scholarly journals Evaluation of two portable pupillometers to assess clinical utility

Concussion ◽  
2020 ◽  
Vol 5 (4) ◽  
pp. CNC82
Author(s):  
Rachel Eshima McKay ◽  
Michael A Kohn ◽  
Elliot S Schwartz ◽  
Merlin D Larson
Keyword(s):  
Clinical Assessment ◽  
Clinical Utility ◽  
Pupil Diameter ◽  
Method Comparison ◽  
Assessment Tools ◽  
Dynamic Measurements ◽  
Reflex Amplitude ◽  
Significant Disagreement ◽  
Practical Tool ◽  
Serial Measurements

Background: Pupillometers have been proposed as clinical assessment tools. We compared two pupillometers to assess measurement agreement. Materials & methods: We enrolled 30 subjects and simultaneously measured the pupil diameter and light reflex amplitude with an iPhone pupillometer and a portable infrared pupillometer. We then enrolled 40 additional subjects and made serial measurements with each device. Results: Failure occurred in 30% of attempts made with the iPhone pupillometer compared with 4% of attempts made with the infrared pupillometer (Fisher’s exact p = 0.0001). Method comparison of the two devices used simultaneously showed significant disagreement in dynamic measurements. Conclusion: The iPhone pupillometer had poor repeatability and suggests that it is not a practical tool to support clinical decisions.

scholarly journals Diagnostic value of transcranial ultrasonography for selecting subjects with large vessel occlusion: a systematic review

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Daria Antipova ◽  
Leila Eadie ◽  
Ashish Stephen Macaden ◽  
Philip Wilson
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Acute Stroke ◽  
Clinical Assessment ◽  
Assessment Tools ◽  
Large Vessel ◽  
Cochrane Library ◽  
Direct Transfer ◽  
Large Vessel Occlusion ◽  
Vessel Occlusion

Abstract Introduction A number of pre-hospital clinical assessment tools have been developed to triage subjects with acute stroke due to large vessel occlusion (LVO) to a specialised endovascular centre, but their false negative rates remain high leading to inappropriate and costly emergency transfers. Transcranial ultrasonography may represent a valuable pre-hospital tool for selecting patients with LVO who could benefit from rapid transfer to a dedicated centre. Methods Diagnostic accuracy of transcranial ultrasonography in acute stroke was subjected to systematic review. Medline, Embase, PubMed, Scopus, and The Cochrane Library were searched. Published articles reporting diagnostic accuracy of transcranial ultrasonography in comparison to a reference imaging method were selected. Studies reporting estimates of diagnostic accuracy were included in the meta-analysis. Results Twenty-seven published articles were selected for the systematic review. Transcranial Doppler findings, such as absent or diminished blood flow signal in a major cerebral artery and asymmetry index ≥ 21% were shown to be suggestive of LVO. It demonstrated sensitivity ranging from 68 to 100% and specificity of 78–99% for detecting acute steno-occlusive lesions. Area under the receiver operating characteristics curve was 0.91. Transcranial ultrasonography can also detect haemorrhagic foci, however, its application is largely restricted by lesion location. Conclusions Transcranial ultrasonography might potentially be used for the selection of subjects with acute LVO, to help streamline patient care and allow direct transfer to specialised endovascular centres. It can also assist in detecting haemorrhagic lesions in some cases, however, its applicability here is largely restricted. Additional research should optimize the scanning technique. Further work is required to demonstrate whether this diagnostic approach, possibly combined with clinical assessment, could be used at the pre-hospital stage to justify direct transfer to a regional thrombectomy centre in suitable cases.

scholarly journals Confusions about ‘Inner’ and ‘Outer’ Voices: Conceptual Problems in the Study of Auditory Verbal Hallucinations

2021 ◽  
Author(s):  
Franz Knappik ◽  
Josef J. Bless ◽  
Frank Larøi
Keyword(s):  
Twentieth Century ◽  
Clinical Assessment ◽  
Empirical Studies ◽  
Diagnostic Value ◽  
Assessment Tools ◽  
Auditory Verbal Hallucinations ◽  
Early Twentieth Century ◽  
Conceptual Problems ◽  
The Mind

AbstractBoth in research on Auditory Verbal Hallucinations (AVHs) and in their clinical assessment, it is common to distinguish between voices that are experienced as ‘inner’ (or ‘internal’, ‘inside the head’, ‘inside the mind’, ...) and voices that are experienced as ‘outer’ (‘external’, ‘outside the head’, ‘outside the mind’, ...). This inner/outer-contrast is treated not only as an important phenomenological variable of AVHs, it is also often seen as having diagnostic value. In this article, we argue that the distinction between ‘inner’ and ‘outer’ voices is ambiguous between different readings, and that lack of disambiguation in this regard has led to flaws in assessment tools, diagnostic debates and empirical studies. Such flaws, we argue furthermore, are often linked to misreadings of inner/outer-terminology in relevant 19th and early twentieth century work on AVHs, in particular, in connection with Kandinsky’s and Jaspers’s distinction between hallucinations and pseudo-hallucinations.

scholarly journals Clinical Utility of Serial Measurements of Antineutrophil Cytoplasmic Antibodies Targeting Proteinase 3 in ANCA-Associated Vasculitis

2020 ◽  
Vol 11 ◽  
Author(s):  
Gwen E. Thompson ◽  
Lynn A. Fussner ◽  
Amber M. Hummel ◽  
Darrell R. Schroeder ◽  
Francisco Silva ◽  
...  
Keyword(s):  
Clinical Utility ◽  
Antineutrophil Cytoplasmic Antibodies ◽  
Proteinase 3 ◽  
Anca Associated Vasculitis ◽  
Serial Measurements

Changes in pupillometry associated with dissipated energy during phacoemulsification

2020 ◽  
pp. 112067212098437
Author(s):  
Giulia Coco ◽  
Pierluca Cremonesi ◽  
Nardine Menassa ◽  
Luca Pagano ◽  
Kunal A Gadhvi ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Generalized Linear Model ◽  
Pupil Diameter ◽  
University Hospital ◽  
Dissipated Energy ◽  
Dynamic Measurements ◽  
Operative Complications ◽  
Cumulative Dissipated Energy ◽  
Chamber Measurements ◽  
Phacoemulsification Cataract Surgery

Purpose: To investigate the effect of ultrasound level during phacoemulsification on pupil dynamics. Methods: Comparative retrospective study on patients who underwent routine cataract surgery at the Royal Liverpool University Hospital. Clinical parameters, anterior chamber measurements, axial length, surgeon grade, time of surgery, level of ultrasound used (cumulative dissipated energy, CDE), intra- and post-operative complications were collected. Pupil diameters were collected before and 4 ± 1 weeks after surgery in static scotopic, mesopic, photopic pupil conditions. Also, pupil dynamic measurements after luminous stimulus were recorded. Changes in static pupil diameters, relative dilation at 3.5 s after luminous stimulus, and time to reach 75% and 95% of maximum dilation were measured. Results: Forty-eight eyes of 24 patients (13 males) were included with a mean age of 73.1 ± 14.6 years. Mean CDE value was 18.11 ± 10.56. Mean scotopic pupil diameters decreased by 0.24 ± 0.48 mm ( p = 0.021) in the operated eye. Significant correlation was found between reduction in scotopic pupil diameter and CDE ( p = 0.05). A generalized linear model confirmed that the level of CDE was significantly associated with reduction in scotopic pupil diameter ( p = 0.026). Patients who underwent surgeries with lower CDE (0 < CDE ⩽ 10 and 10 < CDE ⩽ 20) did not experience significant changes in scotopic pupil diameter after surgery ( p = 0.28 and p = 0.79, respectively) as opposed to those with higher CDE (CDE > 20; p = 0.03). Conclusion: Phacoemulsification cataract surgery and the cumulative dissipated energy may be associated with changes in pupil behaviour.

scholarly journals Psychometric properties of gross motor assessment tools for children: a systematic review

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e021734 ◽  
Author(s):  
Alison Griffiths ◽  
Rachel Toovey ◽  
Prue E Morgan ◽  
Alicia J Spittle
Keyword(s):  
Psychometric Properties ◽  
Predictive Validity ◽  
Methodological Quality ◽  
Clinical Utility ◽  
Assessment Tools ◽  
Motor Assessment ◽  
Gross Motor ◽  
Retest Reliability ◽  
Validity Test ◽  
Test Retest Reliability

ObjectiveGross motor assessment tools have a critical role in identifying, diagnosing and evaluating motor difficulties in childhood. The objective of this review was to systematically evaluate the psychometric properties and clinical utility of gross motor assessment tools for children aged 2–12 years.MethodA systematic search of MEDLINE, Embase, CINAHL and AMED was performed between May and July 2017. Methodological quality was assessed with the COnsensus-based Standards for the selection of health status Measurement INstruments checklist and an outcome measures rating form was used to evaluate reliability, validity and clinical utility of assessment tools.ResultsSeven assessment tools from 37 studies/manuals met the inclusion criteria: Bayley Scale of Infant and Toddler Development-III (Bayley-III), Bruininks-Oseretsky Test of Motor Proficiency-2 (BOT-2), Movement Assessment Battery for Children-2 (MABC-2), McCarron Assessment of Neuromuscular Development (MAND), Neurological Sensory Motor Developmental Assessment (NSMDA), Peabody Developmental Motor Scales-2 (PDMS-2) and Test of Gross Motor Development-2 (TGMD-2). Methodological quality varied from poor to excellent. Validity and internal consistency varied from fair to excellent (α=0.5–0.99). The Bayley-III, NSMDA and MABC-2 have evidence of predictive validity. Test–retest reliability is excellent in the BOT-2 (intraclass correlation coefficient (ICC)=0.80–0.99), PDMS-2 (ICC=0.97), MABC-2 (ICC=0.83–0.96) and TGMD-2 (ICC=0.81–0.92). TGMD-2 has the highest inter-rater (ICC=0.88–0.93) and intrarater reliability (ICC=0.92–0.99).ConclusionsThe majority of gross motor assessments for children have good-excellent validity. Test–retest reliability is highest in the BOT-2, MABC-2, PDMS-2 and TGMD-2. The Bayley-III has the best predictive validity at 2 years of age for later motor outcome. None of the assessment tools demonstrate good evaluative validity. Further research on evaluative gross motor assessment tools are urgently needed.

scholarly journals Clinical assessment tools identify functional deficits in fragility fracture patients

2016 ◽  
pp. 563
Author(s):  
Carmen Quatman ◽  
Tyler Ames ◽  
Corinne Wee ◽  
Khoi Le ◽  
Tiffany Wang ◽  
...  
Keyword(s):  
Clinical Assessment ◽  
Fragility Fracture ◽  
Assessment Tools ◽  
Functional Deficits

Avatars for Clinical Assessment

2020 ◽  
pp. 313-341
Author(s):  
Stefano Triberti ◽  
Valeria Sebri ◽  
Lucrezia Savioni ◽  
Alessandra Gorini ◽  
Gabriella Pravettoni
Keyword(s):  
Social Networks ◽  
Clinical Assessment ◽  
Experimental Manipulation ◽  
The Self ◽  
Assessment Tools ◽  
Digital Representations ◽  
Digital Environments ◽  
Static Images ◽  
Online Video Games ◽  
The Given

Avatars are an important feature of digital environments. Existing both in social networks and webchats (usually as static images) and in single-player and online video games (as dynamic characters, often humanoid), avatars are meant to represent users' action and communication within digital environments. Research has shown that, when they are customized by users, avatars are not created “randomly,” rather they maintain some kind of relationship with users' actual self-representation and identity. However, more recent studies showed that users may have multiple digital representations: the same person could create multiple avatars depending on which facet of the self is primed by an experimental manipulation, or on which aims they have to pursue in the given virtual environments (e.g., to seduce, to play, to work). With this background, this contribution explores the possibility to use customized avatars within psychological assessment, as adjunctive assessment tools useful to get information on patients' self-representation(s) and communicative intentions.

Overview and critical revision of clinical assessment tools in chemotherapy‐induced peripheral neurotoxicity

2019 ◽  
Vol 24 (S2) ◽  
Author(s):  
Susanna B. Park ◽  
Paola Alberti ◽  
Noah A. Kolb ◽  
Jennifer S. Gewandter ◽  
Angelo Schenone ◽  
...  
Keyword(s):  
Clinical Assessment ◽  
Assessment Tools ◽  
Peripheral Neurotoxicity ◽  
Critical Revision

scholarly journals The clinical assessment of acts of violence: mental mechanisms and subjectivity

2019 ◽  
Vol 26 (3) ◽  
pp. 135-144 ◽  
Author(s):  
Rajan Nathan ◽  
Peter Wilson
Keyword(s):  
Risk Assessment ◽  
Risk Management ◽  
Clinical Practice ◽  
Clinical Assessment ◽  
Clinical Utility ◽  
Individual Case ◽  
Evidence Base ◽  
Routine Clinical Practice ◽  
Factors Associated ◽  
The Individual

SUMMARYApproaches to assessing violence in clinical practice have been influenced by developments in the field of risk assessment. As a result, there has been a focus on identifying and describing factors associated with violence. However, a factor-based approach to assessing violence in individual cases has limited clinical utility. In response, the benefits of a formulation-based approach have been promoted. This approach is enhanced by an understanding of the specific mental mechanisms that increase the likelihood of violence in the individual case. Although there is an empirical evidence base for mental mechanisms associated with violence, this literature has not been distilled and synthesised in a way that informs routine clinical practice. In this article the authors present the key mechanisms that are known to be associated with violence in a way that is relevant to the clinical assessment of violence and, in turn, can inform clinical and risk management.

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