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PubMed1995

Reliability of the Health Utilities Index--Mark III used in the 1991 cycle 6 Canadian General Social Survey Health Questionnaire.

This study presents information on the test-retest reliability of the Health Utility Index--Mark III (HUI) system used in cycle 6 of the Canadian General Social Survey (GSS). The HUI system used in this reliability study consists of an eight-attribute health status classification system (HSCS) and a function for generating a summary score of health-related quality of life. To estimate test-retest reliability, a stratified random sample of individuals (n = 506) completing GSS telephone interviews during August and September, 1991 were interviewed again 1 month later. Weighting adjustments based on the probability of selection were invoked during the analyses to provide unbiased estimates of test-retest reliability for all GSS respondents in the August-September period. The results indicate that the individual questions, attributes and provisional index scores generally provided reliable information on health status in the GSS. The exceptions to this were limitations in speech and dexterity which were reported very infrequently. Kappa estimates of test-retest reliability for individual questions varied from 0.184 to 0.766. For the eight attributes, kappa estimates varied from 0.137 to 0.728. Using the provisional index scores to quantify health overall, a test-retest reliability of 0.767 was obtained (intra-class correlation coefficient).

Activities of Daily Living↗
PubMedDate not supplied

Factors affecting the reliability of ratings of students' clinical skills in a medicine clerkship.

OBJECTIVE: To determine the overall reliability and factors that might affect the reliability of ratings of students' clinical skills in a medicine clerkship. DESIGN: A nine-item instrument was used to evaluate students' clinical skills. Raters were also asked to provide a grade of each student's overall clinical performance. Generalizability studies were performed to estimate the reliability of the ratings. The effects of rater experience and clerkship setting were investigated by regression analysis. SETTING: Teaching hospitals and community-based sites in three Northwestern states. PARTICIPANTS: All students (328) who had completed the 12-week clerkship in internal medicine at one medical school during the academic years 1987-1989. Raters included attending physicians, chief residents, and other residents. RESULTS: Seven observations were needed to provide a reliable rating of the overall clinical grade. More observations were needed to obtain reliable ratings for individual items, ranging from seven observations needed for the rating of data gathering skills to 27 observations needed for the rating of interpersonal relationships with patients. Rater experience and clerkship setting (i.e., teaching hospitals vs. community-based clinics) were found, in general, not to affect significantly the ratings received by students. CONCLUSIONS: Reliable ratings of students' overall clinical skills, including overall clinical grades, can be achieved by collecting a minimum of seven observations. More observations are needed to measure reliably the interpersonal aspects of clinical performance. These findings support the use of performance ratings to evaluate clinical skills and knowledge of students in clerkship settings.

Clinical Clerkship↗
PubMed1998

Reliability of the timeline follow-back sexual behavior interview.

The reliability of self-reported sexual behavior is a question of utmost importance to human immunodeficiency virus (HIV) prevention research. The Timeline Follow-Back (TLFB) interview, which was developed to assess alcohol consumption on the event level, incorporates recall-enhancing techniques that result in reliable information. In this study, the TLFB interview was adapted to assess HIV-related sexual behaviors and their antecedents, and its reliability was assessed. The interview was administered to 110 participants (46% women, M age = 19.7; range = 18-41), and 58 participants who reported sexual behavior during the previous three months returned one week later for a second interview. Test-retest intraclass correlations (rho) from the TLFB protocol showed that all sexual behaviors were reported reliably (rho range = .86 to .97, median = .96). Bootstrapping, a nonparametric statistical technique, was used for significance testing in the reliability analyses. Reliability was equivalent across each of the three months assessed with the TLFB and was equivalent to conventional assessment methods (i.e. single-item questions). These findings show that the TLFB sexual behavior interview provides reliable reports of sexual behavior over three months and yields event-level data that are extremely valuable for sexual behavior and HIV-prevention research.

Adolescent↗
PubMed2000

Inter- and intrajudge reliability of a clinical examination of swallowing in adults.

This study investigates inter- and intrajudge reliability of a clinical examination of swallowing in adults. Several investigations have sought correlations between clinical indicators of dysphagia and the actual presence of dysphagia as determined by videofluoroscopy. Whereas some investigations have reported interjudge reliability for the videofluoroscopic measures employed, none have reported reliability for clinical measures. Without established reliability for rating clinical measures, conclusions drawn regarding the utility of a measure for detecting aspiration can be called into question. Results of the present study indicate that fewer than 50% of the measures clinicians typically employ are rated with sufficient inter- and intrajudge reliability. Measures of vocal quality and oral motor function were rated more reliably than were history measures or measures taken during trial swallows. There is a need to define more clearly the measures employed in clinical examinations and to be consistent in reporting reliability for clinical measures of swallowing function in future research.

Adult↗
PubMed1993

Reliability of goniometric measurements and visual estimates of ankle joint active range of motion obtained in a clinical setting.

We examined intratester and intertester reliability for goniometric measurements of ankle dorsiflexion (ADF) and ankle plantar flexion (APF) active range of motion (AROM). Parallel-forms intratester reliability for ankle AROM measurements obtained by the universal goniometer (UG) and by visual estimation (VE) and intertester reliability for VE of ADF and APF were examined. Repeated measurements were obtained on 38 patients with orthopedic problems by 10 physical therapists in a clinical setting. For intratester reliability of measurements obtained with UG, intraclass correlation coefficients (ICC) for all physical therapists were 0.64 to 0.92 (median, 0.825) for ADF and 0.47 to 0.96 (median, 0.865) for APF. Intertester reliability was quantified with use of ICC. ICCs for measurements obtained by UG were 0.28 for ADF and 0.25 for APF; ICC of VE for ADF was 0.34 and was 0.48 for APF. ICC for parallel-forms intratester reliability obtained with UG and VE ranged from 0 to 0.94 (median, 0.58) for ADF and 0 to 0.86 (median, 0.625) for APF. Thus, a physical therapist should use a goniometer when making repeated measurements of ankle joint AROM. Considerable inconsistency exists when two or more physical therapists make repeated goniometric and visual measurements of ankle motion on the same subject. Physical therapists may erroneously conclude that a patient's AROM has changed because of treatment when the change could be attributed to a lack of intertester reliability.

Adolescent↗
PubMed1975

Reliability of the TIP and DIP speech-hearing tests for children.

The reliability of SRT and speech intelligibility tests has been studied on adults. Reliability estimates for SRT are between .60 and .90, with standard error estimates from 1.5 to over five dB. For speech intelligibility tests the reliability estimates range from .50 to 90, with standard error of estimates from 2.5% to over 10%. Little has been reported on test reliability with children. For this study the TIP and DIP tests, for threshold and discrimination, respectively, were given to 295 normal and 138 hypacusic children three through twelve years of age. Subjects were retested within one week. TIP test-retest reliability was .72 for normals, and .89 to .99 for hypacusics. DIP test-retest reliability was .46 to .51 for normals and .60 to .93 for hypacusics. Standard error of estimate was about 3 dB for TIP, and 10% for DIP. These values are about the same as the reliability values for adults.

Child↗
PubMed1990

Assessing clinical signs of temporomandibular disorders: reliability of clinical examiners.

Data on interrater reliability in assessing a number of clinical signs commonly evaluated in the diagnosis and treatment of temporomandibular disorders (TMD) is presented in this article. Four experienced dental hygienists who were field examiners for a large epidemiologic study of TMD and three experienced clinical TMD specialists (dentists) who are coinvestigators in the same study followed carefully detailed specifications and criteria for examination of TMD patients and pain-free controls. Excellent reliability was found for vertical range of motion measures and for summary indices measuring the overall presence of a clinical sign that could arise from several sources (for example, summary indices of muscle palpation pain). However, many clinical signs important in the differential diagnosis of subtypes of TMD were not measured with high reliability. In particular, assessment of pain in response to muscle palpation and identification of specific temporomandibular joint sounds seemed to be possible only with modest, sometimes marginal, reliability. These modest reliabilities could arise from examiner error because the clinical signs are themselves unreliable, changing spontaneously over time and making it difficult to find the same sign on successive examinations. The finding that, without calibration, experienced clinicians showed low reliability with other clinicians suggests the importance of establishing reliable clinical standards for the examination and diagnostic classification of TMD.

Adult↗
PubMed1996

PRES- and orthostatic-induced heart-rate changes as markers of labile hypertension: magnitude and reliability measures.

Split-half and test-retest reliabilities of heart-rate responses to a baroreceptor manipulation and an orthostatic maneuver were compared between subjects with either normal or elevated blood-pressure. Ten subjects showing elevated resting blood-pressure and II normotensive subjects participated in two experimental sessions, each including heart-rate recordings during baroreceptor manipulation and orthostatic challenge. Carotid baroreceptors were manipulated by applying the baroreceptor-specific phase-related external suction (PRES) technique. The orthostatic stimulation procedure (OSP) was a change of body position from lying to standing. Heart rate responses evoked by OSP failed to discriminate significantly between the groups either in the magnitude or the (test, retest) reliability measure. The PRES procedure also failed to discriminate with the conventional magnitude measure, but the reliability measures showed significant differences. Paradoxically, the high-blood-pressure group manifested the higher baroreceptor reliability. The present findings are consistent with the view that operant conditioning produces phasic blood-pressure increases. In this view, blood-pressure increases activate the arterial baroreceptors which, in turn, dampen pain and/or stress sensitivity. Individuals showing high consistency (reliability) in their cardiovascular responses are more likely to learn this form of conditioning, and hence to eventually increase their tonic blood-pressure. High reliability of cardiovascular responses may therefore constitute a risk for hypertension. Aside from such theoretical considerations, the findings indicate that less conventional dependent variables like reliability may be worth exploring in the search for the etiology of essential hypertension, and that, in this search, specificity (relative to baroreceptor function) is more important than the magnitude of the heart-rate changes that are produced.

Adult↗
PubMed1993

Reliability of in vivo volume measures of hippocampus and other brain structures using MRI.

Volume reductions of the hippocampus are associated with Alzheimer's disease, schizophrenia, and epilepsy. We used clinically available MRI methods (2D acquisition; inversion recovery and calculated T2 images; 3 mm contiguous slices) that optimize image contrast, quality, and resolution and standardized positioning protocols to maximize the in vivo accuracy (test-retest reliability) of brain volume measurements in volunteers who were scanned two or three times. Volunteers were scanned in the same MRI instrument (intrascanner reliability) as well as in two different instruments (interscanner reliability). A single rater obtained brain volume measures of seven contiguous slices centered on the anterior commissure. The in vivo intrascanner reliability for measures of anterior hippocampus and ventricular volumes was very good, with reliability coefficients [intraclass r (rxx)] ranging between .855 and .997, and a median coefficient of variation (CV) of 6.4%. Reliability was good for amygdala (rxx of .740 and .764) and for total frontal and temporal lobe volumes and white matter volume measures (rxx ranging between .640 and .823, median coefficient of variation was 3.2%). Overall, interscanner reliability was also good. We discuss the implications of our results relative to the possible clinical utility of hippocampal quantification and the feasibility of prospective studies aimed at quantifying progressive neurodegeneration.

Adult↗
PubMed1995

Psychological measures: reliability in the assessment of stroke patients.

OBJECTIVE: To determine whether acute stroke patients can give reliable responses to standardized psychological measures. DESIGN: Survey design with retrospective review of Neurobehavioral Cognitive Status Examination (NCSE) scores. SETTING: A rehabilitation hospital in Philadelphia. PATIENTS: 106 consecutive admissions to stroke services at a rehabilitation hospital were evaluated according to the following inclusion criteria: Patients at least 65 years of age, English speaking, having a documented history of cerebrovascular accident (CVA), possession of receptive speech comprehension, and the ability to maintain attention adequate for participation in the study interview. Of the 47 eligible for participation, 10 patients refused participation and 13 were discharged before the interview could be completed. Thus 24 patients were interviewed, with one patient unable to complete the second half of the interview. MAIN OUTCOME MEASURES: In phase 1, the patient's performance on a structured interview (including the Multidimensional Health Locus of Control Scales (MHLC), Life Orientation Test (LOT), and Center for Epidemiological Studies Depression Scale (CES-D) scales) produced a Total Reliability Score, indicating the overall reliability of the patient's responses. In phase 2, NCSE scores were examined (retrospectively) for their ability to predict the patient's Total Reliability Score on the structured interview. RESULTS: Using Total Reliability Scores, 9 patients were categorized as "passing," 9 were categorized as "uncertain," and 5 were categorized as "failing" the interview. The NCSE was predictive for individuals who had a very low likelihood of being able to respond consistently. The NCSE failed to identify which individuals would respond in a reliable fashion. CONCLUSIONS: It is both possible and important to assess response reliability when using psychological measures soon after stroke. Future research will need to document other potential predictors of interview performance, including combinations of NCSE subscales.

Aged↗
PubMed1997

Cumulative trauma disorders in the upper extremities: reliability of the postural and repetitive risk-factors index.

OBJECTIVE: This study addresses test-retest reliability of the Postural and Repetitive Risk-Factors Index (PRRI) for work-related upper body injuries. This assessment was developed by the present authors. DESIGN: A repeated measures design was used to assess the test-retest reliability of a videotaped work-site assessment of subjects' movements. SUBJECTS: Ten heavy users of video display terminals (VDTs) from a local banking industry participated in the study. SETTING: The 10 subjects' movements were videotaped for 2 hours on each of 2 separate days, while working on-site at their VDTs. MAIN OUTCOME MEASURE: The videotaped assessment, which utilized known postural risk factors for developing musculoskeletal disorder, pain, and discomfort in heavy VDT users (ie, repetitiveness, awkward and static postures, and contraction time), was called the PRRI. The videotaped movement assessments were subsequently analyzed in 15-minute sessions (five sessions per 2-hour videotape, which produced a total of 10 sessions over the 2 testing days), and each session was chosen randomly from the videotape. The subjects' movements were given a postural risk score according to the criteria in the PRRI. Each subject was therefore tested a total of 10 times (ie, 10 sessions), over two days. The maximum PRRI score for both sides of the body was 216 points. RESULTS: Reliability coefficients (RCs) for the PRRI scores were calculated, and the reliability of any one session met the minimum criterion for excellent reliability, which was .75. A two-way analysis of variance (ANOVA) confirmed that there was no statistically significant difference between sessions (p < .05). Calculations using the standard error of measurement (SEM) indicated that an individual tested once, on one day and with a PRRI score of 25, required a change of at least 8 points in order to be confident that a true change in score had occurred. The significant results from the reliability tests indicated that the PRRI was a reliable measurement tool that could be used by occupational health practitioners on the job site.

Adult↗
PubMed1997

The Arm Motor Ability Test: reliability, validity, and sensitivity to change of an instrument for assessing disabilities in activities of daily living.

OBJECTIVE: To continue and expand determination of the reliability, validity, and sensitivity to change of the Arm Motor Ability Test (AMAT), an instrument for assessing deficits in activities of daily living (ADL). DESIGN: The AMAT was administered twice to patients, with an interest interval of either 1 or 2 weeks, by one of two examiners assigned to patients in counterbalanced order. Patients' interest intervals and scores on the arm portion of the Motricity Index was unknown to the raters. SETTING: A referral inpatient neurological rehabilitation center. PATIENTS: Thirty-three subacute stroke inpatients with moderate to mild upper extremity motor deficit: median Motricity-Index-Arm score = 89, median chronicity = 43d, median age = 66yr; 12 were women. MAIN OUTCOME MEASURE AND RESULTS: The AMAT was developed in 1987, and interrater reliabilities at that time were found to range from .95 to .99. The present values for interrater reliability (2 scales) from videotaped test performance were: kappas = .68 to .77. Spearman correlations = .97 to .99. For performance time, interscorer reliability from videotaped test performance was .99. Homogeneities for the three AMAT measures for the total sample (Cronbach's alpha and split-half reliability) were .93 to .99. The test-retest reliabilities for the total sample were .93 to .99. The correlations to the Motricity-Index-Arm score were .45 to .61. The AMAT detected the difference in change occurring as a result of the passage of 1 versus 2 weeks in these subacute inpatients, presumably as a result of intensive therapy and/or spontaneous recovery, confirming the results of an earlier intervention study. CONCLUSION: The AMAT is an instrument with high interrater reliability, internal consistency, and sensitivity to change, as well as having satisfactory concurrent validity.

Activities of Daily Living↗
PubMed2000

High internight reliability of computer-measured NREM delta, sigma, and beta: biological implications.

BACKGROUND: Computer analysis of the sleep electroencephalogram (EEG) waveforms is widely employed, but there have been no systematic studies of its reliability. METHODS: The most commonly used computer methods are power spectral analysis with the fast-Fourier transform (FFT) and period amplitude analysis (PAA) with zero cross or zero first derivative half-wave measurement. We applied all three computer methods to the digitized EEG of 16 normal subjects who underwent 5 consecutive nights of baseline (placebo) recording. We evaluated the internight reliability of three non-rapid eye movement (NREM) frequency bands of special importance to sleep research: delta (0.3-3 Hz), sigma (12-15 Hz), and beta (15-23 Hz). RESULTS: Both FFT and the two methods of PAA gave excellent internight reliability for delta and sigma. Even a single night of recording correlated highly (r >.9) with the 5-night mean. Beta reliability was lower but still highly significant for both the PAA and the FFT measures. CONCLUSIONS: Computer-analyzed sleep EEG data are highly reliable. Period amplitude methods demonstrate that wave incidence and period as well as amplitude are reliable, indicating that the reliability of composite measures (FFT power, PAA integrated amplitude) is not solely based on individual differences in EEG amplitude. The high internight stability of NREM delta indicates that it possesses traitlike characteristics and is relatively independent of day-to-day variations in state.

Adult↗
PubMed1996

A multirater validation study to assess the reliability of acne lesion counting.

BACKGROUND: Despite widespread use of acne lesion counting, little has been published on its reliability, particularly for multiple raters. OBJECTIVE: Our purpose was to assess reliability of acne lesion counting with the use of a five-segment facial template. METHODS: After training, 12 raters each evaluated 12 patients in randomized order, in the morning and again in the afternoon, and recorded counts for different types of lesions on a five-segment facial template. RESULTS: Individual raters could reproduce their total lesion counts (reliability estimates, 0.81 to 0.97). Variability between raters was high, and overall reliability estimated across raters was 0.61. For a subgroup of commonly trained raters, overall reliability was higher (0.80). CONCLUSION: The reliability of acne lesion counting is excellent when performed by the same trained rater over time. The high variability between raters appears to be reduced by standardized training. Because fewer lesions are counted with less variation, use of a template may have contributed to the high within-rater reliability.

Acne Vulgaris↗
PubMed2001

Dissection and weighing of accessory sex glands after formalin fixation, and a 5-day assay using young mature rats are reliable and feasible in the Hershberger assay.

The rodent Hershberger assay has been used predominantly by the pharmaceutical industry to evaluate androgenic and antiandrogenic chemicals for potential therapeutic use. However, this assay has not yet been formally validated and standardized for use in toxicology testing. There are many variations in the protocol used for this assay. The weight of androgen-dependent tissues is a definitive endpoint in the Hershberger assay. To find out the reliable assay protocol with feasibility, although many possible factors may affect assay reliability, the present study consist of a series of three separate experiments focused on method of dissection and weighing of accessory sex glands (ASGs: ventral and dorso-lateral prostate, seminal vesicles together with coagulating glands, and Cowper's glands), animal age and number of doses. Furthermore, male pubertal assay, an alternative to the Hershberger assay, was also examined its reliability. Experiment 1 explored whether reliably accurate ASG weights can be obtained after formalin fixation. The ASGs were collected from castrated male rats (11 weeks of age) treated daily with corn oil, or testosterone propionate (TP, 0.25 mg/kg/day, s.c.) and p,p'-DDE (0 or 100 mg/kg/day, p.o.) for 5 days. One day after the final treatment, the ASGs were removed carefully and weighed separately, and then fixed overnight in a 10% neutral-buffered formalin and weighed again. After that, the tissues were dried overnight in an oven and weighed again. A high correlation between fresh and fixed tissue weights, and a high correlation between fixed and dried tissue weights were noted. The changes in the tissue weight due to fixation were marginal and were proportional to the fresh weights of the individual tissue. Standard deviation of the fixed tissue weight in each group and the magnitude of responses to TP or p,p'-DDE in fixed tissues were equivalent to those in fresh or dried tissues. These findings indicate that formalin fixation does not interfere with interpretation of assay results, and this procedure was used in the subsequent experiments. Experiments 2 and 3 explored whether animal age or treatment duration altered assay sensitivity. In Experiment 2, antiandrogenic effect of p,p'-DDE (100 mg/kg/day) was detected after 5-and 10-day treatment irrespective of animal age (7 vs 11 weeks). In Experiment 3, antiandrogenic effects of flutamide (1 and 10 mg/kg/day) and p,p'-DDE (10 and 100 mg/kg/day) were compared between two different protocols, the 10-day assay using peripubertal rats and the 5-day assay using young mature rats. Results demonstrated that both protocols could significantly detect antiandrogenic effects of flutamide and p,p'-DDE. These findings demonstrate that (1) dissection and weighing of ASGs after formalin fixation is reliable in the Hershberger assay, (2) when this procedure is used, the 5-day Hershberger assay using young mature rats, expected to be more feasible assay than the 10-day assay using peripubertal rats, is also reliable as well as the 10-day assay using peripubertal rats. Furthermore, we confirmed that male pubertal assay with use of dissection and weighing of fixed tissues also reliable.

Androgens↗
PubMed1997

WHO Study on the reliability and validity of the alcohol and drug use disorder instruments: overview of methods and results.

The WHO Study on the reliability and validity of the alcohol and drug use disorder instruments in an international study which has taken place in centres in ten countries, aiming to test the reliability and validity of three diagnostic instruments for alcohol and drug use disorders: the Composite International Diagnostic Interview (CIDI), the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and a special version of the Alcohol Use Disorder and Associated Disabilities Interview schedule-alcohol/drug-revised (AUDADIS-ADR). The purpose of the reliability and validity (R&V) study is to further develop the alcohol and drug sections of these instruments so that a range of substance-related diagnoses can be made in a systematic, consistent, and reliable way. The study focuses on new criteria proposed in the tenth revision of the International Classification of Diseases (ICD-10) and the fourth revision of the diagnostic and statistical manual of mental disorders (DSM-IV) for dependence, harmful use and abuse categories for alcohol and psychoactive substance use disorders. A systematic study including a scientifically rigorous measure of reliability (i.e. 1 week test-retest reliability) and validity (i.e. comparison between clinical and non-clinical measures) has been undertaken. Results have yielded useful information on reliability and validity of these instruments at diagnosis, criteria and question level. Overall the diagnostic concordance coefficients (kappa, kappa) were very good for dependence disorders (0.7-0.9), but were somewhat lower for the abuse and harmful use categories. The comparisons among instruments and independent clinical evaluations and debriefing interviews gave important information about possible sources of unreliability, and provided useful clues on the applicability and consistency of nosological concepts across cultures.

Adult↗
PubMed2001

Reproducibility of optical biometry using partial coherence interferometry : intraobserver and interobserver reliability.

PURPOSE: To evaluate the intraobserver and interobserver variability in axial length (AL), anterior chamber depth (ACD), and corneal radius measurements using an optical biometry instrument based on partial coherence interferometry (PCI). SETTING: Johannes Gutenberg University, Mainz, Germany. METHODS: In this observational case series and interobserver reliability trial, 30 healthy, emmetropic to moderately myopic eyes of 15 volunteers were evaluated. The AL, ACD, and corneal radius were measured 20 times in 10 eyes by 1 observer to evaluate the intraobserver variability. To evaluate the interobserver variability, the measurements were taken in 20 eyes by 5 different observers. Measurements were performed using the IOLMaster (Carl Zeiss) based on PCI. The data description is based on coefficients of variation and the statistical inference on reliability estimation based on analysis of variance. The main outcome measures were intraobserver and interobserver variability and reliability in AL, ACD, and corneal radii. RESULTS: The intraobserver variability (SD) was +/-25.6 microm for AL, +/-33.4 microm for ACD, and +/-12.9 microm for corneal radius. The coefficients of variation were 0.1%, 0.9%, and 0.17%, respectively. The interobserver variability (SD) was +/-21.5 microm for AL, +/-29.8 microm for ACD, and +/-15.9 microm for corneal radius. The coefficients of variation were 0.09%, 0.82%, and 0.21%, respectively. The reliability was 99.9% for AL, 97.8% for ACD, and 99.8%/99.5% for corneal radius (r1/r2). The slightly reduced reliability in ACD measurement was caused by a reduced intraobserver reliability of 1 of the 5 observers (R = 0.87). CONCLUSION: Partial coherence biometry using the IOLMaster for AL measurement was highly reliable, offering observer-independent measurement results.

Adult↗
PubMedDate not supplied

Reliability of blood pressure, heart rate, and Doppler-derived hemodynamic measurements during exercise.

Doppler echocardiography of aortic blood flow, heart rate, and blood pressure represent noninvasive methods for evaluation of the hemodynamic effects of pharmacologic agents or other stimuli during rest and exercise. In this study the reliability of continuous-wave Doppler echocardiography for detecting the effects of various interventions on left ventricular systolic function during exercise was assessed. The reliability of Doppler measurements was compared with that found for measurements of simultaneously obtained heart rate and blood pressure. Exercise treadmill testing was performed at 0, 2, 4, 6, and 8 hours in 18 healthy male subjects. All measurements were performed at rest and during the last half of each exercise stage. Reliability of peak modal velocity, peak aortic blood flow acceleration, heart rate, and blood pressure was measured by the intraclass correlation coefficient (ICC) at each stage. ICC reliability of greater than 0.75 is considered excellent, 0.4 to 0.75 fair to good, and less than 0.4 poor. The reliability of all Doppler-derived parameters, heart rate, and blood pressure improved with increasing stage of exercise. Peak modal velocity, peak acceleration, heart rate, and manually obtained systolic blood pressure had ICCs of 0.75 or greater by stage 3. The reliability of Doppler-derived aortic blood flow parameters was good or excellent at rest and advanced stages of exercise. Continuous-wave Doppler echocardiography is a reliable method for performing studies to assess the effects of interventions on cardiovascular function during exercise.

Adult↗