High inter- and intra-observer agreement for measuring tissue oxygenation of the plantar surface of the foot in healthy participants with the Hyperview®: A pilot study

Vascular ◽  
2021 ◽  
pp. 170853812110027
Author(s):  
Kaz LJ van Schilt ◽  
Evert-Jan F Hollander ◽  
Oscar C Veen ◽  
Mark J Koelemay ◽  
Anna AW van Geloven ◽  
...  
Keyword(s):  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Arterial Disease ◽  
Observer Agreement ◽  
Future Research ◽  
Plantar Surface ◽  
Patients With Diabetes ◽  
Peripheral Arterial ◽  
The Right ◽  
Healthy Participants

Objectives The Hyperview® is a novel camera that applies hyperspectral imaging to project local concentrations of oxyhaemoglobin (OXY), deoxyhaemoglobin (DEOXY) and O2-saturation (O2-SAT) in a map. In this pilot validation study, we assessed inter - and intra-observer agreement for measuring OXY, DEOXY and O2-SAT in healthy participants. Methods The plantar region of the right foot was assessed with the Hyperview® in 50 healthy participants. Two consecutive pictures were taken by the same observer, followed by two images by a second observer. Measurements were performed without and with standardization (a static device for both the foot and the Hyperview camera). Inter- and intra-observer agreements were expressed as Intraclass Correlation coefficients (ICC) with their 95% confidence interval (CI). A score <0.40 indicates poor agreement, 0.40–0.59 fair, 0.60–0.74 good and 0.75–1.00 excellent agreement. Bland and Altman plots were also generated. Results Without standardization, the ICC values between the observers for OXY, DEOXY and O2-SAT ranged from 0.70 to 0.83. The intra-observer agreement of both observers ranged from 0.36 to 0.83. With standardization, the ICC values between the observers ranged from 0.80 to 0.82 and intra-observer agreement varied from 0.75 to 0.92. Four Bland and Altman plots were generated of the measurements of OXY by observers 1 and 2. Conclusions When standardization is used, the Hyperview® camera is a reliable device with excellent intra- and inter-observer agreements for the assessment of OXY, DEOXY and O2-SAT. In future research, the inter- and intra-observer agreements of the camera should be investigated in patients with diabetes and/or peripheral arterial disease.

Laser Doppler Measurements of Systolic Blood Pressure on the First and Second Toe in Patients with Peripheral Arterial Disease

2021 ◽  
Author(s):  
Stefan Rosfors ◽  
Agnes Modin ◽  
Johan Petrini
Keyword(s):  
Blood Pressure ◽  
Peripheral Arterial Disease ◽  
Intraclass Correlation ◽  
Arterial Disease ◽  
Laser Doppler ◽  
Daily Routine ◽  
Measurement Variability ◽  
Peripheral Arterial ◽  
The Right ◽  
Second Toe

AbstractLaser Doppler was used to measure toe blood pressure (TBP) in 40 consecutive patients with various degree of peripheral arterial disease. The aim of this methodological study was to increase the usefulness of TBP by exploring the interchangeability between TBP from the first and second toe and by investigating daily routine reproducibility and measurement variability. According to our study design pressure values were based on three measurements that were averaged. At simultaneous measurements, TBP of the first toe was 71 mm Hg (standard deviation [SD] 25) compared with 70 mm Hg (SD 25) on the second toe. The correlation (r) between first and second toe pressure measurements was 0.84 and intraclass correlation coefficient (ICC) was 0.84. The difference between TBP on the first and second toe was not related to gender, diabetes, or magnitude of the pressures. Repeated TBP measurements of the right first toe after disconnection of cuffs, 5 to 10 minutes rest, and reconnection of cuffs had a coefficient of variation (CV) of 9% and an ICC of 0.93. CV for toe-brachial index (TBI) was 8%. Our results show that measurements of TBP from the second toe to a large extent are interchangeable with those assessed from the first toe and can be used in clinical situations where measurements from the first toe are not feasible. Flow detection with three averaged laser Doppler measurements generates TBP and TBI with low variability.

scholarly journals Psychometric Properties of the MyotonPRO in Dementia Patients with Paratonia

Gerontology ◽  
2017 ◽  
Vol 64 (4) ◽  
pp. 401-412 ◽  
Author(s):  
Hans Drenth ◽  
Sytse U. Zuidema ◽  
Wim P. Krijnen ◽  
Ivan Bautmans ◽  
Cees van der Schans ◽  
...  
Keyword(s):  
Psychometric Properties ◽  
Correlation Coefficient ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Functional Mobility ◽  
Future Research ◽  
Minimal Detectable Change ◽  
Muscle Properties ◽  
Dementia Patients ◽  
Longitudinal Outcome

Background: Paratonia is a distinctive form of hypertonia, causing loss of functional mobility in early stages of dementia to severe high muscle tone and pain in the late stages. For assessing and evaluating therapeutic interventions, objective instruments are required. Objective: Determine the psychometric properties of the MyotonPRO, a portable device that objectively measures muscle properties, in dementia patients with paratonia. Methods: Muscle properties were assessed with the MyotonPRO by 2 assessors within one session and repeated by the main researcher after 30 min and again after 6 months. Receiver operating characteristic curves were constructed for all MyotonPRO outcomes to discriminate between participants with (n = 70) and without paratonia (n = 82). In the participants with paratonia, correlation coefficients were established between the MyotonPRO outcomes and the Modified Ashworth Scale for paratonia (MAS-P) and muscle palpation. In participants with paratonia, reliability (intraclass correlation coefficient) and agreement values (standard error of measurement and minimal detectable change) were established. Longitudinal outcome from participants with paratonia throughout the study (n = 48) was used to establish the sensitivity for change (correlation coefficient) and responsiveness (minimal clinical important difference). Results: Included were 152 participants with dementia (mean [standard deviation] age of 83.5 [98.2]). The area under the curve ranged from 0.60 to 0.67 indicating the MyotonPRO is able to differentiate between participants with and without paratonia. The MyotonPRO explained 10-18% of the MAS-P score and 8-14% of the palpation score. Interclass correlation coefficients for interrater reliability ranged from 0.57 to 0.75 and from 0.54 to 0.71 for intrarater. The best agreement values were found for tone, elasticity, and stiffness. The change between baseline and 6 months in the MyotonPRO outcomes explained 8-13% of the change in the MAS-P scores. The minimal clinically important difference values were all smaller than the measurement error. Conclusion: The MyotonPRO is potentially applicable for cross-sectional studies between groups of paratonia patients and appears less suitable to measure intraindividual changes in paratonia. Because of the inherent variability in movement resistance in paratonia, the outcomes from the MyotonPRO should be interpreted with care; therefore, future research should focus on additional guidelines to increase the clinical interpretation and improving reproducibility.

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&gt;0.97; MD&lt;0.7; SEM&lt;0.56; MAPE&lt;1.45%). The validity as determined by comparing the left wrist Fizzo and right wrist Fizzo was excellent (ICC&gt;0.98; MAPE&lt;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&gt;0.70; MAPE&lt;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 Norwegian trends in numbers of lower extremity revascularisations and amputations including regional trends in endovascular treatments for peripheral arterial disease: a retrospective cross-sectional registry study from 2001 to 2014

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e016210 ◽  
Author(s):  
Kjersti Wendt ◽  
Ronny Kristiansen ◽  
Kirsten Krohg-Sørensen ◽  
Fredrik Alexander Gregersen ◽  
Erik Fosse
Keyword(s):  
Lower Extremity ◽  
Arterial Disease ◽  
Major Amputation ◽  
Cross Sectional Study ◽  
Incidence Rates ◽  
Cross Sectional ◽  
Regional Trends ◽  
Treatment Knowledge ◽  
Patients With Diabetes ◽  
Peripheral Arterial

ObjectiveThe numbers of lower extremity revascularisations and amputations are insufficiently reported in Norway. To support future policy decisions regarding the provision of vascular treatment, knowledge of such trends is important.MethodsThis retrospective cross-sectional study from 2001 to 2014 used data from the Norwegian Patient Registry. The revascularisation treatments were categorised in multilevel, aortoiliac, femoral to popliteal and popliteal to foot levels and sorted as open, endovascular and hybrid. The sessions in amputations were divided in major (thigh and below knee) and minor (ankle, foot or digit). Incidence rates were assessed per 100 000 for patients in the age group>60 years. The diabetic prevalence was calculated and the endovascular numbers at the South-Eastern, Western, Central and Northern Norway Regional Health Authority were compared.ResultsThe overall revascularisation rates increased from 308.7 to 366.8 (p=0.02). Open revascularisations decreased from 158.9 to 98.7 (p<0.01) while endovascular revascularisations increased from 142.2 to 243.4 (p<0.01). Hybrid revascularisations increased from 7.4 to 24.8 (p<0.01). Major amputation rates decreased from 87.8 to 48.7 (p<0.01) while minor amputations increased from 12.3 to 19.6 (p=0.01). The diabetic percentages increased from 12.2 to 22.3 (p<0.01) in revascularisations, from 26.5 to 30.8 (p=0.02) in major amputations and from 43.0 to 49.3 (p=0.13) in minor. (p values refer to average annual changes.) The regional trends in endovascular treatments varied within and between the vascular groups.ConclusionFrom 2001 to 2014, the revascularisation rates increased due to the rise in endovascular procedures. Open revascularisations and major amputation rates decreased, minor increased. The regional variances in endovascular treatments indicate that the availability of this technology differed between the health regions of Norway. The increase in patients with diabetes requires continued awareness of diabetes and its complications.

Lower Limb Amputation Rates in Patients With Diabetes and an Infected Foot Ulcer: A Prospective Observational Study

2021 ◽  
Vol 67 (7) ◽  
pp. 22-30
Author(s):  
Natasha Chaudhary ◽  
Farhanul Huda ◽  
Ravi Roshan ◽  
Somprakas Basu ◽  
Deepak Rajput ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Clinical Signs ◽  
Foot Ulcer ◽  
Arterial Disease ◽  
Major Amputation ◽  
Lower Extremity Amputation ◽  
Patients With Diabetes ◽  
Peripheral Arterial ◽  
Extremity Amputation

BACKGROUND: Lower extremity amputation is a serious complication of diabetes mellitus and occurs most commonly in persons who have a foot ulcer. PURPOSE: To examine variables that affect the rate of lower extremity amputation in patients with diabetes and infected foot ulcers. METHODS: A prospective observational study was performed including all consecutive patients who were 18 to 65 years, had a diagnosis of diabetes, and a foot ulcer showing clinical signs of infection. Patients were followed for 6 months or until ulcer healing, minor, or major amputation. A total of 81 persons were enrolled. Demographic variables were obtained, and clinical assessments, blood tests, and radiological investigations were performed. Ulcers were categorized using the Perfusion, Extent, Depth, Infection and Sensation classification system. Differences between variables and outcomes were assessed using the Wilcoxon test, Fisher’s exact test, Chi-square test, and t-test. RESULTS: Mean patient age was 54.58 ± 9.04 years, and the majority (61, 75%) were male. After 6 months, 33 (41%) were healed, 2 patients died, and 17 (21%) underwent major and 24 (30%) minor amputations. Major amputation rates were significantly higher in patients with a high Perfusion, Extent, Depth, Infection and Sensation score (6.92 ± 1.36; P = .005), elevated HbA1c (%) (9.43 ± 2.19; P = .049), presence of growth on wound culture (41 [64.1%]; P = .016), culture sensitivity to beta lactam (20 [31.2%]; P = .012), and presence of peripheral arterial disease seen on arterial Doppler ultrasound (P < .001). Minor amputation rates were higher in men (P = .02) and in the presence of peripheral arterial disease (P = .01). CONCLUSION: The presence of the above factors in persons with diabetes and foot ulcer with clinical signs of infection should alert the clinician to the need for focused and individualized treatment to attempt to prevent amputation.

Comparing Counts of Park Users With a Wearable Video Device and an Unmanned Aerial System

2021 ◽  
pp. 1-8
Author(s):  
Richard R. Suminski ◽  
Gregory M. Dominick ◽  
Matthew Saponaro
Keyword(s):  
Repeated Measures ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Future Research ◽  
Unmanned Aerial Systems ◽  
Park Use ◽  
Intraclass Correlation Coefficients ◽  
Potential Benefits ◽  
Absolute Agreement ◽  
Aerial Systems

Evidence suggests that video captured with a wearable video device (WVD) may augment or supplant traditional methods for assessing park use. Unmanned aerial systems (UASs) are used to assess human activity, but research employing them for park assessments is sparse. Therefore, this study compared park user counts between a WVD and UAS. A diverse set of 33 amenities (e.g., playground) in three parks were videoed simultaneously by one researcher wearing a WVD and another operating the UAS. Assessments were done at 12 p.m. and 7 p.m. on weekends, with one park evaluated on two occasions 7 days apart. Two investigators independently reviewed videos and reached consensus on the counts of individuals at each amenity. Intraclass correlation coefficients (ICCs) were used to determine intra- and interrater reliabilities. A total of 404 (M = 4.7; SD = 9.6) and 389 (M = 4.5; SD = 9.0) individuals were counted in the UAS and WVD videos, respectively. Absolute agreement was 86% (74/86) and 100% when no individuals were using the amenity. Whether using all 86 videos or only videos having people (48 videos), ICCs indicated excellent reliability (ICC = .99; p < .001). The totals seen for the repeated measures were UAS = 146 and WVD = 136 for Day 1 and UAS = 169 and WVD = 161 for Day 2. Intrarater reliability was excellent for the UAS (ICC = .92; p < .001) and good for the WVD (ICC = .89; p < .001). Disagreement was mainly due to obstructions—people behind or under structures. This study provides support for the use of UASs for counting park users and future research examining the potential benefits of video analysis for assessing park use.

scholarly journals Review of 20 years of vascular surgery research in Australasia: Defining future directions

2019 ◽  
Vol 7 ◽  
pp. 205031211987106
Author(s):  
Judy Wang ◽  
Jasamine Coles-Black ◽  
Matija Radojcic ◽  
Jason Chuen ◽  
Philip Smart
Keyword(s):  
New Zealand ◽  
Peripheral Arterial Disease ◽  
Vascular Surgery ◽  
Case Series ◽  
Arterial Disease ◽  
Future Research ◽  
Hybrid Surgery ◽  
Peripheral Arterial ◽  
High Level ◽  
Over Time

Objectives: High-quality research is fundamental to the advancement of surgical practice. Currently, there is no quantitative assessment of the research output of vascular surgeons in Australia and New Zealand. By conducting this bibliometric analysis, we aim to provide an objective representation of the trends in vascular surgery and guide future research. Methods: A list of all current vascular surgeons in Australia and New Zealand was compiled from the Royal Australasian College of Surgeons ‘Find a Surgeon’ website tool and correlated with the Australia and New Zealand Society for Vascular Surgery database. A Scopus search of each surgeon’s author profile over the last 20 years was conducted. Results: In total, 2120 articles were published by 208 Australasian vascular surgeons between 1998 and July 2018, with an overall increase in publications over time. Audits or case series were the most published type of study and only 8% of the publications were of high-level evidence. The most popular topics were thoracoabdominal aortic pathologies (24%), followed by peripheral arterial disease (15%). Chronological analysis illustrates an increasing volume of peripheral arterial disease research over time and there is a clear trend towards more endovascular and hybrid surgery publications. The top 10 (5%) highest publishing authors by h-index account for 41% of all publications and 49% of all citations and are also responsible for producing significantly more high-level evidence research. Conclusion: Australasian vascular surgeons have made a significant contribution to medical research. However, the majority of these articles are of low-level evidence. In this time, there has been an increasing number of publications on endovascular and hybrid surgery in keeping with the trend in clinical practice. These areas, as well as research regarding peripheral arterial disease, show potential for high-evidence research in the future.

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