Confiabilidade e concordância intra e interavaliadores na avaliação da pressão perineal em nulíparas

AIMS: To verify intra and inter-rater reliability and concordance in the assessment of perineal pressure in nulliparous women.METHODS: Young, healthy, nulliparous, non-pregnant women who had had sexual intercourse and had a correct contraction of the perineal musculature on physical examination were included. Women were excluded if they used other muscles in a visually perceptible way during the perineal contraction; with changes in the pelvic muscles tone; with urinary incontinence; with cognitive alterations; with disease that could affect the muscular and nervous tissues; or practitioners of high-impact physical activity. The participants were submitted to two assessments of perineal pressure on the same day, with different evaluators. After one week the protocol was repeated. Perineal pressure was determined by means of a perineometer and obtained by the difference between the maximum pressure (Pmax) and the minimum pressure (Pmin) recorded by the device, in millimeters of mercury. Sustained contraction (SC) was evaluated by the time in seconds. In order to determine reliability, the intraclass correlation coefficient (ICC) was used. Bland-Altman test was used for the concordance analysis. Comparison of means was performed by the Wilcoxon test. A value of p≤0.05 was considered significant.RESULTS: Ten participants were included, with a mean age of 23.8±2.9 years and a body mass index of 22.2±1.8 kg / m². The evaluator A obtained excellent intra-rater reliability for Pmin (ICC=0.86, p<0.01) and Pmax (ICC=0.92, p<0.01); very good reliability for perineal pressure (ICC=0.65, p=0.01); and no statistical significance for SC. For evaluator B, there was no statistical significance for Pmin and Pmax, but there was very good reliability for perineal pressure (ICC=0.78, p<0.01) and SC (ICC = 0.70, p<0.01). In the inter-rater analysis (A vs B), on day 1 there was no statistical significance for Pmin, Pmax and perineal pressure; but there was very good reliability for SC (ICC=0.71, p<0.01). On day 2, there was no statistical significance for Pmin and Pmax, but there was very good reliability for perineal pressure (ICC=0.62, p=0.02) and good for SC (ICC=0.56, p=0.03). There was agreement between intra and inter-rater measurements.CONCLUSIONS: Perineal pressure measurements showed very good intra-rater reliability and good to very good inter-rater reliability, with intra and inter-rater concordance.

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Validity and reliability of a wearable-controlled serious game and goniometer for telemonitoring of wrist fracture rehabilitation

European Journal of Trauma and Emergency Surgery ◽

10.1007/s00068-021-01657-5 ◽

2021 ◽

Author(s):

Henriëtte A. W. Meijer ◽

Maurits Graafland ◽

Miryam C. Obdeijn ◽

Marlies P. Schijven ◽

J. Carel Goslings

Keyword(s):

Range Of Motion ◽

Intraclass Correlation ◽

Internal Validity ◽

Wrist Fracture ◽

Serious Game ◽

Reference Standard ◽

Validity And Reliability ◽

Good Reliability ◽

Rater Reliability ◽

Flexion Extension

Abstract Purpose To determine the validity of wrist range of motion (ROM) measurements by the wearable-controlled ReValidate! wrist-rehabilitation game, which simultaneously acts as a digital goniometer. Furthermore, to establish the reliability of the game by contrasting ROM measurements to those found by medical experts using a universal goniometer. Methods As the universal goniometer is considered the reference standard, inter-rater reliability between surgeons was first determined. Internal validity of the game ROM measurements was determined in a test–retest setting with healthy volunteers. The reliability of the game was tested in 34 patients with a restricted range of motion, in whom the ROM was measured by experts as well as digitally. Intraclass-correlation coefficients (ICCs) were determined and outcomes were analyzed using Bland–Altman plots. Results Inter-rater reliability between experts using a universal goniometer was poor, with ICCs of 0.002, 0.160 and 0.520. Internal validity testing of the game found ICCs of − 0.693, 0.376 and 0.863, thus ranging from poor to good. Reliability testing of the game compared to medical expert measurements, found that mean differences were small for the flexion–extension arc and the radial deviation-ulnar deviation arc. Conclusion The ReValidate! game is a reliable home-monitoring device digitally measuring ROM in the wrist. Interestingly, the test–retest reliability of the serious game was found to be considerably higher than the inter-rater reliability of the reference standard, being healthcare professionals using a universal goniometer. Trial registration number (internal hospital registration only) MEC-AMC W17_003 #17.015.

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Comparing Reliability Between 3D Imaging And 2D Photography For External Nasal Anthropometry

10.21203/rs.3.rs-669579/v1 ◽

2021 ◽

Author(s):

Yoon-Soo Seo ◽

Ki-Hun Jo ◽

Jun-Sang CHA ◽

Joo-Yeon Kim ◽

Jae-Hwan Kwon

Keyword(s):

3D Imaging ◽

Intraclass Correlation ◽

Digital Camera ◽

Angular Parameter ◽

Good Reliability ◽

Rater Reliability ◽

3D Images ◽

Imaging Result ◽

External Nose ◽

2D And 3D

Abstract Background: This study investigates and compare the reliability and reproducibility of two facial anthropometric methods about external nasal angles, 3D imaging and conventional 2D photography. Methods: 2D photograph images and 3D images about external nose of 30 volunteers were taken using digital camera and Morpheus 3D scanner. To evaluate intra-rater reliability, each images were taken over two different days for each subject by the same researcher. To evaluate inter-rater reliability, another researcher took each images for each subject on the first day. The reliability of each method for measuring 4 external nasal angle is obtained using intraclass correlation coefficient (ICC) and compared.Results: Inter-rater and intra-rater reliability of both 3D imaging and 2D photography had excellent agreement in all 4 nasal angles. In the nasofacial angular parameter, Inter-rater ICC, 2D photography was significantly higher than 3D imaging. Result of intra-rater ICC also showed both 3D imaging and 2D photography had good reliability in all 4 nasal angles. Similar to those of inter-rater ICC, nasofacial angular parameter showed statistically significant differences between 3D imaging and 2D photography.Conclusion: In terms of reliability, both 2D and 3D showed appropriate anthropometric results and considering its own advantage, each methods can be used complementarily.

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The use of evidence-based guidance to enable reliable and accurate measurements of the home environment

British Journal of Occupational Therapy ◽

10.1177/0308022617737689 ◽

2017 ◽

Vol 81 (1) ◽

pp. 32-41 ◽

Cited By ~ 3

Author(s):

Georgia Spiliotopoulou ◽

Anita Atwal ◽

Anne McIntyre

Keyword(s):

Older People ◽

Home Environment ◽

Statistical Significance ◽

Descriptive Analysis ◽

Wilcoxon Test ◽

Evidence Based ◽

Rater Reliability ◽

Group Design ◽

Accuracy Of Measurements ◽

Accuracy Of Results

Introduction High quality guidance in home strategies is needed to enable older people to measure their home environment and become involved in the provision of assistive devices and to promote consistency among professionals. This study aims to investigate the reliability of such guidance and its ability to promote accuracy of results when measurements are taken by both older people and professionals. Method Twenty-five health professionals and 26 older people participated in a within-group design to test the accuracy of measurements taken (that is, person’s popliteal height, baths, toilets, beds, stairs and chairs). Data were analysed with descriptive analysis and the Wilcoxon test. The intra-rater reliability was assessed by correlating measurements taken at two different times with guidance use. Results The intra-rater reliability analysis revealed statistical significance ( P < 0.05) for all measurements except for the bath internal width. The guidance enabled participants to take 90% of measurements that they were not able to complete otherwise, 80.55% of which lay within the acceptable suggested margin of variation. Accuracy was supported by the significant reduction in the standard deviation of the actual measurements and accuracy scores. Conclusion This evidence-based guidance can be used in its current format by older people and professionals to facilitate appropriate measurements. Yet, some users might need help from carers or specialists depending on their impairments.

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

The Angle Orthodontist ◽

10.2319/120715-833.1 ◽

2016 ◽

Vol 86 (6) ◽

pp. 1004-1009 ◽

Cited By ~ 14

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 <0.5 mm, 0.5–1 mm, and >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 < .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.

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PELATIHAN MINDFULNESS UNTUK MENURUNKAN TINGKAT STRES PADA SISWI KELAS X

Jurnal Psikohumanika ◽

10.31001/j.psi.v12i2.986 ◽

2020 ◽

Vol 12 (2) ◽

pp. 159-178

Author(s):

Ulfa Noor Laili Uswatun Hasanah ◽

Siti Muthia Dinni

Keyword(s):

Experimental Research ◽

Mindfulness Training ◽

Test Method ◽

Wilcoxon Test ◽

Severe Stress ◽

A Value ◽

Stress Levels ◽

Before And After ◽

The Difference ◽

Research Type

This study aims to determine the effect of mindfulness training to reduce the stress levels of 7 students in SMK X Pundong who have moderate to severe stress levels. The stress level was measured using the DASS scale. This research is categorized into experimental research type with one group pretest-posttest design. The data obtained were then analyzed using the non-parametric Wilcoxon test method to see the difference between students’ stress levels before and after the intervention through the IBM SPSS Statistics 25 for windows program. The results showed that there were significant differences in students’ stress levels before and after the intervention was given with a value of p = 0.018 (p <0.05). This proves that mindfulness training can reduce the stress levels of students in class X.

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

Medical Ultrasonography ◽

10.11152/mu-868 ◽

2016 ◽

Vol 18 (4) ◽

pp. 431 ◽

Cited By ~ 4

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.

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A Validated, Automated, 3-Dimensional Method to Reliably Measure Tibial Torsion

The American Journal of Sports Medicine ◽

10.1177/0363546520986873 ◽

2021 ◽

Vol 49 (3) ◽

pp. 747-756

Author(s):

Joanna M. Stephen ◽

Robert A. Teitge ◽

Andy Williams ◽

James D.F. Calder ◽

Hadi El Daou

Keyword(s):

Intraclass Correlation ◽

Ct Scanning ◽

Tibial Torsion ◽

Good Reliability ◽

Automated Method ◽

Clinical Methods ◽

Significant Difference ◽

Mri Scans ◽

Males And Females ◽

The Difference

Background: Tibial torsion is a twist in the tibia measured as an angle between a proximal axis line and a distal axis line. Abnormal torsion has been associated with a variety of painful clinical syndromes of the lower limb. Measurements of normal tibial torsion reported by different authors vary by 100% (ranging from 20° to 42°), making it impossible to determine normal and pathological levels. Purpose: To address the problem of unreliable measurements, this study was conducted to define an automated, validated computer method to calculate tibial torsion. Reliability was compared with current clinical methods. The difference between measurements of torsion generated from computed tomography (CT) and magnetic resonance imaging (MRI) scans of the same bone, and between males and females, was assessed. Study Design: Controlled laboratory study. Methods: Previous methods of analyzing tibial torsion were reviewed, and limitations were identified. An automated measurement method to address these limitations was defined. A total of 56 cadaveric and patient tibiae (mean ± SD age, 37 ± 15 years; range, 17-71 years; 28 female) underwent CT scanning, and 3 blinded assessors made torsion measurements by applying 2 current clinical methods and the automated method defined in the present article. Intraclass correlation coefficient (ICC) values were calculated. Further, 12 cadaveric tibiae were scanned by MRI, stripped of tissue, and measured using a structured light (SL) scanner. Differences between torsion values obtained from CT, SL, and MRI scans, and between males and females, were compared using t tests. SPSS was used for all statistical analysis. Results: When the automated method was used, the tibiae had a mean external torsion of 29°± 11° (range, 9°-65). Automated torsion assessment had excellent reliability (ICC, 1), whereas current methods had good reliability (ICC, 0.78-0.81). No significant difference was found between the torsion values calculated from SL and CT ( P = .802), SL and MRI ( P = .708), or MRI and CT scans ( P = .826). Conclusion: The use of software to automatically perform measurements ensures consistency, time efficiency, validity, and accuracy not possible with manual measurements, which are dependent on assessor experience. Clinical Relevance: We recommend that this method be adopted in clinical practice to establish databases of normal and pathological tibial torsion reference values and ultimately guide management of related conditions.

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Head Orientation in CBCT-generated Cephalograms

The Angle Orthodontist ◽

10.2319/090208-460.1 ◽

2009 ◽

Vol 79 (5) ◽

pp. 971-977 ◽

Cited By ~ 48

Author(s):

Lucia Cevidanes ◽

Ana E. F. Oliveira ◽

Alexandre Motta ◽

Ceib Phillips ◽

Brandon Burke ◽

...

Keyword(s):

Intraclass Correlation ◽

Three Dimensional ◽

Correlation Coefficients ◽

Dental Student ◽

Head Orientation ◽

Class Iii ◽

Good Reliability ◽

Mean Values ◽

Lateral Cephalograms ◽

The Difference

Abstract Objective: To determine the reliability of obtaining two-dimensional cephalometric measurements using two virtual head orientations from cone-beam computed tomography (CBCT) models. Materials and Methods: CBCT scans of 12 patients (6 class II and 6 class III) were randomly selected from a pool of 159 patients. An orthodontist, a dental radiologist, and a third-year dental student independently oriented CBCT three-dimensional (3D) renderings in either visual natural head position (simulated NHP) or 3D intracranial reference planes (3D IRP). Each observer created and digitized four CBCT-generated lateral cephalograms per patient, two using simulated NHP and two using 3D IRP at intervals of at least 3 days. Mixed-effects analysis of variance was used to calculate intraclass correlation coefficients (ICCs) and to test the difference between the orientations for each measure. Results: ICC indicated good reliability both within each head orientation and between orientations. Of the 50 measurements, the reliability coefficients were ≥0.9 for 45 measurements obtained with 3D IRP orientation and 36 measurements with simulated NHP. The difference in mean values of the two orientations exceeded 2 mm or 2° for 14 (28%) of the measurements. Conclusions: The reliability of both virtual head orientations was acceptable, although the percentage of measurements with ICC >0.9 was greater for 3D IRP. This may reflect the ease of using the guide planes to position the head in the 3D IRP during the simulation process.

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Evaluation of the Reliability, Reproducibility and Validity of Digital Orthodontic Measurements Based on Various Digital Models among Young Patients

Journal of Clinical Medicine ◽

10.3390/jcm9092728 ◽

2020 ◽

Vol 9 (9) ◽

pp. 2728 ◽

Cited By ~ 1

Author(s):

Seo-Hyun Park ◽

Soo-Hwan Byun ◽

So-Hee Oh ◽

Hye-Lim Lee ◽

Ju-Won Kim ◽

...

Keyword(s):

Correlation Coefficient ◽

High Reliability ◽

Intraclass Correlation ◽

Young Patients ◽

Digital Model ◽

Good Reliability ◽

Length Discrepancy ◽

Tooth Width ◽

The Difference ◽

Plaster Model

The advantages of intraoral model scanning have yielded recent developments. However, few studies have explored the orthodontic clinical use of this technique particularly among young patients. This study aimed to evaluate the reliability, reproducibility and validity of the orthodontic measurements: tooth width, arch length and arch length discrepancy in each digital model obtained by model scanner and intraoral scanner, relative to a plaster model. Arch length measured using two methods: curved arch length (CAL) measured automatically by digital program and sum of sectional liner arch length (SLAL) measured sum of anterior and posterior liner arch lengths. Arch length discrepancy calculated each arch length measurement methods: curved arch length discrepancy (CALD) and sum of sectional liner arch length discrepancy (SLALD). Forty young patients were eligible for the study. A plaster model (P), model-scanned digital model (MSD) and intraoral scanned digital model (ISD) were acquired from each patient. The reliability of the measurements was evaluated using Pearson’s correlation coefficient, while the reproducibility was evaluated using the intraclass correlation coefficient. The validity was assessed by a paired t-test. All measurements measured in P, MSD and ISD exhibited good reliability and reproducibility. Most orthodontic measurements despite of CAL in MSD exhibited high validity. Only the SLAL and SLALD in ISD group differed significantly, despite the good validity of the tooth width, CAL and CALD. The measurements based on the digital program appeared high reliability, reproducibility and accurate than conventional measurement. However, SLAL and SLALD in ISD group appeared shorter because of distortion during intraoral scanning. However, this could be compensated by using digital programed curved arch. Although the validity of SLAL and SLALD in the ISD group differed statistically, the difference is not considered clinically significant. Although MSD and ISD are acceptable for a clinical space analysis, clinicians should be aware of digital model-induced errors.

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Repeatability of OPD-Scan III and its agreement with Pentacam in measuring keratometry, astigmatism and axis in patients with cataract and moderate to high astigmatism

10.21203/rs.3.rs-35643/v1 ◽

2020 ◽

Author(s):

YU Song ◽

Panpan Li ◽

Yuanyuan Tu ◽

Ying Wu ◽

Lili Huang ◽

...

Keyword(s):

Intraclass Correlation ◽

Correlation Coefficients ◽

High Accuracy ◽

Wilcoxon Test ◽

Spearman Correlation ◽

Limits Of Agreement ◽

Intraclass Correlation Coefficients ◽

Bland Altman Method ◽

The Difference ◽

Cataract Patients

Abstract Purpose To assess accuracy of OPD-Scan III in measuring keratometry, astigmatism and axis in patients with cataract and moderate to high astigmatism Materials and Methods Measurements were taken with OPD-Scan III and Pentacam in cataract patients with keratometric astigmatism (KA) more than 0.75 D. Keratometry in the steepest axis (Ks) and flattest axis (Kf), KA and axis, which are power vector components of astigmatism (J0 and J45), were evaluated. Intraclass correlation coefficients (ICCs) were used to assess repeatability. The Wilcoxon test was used to assess differences, the Spearman correlation was used to assess correlations, and the Bland-Altman method was used to assess agreement. Results Seventy eyes of 63 patients were included to analyze the repeatability of the two devices. The ICCs of Ks, Kf, KA, axis, J0 and J45 were 0.991, 0.995, 0.946, 0.883, 0.946 and 0.892, respectively, with OPD-Scan III. Seven hundred and thirty-two eyes of 516 patients were included to analyze the difference, correlation and agreement of the two devices. There were significant differences between the two devices in terms of Ks, Kf, axis, J0 and J45 (all p < 0.01). There were significant correlations between the two devices in each parameter (all p < 0.01). The 95% limits of agreement (LOAs) for Ks, Kf, KA, astigmatic axis, J0 and J45 were (-0.34, 0.44) D, (-0.24, 0.38) D, (-0.46, 0.48) D, (-10.20, 12.92)°, (-0.24, 0.24) D, and (-0.27, 0.35) D respectively.The 95% LOAs for the degree of IOL caculated according to parameter measured by OPD-Scan III and Pentacam was (-0.32, 0.22) D. Conclusions OPD-Scan III has a high accuracy for measuring keratometry, but its accuracy for measuring astigmatism and axis is poor in eyes with moderate to high astigmatism.

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