scholarly journals Reliability and Validity of an Ultrasonic Device for Measuring Height in Adults

2021 ◽  
Vol 42 (5) ◽  
pp. 376-381
Author(s):  
Seon Hwa Cho ◽  
Young Gyu Cho ◽  
Hyun Ah Park ◽  
A Ra Bong
Keyword(s):  
Correlation Coefficient ◽  
Health Surveys ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Altman Analysis ◽  
Bland Altman Analysis ◽  
Community Health Survey ◽  
Measurement Devices ◽  
The Difference ◽  
Very High

Background: The ultrasonic stadiometer was originally developed as a device to measure and monitor children’s height. However, an ultrasonic stadiometer (InLab S50; InBody Co., Seoul, Korea) was used to measure adults’ height in the 2018 Korea Community Health Survey (KCHS). This study was conducted to assess the reliability and validity of the InLab S50 in adults. Methods: The study subjects were 120 adults (reliability test, n=20; validity test, n=100) who had visited a health screening center. The intra- and inter-rater reliabilities of InLab S50 were assessed using the intraclass correlation coefficient (ICC). The agreement between InLab S50 and an automatic stadiometer (HM-201; Fanics, Busan, Korea) was assessed using Pearson’s correlation coefficient and Bland-Altman analysis. Results: The intra- and inter-rater reliabilities of the InLab S50 were excellent (ICC=0.9999 and 0.9998, respectively). The correlation coefficient of the height measured by the two measurement devices was very high (r=0.996). The difference (Δheight [HM-201-InLab S50]) was -0.15±0.78 cm (95% limit of agreement [LOA], -1.69 to 1.38). After excluding the values outside 95% LOA, the difference was further reduced to -0.05±0.59 cm (95% LOA, -1.20 to 1.10). Conclusion: This study showed that the InLab S50 is a reliable and valid device for the measurement of adults’ height. Therefore, we think that InLab S50 could be used to measure adults’ height in household health surveys such as the KCHS.

scholarly journals Validity and reliability of assessing diaphragmatic mobility by area on X-rays of healthy subjects

2018 ◽  
Vol 44 (3) ◽  
pp. 220-226 ◽  
Author(s):  
Aline Pedrini ◽  
Márcia Aparecida Gonçalves ◽  
Bruna Estima Leal ◽  
Michelle Gonçalves de Souza Tavares ◽  
Wellington Pereira Yamaguti ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Intraclass Correlation ◽  
X Rays ◽  
Altman Analysis ◽  
Validity And Reliability ◽  
Anthropometric Parameters ◽  
Rater Reliability ◽  
Bland Altman Analysis ◽  
Left Hemidiaphragm ◽  
The Right

ABSTRACT Objective: To investigate the concurrent validity, as well as the intra- and inter-rater reliability, of assessing diaphragmatic mobility by area (DMarea) on chest X-rays of healthy adults. Methods: We evaluated anthropometric parameters, pulmonary function, and diaphragmatic mobility in 43 participants. Two observers (rater A and rater B) determined diaphragmatic mobility at two time points. We used Pearson’s correlation coefficient to evaluate the correlation between DMarea and the assessment of diaphragmatic mobility by distance (DMdist). To evaluate intra- and inter-rater reliability, we used the intraclass correlation coefficient (ICC [2,1]), 95% CI, and Bland-Altman analysis. Results: A significant correlation was found between the DMarea and DMdist methods (r = 0.743; p < 0.0001). For DMarea, the intra-rater reliability was found to be quite high for the right hemidiaphragm (RHD)-ICC (2,1) = 0.92 (95% CI: 0.86-0.95) for rater A and ICC (2,1) = 0.90 (95% CI: 0.84-0.94) for rater B-and the left hemidiaphragm (LHD)-ICC (2,1) = 0.96 (95% CI: 0.93-0.97) for rater A and ICC (2,1) = 0.91 (95% CI: 0.81-0.95) for rater B-(p < 0.0001 for all). Also for DMarea, the inter-rater reliability was found to be quite high for the first and second evaluations of the RHD-ICC (2,1) = 0.99 (95% CI: 0.98-0.99) and ICC (2,1) = 0.95 (95% CI: 0.86-0.97), respectively-and the LHD-ICC (2,1) = 0.99 (95% CI: 0.98-0.99) and ICC (2,1) = 0.94 (95% CI: 0.87-0.97)-(p < 0.0001 for both). The Bland-Altman analysis showed good agreement between the mobility of the RHD and that of the LHD. Conclusions: The DMarea method proved to be a valid, reliable measure of diaphragmatic mobility.

scholarly journals Reliability and Validity of Trunk Assessment for People With Multiple Sclerosis

2006 ◽  
Vol 86 (1) ◽  
pp. 66-76 ◽  
Author(s):  
Geert Verheyden ◽  
Godelieve Nuyens ◽  
Alice Nieuwboer ◽  
Pol Van Asch ◽  
Piet Ketelaer ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Construct Validity ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Correlation Coefficients ◽  
Weighted Kappa ◽  
Altman Analysis ◽  
Bland Altman Analysis ◽  
Intraclass Correlation Coefficients ◽  
Test Retest Reliability

Abstract Background and Purpose. Standardized scales are a prerequisite for rehabilitation and research. This study was designed to determine the reliability and validity of scores on items of the trunk assessment of the Melsbroek Disability Scoring Test (MDST) and Trunk Impairment Scale (TIS) in people with multiple sclerosis (MS). Subjects. Thirty people with MS participated in the study. Methods. Interrater and test-retest reliability and construct validity were assessed. Results. Kappa and weighted kappa values for the items of the trunk assessment of the MDST ranged from .74 to .95, and the kappa and weighted kappa values for the TIS items ranged from .46 to 1.00. Intraclass correlation coefficients for interrater and test-retest agreement were .93 and .92, respectively, for the trunk assessment of the MDST and .97 and .95, respectively, for the TIS. Bland-Altman analysis showed consistency of scores without observer bias. Construct validity was established. Discussion and Conclusion. The MDST and TIS provide reliable assessments of the trunk and are valid scales for measuring trunk performance in people with MS. [Verheyden G, Nuyens G, Nieuwboer A, et al. Reliability and validity of trunk assessment for people with multiple sclerosis.

Verification of the accuracy and reliability of the TrackMan tennis radar

2020 ◽  
pp. 175433712095300
Author(s):  
Munenori Murata ◽  
Hiroo Takahashi
Keyword(s):  
Measurement Accuracy ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Spin Axis ◽  
Altman Analysis ◽  
Bland Altman Analysis ◽  
Practical Applications ◽  
Intraclass Correlation Coefficients ◽  
The Difference ◽  
Proven Method

TrackMan, a device used to measure the kinematics of a ball in flight, has recently been used for research and coaching purposes in tennis, and the number of studies on this device is expected to increase. This study is focused on verifying the accuracy of TrackMan; three participants performed services with various velocities and angular velocity combinations. TrackMan and a proven method based on computer vision were used to measure the speed, spin rate, and spin axis of the ball. The results obtained using each method were compared using regression analysis, intraclass correlation coefficients, and Bland–Altman analysis. The speed and spin rate of the two methods agreed well; the degree of error would not be problematic in practical applications. However, TrackMan underestimated the speed if it was unable to detect the hitting position. The spin axis measured by TrackMan was unstable under low spin rate conditions (<3000 rpm). Furthermore, the standard deviation of the spin axis measurement error exceeded the difference between the average slice and kick service spin axes reported in the previous study, so the spin axis measurement accuracy was very low for research purposes, even when the spin rate was above 3000 rpm. For those who are aware of the existence of outliers, TrackMan can be useful for coaching because it provides instant feedback. Similarly, the measured rotational speed and spin rate could be used in the study.

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.

Reliability and validity of short Beck Hopelessness Scale in psychological autopsy study among Chinese rural elderly

2019 ◽  
Vol 32 (4) ◽  
pp. 525-531
Author(s):  
Zhenyu Ma ◽  
Qiuping He ◽  
Guanghui Nie ◽  
Cunxian Jia ◽  
Liang Zhou
Keyword(s):  
Correlation Coefficient ◽  
High Reliability ◽  
Common Factor ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Rural Elderly ◽  
Cluster Sampling ◽  
Psychological Autopsy ◽  
Autopsy Study ◽  
Beck Hopelessness Scale

ABSTRACTBackground:Older adults represent the segment of population most exposed to the risk of suicide nearly everywhere in the world. Previous studies showed that hopelessness was an important risk factor for suicide.Aims:This study aimed to evaluate the reliability and validity of the four-item Beck Hopelessness Scale (BHS-4) in psychological autopsy study among Chinese rural elderly.Method:Two-stage stratified cluster sampling method was used to select research sites. Using case-control psychological autopsy study, face-to-face interviews were conducted to collected information.Results:A total of 242 elderly suicide deaths and 242 matched living comparisons were investigated, including 135 males and 107 females for each group. Intraclass Correlation Coefficients (ICC) of the controls were 0.682-0.713. The median score of BHS-4 among suicides was significantly higher than that among controls. The corrected correlation coefficient between items and total score were 0.184-0.723. Cronbach’s Alphas coefficient was 0.834. Only one common factor was precipitated by exploratory factor analysis and the cumulative variance contribution rates were 59.558% for suicides and 52.722% for living controls. The correlation coefficient between hopelessness and depression were 0.481 among suicide death and 0.617 among living controls.Conclusion:The information provided by the informants through psychological autopsy method had high reliability to reflect the actual situation of suicides and controls. BHS-4 has good reliability and validity among Chinese rural elderly suicides. It is suitable for psychological autopsy study among Chinese rural elderly.

Reliability and Validity of the Thai Version of the Carolinas Comfort Scale

2021 ◽  
Vol 104 (11) ◽  
pp. 1784-1787
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Internal Consistency Reliability ◽  
Retest Reliability ◽  
Test Retest Reliability

Objective: To evaluate the reliability and validity of the Thai version of the Carolinas Comfort Scale (CCS) to measure health-related quality of life (HRQoL) in post-hernia repaired patients. Materials and Methods: Three hundred twenty-eight patients that underwent the inguinal hernia repair procedure in Vajira Hospital were recruited in the present study. The Thai version of CCS (TCCS) was performed entirely by the patient, and the test-retest reliability was conducted at a 2-week interval. Results: The TCCS’s internal consistency reliability was excellent (Cronbach’s alpha 0.89). The inter-rater reliability was found to agree with the intraclass correlation coefficient of 0.90. The test-retest reliability over two weeks was high, with an intraclass correlation coefficient of 0.92. Conclusion: The Thai version of CCS was found to have adequate reliability and validity and could be used to measure HRQoL in Thai patients that undergo inguinal hernia repair. Keywords: Reliability; Validity; Carolinas Comfort Scale; Thai version

The Accuracy and Reproducibility of Linear Measurements Made on CBCT-derived Digital Models

2016 ◽  
Vol 17 (4) ◽  
pp. 294-299 ◽  
Author(s):  
Mohammad Y Hajeer ◽  
Ahmad L Maroua ◽  
Mowaffak Ajaj
Keyword(s):  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Intraobserver Reliability ◽  
Altman Analysis ◽  
Digital Models ◽  
Linear Measurements ◽  
Bland Altman Analysis ◽  
Accuracy Of Measurements ◽  
The Mean ◽  
Plaster Models

ABSTRACT Objective To evaluate the accuracy and reproducibility of linear measurements made on cone-beam computed tomography (CBCT)-derived digital models. Materials and methods A total of 25 patients (44% female, 18.7 ± 4 years) who had CBCT images for diagnostic purposes were included. Plaster models were obtained and digital models were extracted from CBCT scans. Seven linear measurements from predetermined landmarks were measured and analyzed on plaster models and the corresponding digital models. The measurements included arch length and width at different sites. Paired t test and Bland–Altman analysis were used to evaluate the accuracy of measurements on digital models compared to the plaster models. Also, intraclass correlation coefficients (ICCs) were used to evaluate the reproducibility of the measurements in order to assess the intraobserver reliability. Results The statistical analysis showed significant differences on 5 out of 14 variables, and the mean differences ranged from −0.48 to 0.51 mm. The Bland–Altman analysis revealed that the mean difference between variables was (0.14 ± 0.56) and (0.05 ± 0.96) mm and limits of agreement between the two methods ranged from −1.2 to 0.96 and from −1.8 to 1.9 mm in the maxilla and the mandible, respectively. The intraobserver reliability values were determined for all 14 variables of two types of models separately. The mean ICC value for the plaster models was 0.984 (0.924–0.999), while it was 0.946 for the CBCT models (range from 0.850 to 0.985). Conclusion Linear measurements obtained from the CBCTderived models appeared to have a high level of accuracy and reproducibility. How to cite this article Maroua AL, Ajaj M, Hajeer MY. The Accuracy and Reproducibility of Linear Measurements Made on CBCT-derived Digital Models. J Contemp Dent Pract 2016;17(4):294-299.

scholarly journals Validation of the pediatric Radboud dysarthria assessment

2021 ◽  
pp. 1-12
Author(s):  
Marieke Ruessink ◽  
Lenie van den Engel-Hoek ◽  
Marjo van Gerven ◽  
Bea Spek ◽  
Bert de Swart ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Intraclass Correlation ◽  
Self Care ◽  
Reliability And Validity ◽  
Correlation Coefficients ◽  
Activity Level ◽  
Clinical Use ◽  
Spearman Correlation ◽  
Rater Reliability ◽  
Video Recordings

PURPOSE: The Radboud Dysarthria Assessment (RDA) was published in 2014. Adaptation into a pediatric version (p-RDA) was required because of relevant differences between children and adults. The purpose of this study was to assess the feasibility of the p-RDA and to test intra-rater and inter-rater reliability as well as the validity of the two severity scales (function and activity level). METHODS: Video recordings were made of 35 participants with (suspected) dysarthria (age 4 to 17 years) while being assessed using the p-RDA. Intra-rater reliability was assessed by one, and inter-rater reliability by two experiments using the Intraclass Correlation Coefficient (ICC). Validity of the severity scales was tested by correlating the consensus scores with the independently rated scores on four communication scales, three mobility scales, and one self-care scale using Spearman correlation coefficients (r s). RESULTS: The assessment was applicable for 89% of the tested sample, with good intra-rater and inter-rater reliability (ICC = 0.88–0.98 and 0.83–0.93). The p-RDA severity scales (function and activity level) correlated from substantially to strongly with the communication scales (r s = 0.69–0.82 and 0.77–0.92) and self-care scale (r s = 0.76–0.71) and correlated substantially with the mobility scales (r s = 0.49–0.60). CONCLUSION: The feasibility, reliability and validity of the p-RDA are sufficient for clinical use.

scholarly journals Validity and reliability of badminton-specific Reactive Agility TestBadmintona özgü geliştirilen Reaktif Çeviklik Testinin geçerlik ve güvenirliği

2018 ◽  
Vol 15 (1) ◽  
pp. 594
Author(s):  
Mehmet Yıldız ◽  
Uğur Fidan
Keyword(s):  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Linear Regression Analysis ◽  
Intraclass Correlation ◽  
T Test ◽  
Validity And Reliability ◽  
Test Protocol ◽  
Significant Difference ◽  
Reactive Agility ◽  
The Difference

Many laboratory and field tests are used in the literature to measure agility. The aim of the present study was to investigate the reliability and validity of a new Reactive Agility Test developed for badminton. A total of fourty male [ 20 elites (age: 20.8 ± 2.98 year, height: 174.55 ± 12.03 cm, weight: 65.70 ± 14.41 kg) and 20 sub-elites (age: 22.20±1,51, height: 170.01 ± 05.80 cm, weight: 62.45 ± 6,45 kg)] badminton players took part in the present study. For validity, the difference and relationship between newly developed reactive agility and planned changing direction tests in terms of elit and sub-elit players was examined. In the reliability measurements of test-retest, The Reactive Agility Test at same route was performed twice. Independent sample t test was carried out in order to detect the difference among the groups in the search for validity. The identification of the relations between the two different tests was performed with linear regression analysis. The reliability of test-retest was tried to be estimated with the coefficient of variances and intraclass correlation coefficient, and the Bland Altman method. In addition, a systematic difference between the test and the retest was estimated with the paired t test. At the end of the study, while there was not a significant difference found in the rates of planned changing direction of the elit and sub-elit players, it was detected that reactive agility rates were better in the elit players (7.14±4.85 sec and 9.87±5.07 sec, respectively). Moreover, a high coefficient determination was revealed between two tests (r2: 0.63, p<0.01). In the comparison of test-retest, a high intraclass correlation coefficient (0.930) and a very low coefficient of variances (4.7) were found. Furthermore, it was observed in the Bland Altman graph that a 95% of concordance range of the data obtained between two measurements was a good and narrow concordance.  In conclusion, it was determined that the new developed badminton specific Reactive Agility Test is a valid and reliable measurement method and it is suggested that this test protocol can be used to enhance and monitor reactive agility ability of badminton players.Extended English summary is in the end of Full Text PDF (TURKISH) file. ÖzetLiteratürde çevikliğin ölçülmesi amacıyla birçok laboratuvar ve saha testi kullanılmaktadır. Bu çalışmanın amacı badminton sporuna göre düzenlenmiş Reaktif Çeviklik Testinin güvenirlik ve geçerliğinin araştırılmasıdır. Araştırmaya toplam kırk erkek [20 elit (yaş: 20,8±2,98 yıl, boy uzunluğu: 174,55±12,03 cm, vücut ağırlığı:65,70±14,41 kg) ve 20 sub-elit (yaş: 22,20±1,51 yıl, boy uzunluğu: 170,01±05,80 cm, vücut ağırlığı:62,45±6,45 kg)] badminton oyuncusu katılmıştır. Geçerlik için yeni geliştirilen reaktif çeviklik ile planlı yön değiştirme testlerinin elit ve sub-elit katılımcılar arasındaki istatistiksel karşılaştırması ve ilişkisi analiz edilmiştir. Test-tekrar test güvenirlik ölçümlerinde aynı rotadaki reaktif çeviklik testi birer gün arayla iki kez uygulanmıştır. Geçerlik çalışmasında gruplar arası farkın belirlenmesi için bağımsız değişken t testi ve testler arası ilişkinin fonksiyonel olarak açıklanması ve bu ilişkinin bir modelle tanımlanması için basit doğrusal regresyon analizi yapılmıştır. Test-tekrar test güvenirliği varyasyon katsayısı, sınıf içi korelasyon katsayısı ve Bland Altman metodu ile kestirim edilmiştir. Ayrıca test- tekrar test arasında sistematik bir farkın olup olmadığı eşleştirilmiş t testi ile sınanmıştır.  Çalışma sonunda elit ve sub-elit oyuncuların planlı yön değiştirme bulguları anlamlı bir fark bulunmazken, reaktif çeviklik derecelerinin elit oyuncularda istatistiksel olarak anlamlı farklı (sırasıyla 7,14±4.85 sn ve 9,87±5,07 sn) şekilde düşük olduğu tespit edilmiştir. Bununla beraber her iki test arasında yüksek düzeyde  bir açıklayıcılık katsayısı tespit (r2: 0,63, p<0.01) edilmiştir. Test- tekrar test karşılaştırılmasında yüksek bir sınıf içi korelasyon katsayısı (0,930) ve çok düşük varyasyon katsayısı (4,7) belirlenmiştir. Ayrıca Bland-Altman grafiğinde iki ölçüm arasında elde edilen tüm verilerin %95 uyum aralığının dar ve iyi bir uyum gösterdiği gözlenmiştir. Sonuç olarak,  badminton sporuna göre düzenlenmiş Reaktif Çeviklik Testinin geçerli ve güvenilir bir ölçüm yöntemi olduğu tespit edilmiştir ve badminton oyuncularının reaktif çeviklik becerilerinin geliştirilmesinde ve gelişimlerinin takibinde kullanılabileceği önerilmektedir. 

scholarly journals Comparing School-Aged Refraction Measurements Using the 2WIN-S Portable Refractor in Relation to Cycloplegic Retinoscopy: A Cross-Sectional Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Ziming Liu ◽  
Emmanuel Eric Pazo ◽  
Hong Ye ◽  
Cui Yu ◽  
Ling Xu ◽  
...  
Keyword(s):  
Gold Standard ◽  
Intraclass Correlation ◽  
Cross Sectional Study ◽  
Mean Value ◽  
Spherical Equivalent ◽  
Sectional Study ◽  
Altman Analysis ◽  
Cross Sectional ◽  
Bland Altman Analysis ◽  
The Mean

Purpose. To assess the repeatability and agreement of refractive measurements using 2WIN-S photoscreening with the gold-standard cycloplegic retinoscope refraction. Design. Single centre, cross-sectional study. Methods. Spherical, cylindrical, axis, and spherical equivalent of 194 bilateral eyes of 97 children were assessed using a retinoscope and 2WIN-S. One week later, another operator repeated the 2WIN-S measurements. The primary outcome measures were to assess the repeatability and agreement between spherical equivalent, J0, and J45 readings of 2WIN-S. The repeatability of measurements was assessed by the within-subject standard deviation (2.77 Sw) and intraclass correlation coefficient (ICC). The agreement between devices was assessed using 95% limits of agreement. The extent of the agreement between cycloplegic retinoscopy and noncycloplegic 2WIN-S measurements was assessed using Bland–Altman analysis. Results. The mean age ± SD was 10.3 ± 2.46 year (range, 4–14 years). The sphere, cylinder, and spherical equivalent measurements were found to be consistent with both apparatus (r value >0.86). ICC for SE, J0, and J45 was 0.900, 0.666, and 0.639, respectively; Sw for SE, J0, and J45 was 0.61D, 0.30D, and 0.31D, respectively; Bland–Altman analysis of retinoscopy with cycloplegia and 2WIN-S for SE was 184/194 (95%) in 95% confidence interval, and the mean value was 0.46. J0 was 184/194 (95%), and the mean value is −0.04. J45 was 181/194 (93%), and the mean value is −0.15. Conclusion. The objective refractive measurement of 2WIN-S had good reliability and high agreement with the gold-standard retinoscopy refraction in children and adolescents. While consistency was observed, it is essential to take into consideration that it is a screening tool.

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