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PubMed1997

Applicability of telemedicine for assessing patients with schizophrenia: acceptance and reliability.

BACKGROUND: Telemedicine holds promise for providing expert psychiatric consultation to underserved populations, but has not been quantitatively studied in schizophrenia or any other major mental disorder. This study was conducted to assess the reliability and acceptance of video-conferencing equipment in the assessment of patients with schizophrenia. METHOD: We assessed reliability of the Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Positive Symptoms (SAPS), and Scale for the Assessment of Negative Symptoms (SANS) under three conditions: (1) in person, (2) by videoconferencing at low (128 kilobits per second [kbs]) bandwidth, (3) by videoconferencing at high (384 kbs) bandwidth. All 45 patients met DSM-IV criteria for schizophrenia. All patients and the two interviewers rated various aspects of the study interviews against previous live psychiatric interviews. RESULTS: Total scores on both the BPRS and SAPS were assessed equally reliably by the three media. Total score on the SANS was less reliably assessed at the low bandwidth, as were several specific negative symptoms of schizophrenia that depend heavily on nonverbal cues. Video interviews were well accepted by patients in both groups, although patients in the high bandwidth group were more likely to prefer the video interview to a live interview. CONCLUSION: Global severity of schizophrenia and overall severity of positive symptoms were reliably assessed by videoconferencing technology. Higher bandwidth resulted in more reliable assessment of negative symptoms and was preferred over low bandwidth, although patients' and raters' acceptance of video was good in both conditions. Videoconsultation appears to be a reliable method of assessing schizophrenic patients in remote locations who have limited access to expert consultation.

Adult↗
PubMedDate not supplied

Reliability and validity of the self-assessment of occupational functioning.

OBJECTIVE: Two studies examined the reliability and validity of the Self-Assessment of Occupational Functioning (SAOF), a 23-item self-assessment of perceptions of strengths, and weaknesses relative to occupational functioning, grounded in the Model of Human Occupation. METHOD: The first study examined the test-retest reliability of the SAOF, and involved 37 college students without disabilities who completed the SAOF twice. The second study, which involved 39 young persons hospitalized with psychiatric disorders, examined internal consistency reliability of the SAOF, and examined correlations between SAOF scores and composite scores on the Self-Perception Profile, a widely used measure of perceived competence. In addition, data from both studies were combined to examine the ability of the SAOF to discriminate between the college students without disabilities and the young persons with psychiatric disorders. RESULTS: Kappa and intraclass correlation coefficients (ICCs) were used to examine test-retest reliability and Cronbach's alpha was used to examine internal consistency. Acceptable levels of test-retest (ICCs) and internal consistency (Cronbach's alpha) reliability were found for the subscale and total scores of the SAOF. However, test-retest reliability (kappa) was lower than desirable for many of the individual SAOF items. The young persons with psychiatric disorders had lower item, subscale, and total scores on the SAOF than did the college students without disabilities. In addition, a discriminant analysis predicting group membership (college students without disability vs. young persons with psychiatric disorder) correctly classified 76.6% of the participants based on the four subscale scores of the SAOF. CONCLUSION: The SAOF has the potential to be a reliable and valid clinical assessment; however, additional research is needed.

Adolescent↗
PubMedDate not supplied

Reliability of the foot posture index and traditional measures of foot position.

Repeatable measures are essential for clinicians and researchers alike. Both need baseline measures that are reliable, as intervention effects cannot be accurately identified without consistent measures. The intrarater and interrater reliability of the new Foot Posture Index and current podiatric measures of foot position were assessed using a same-subject, repeated-measures study design across three age groups. The Foot Posture Index total score showed moderate reliability overall, demonstrating better reliability than most other current measures, although navicular height (normalized for foot length) was the single most reliable measure in adults. None of the tested measures exhibited adequate reliability in young children, and, with less-than-desirable reliability being demonstrated, most measures need to be interpreted accordingly when repeated measures are involved.

Adolescent↗
PubMed1998

The Norwegian version of the Quality of Life Scale (QOLS-N). A validation and reliability study in patients suffering from psoriasis.

The aim of this study was to adapt, validate, and test for reliability the Quality of Life Scale in Norwegian (QOLS-N) for patients suffering from psoriasis. Two hundred and eighty-two patients with psoriasis were included in the study. Self-reported health was measured using the SF-36. Disease severity was also measured in 95 patients using the Psoriasis Area and Severity Index (PASI). The reliability of the QOLS-N was computed using the internal consistency reliability (Cronbach's alpha) and the test-retest reliability test. Face and content validity and construct discriminant ability of the QOLS-N were assessed. The results indicated that the QOLS-N has highly satisfactory rates of test-retest reliability (r = 0.83) and internal consistency reliability (alpha 0.86). As expected, the QOLS-N had a lower correlation with physical health (r = 0.24, p < 0.000) and self-reported symptoms (r = -0.20, p < 0.001), and a higher correlation with mental health (r = 0.52, p < 0.000). The correlation with disease severity was not significant (-0.06). The results reported in the present paper are in accordance with those derived in other validation studies. The QOLS-N seems to be a reliable and valid measure of global quality of life in patients suffering from psoriasis.

Activities of Daily Living↗
PubMed1999

Reliability and sensitivity of diagnostic tests for primary Sjögren's syndrome.

OBJECTIVE: To investigate whether diagnostic tests for primary Sjögren's syndrome (pSS) are reproducible when repeated after one year (reliability). To evaluate whether the sensitivity of the diagnostic tests increases with repeated testing. METHODS: A structured interview investigating the subjective sensation of dry eyes and dry mouth, and the diagnostic tests Schirmer I, unstimulated whole saliva collection (UWSC), serological tests for antinuclear antibodies (ANA), for anti-Ro/SSA and anti-La/SSB antibodies as well as Waaler's test for rheumatoid factor, were performed twice with a one year interval in 66 patients with pSS. Reliability was given as the percentage of positive tests remaining positive at the second examination, while sensitivity was given as the percentage of patients with positive tests. RESULTS: Highest reliability was obtained for the sensation of dry mouth (98.2%) and sensation of dry eyes (96.4%), and anti-SSA/SSB antibodies (93.3%). Lowest reliability was obtained for rheumatoid factor at cutoff titer 1:32 (70.6%) and positive Schirmer I in one eye (77.4%). The reliability for ANA was 80% at cutoff titer 1:32, and increased to 93.3% at cutoff titer 1:128. UWSC had a reliability of 84.2%. The pooled sensitivity for all the tests increased significantly (p < 0.05) compared to the examination, which had the lowest sensitivity. CONCLUSION: The diagnostic tests for pSS are generally highly reliable when performed twice with a one year interval. The gain in sensitivity by repeating the tests is limited, being most marked for Schirmer I.

Adult↗
PubMed1999

Radiological scoring methods in ankylosing spondylitis: reliability and sensitivity to change over one year.

Our aim was to compare reliability and sensitivity to change of different radiological scoring methods in ankylosing spondylitis (AS). Two trained observers scored 30 AS radiographs twice with an interval of 4 weeks. The same two observers scored 187 AS radiographs in pairs, at baseline and after one year followup, to measure change and agreement on change. The sacroiliac (SI) joints were scored in 5 grades by the New York method and the SASSS (Stoke Ankylosing Spondylitis Spine Score). Hips were graded 0-5 (according to Larsen). Cervical and lumbar spine were graded (0-4, Bath Ankylosing Spondylitis Radiological Index, BASRI), and scored in detail (0-72, SASSS). SASSS of the cervical and lumbar spine scored on the anterior sites of the vertebrae proved most reliable, with both intra and interobserver intraclass correlation coefficients (ICC) between 0.87 and 0.97. BASRI was only moderately reliable, with Cohen's kappa ranging between 0.50 and 0.82 for intra, and 0.38-0.64 for interobserver reliability. Similarly, SI joint scores (New York, SASSS) showed intraobserver kappa between 0.56 and 0.84, and interobserver reliability with kappa between 0.37 and 0.47. Larsen hip scores proved unreliable: moderate intraobserver kappa of 0.47-0.58 and low interobserver kappa of 0.29. After retraining, interobserver kappa did not improve (0.45 and 0.17). In retrospect, a one year period was too short to measure sensitivity to change. Observers agreed that no change occurred in up to 89% of cases. A measurable change of deterioration or improvement occurred rarely. We conclude that in AS, only the SASSS method for the spine and the BASRI reached good reliability. Other methods for spine, SI joints, and hips were moderately reliable at best. There was moderate to good agreement on no change between the observers. No method showed change over a period of one year in a considerable number of patients.

Arthrography↗
PubMed2000

Good test--retest reliability for standard and advanced false-belief tasks across a wide range of abilities.

Although tests of young children's understanding of mind have had a remarkable impact upon developmental and clinical psychological research over the past 20 years, very little is known about their reliability. Indeed, the only existing study of test-retest reliability suggests unacceptably poor results for first-order false-belief tasks (Mayes, Klin, Tercyak, Cicchetti, & Cohen, 1996), although this may in part reflect the nonstandard (video-based) procedures adopted by these authors. The present study had four major aims. The first was to re-examine the reliability of false-belief tasks, using more standard (puppet and storybook) procedures. The second was to assess whether the test-retest reliability of false-belief task performance is equivalent for children of contrasting ability levels. The third aim was to explore whether adopting an aggregate approach improves the reliability with which children's early mental-state awareness can be measured. The fourth aim was to examine for the first time the test-retest reliability of children's performances on more advanced theory-of-mind tasks. Our results suggest that most standard and advanced false-belief tasks do in fact show good test-retest reliability and internal consistency, with very strong test-retest correlations between aggregate scores for children of all levels of ability.

Aptitude↗
PubMed2001

Interexaminer reliability of transrectal ultrasound for estimating prostate volume.

PURPOSE: We investigated the interexaminer reliability of transrectal ultrasound measurement of total prostate and transition zone volume among 3 examiners with various levels of experience. MATERIALS AND METHODS: A total of 121 patients 39 to 82 years old (average plus or minus standard deviation 60.7 +/- 10.3) from a single urology clinic volunteered to participate. Patients with prostate cancer, previous prostate surgery or recent invasive prostatic examination were excluded from study. Each individual was examined independently by each of 3 examiners with various levels of experience, including an attending urologist, a PGY-2 resident in the second year of general surgery before urology training and a PGY-4 resident in the second year of urology training. Transrectal ultrasound was performed in each case by each examiner in pre-specified random order. RESULTS: Mean total prostate and transition zone volume was 35.9 +/- 27.2 and 15.6 +/- 18.8 ml., respectively. Interexaminer agreement or reliability of the ultrasound measurements was high for total prostate and transition zone volume (intraclass correlation 0.96, 95% confidence interval [CI] 0.95 to 0.97 and 0.93, 95% CI 0.90 to 0.95, respectively). For individual prostatic dimensions reliability estimates were 0.78 to 0.86, while for transition zone dimensions reliability was 0.85 to 0.90. Total prostate volume reliability was higher for prostate volume greater than 40 ml. versus smaller prostates (intraclass correlation 0.95, 95% CI 0.90 to 0.97 versus 0.77, 95% CI 0.67 to 0.84). Mean differences in transrectal ultrasound measurements by different examiners were highest for the resident with least experience. CONCLUSIONS: The reliability of transrectal ultrasound measured total prostate and transition zone volume is high for examiners with different levels of experience at this institution. Reliability in patients without prostate cancer appears to be better for larger volume prostates and for examiners with more experience.

Adult↗
PubMed2003

[Mathematical model for study the reliability of organism function in extreme conditions of high altitude].

The health of a person and his capacity for work under conditions of high mountains in many respects is determined by the reliability of the function of physiological systems. Mathematical methods of both the reliability theory and mathematical simulation of basic functional systems are proposed to be used for investigating the reliability. It is shown that the most suitable reliability model for living systems is a chain model-a successive connection of links representing separate functional systems of organism. Besides, the weakest links determining the reliability of functioning of the whole organism under the extreme conditions of high mountains even for a healthy person are-respiration, blood circulation, thermoregulation and psychophysiological systems. Quantitative characteristics of the reliability of these systems are determined through the main indicators. The influence of non-sufficient contents of oxygen in respiration mixture, low atmospheric pressure, low temperatures of the environment are simulated by computer models of organism. An analyses of modeling data shows that moderate physical loading improves indicators of organisms adaptively to external conditions of high mountains and promotes the increasing of persons capacity for work and the reliability of his functioning.

Adaptation, Physiological↗
PubMed2003

[Determination of reliability of psychometric tests in psychiatry using canonical correlation].

Test results (raw scores) are composed of an unknown true score and an error term. The error term can be estimated by means of test reliability which is defined by the ratio of true variance and obtained variance. Different estimates of reliability either based on single measurements (e.g. Cronbach's coefficient, split half reliability, Kuder Richardson method) or two measurements (test/retest, inter- or intrarater reliability) are available. Parallel test reliability depends on the correlation of two different tests obtained in one session. Canonical correlation methods allow an extension of the parallel test situation and split half technique. Two or more tests are performed in a sample of subjects. Randomized subsets are correlated using canonical correlation technique. The objective of this study is to estimate the homogeneity of test batteries. 94 patients (64 f, 30 m; age: 54-89 ys.) supposed to have dementia were tested using the clocktest (CT, scores: 1-5), MMSE (mini mental state examination) and SKT (Syndrom Kurztest). Four (i, j: 1-4) subsets of 20 patients each were determined by random and the following characteristics were calculated: Empiric correlation coefficient for n = 94 (R), canonical correlation coefficient (Rcan), eigenvalues (EV) and redundancy (Rnd) of corresponding variable sets. The results of canonical analysis showed canonical correlation coefficients in order of 0.8 to 0.9 (p-values < 0.001). This high internal consistency can be interpreted as a measure of reliability of the test batteries. In conclusion, canonical correlation based on parallel tests splitted in subsets gives information on consistency, i.e. reliability, of test batteries in addition to conventional correlation methods.

Adult↗
PubMed1992

Validity and reliability of lupus activity measures in the routine clinic setting.

As part of a cohort study of 150 patients with systemic lupus erythematosus (SLE), we investigated the validity and reliability of several indices of lupus activity, including the UCSF/JHU Lupus Activity Index (LAI), the SLE Disease Activity Index (SLEDAI), and a simple Core Index combining common elements. Validity was assessed by measuring correlations of these indices at the first cohort visit with the physician's global assessment (PGA) of SLE activity. The correlation of M-LAI (LAI modified so as not to contain PGA) and SLEDAI with PGA was 0.64 (95% CI 0.50, 0.70) and 0.55 (95% CI 0.42, 0.64), respectively. Reliability was assessed in a study of 6 patients seen twice, one week apart, by 9 physicians. The interrater reliability and test-retest reliability was greater for LAI (or M-LAI) than for SLEDAI. The Core Index performed better in its correlation with PGA (R = 0.78), although it contained no treatment data or serologic tests. Its interrater reliability and test-retest reliability were comparable with LAI. We conclude that (1) all indices have high validity; (2) LAI and the Core Index have higher reliability; and (3) these indices can be readily assimilated into routine clinic practice.

Adult↗
PubMedDate not supplied

Measurement precision and reliability in craniofacial anthropometry: implications and suggestions for clinical applications.

Craniofacial anthropometry has become an important tool used by both clinical geneticists and reconstructive surgeons. Yet little attention has been paid to the potentially serious problem of measurement error. This paper examines intra-observer measurement error and precision (also called repeatability or reliability) for 52 commonly used anthropometric variables of the head and face. Two factors proved critical to reliability: magnitude of the measurement in question and the degree to which its constituant landmarks could be readily identified. Thus, all of the measurement variables with means above 10 cm proved to have good or excellent reliability. In contrast measurement variables with means below 10 cm were more likely to have poor reliability. This trend was especially evident in variables with means of 6 cm or less where 18 of the 20 variables in this range had poor reliability. The least reliable variables were those like philtrum breadth, columella breadth, and nasal root breadth that combine small magnitude with difficult to define landmarks. While these results suggest that it may be prudent to avoid using craniofacial variables with small dimensions this may be neither practical nor desirable. In such cases repeat measurements may be the best means for optimizing reliability.

Adult↗
PubMedDate not supplied

Interexaminer reliability of the electromagnetic radiation receiver for determining lumbar spinal joint dysfunction in subjects with low back pain.

Twenty subjects (6 male, 14 female) with low back pain were examined by two experienced and licensed chiropractic doctors (E1 and E2). Both examiners examined the patients using a Toftness Electromagnetic Radiation Receiver (EMRR) and by manual palpation (MP) of the spinous processes. Interexaminer reliability was calculated at three sites (L3, L4, L5) for the following combinations: a) E1,MP--E2,MP; b) E1,EMRR--E2,EMRR; c) E1,MP--E2,EMRR; and) d) E2,MP--E1,EMRR, and intraexaminer reliability was calculated for the following variables: e) E1,MP--E1,EMRR; and f) E2,MP--E2,EMRR. Results of a Kappa coefficient analysis for interexaminer reliability of the stated combinations and at the specific sites were: a) -0.071, 0.400, 0.200; b) -0.013, 0.100, -0.120; c) 0.286, 0.300, 0.200; d) -0.081, 0.000, 0.048. These results predominantly indicate a poor to fair interexaminer reliability. The results of a Kappa coefficient analysis for intraexaminer reliability of the stated combinations were: e) 0.111, 0.400, 0.737; f) 0.000, 0.100, 0.368. These results indicate a poor to fair reliability. It was concluded that in subjects with low back pain the EMRR may not be a reliable indicator of spinal joint dysfunction.

Adult↗
PubMedDate not supplied

Effects of specific criteria and calibration on examiner reliability.

The purpose of this pilot study was to investigate the use of specific criteria and examiner calibration on the reliability of inexperienced examiners on dental sealant evaluations. Dental (N = 8) and dental hygiene (N = 8) students participated as examiners. The study objectives were to identify differences in calibrated and non-calibrated examiners, examiners calibrated by an expert or non-expert, and reliability between dental and dental hygiene student examiners. A criterion-referenced evaluation form was used to evaluate dental sealant end product on 20 teeth, twice by each examiner. Eight of 16 examiners participated in a one-hour calibration session between evaluations. The session consisted of a discussion of operational definitions, the evaluation procedure for dental sealants, and use of the criterion-referenced form. Intra- and interexaminer reliabilities were measured. There were no statistically significant differences (p less than .05) in intraexaminer reliability. Although calibration produced no significant increase in interexaminer reliability, the post-training reliability scores for the group calibrated by an expert decreased, and scores for the group calibrated by a non-expert increased. No significant difference was found in reliability between dental and dental hygiene student examiners.

Humans↗
PubMed1989

Reliability in perimetry.

As perimetric instrumentation becomes more sophisticated, patient reliability emerges as an important limiting factor in testing. Modern instrumentation for threshold and suprathreshold perimetry incorporate up to five separate indicators of patient reliability. For these perimetric methods, patient reliability is enhanced with specific techniques such as refractive correction, control of pupil size, and actively monitoring patient responses. With the manual (Goldmann) perimeter and the tangent screen, special statokinetic techniques help in both assessment and enhancement of patient reliability. In screening perimetry, reliability is assessed by analyzing the relative number, relative location, and repeatability of misses. Reliability in confrontation perimetry is both assessed and enhanced by using finger-counting and color-naming techniques. Review of the ophthalmic literature on perimetry shows how the various methods of patient reliability assessment and enhancement can be applied in the clinic.

Humans↗
PubMed1984

A study of the reliability of carcinoembryonic antigen blood levels in following the course of colorectal cancer.

Twenty-three patients were studied to assess the reliability of carcinoembryonic antigen (CEA) levels in following the course of colorectal cancer. CEA estimations were made prior to surgery and again postoperatively. The resected specimens were allocated a Dukes' Stage and histological grading (well, moderate or poorly differentiated). In addition, sections were stained for the presence of CEA by an immunoperoxidase method. Of the 23 patients, twelve had either disseminated disease at initial surgery or subsequently developed metastasis/recurrence. Eleven remain disease-free at a minimum follow-up of one year. In all of these the reliability of plasma CEA values in reflecting the disease status has been assessed. No false positive elevations of CEA were found. Three factors emerge as positive predictors of CEA estimation reliability: pre-operative CEA elevation; tumour grading as well differentiated; dark staining for the presence of CEA. These factors identified 15 of the 18 patients (83%) in whom CEA appeared reliable and were not present in any of the five patients where CEA was not reliable. This reliability achieves statistical significance (X2 = 8.5, p less than 0.02). Histological demonstration of CEA may contribute to the reliability placed on plasma CEA estimations and should be considered if serial estimations are to be performed.

Carcinoembryonic Antigen↗
PubMed1994

Reliability of measuring isometric and isokinetic peak torque, rate of torque development, integrated electromyography, and tibial nerve conduction velocity.

To determine the reliability of measures used in neuromuscular diagnosis and rehabilitation, 23 adults underwent identical testing on two occasions. Intraclass correlation coefficients (ICC) showed the reliability of peak torque measurement to depend both on the movement tested and velocity of contraction (leg extension ICC = 0.64-0.94, plantar flexion ICC = 0.55-0.76, leg press ICC = 0.72-0.91). Peak rate of torque development (RTD) and the percentage of peak torque at peak RTD were not reliable for any movement (ICC = 0.02-0.28). Mean RTD between 30% and 60% of peak torque was unreliable for leg press (ICC = 0.46), yet fairly reliable for both knee extension (ICC = 0.61) and plantar flexion (ICC = 0.63). Mean integrated electromyography (IEMG) showed fair to good reliability for isometric and 1.05 rad.s-1 leg press (ICC = 0.66, 0.90, respectively), and plantar flexion and leg extension (ICC = 0.75-0.89). Tibial nerve conduction velocity was highly reliable (ICC = 0.89). A range of reliabilities can be expected when measuring these variables, and must be considered when interpreting neuromuscular data.

Adult↗
PubMedDate not supplied

Forearm pronation and supination: reliability of absolute torques and nondominant/dominant ratios.

This study examined the reliability of pronation and supination measurements expressed in absolute units (newton-meters [Nm]) and nondominant/dominant ratios (%), and determined isometrically using the BTE (WS20) and the Cybex (340) dynamometers. Twenty-one healthy men and 22 healthy women were tested twice on each machine, within 14 days. Twelve of 16 reliability coefficients for absolute torques were considered acceptable (> 0.75) when determined as the reliability of two repetitions on one occasion, while 14 of 16 coefficients were acceptable when determined as the reliability of two repetitions on each of two occasions. However, reliability coefficients for the nondominant/dominant ratios were not acceptable on one (0 of 8 coefficients > 0.75) or two (2 of 8 coefficients > 0.75) occasions. Ratio data were also characterized by larger standard errors of measurement (SEMs) and wider 95% confidence intervals, relative to the sample mean and standard deviation. Overall, reliability coefficients, SEMs, and 95% confidence intervals were similar for men and women, pronation and supination movements, and the BTE and Cybex dynamometers. The authors suggest that absolute scores be used when possible, as these data tend to provide more reliable measurements--especially when the clinician has only limited test occasions to establish baseline scores.

Bias↗