽  
pp. 431 ◽  
Author(s):  
Heon-Ju Kwon ◽  
Kyoung Won Kim ◽  
Jin-Hee Jung ◽  
Sang Hyun Choi ◽  
Woo Kyoung Jeong ◽  
...  
Keyword(s):  
Hepatic Steatosis ◽  
Interobserver Agreement ◽  
Quantitative Estimation ◽  
Statistical Significance ◽  
Characteristic Curve ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Ultrasound Attenuation ◽  
Attenuation Index ◽  
The Difference

Aims: To compare the accuracy of the ultrasound attenuation index (USAI) and hepato-renal index (HRI) for the diagnosis of hepatic steatosis (HS). Material and methods: Two hundred and twenty-four potential living hepatic donors underwent US and subsequent US-guided liver biopsy. The USAI was calculated from US images with an 8 MHz transducer and HRI was measured on sagittal images with a clear visualization of both the liver and kidney. Using histological degrees of HS as the reference standard, we compared the performance of USAI and HRI for diagnosing HS ≥ 5% and ≥ 30% by receiver operating characteristic curve analysis. The interobserver agreement was evaluated by using intraclass correlation coefficients (ICCs) or Bland–Altman statistics. Results: Histologic degree of HS was 0–70% (median, 5%). HRI showed a tendency towards higher accuracy than USAI for diagnosing HS ≥ 5% (the area under the ROC curve, 0.856 vs. 0.820; p= 0.279) and ≥ 30% (0.937 vs. 0.909; p = 0.378) without statistical significance. There was an excellent interobserver agreement for both USAI and HRI (ICC = 0.931 and 0.973, respectively). According to the Bland–Altman method, the 95% limits of difference between two readers for HS were −8.5% to 6.6% by USAI and −4.8% to 6.2% by HRI. Most patients would have the difference of calculated HS by USAI (74.0%) and HRI (96.0%) from different operators within a range of ±5%. Conclusions: Although statistically insignificant, HRI was superior to USAI for the diagnosis and quantitative estimation of HS in terms of diagnostic performance, including accuracy and reproducibility.

scholarly journals Diagnosing Syndesmosis Instability: Dynamic Ultrasound versus Arthroscopy: A Cadaveric Study

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0024
Author(s):  
Noortje Hagemeijer ◽  
Go Sato ◽  
Rohan Bhimani ◽  
Bart Lubberts ◽  
Mohamed Abdelaziz Elghazy ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Sagittal Plane ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Rank Test ◽  
Proximal Tibiofibular Joint ◽  
Interosseous Ligament ◽  
P Values ◽  
Cadaveric Specimen ◽  
Tibiofibular Ligament

Category: Ankle Introduction/Purpose: To evaluate whether sagittal translation could be detected with ultrasound and arthroscopy and to compare the increasing tibiofibular sagittal translation seen with ultrasound (US) and Arthroscopy. Methods: Eight fresh lower leg cadaveric specimen amputated above the proximal tibiofibular joint were used in this study. The ankle syndesmosis was evaluated using a handheld US device (Butterfly iQ, Butterfly Network Inc, Guilford) and arthroscopy with intact-, and after sequent sectioning of anterior-inferior tibiofibular ligament (AITFL), interosseous ligament (IOL), and posterior- inferior tibiofibular ligament (PITFL). Sagittal plane translation was simulated with 100N of anterior to posterior (A-to-P) and posterior to anterior (P-to-A) hook force which was applied 5cm above of the ankle joint (Figure 1). Pearson’s correlation, one- way repeated measures ANOVA, and Wilcoxon signed-rank test were used for comparison. Three cadavers were measured by two independent observers to assess reliability and analyzed using intraclass correlation coefficients (ICC). Results: A-to-P translation values obtained with US and Arthroscopy had a correlation of -0.14, and P-to-A translation correlation of 0.44. Using US, intact translation was 0.94+-0.62 with A-to-P hook and 0.87+-0.5 with P-to-A hook. Subsequent A- to-P and P-to-A translation increased with 0.07+-0.96mm and 0.04+-0.76 after AITFL cut, with 0.53+-0.9 and 0.15+-0.5 after IOL cut, and with 0.81+-1.3mm and 0.45+-0.8 after PITFL cut (p-values between 0.122 and 0.270) . Using arthroscopy, intact translation was 0.40 +-0.3 with A-to-P hook and 0.99+-0.5 with P-to-A hook. Subsequent A-to-P and P-to-A translation increased from intact with; 0.001+-0.3 and 0.30+-0.4 after AITFL cut, 0.19+-0.4 and 0.74+-0.7 after IOL cut, and 0.40+-0.5 and 1.1+-0.9 after PITFL cut (p-values between 0.005 and 0.037). No statistical differences between US and Arthroscopy were found. Conclusion: US was unable to differentiate between the different stages of injury, even though a similar increase in translation was seen as compared to arthroscopy. Probably this is due to the high variability seen in the US translation values. As US does have several advantages over arthroscopy; availability, non-invasiveness, low costs, and allowance of using the contralateral side as a direct comparison, this technique should be further explored as a potential diagnostic assessment technique of diagnosing occult syndesmotic instability in the sagittal plane.

scholarly journals Establishing Intra- and Inter-Rater Agreement of the Face, Legs, Activity, Cry, Consolability Scale for Evaluating Pain in Toddlers During Immunization

2013 ◽  
Vol 18 (6) ◽  
pp. e124-e128 ◽  
Author(s):  
Rebecca J Gomez ◽  
Nick Barrowman ◽  
Sonja Elia ◽  
Elizabeth Manias ◽  
Jenny Royle ◽  
...  
Keyword(s):  
Young Children ◽  
Controlled Trial ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Random Order ◽  
Video Data ◽  
Rater Agreement ◽  
Convenience Sample ◽  
Final Injection ◽  
The Face

BACKGROUND: The Face, Legs, Activity, Cry, Consolability (FLACC) scale is a five-item tool that was developed to assess postoperative pain in young children. The tool is frequently used as an outcome measure in studies investigating acute procedural pain in young children; however, there are limited published psychometric data in this context.OBJECTIVE: To establish inter-rater and intrarater agreement of the FLACC scale in toddlers during immunization.METHODS: Participants comprised a convenience sample of toddlers recruited from an immunization drop-in service, who were part of a larger pilot randomized controlled trial. Toddlers were video- and audiotaped during immunization procedures. The first rater scored each video twice in random order over a period of three weeks (intrarater agreement), while the second rater scored each video once and was blinded to the first rater’s scores (inter-rater agreement). The FLACC scale was scored at four time-points throughout the procedure. Intraclass correlation coefficients were used to assess agreement of the FLACC scale.RESULTS: Thirty toddlers between 12 and 18 months of age were recruited, and video data were available for 29. Intrarater agreement coefficients were 0.88 at baseline, 0.97 at insertion of first needle, and 0.80 and 0.81 at 15 s and 30 s following the final injection, respectively. Inter-rater coefficients were 0.40 at baseline, 0.95 at insertion of first needle, and 0.81 and 0.78 at 15 s and 30 s following the final injection, respectively.CONCLUSIONS: The FLACC scale has sufficient agreement in assessing pain in toddlers during immunizations, especially during the most painful periods of the procedure.

scholarly journals Thumb Proprioception in Hypermobile and Non-Hypermobile Adults: An Observational Study

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Leon Fonseka ◽  
Nicola Massy-Westropp ◽  
Steve Milanese ◽  
Arjun Burlakoti
Keyword(s):  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Joint Hypermobility ◽  
Angular Distance ◽  
Test Reliability ◽  
Joint Position ◽  
Convenience Sample ◽  
Intraclass Correlation Coefficients ◽  
The Difference ◽  
Design And Methods

Aims and Background Hypermobility is a common presentation in the community and is reported related to higher rates of injury and musculoskeletal pain, however the mechanism underpinning this relationship remains unclear. Poor proprioception in hypermobile joints has been proposed as a potential mechanism. This study aims to determine if there is a difference in proprioceptive acuity, as measured by joint position reproduction, in adults with generalised joint hypermobility. Design and methods A convenience sample of 26 university students and staff (mean age 29.23 years, range 18-47) were recruited, of which 12 participants displayed generalised joint hypermobility, and 14 did not. A laser light, mounted to the dominant thumb, was used to test joint position reproduction sense by pointing to targets using a unilateral active-active position reproduction protocol. Results/Findings Test reliability across a range of targets was poor to good (intraclass correlation coefficients ranged from 0.1163 to 0.7256), indicating significant variability between participants. No significant differences was found in absolute angle of error between generalised joint hypermobility and non-generalised joint hypermobility participants. For direction of error in relation to the proprioceptive targets, only 30° thumb extension above horizontal was found to be significantly different between the hypermobile and non-hypermobile groups, with hypermobile participants tending to underestimate distance to target. Age and sex were not correlated to thumb proprioception. Application and Conclusion The difference found in direction of error and tendency to underestimate angular distance may be protective against straying into possibly injurious end-ranges; however, larger studies are recommended to confirm this.

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