scholarly journals Intra- and inter-rater reliability in a comparative study of cross-sectional and spiral computed tomography pelvimetry methods

2019 ◽  
Vol 8 (6) ◽  
pp. 205846011985518 ◽  
Author(s):  
Erika Phexell ◽  
Anna Åkesson ◽  
Marcus Söderberg ◽  
Anetta Bolejko

Background Different low-dose computed tomography (CT) pelvimetry methods can be used to evaluate the size of birth canal before delivery. CT pelvimetry might generate an acceptable low fetal radiation dose but its measurement accuracy is unknown. Purpose To investigate intra- and inter-rater measurement reliability of cross-sectional and two spiral CT pelvimetry methods: standard spiral and short spiral. Material and Methods Ten individuals (age ≥60 years, body mass index ≥30 kg/m2) having a CT scan of the abdomen also had CT pelvimetry scans. Three radiologists made independent measurements of each pelvimetry method on two occasions and also in consensus for a reference pelvimetry computed from the standard-dose CT scan of the abdomen. Inter- and intra-rater reliability was analyzed by intraclass correlation coefficient. Results Measurements in the short spiral pelvimetry demonstrated excellent intra- and inter-rater reliability, intraclass correlation coefficient ≥0.93, and good to excellent 95% confidence interval 0.87–0.99. Corresponding results of the standard spiral and cross-sectional pelvimetry showed good to excellent intraclass correlation coefficient ≥0.85 and ≥0.76, and 95% confidence interval was least good and moderate 0.73–0.98 and 0.59–0.97, respectively. Intraclass correlation coefficient between reference pelvimetry and other CT methods showed analogous results. Conclusion The short spiral pelvimetry demonstrated high and best reliability in comparison to other methods. Standard spiral method showed also good measurement reliability but the short spiral pelvimetry generates lower fetal radiation dose. This method might be suitable for measurements at narrow pelvis. Patient acceptance and attitude to CT pelvimetry should be investigated.

Ultrasound ◽  
2019 ◽  
Vol 27 (3) ◽  
pp. 156-166 ◽  
Author(s):  
Vanessa L Kennedy ◽  
Carol A Flavell ◽  
Kenji Doma

A “free hand” real-time-ultrasound method is commonly applied to measure transversus abdominis. Potentially, this increases transversus abdominis measurement error due to uncontrolled variability in probe to skin force, inclination, and roll, particularly for novice examiners. This single-group repeated-measures reliability study compared the intra-rater reliability of transversus abdominis thickness and activation measurement by a novice examiner between free hand and a standardized probe force device method. The examiner captured ultrasound videos of transversus abdominis in a single session in healthy participants ( n =  33). Free hand ultrasound featured uncontrolled probe force, inclination, and roll, while probe force device method ultrasound standardized these parameters. Images of transversus abdominis at rest and contracted were measured and transversus abdominis activation calculated. Intraclass correlation coefficient, coefficient of variation, standard error of measurement, and worthwhile differences were calculated. The probe force device method resulted in greater reliability (intraclass correlation coefficient = 0.75–0.96) and lower measurement error (coefficient of variation = 8.89–28.7%) compared to free hand (intraclass correlation coefficient = 0.63–0.93; coefficient of variation = 6.52–29.4%). Reliability was good for all measurements except free hand TrA-C, which was moderate. TrA-C had the lowest reliability, followed by contracted thickness of the transverse abdominis, with resting thickness of the transverse abdominis being highest. Worthwhile differences were lower using a probe force device method versus free hand for resting thickness of the transverse abdominis and contracted thickness of the transverse abdominis and similar for TrA-C. Standardization using probe force device method ultrasound to measure transversus abdominis improved intra-rater reliability in a novice examiner. Use of a probe force device method is recommended to improve reliability through reduced sources of measurement error. Probe force device method intra- and inter-rater reliability in examiners of varying experience, in clinical populations, and to visualize other structures merits exploration.


Vascular ◽  
2016 ◽  
Vol 25 (1) ◽  
pp. 54-62 ◽  
Author(s):  
Kenneth Ouriel ◽  
Richard L Ouriel ◽  
Yeun J Lim ◽  
Gregory Piazza ◽  
Samuel Z Goldhaber

Purpose Computed tomography angiography is used for quantifying the significance of pulmonary embolism, but its reliability has not been well defined. Methods The study cohort comprised 10 patients randomly selected from a 150-patient prospective trial of ultrasound-facilitated fibrinolysis for acute pulmonary embolism. Four reviewers independently evaluated the right-to-left ventricular diameter ratios using the standard multiplanar reformatted technique and a simplified (axial) method, and thrombus burden with the standard modified Miller score and a new, refined Miller scoring system. Results The intraclass correlation coefficient for intra-observer variability was .949 and .970 for the multiplanar reformatted and axial methods for estimating right-to-left ventricular ratios, respectively. Inter-observer agreement was high and similar for the two methods, with intraclass correlation coefficient of .969 and .976. The modified Miller score had good intra-observer agreement (intraclass correlation coefficient .820) and was similar to the refined Miller method (intraclass correlation coefficient .883) for estimating thrombus burden. Inter-observer agreement was also comparable between the techniques, with intraclass correlation coefficient of .829 and .914 for the modified Miller and refined Miller methods. Conclusions The reliability of computed tomography angiography for pulmonary embolism was excellent for the axial and multiplanar reformatted methods for quantifying the right-to-left ventricular ratio and for the modified Miller and refined Miller scores for quantifying of pulmonary artery thrombus burden.


2019 ◽  
Author(s):  
Seyedeh Somayeh Kazemi ◽  
Sedigheh-Sadat Tavafian ◽  
Alireza Hidarnia ◽  
Ali Montazeri

Abstract Background: Occupational back pain is the most prevalent health problem among nurses and needs to be assessed by a valid and multi-factorial questionnaire. The purpose of the present study was to design and develop an instrument based on the PRECEDE-PROCEED model for assessing job-related behaviors that cause low back pain. Methods: First an item pool of 49 items was generated. Then, content and face validity was carried out. Consequently, a cross-sectional study was conducted in Mazandaran, Iran. The questionnaire was distributed among a sample of nurses working in hospitals affiliated to Mazandaran University of Medical Sciences. Exploratory factor analysis was used to determine the factor structure of the questionnaire. The Cronbach’s alpha was estimated to assess the reliability and the intraclass correlation coefficient was calculated to examine stability. Results: In all 155 nurses participated in the study. The mean age of respondents was 34.1 (SD = 7.66) years, and 83.2% were female. Six factors with 30 items emerged from the exploratory factor analysis: knowledge, attitude, self-efficacy, reinforcing factors, enabling factors and behavior that jointly accounted for %66.5 of behavior change variance observed. The Cronbach’s alpha coefficient showed excellent internal consistency (alpha=0.92). The intraclass correlation coefficient with 2-weeks interval also indicated that the questionnaire has satisfactory stability (ICC = 0.97). Conclusions: The findings showed that the Occupational Back Pain Prevention Behavior Questionnaire is a reliable and valid instrument for measuring occupational back pain and prevention behaviors among nurses. Keywords: Occupational Back Pain, Prevention behaviors, Psychometric evaluation, PRECEDE-PROCEED model, Nurse


2021 ◽  
Vol 28 (9) ◽  
pp. 1-10
Author(s):  
Taelim Yoon ◽  
Jihyun Lee

Background/aims Ankle instability is one of the most common injuries that can occur during everyday life, sports and exercise. Recently, smartphone accelerometers have been used to measure single leg balance associated with ankle instability, because they are easy to use, inexpensive and can be used in small spaces. Thus, the purpose of this study was to introduce and investigate the intra- and inter-rater reliability of the smartphone accelerometer when assessing ankle instability. Methods A total of 26 individuals who had ankle instability were recruited. The single leg stance balance was measured using a smartphone accelerometer (Accelerometer application) and a force platform (I-Balance) for 5 seconds with their eyes open or their eyes closed. Results In the eyes open position, intra-rater reliability of the smartphone accelerometer was excellent for both raters (intraclass correlation coefficient: 0.87–0.90); and the inter-rater reliability was moderate (intraclass correlation coefficient: 0.71). In the eyes closed position, the intra-rater reliability of the smartphone accelerometer was excellent for both raters (intraclass correlation coefficient: 0.90–0.93); the inter-rater reliability was good (intraclass correlation coefficient: 0.82). Additionally, there were fair positive correlations between the smartphone accelerometer and the Cumberland Ankle Instability Tool, and between the smartphone accelerometer and I-Balance (r=0.33, 0.30 respectively). Conclusions The present study demonstrated excellent intra-rater reliabilities of two raters and moderate to good inter-rater reliabilities. The smartphone accelerometer offers several important advantages as a potential portable medical device to assess ankle instability accurately. Although there was a positive correlation, the relationships between the smartphone accelerometer and Cumberland Ankle Instability Tool and that between the smartphone accelerometer and I-Balance were fair. Future studies should investigate the validity of the smartphone accelerometer as a portable medical device for determining ankle instability.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 789-789
Author(s):  
Mariana Wingood ◽  
Salene Jones ◽  
Nancy Gell ◽  
Denise Peters ◽  
Jennifer Brach

Abstract Addressing physical activity (PA) barriers is an essential component of increasing PA among the 56-73% of community-dwelling adults 50 years and older who are not performing the recommended 150 minutes of moderate-to-vigorous PA. As there is no feasible, multi-factorial tool to assess PA barriers among this population, we developed and validated a PA barrier assessment tool called the Inventory of Physical Activity Barriers (IPAB). We collected cross-sectional data on 503 adults (mean age 70.1), with 79 participants completing the scale twice for test-retest reliability and 64 completing a cross-over design examining the ability to use two administration formats interchangeably. Our analyses consisted of exploratory and confirmatory factor analysis, Cronbach alpha, intraclass correlation coefficient, Bland-Altman Plot, and t-tests. Using factor analysis, we identified and confirmed an eight-factor solution consisting of 27 items. The 27-item IPAB is internally consistent (alpha= 0.91), has a high test-retest reliability (intraclass correlation coefficient=0.99), and can differentiate between individuals who meet the recommended levels of PA and those who do not (p < 0.001). The IPAB scores ranged between 1.00-3.11 for the paper format (mean=1.78) and 1.07-3.48 for the electronic format (mean=1.78), with no statistical difference between the paper and electronic administration formats (p=0.94), resulting in the conclusion that the two administration formats can be used interchangeably. Participant feedback illustrates that the IPAB is easy to use, has clear instruction, and is an appropriate length. The newly validated IPAB scale can be used to develop individualized PA interventions that address PA barriers among patients 50 years and older.


2019 ◽  
pp. 1357633X1988354 ◽  
Author(s):  
Frederic Venail ◽  
Marie C Picot ◽  
Gregory Marin ◽  
Sylvain Falinower ◽  
Jacques Samson ◽  
...  

Introduction Current literature does not provide strong evidence that remote programming of hearing aids is effective, despite its increasing use by audiologists. We tested speech perception outcomes, real-ear insertion gain, and changes in self-perceived hearing impairment after face-to-face and remote programming of hearing aids in a randomized multicentre, single-blind crossover study. Methods Adult experienced hearing aid users were enrolled during routine follow-up visits to audiology clinics. Hearing aids were programmed both face to face and remotely, then participants randomly received either the face-to-face or remote settings in a blinded manner and were evaluated 5 weeks later. Participants then received the other settings and were evaluated 5 weeks later. Results Data from 52 out of 60 participants were analysed. We found excellent concordance in performance of hearing aids programmed face to face and remotely for speech understanding in quiet (phonetically balanced kindergarten test – intraclass correlation coefficient of 0.92 (95% confidence interval: 0.87–0.95)), and good concordance in performance for speech understanding in noise (phonetically balanced kindergarten +5 dB signal-to-noise ratio – intraclass correlation coefficient of 0.71 (95% confidence interval: 0.55–0.82)). Face-to-face and remote programming took 10 minutes (±2.9) and 10 minutes (±2.8), respectively. Real-ear insertion gains were highly correlated for input sound at 50, 65 and 80 dB sound pressure levels. The programming type did not affect the abbreviated profile of hearing aid questionnaire scores. Conclusions In experienced hearing aid users, face-to-face and remote programming of hearing aids give similar results in terms of speech perception, with no increase in the time spent on patients’ care and no difference in self-reported hearing benefit. ClinicalTrials.gov Identifier NCT02589561


2019 ◽  
Vol 33 (9) ◽  
pp. 1479-1491 ◽  
Author(s):  
Yulong Wang ◽  
Shanshan Guo ◽  
Jiejiao Zheng ◽  
Qing Mei Wang ◽  
Yuling Zhang ◽  
...  

Objective:The aim of this study was to validate a novel pictorial-based Longshi Scale for evaluating a patient’s disability by healthcare professionals and non-professionals.Design:Prospective study.Setting:Rehabilitation departments from a grade A, class 3 public hospital, a grade B, class 2 public hospital, and a private hospital and seven community rehabilitation centers.Subjects:A total of 618 patients and 251 patients with functional disabilities were recruited in a two-phase study, respectively.Main measures:Outcome measure: pictorial scale of activities of daily living (ADLs, Longshi Scale). Reference measure: Barthel Index. The Spearman correlation coefficient was used to analyze the validity of Longshi Scale against Barthel Index.Results:In phase 1 study, from March 2016 to August 2016, the results demonstrated that the Longshi Scale was both reliable and valid (intraclass correlation coefficient based on two-way random effect (ICC2,1) = 0.877–0.974 for intra-rater reliability; ICC2,1= 0.928–0.979; κ = 0.679–1.000 for inter-rater reliability; intraclass correlation coefficient based on one-way random effect (ICC1,1) = 0.921–0.984 for test–retest reliability and Spearman correlation coefficient = 0.836–0.899). In the second phase, in March 2018, results further demonstrated that the Longshi Scale had good inter-rater and intra-rater reliability among healthcare professionals and non-professionals including therapists, interns, and personal care aids (ICC1,1= 0.822–0.882 on Day 1; ICC1,1= 0.842–0.899 on Day 7 for inter-rater reliability). In addition, the Longshi Scale decreased assessment time significantly, compared with the Barthel Index assessment ( P < 0.01).Conclusion:The Longshi Scale could potentially provide an efficient way for healthcare professionals and non-professionals who may have minimal training to assess the ADLs of functionally disabled patients.


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