scholarly journals Fidedignidade nas medidas derivadas do método de palpação de um software para avaliação postural: a experiência clínica importa?

Author(s):  
Isabella Da Silva Almeida ◽  
Larissa Pitanga Barreto ◽  
Letícia De Souza Andrade ◽  
Caio Victor Sousa ◽  
Yomara Lima Mota

The postural evaluation software (SAPO) has been used as a valuable tool for the analysis of postural alterations, however, such a tool depends on palpation performed by the evaluator. The aim of the present study was to evaluate the inter- and intra-examiner reliability of experienced and inexperienced examiners in measurements derived from the palpation method, and its possible influence on measurements obtained by SAPO. Nine evaluators participated in the study, which were divided into three groups according to experience with respect to palpation (GI: inexperienced group, GSE: semi-experienced group and GE: experienced group). Each evaluator performed the postural analysis of 10 volunteers, which were photographed in orthostatic position, following the SAPO recommendations. The intra-examiner reliability analysis indicated that all three groups had higher, good and moderate mean correlation values for each examiner than low correlations. In the inter-examiner reliability assessment, GE and GSE groups exhibited higher correlation values. The intra-class correlation coefficient, in the single-measure analysis, presented correlation coefficients <0.70 in 9 of the variables analyzed, indicating non-significant correlation. It was concluded that the measures analyzed by SAPO have high intra-examiner reliability. However, regarding inter-examiner reliability, the group composed of inexperienced evaluators presented lower values, suggesting that the experience time may have influenced the inter-examiner reliability regarding postural evaluation.

2021 ◽  
pp. 003151252110365
Author(s):  
Alessandra V. Prieto ◽  
Kênnea Martins Almeida Ayupe ◽  
Ana C. A. Abreu ◽  
Paulo J. B. Gutierres Filho

Improvement in rider mobility represents an important functional gain for people with disabilities undergoing hippotherapy. However, there is no validated measuring instrument to track and document the rider's progress in riding activities. In this study, we aimed to develop and establish validity evidence for an instrument to assess hippotherapy participants’ mobility on horseback. We report on this development through the stages of: (a) content validation, (b) construct validation, (c) inter- and intra-rater reliability and (d) internal consistency analysis. We evaluated its factor structure with exploratory factor analyses, calculated values for inter- and intra-rater reliability using the intra-class correlation coefficient, and calculated its internal consistency using Cronbach's alpha. We followed recommendations by the Guidelines for Reporting Reliability and Agreement Studies. We found good inter-rater reliability (intra-class correlation coefficient – ICC = 0.991–0.999) and good intra-rater reliability (ICC = 0.997–1.0), and there was excellent internal consistency (Cronbach's α = 0.937–0.999). The instrument’s factor structure grouped its three domains into one factor. As this instrument is theoretically consistent and has been found to be appropriate and reliable for its intended use, it is now available for the measurement of horseback mobility among hippotherapy riders.


Hand Surgery ◽  
2010 ◽  
Vol 15 (02) ◽  
pp. 71-73 ◽  
Author(s):  
Rouin Amirfeyz ◽  
Sanchit Mehendale ◽  
Sarah Tyrrell ◽  
Raj Bhatia ◽  
Ian Leslie ◽  
...  

Katz and Stirrat devised a hand diagram, which uses subjective information from the patient for the diagnosis of carpal tunnel syndrome (CTS). They reported a good result. We tested the inter-observer and intra-observer reliability of this hand diagram. Twenty five consecutive patients with a diagnosis of CTS, 25 with other common hand and wrist problems but CTS and 25 healthy individuals were prospectively recruited. Each patient filled in a hand diagram. Two experienced hand surgeon scored the diagrams blindly on two different sittings four-week apart. The intra-class correlation coefficient (ICC) and Cohen's Kappa were used for intra and inter-observer reliability respectively. The intra-observer agreement was poor (ICC 95% 0.33–0.65) and inter-observer was fair (Kappa = 0.241). This study does not support the use of Katz and Stirrat Hand Diagram for the diagnosis of carpal tunnel syndrome in place if a thorough clinical examination.


2017 ◽  
Vol 30 (10) ◽  
pp. 691 ◽  
Author(s):  
Debora Soccal Schwertner ◽  
Raul Oliveira ◽  
Ana Paula Ramos Marinho ◽  
Magnus Benetti ◽  
Thais Silva Beltrame ◽  
...  

Introduction: The objective of this study was to adapt the Brazilian version, and verify the validity, reliability and internal consistency of the Oliveira questionnaire on low back pain in young people.Material and Methods: The questionnaire was translated from European Portuguese into Brazilian Portuguese by means of translation and re-translation. The validity of the contents was determined by experts who analyzed the clarity and pertinence of the questions. Fifteen young people aged 15 to 18 took part in the pre-test step (qualitative analysis), 40 in the test-retest (reliability) and 679 in the evaluation of internal consistency. The intra-class correlation coefficient and Spearman’s correlation coefficient were used in the reliability analysis (test-retest), and Cronbach’s alpha to determine the internal consistency (stability).Results: In the translation phase the questionnaire was modified and considered suitable, observing similarity and equivalence of the two versions. After being corrected by the experts in the validation of the contents, the instrument was considered suitable and valid, and in the pre-test, the young people suggested some modifications to make the questionnaire more succinct. With respect to reliability, the values for the intra-class correlation coefficient were between 0.512 – acceptable and 1 – excellent and Spearman’s correlation coefficient varied between 0.525 and 1, classifying the instrument as reproducible. The internal consistency was considered acceptable with a 0.757 Cronbach’s alpha.Discussion: The Oliveira questionnaire was choosen since it has been used in several Portuguese studies; moreover, it addresses the need to raise data regarding low back pain and associated risk factors.Conclusions: The Brazilian version of the Oliveira questionnaire on low back pain in young people showed valid and reliable cultural adaptation, with good reliability and stability.


Author(s):  
Sema A. Kalaian

The present article aims to (1) conceptualize and present the two-level multilevel model for e-collaboration research, (2) conceptualize the Intra-Class Correlation Coefficient (ICC), (3) conceptualize R2 in e-collaboration multilevel modeling, (4) present centering methods that can be used in e-collaboration multilevel modeling, (5) present parameter estimation and hypothesis testing methods for e-collaboration multilevel modeling, and (6) list some of the existing commercial software packages that can be used for analyzing the e-collaboration multilevel data.


2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M Gavazzoni ◽  
M Z Zuber ◽  
A P Pozzoli ◽  
M T Taramasso ◽  
F M Maisano

Abstract Background/Introduction. Recently the central role of hemodynamic invasive monitoring during MitraClip (Abbott Vascular, Santa Clara, CA, USA) procedure has been raised. After removal of Steerable Guide Catheter (SGC) at the end of procedure, iatrogenic interatrial septum defect determines acute sub-clinical hemodynamic changes depending on right atrial (RA) and left atrial (LA) pressures. The possibility to assess LAP non-invasively by Doppler -echocardiography at the end of the procedure allows to quantify real hemodynamic impact of reduction of MR and leaves the door open to further therapeutic decisions (such as closure of iatrogenic IASd). Purpose This prospective study aimed to assess the role of evaluation of post-procedural mean trans-atrial gradient with continuous-wave (CW) Doppler (DPmean-IAS) in estimating final m-LAP after removal of SGC. Methods We prospectively performed the computation of trans-atrial CW- Doppler tracing for estimation of mean-transatrial gradient (meanGp-LA-RA) in patients treated with MitraClip; we added the estimation of central venous pressure (CVP) according to: i) dilatation of superior vena cava (IVC, mm); ii) presence or not of systolic excursion of IVC (end-inspiratory excursion was not evaluable in patients under sedation); iii) hepatic vein dilatation. The sum of CVP estimated and meanGp-LA-RA (mmHg) represents the m-LAP-Echo-measured at the end of procedure. This value has been compared with m-LAP measured invasively before removal of SGC. We tested the inter-rater reliability with the Intra-class Correlation Coefficient for comparing this method with the gold standard (invasive assessment of LAP). Results we included 19 patients; aetiology of MR was degenerative in 89% of cases. Basal m-LAP was 15 ± 13,3 mmHg and decreased by 32% by the end of procedure (mean-LAP at the end: 10,1 ± 3,3 mmHg, p &lt; 0.001). At the end of the procedure mean Gp-LA-RA was 2.5 ± 1.2 mmHg and CVP 7.5 ± 3.5; the m-LAP-Echo-measured was 9.6 ± 2.4. The delay in time of computation of m-LAP by echocardiography with respect to last invasive assessment available was computed and settled around 5 minutes (IQR 3-9 min). The inter-rater reliability with the Intra-class Correlation Coefficient was high: 0.8, (CI95% 0.647-0.948, p &lt; 0.01); with Bland-Altman test we could assess that bias of measures was acceptable for this clinical context with upper concordance limit of 2,7 mmHg and lower of 4,7 mmHg, with a bias of 0,9 mmHg, not relevant for this clinical purpose. Conclusions The present study represents the first validation of a Doppler-based method for non invasively assessing post-procedural LAP in percutaneous mitral valve interventions requiring transeptal approach. Follow up is needed for correlate this value with clinical outcomes.


2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M A R Torres ◽  
T F Texeira ◽  
A C Camarozano ◽  
C Bertoluci ◽  
A I Heidemann Jr ◽  
...  

Abstract OnBehalf On behalf of the Stress Echo 2020 study group of the Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI) Background The measurement of left atrium (LA) can be obtained with simple linear or more complex biplane disk summation Simpson (S) method at rest and during stress echocardiography (SE). Although planimetric methods are mandatory to accurately assess resting LA volume, we sought to study if linear (L) methods can be equally valuable in assessing dynamic changes during SE. Purpose To assess accuracy of LA- SE with S compared to L method. Methods SE was performed in 34 patients (age 59 ± 16 years, 18 females) with known or suspected coronary artery disease. All had acceptable acoustic window at rest and were referred for clinically-driven SE (dobutamine in 21, dipyridamole in 13). LA was measured at rest and peak stress with both methods: 1- S biplane method from 4- and 2-chamber views; 2- L method with measurement of anteroposterior diameter from 2-D targeted M-mode in parasternal long-axis view. Two independent observers measured a set of 20 clips and repeated the measurements after 1 month on the same images. Stress-rest differences of L and S were compared with Spearman non-parametric correlation. Results LA measurement was obtained in all patients with L, 34/42 with S (feasibility 100%, and 80%, respectively). The off-line analysis time at each step (rest and stress) measured by stop-clock was 22.3 sec for L and 93 sec for S method (p &lt; 0.001). The intra-rater intra-class correlation coefficient for L was 0.965 for single measures and 0.982 for average measures. For S, it was 0.830 in single measures and 0.907 for average measures. The inter-rater correlation coefficient for L was 0.920 for single measures and 0.958 for average measures. For S, it was 0.901 for single measures and 0.948 for average measures. Absolute LA dimensions were moderately correlated between S and L at rest (r = 0.61, p &lt; 0.01), and during stress (r = 0.476, p &lt; 0.01). Rest-stress variations were not correlated (r = 0.004, p = NS). Conclusion LA measurement is highly feasible during SE with L and S methods. Absolute values with both are only moderately correlated at rest, less at peak stress, and not correlated when only rest-to-stress variations are considered. Although L is more feasible, less time-consuming, and more reproducible, S should be the first choice for more accurate assessment of rest-stress LA dimensions in pharmacologic SE. Abstract P326 Figure. Correlation of LA rest-stress


CJEM ◽  
2000 ◽  
Vol 2 (04) ◽  
pp. 237-245 ◽  
Author(s):  
Jeremy Etherington ◽  
Grant Innes ◽  
James Christenson ◽  
Jonathan Berkowitz ◽  
Robert Chamberlain ◽  
...  

ABSTRACT Evaluation of physician practice is necessary, both to provide feedback for self-improvement and to guide department heads during yearly evaluations. Objective: To develop and implement a peer-based performance evaluation tool and to measure reliability and physician satisfaction. Methods: Each emergency physician in an urban emergency department evaluated their peers by completing a survey consisting of 21 questions on effectiveness in 4 categories: clinical practice, interaction with coworkers and the public, nonclinical departmental responsibilities, and academic activities. A sample of emergency nurses evaluated each emergency physician on a subset of 5 of the questions. Factor analysis was used to assess the reliability of the questions and categories. Intra-class correlation coefficients were calculated to determine inter-rater reliability. After receiving their peer evaluations, each physician rated the process’s usefulness to the individual and the department. Results: 225 surveys were completed on 16 physicians. Factor analysis did not distinguish the nonclinical and academic categories as distinct; therefore, the survey questions fell into 3 domains, rather than the 4 hypothesized. The overall intra-class correlation coefficient was 0.43 for emergency physicians, indicating moderate, but far from perfect, agreement. This suggests that variability exists between physician evaluators, and that multiple reviewers are probably required to provide a balanced physician evaluation. The intra-class correlation coefficient for emergency nurses was 0.11, suggesting poor reliability. Overall, 11 of 15 physicians reported the process valuable or mostly valuable, 3 of 15 were unsure and 1 of 15 reported that the process was definitely not valuable. Conclusion: Physician evaluation by a single individual is probably unreliable. A useful physician peer evaluation tool can be developed. Most physicians view a personalized, broad-based, confidential peer review as valuable.


2006 ◽  
Vol 21 (4) ◽  
pp. 242-245 ◽  
Author(s):  
M. Barba ◽  
A. Cavalleri ◽  
H.J. Schünemann ◽  
V. Krogh ◽  
A. Evangelista ◽  
...  

The objective of this study is to evaluate the effect of cryopreservation at different storage temperatures on urinary 6-sulfatoxymelatonin (aMT6s) concentration. Overnight urine from 28 postmenopausal women participating in the ORDET cohort study was filtered and separated into 6 mL aliquots. Urine samples were stored at –80°C and at –30°C for an average of 14 years. Urinary aMT6s concentration was assessed using a competitive immunoassay. Mean aMT6s values of samples stored at –30°C were systematically lower than those of samples stored at –80°C (10.7 ng/mL versus 15.8 ng/mL, p<0.001). Bland Altman plots showed disagreement between determinations at different storage temperatures at the highest levels of the metabolite concentration. The degree of agreement evaluated in terms of intra-class correlation coefficient was 0.68 (95% CI 0.41–0.84, p<0.0001). Pearson's correlation coefficient between aMT6s values of the two differently stored samples was 0.93 (p<0.001), while the Kendal tau coefficient for rank distribution was 0.73 (p<0.001). Our data suggest that storage temperatures might affect degradation of aMT6s during storage. However, individual characterization by melatonin levels does not seem to be affected by cryopreservation conditions.


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