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Myocardial perfusion SPECT reconstruction: receiver operating characteristic comparison of CAD detection accuracy of filtered backprojection reconstruction with all of the clinical imaging information available to readers and solely stress slices iteratively reconstructed with combined compensation.

BACKGROUND: Past receiver operating characteristic (ROC) studies have demonstrated that single photon emission computed tomography (SPECT) perfusion imaging by use of iterative reconstruction with combined compensation for attenuation, scatter, and detector response leads to higher area under the ROC curve (A(z)) values for detection of coronary artery disease (CAD) in comparison to the use of filtered backprojection (FBP) with no compensations. A new ROC study was conducted to investigate whether this improvement still holds for iterative reconstruction when observers have available all of the imaging information normally presented to clinical interpreters when reading FBP SPECT perfusion slices. METHODS AND RESULTS: A total of 87 patient studies including 50 patients referred for angiography and 37 patients with a lower than 5% likelihood for CAD were included in the ROC study. The images from the two methods were read by 4 cardiology fellows and 3 attending nuclear cardiologists. Presented for the FBP readings were the short-axis, horizontal long-axis, and vertical long-axis slices for both the stress and rest images; cine images of both the stress and rest projection data; cine images of selected cardiac-gated slices; the CEQUAL-generated stress and rest polar maps; and an indication of patient gender. This was compared with reading solely the iterative reconstructed stress slices with combined compensation for attenuation, scatter, and resolution. With A(z) as the criterion, a 2-way analysis of variance showed a significant improvement in detection accuracy for CAD for the 7 observers (P = .018) for iterative reconstruction with combined compensation (A(z) of 0.895 +/- 0.016) over FBP even with the additional imaging information provided to the observers when scoring the FBP slices (A(z) of 0.869 +/- 0.030). When the groups of 3 attending physicians or 4 cardiology fellows were compared separately, the iterative technique was not statistically significantly better; however, the A(z) for each of the 7 observers individually was larger for iterative reconstruction than for FBP. Compared with results from our previous studies, the additional imaging information did increase the diagnostic accuracy of FBP for CAD but not enough to undo the statistically significantly higher diagnostic accuracy of iterative reconstruction with combined compensation. CONCLUSIONS: We have determined through an ROC investigation that included two classes of observers (experienced attending physicians and cardiology fellows in training) that iterative reconstruction with combined compensation provides statistically significantly better detection accuracy (larger A(z)) for CAD than FBP reconstructions even when the FBP studies were read with all of the extra clinical nuclear imaging information normally available.

Coronary Artery Disease↗

PubMed2006

Do risk factors influence the diagnostic accuracy of noninvasive coronary angiography with multislice computed tomography?

BACKGROUND: Multislice computed tomography (MSCT) is a relatively new noninvasive imaging modality in the evaluation of patients with suspected coronary artery disease (CAD). Whether diagnostic accuracy is influenced by gender or risk factors for CAD is currently unknown and was evaluated in this study. METHODS AND RESULTS: In 197 patients (171 men and 26 women; mean age, 60 +/- 11 years) 16-slice MSCT was performed and compared with invasive coronary angiography at 2 different centers (Leiden and Rotterdam, The Netherlands). Diagnostic accuracy for the detection of 50% luminal narrowing or greater was calculated for all patients combined, as well as for patients with known versus suspected CAD. In addition, diagnostic accuracy was determined in men versus women and in different subsets of patients based on the presence of risk factors for CAD including hypertension, type 2 diabetes mellitus, hypercholesterolemia, and obesity. Only segments with a diameter of 2.0 mm or greater were evaluated, whereas smaller segments and stents were excluded from the analysis. Overall, a sensitivity and specificity of 99% and 86%, respectively, on a patient level were demonstrated, with corresponding positive and negative predictive values of 95% and 96%, respectively. Similar values were observed in the different subsets of patients, with no statistical differences. CONCLUSION: These findings confirm the high diagnostic accuracy of MSCT, regardless of gender or risk factors.

Aged↗

PubMed2005

Evaluation of a clinical aberrometer for lower-order accuracy and repeatability, higher-order repeatability, and instrument myopia.

BACKGROUND: Refractive surgery has stimulated the development of aberrometers, which are instruments that measure higher-order aberrations. The purpose of this study was to test one clinical aberrometer, the Complete Ophthalmic Analysis System (COAS), for its accuracy, repeatability, and instrument myopia for measuring sphere and astigmatism and its repeatability for measuring higher-order aberrations. METHODS: Aberrations of 56 normal eyes (28 subjects) were measured with and without cycloplegia using a COAS, a conventional autorefractor and by subjective refraction. We evaluated lower-order accuracy (sphere and astigmatism) of the COAS and autorefractor by comparing that data with that of subjective refraction. We also tested COAS lower- and higher-order repeatability for 5 measurements taken in less than 1 minute. We evaluated instrument myopia by comparing cycloplegic and noncycloplegic measurements of the same eye. Data were analyzed for a 5.0-mm-diameter pupil. RESULTS: Mean COAS spherical error was between -0.1 and +0.4 diopters (D), depending on cycloplegia and the kind of sphere power computation selected. Cylinder power errors were less than 0.1 D. COAS repeatability coefficients were better than 0.25 D, and instrument myopia was less than 0.4 D. These were comparable with those of autorefraction. Higher-order repeatability was sufficient to allow reliable measurement of normal third-order aberrations and spherical aberration. CONCLUSIONS: Accuracy, repeatability, and instrument myopia of the COAS are similar to those of a conventional autorefractor. Accuracy and repeatability are also similar to those of subjective refraction. Like an autorefractor, the COAS provides instantaneous, objective measurements of sphere and astigmatism, but it also measures higher-order aberrations. We found that it is capable of reliably measuring problematic higher-order aberrations and is therefore a valuable asset for modern clinical eye care.

Adult↗

PubMed2005

Accuracy and precision of radiostereometric analysis in the measurement of three-dimensional micromotion in a fracture model of the distal radius.

The purpose of the current study was to verify the feasibility of radiostereometric analysis (RSA) in monitoring three-dimensional fracture micromotion in fractures of the distal radius. The experimental set-up consisted of a simulated model of an extra-articular Colles' fracture, including metallic beads inserted into the bone on either side of the fracture site. The model was rigidly fixed to high precision micrometer stages allowing controlled translation in three axes and rotation about the longitudinal and transverse axes. The whole construct was placed inside a RSA calibration cage with two perpendicular radiographic film cassettes. Accuracy was calculated as the 95% prediction intervals from the regression analyses between the micromotion measured by RSA and actual displacements measured by micrometers. Precision was determined as the standard deviation of five repeated measurements of a 200 microm displacement or a 0.5 degrees rotation along a specific axis. Translations from 25 microm to 5mm were measured with an accuracy of +/-6 microm and translations of 200 microm were measured with a precision of 2-6 microm. Rotations ranging from 1/6 degrees to 2 degrees were measured with an accuracy of +/-0.073 degrees and rotations of 1/2 degrees were measured with a precision of 0.025 degrees -0.096 degrees . The number of markers and their configuration had greater impact on the accuracy and precision of rotation than on those of translation. Aside from the unknown rate of clinical marker loosening, the current results favor the use of at least four markers in each bone fragment in distal radius fractures. These results suggest a strong rationale for the use of RSA as an objective tool for comparing different treatment modalities and novel bone graft substitutes aimed at stabilization of fractures of the distal radius.

Humans↗

PubMed2005

Accuracy of newly formulated fast-setting elastomeric impression materials.

STATEMENT OF PROBLEM: Elastomeric impression materials have been reformulated to achieve a faster set. The accuracy of fast-setting elastomeric impression materials should be confirmed, particularly with respect to disinfection. PURPOSE: The purpose of this study was to assess the accuracy of 2 types of fast-setting impression materials when disinfected with acid glutaraldehyde. MATERIAL AND METHODS: Impressions of the mandibular arch of a modified dentoform master model were made, from which gypsum working casts and dies were formed. Measurements of the master model and working casts included anteroposterior (AP) and cross-arch (CA) dimensions. A stainless steel circular crown preparation incorporated within the master model was measured in buccolingual (BL), mesiodistal (MD), and occlusogingival (OG) dimensions and compared to measurements from recovered gypsum dies. The impression materials examined were a fast-set vinyl polysiloxane (VPS-FS, Aquasil Ultra Fast Set), a fast-set polyether (PE-FS, Impregum Penta Soft Quick Step), and a regular-setting polyether as a control (PE, Impregum Penta). Disinfection involved immersion in 3.5% acid glutaraldehyde (Banicide Advanced) for 20 minutes, and nondisinfected impressions served as a control. Linear measurements were made with a measuring microscope. Statistical analysis utilized a 2-way and single-factor analysis of variance with pair-wise comparison of mean values when appropriate. Hypothesis testing was conducted at alpha = .05 RESULTS: No differences were shown between the disinfected and nondisinfected conditions for all locations. However, there were statistical differences among the 3 materials for AP, CA, MD, and OG dimensions. AP and CA dimensions of all working casts were larger than the master model. Impressions produced oval-shaped working dies for all impression materials. PE and PE-FS working dies were larger in all dimensions compared to the stainless steel preparation, whereas VPS-FS-generated working dies were reduced in OG and MD dimensions. Differences detected were small and may not be of clinical significance. CONCLUSIONS: Impression material accuracy was unaffected by immersion disinfection. The working casts and dies were similar for PE and PE-FS. VPS-FS generated gypsum dies that were smaller in 2 of the 3 dimensions measured and may require additional die relief. Overall accuracy was acceptable for all 3 impression materials.

Analysis of Variance↗

PubMed2006

Influence of investment type and sprue number on the casting accuracy of titanium crown margins.

STATEMENT OF PROBLEM: Titanium offers biocompatibility and adequate mechanical properties for fabricating dental prostheses; however, casting difficulties can compromise the accuracy of titanium crown margins. PURPOSE: The aim of this study was to evaluate the influence of investment type and number of sprues on accuracy of crown castings made with commercially pure titanium. MATERIAL AND METHODS: The casting accuracy was evaluated indirectly by determining the deficiency of titanium crown margins cast using the lost-wax technique. Crown margins were recorded in a silicone impression material. The degree of marginal rounding was measured and margin deficiencies were calculated. Seventy-five acrylic resin crown patterns with wax margins were prepared on a stainless steel stylized crown die having a 30-degree beveled finish line. Fifteen patterns were selected for the control group, and the degree of wax margin rounding was determined (group W, control). The remaining 60 were divided into 4 groups of 15 each, and cast using 2 different titanium investments: a monoammonium dihydrogenphosphate-bonded investment (Rematitan Plus; groups PI and PII), and a magnesium oxide-bonded investment (Rematitan Ultra; groups UI and UII). Each pattern was cast with either 1 (groups PI and UI) or 2 (groups PII and UII) sprues. Margin configurations for both wax pattern and cast specimens were measured and recorded with the same method, using silicone impressions of the margins. After polymerization, the silicone material was sectioned precisely in 8 locations through the margin area so that cross-sections of the margins could be observed. Marginal deficiency was determined using microscopic measurements from the silicone patterns and calculations. Data were subjected to 2-way analysis of variance (alpha=.05). RESULTS: Specimens from group W presented a mean marginal deficiency of 19 +/- 6 microm. The analysis of variance indicated a significant difference for the main factors, investment (P<.01) (P=91 +/- 28 microm and U=78 +/- 17 microm) and sprue number (P<.001) (I=97 +/- 23 microm and II=72 +/- 16 microm), as well as for interaction (P<.05) (PI=109 +/- 25 microm; PII=73 +/- 17 microm; UI=85 +/- 15 microm; and UII=71 +/- 16 microm). CONCLUSION: Within the limitations of this study, investment U provided better casting accuracy than investment P. Two sprues provided more accurate results than 1 sprue; however, this effect was more notable for investment P, as it produced similar results between groups PII and UII.

Analysis of Variance↗

PubMed2003

Evaluation of a multimodality image (CT, MRI and PET) coregistration procedure on phantom and head and neck cancer patients: accuracy, reproducibility and consistency.

BACKGROUND AND PURPOSE: In radiotherapy planning of head and neck tumors, coregistration of various anatomical (e.g. CT and MRI) and functional (e.g. PET) images is a promising way to improve the delineation of the target volumes. In this paper, we report data on accuracy, reproducibility and consistency of an interactive coregistration procedure in a specifically designed phantom and in a group of patients with primary head and neck tumors. PATIENTS AND METHODS: A phantom and a group of four patients with pharyngo-laryngeal tumors were imaged by CT scan (taken as the reference image), MRI (T1- and T2-weighed sequences) and PET (transmission and FDG emission). Sets of images were coregistered using an interactive rigid coregistration method based on interactive surface segmentation. Translational and rotational displacements relative to the reference CT scan were measured and expressed in terms of accuracy, reproducibility (inter- and intra-observer variation) and consistency (between T1- and T2-weighed MRI). RESULTS: Coregistration accuracy was in the range of 0.8-6.2 mm and 1.2-4.6 mm for the phantom and the patients, respectively. Accuracy was slightly worse in the z direction, and was significantly correlated with the spatial resolution of the imaging modalities, at least for the phantom. Inter- and intra-observer variations were very small and always far below the residual variance. Consistency was perfect except in the y direction. CONCLUSION: Providing adequate set-up is chosen, accurate coregistration of CT, MR and FDG-PET images can be obtained in the head and neck area. Coregistration was consistent and highly reproducible among observers.

Head and Neck Neoplasms↗

PubMed2006

Teaching recognition of agonal breathing improves accuracy of diagnosing cardiac arrest.

OBJECTIVE: Agonal breathing is present in up to 40% of pre-hospital cardiac arrests and is commonly mistaken as a sign of circulation leading to omission of bystander resuscitation. The aim of this study was to test the hypothesis that specific tuition on agonal breathing improves the accuracy of checking for signs of circulation as a diagnostic test for cardiac arrest. METHODS: First year medical students were randomised to control or intervention groups. The control group were taught standard CPR according to current guidelines. The intervention group received standard CPR training plus specific tuition on the characteristics of agonal breathing. Two weeks after initial training, the students' ability to recognise cardiac arrest was tested using a simulated cardiac arrest victim demonstrating normal, absent or agonal breathing. Diagnostic accuracy, sensitivity and specificity for the decision to start CPR was calculated. RESULTS: Sixty-four students were equally randomised to intervention and control groups. The intervention group had greater diagnostic accuracy for cardiac arrest compared to the control group (90% versus 78%, P=0.03). The intervention group were more likely to recognise cardiac arrest correctly and initiate CPR than the control group (sensitivity 90% versus 78%, P=0.02). The improved results were predominantly due to recognition that agonal breathing is a sign of cardiac arrest (75% intervention group versus 43% control group, P=0.01). CONCLUSION: This study demonstrates improved diagnostic accuracy and sensitivity of "checking for signs of circulation" by teaching CPR providers to recognise agonal breathing as a sign of cardiac arrest.

Cardiopulmonary Resuscitation↗

PubMed2004

The combined effect of nonlinear filtration and window size on the accuracy of tissue displacement estimation using detected echo signals.

In cardiac elastography, the regional strain and strain rate imaging is based on displacement estimation of tissue sections within the heart muscle carried out with various block-matching techniques (cross-correlation, sum of absolute differences, sum of squared differences, etc.). The accuracy of these techniques depends on a combination of ultrasonic imaging parameters such as ultrasonic frequency of interrogation, signal-to-noise ratio, size of a kernel used in a block-matching algorithm, type of data and speckle decorrelation. In this paper, we discuss the possibility to enhance the accuracy of the displacement estimation via nonlinear filtering of B-mode images before block-matching operation. The combined effect of a filter algorithm and a kernel size on the accuracy of the displacement estimation is analyzed using a 36-frame sequence of grayscale B-mode images of a human heart acquired by an ultrasound system operating at 1.77 MHz. It is shown that the nonlinear filtering of images enables to obtain the desired accuracy (less than one pixel) of the displacement estimation with smaller kernels than without filtering. These results are obtained for two filters--an adaptive anisotropic diffusion filter and a nonlinear Gaussian filter chain.

Algorithms↗

PubMed2005

Comparison of extended field of view and dual image ultrasound techniques: accuracy and reliability of distance measurements in phantom study.

This study was undertaken to investigate and compare the accuracy and reliability of dual image and extended field-of-view (EFOV) ultrasound (US) techniques in distance measurements using acoustic phantoms. Ten tissue phantoms were constructed and were scanned twice with an interval of 3 days by two operators. Measurements of various known distance (ranging from 4.6 to 7.2 cm) in the phantoms were made with dual image and EFOV US. Results showed that both dual image and EFOV US have a high accuracy and reliability in distance measurements, with the EFOV US (r = 0.997 to 0.998, reproducibility = 99.8%, repeatability = 98.2 to 99.8%) being slightly more accurate and reliable than dual image US (r = 0.948 to 0.981, reproducibility = 94.6%, repeatability = 89.6 to 97.9%). EFOV US has a higher accuracy and reliability than dual image US in distance measurements. However, the dual image US is a useful alternative with a high accuracy and reliability when EFOV US is not available.

Data Display↗

PubMed2004

Accuracy and completeness in reporting family history of prostate cancer by unaffected men.

OBJECTIVES: To determine the accuracy of prostate cancer reports and completeness of the family history provided by unaffected men with a family history of prostate cancer. A positive family history is associated with increased prostate cancer risk and could influence surveillance recommendations and patient selection for genetic testing in the future. However, the accuracy of prostate cancer reports and completeness of the family history provided by unaffected men is poorly understood. METHODS: Eligible respondents were ascertained through participation in a population-based study of prostate cancer. The family history was collected by questionnaire and compared with the verified research pedigree. Information about the family history was also independently collected from spouses. A standard statistical method was used to determine the variables associated with accuracy and failure to report cases. RESULTS: A total of 154 unaffected men (51%) responded. Most (82%) reports of prostate cancer cases were verified. Overall, 63% reported a family history that precisely matched the verified family history. The respondents' wives contributed little additional information. Age and degree of relationship to an affected person were associated with both accuracy and completeness of the family history. Verification altered the empirical risk category of 29% of the respondents; however, most (93%) remained at increased risk. CONCLUSIONS: Unaffected men with a family history of prostate cancer generally provide a reliable family history. We conclude that surveillance advice can be reasonably based on a man's reported family history. However, the identification of certain high-risk individuals, which may be relevant for selection for genetic testing in the future, requires more extensive ascertainment of the family history.

Adult↗

PubMed2004

Novel algorithm for improving accuracy of ultrasound measurement of residual urine volume according to bladder shape.

OBJECTIVES: To suggest a novel algorithm based on individually determined proportionality constants to improve the accuracy of noninvasively calculated residual urine volume using ultrasound bladder images. METHODS: The residual urine volume of 116 subjects was calculated from ultrasound images obtained using a conventional two-dimensional ultrasound device at two institutions. The proposed method uses individually determined proportionality constants for specific bladder shapes. The corresponding true residual volumes were determined by measuring the catheterized volume. The accuracy of our method was confirmed by comparing the mean and standard deviation of the fractional absolute error (FAE) versus true volume with values obtained using other methods, which rely on fixed constants. RESULTS: The calculated residual bladder volume of 116 patients correlated significantly (r = 0.94, P <0.001) and the differences from the true values were not statistically significant (P = 0.42). The mean FAE was 0.17 +/- 0.10. Subgroups divided by sex, postvoid residual urine volume (over and under 150 mL), and institution produced different results (mean FAE for men 0.15 +/- 0.11 and for women 0.18 +/- 0.12; mean FAE for greater than 150 mL, 0.16 +/- 0.11 and for less than 150 mL, 0.17 +/- 0.14; mean FAE for Seoul National University Hospital 0.15 +/- 0.10 and for Seoul National University Bundang Hospital 0.18 +/- 0.18). Our method provided better accuracy than other known formulas using a conventional two-dimensional ultrasound scanner. The latter multiply the product of the sagittal height and depth and transverse width by a fixed coefficient. CONCLUSIONS: Our method, based on individually determined proportionality constants, improved the accuracy of residual bladder volume determinations. The proposed algorithm can easily be implemented on a personal computer connected to a conventional ultrasound imaging unit.

Adult↗

PubMed2006

Accuracy of an anaemia scoring chart applied on goats in sub-humid Kenya and its potential for control of Haemonchus contortus infections.

We tested the practical application of an anaemia scoring chart (the FAMACHA chart) as a method for controlling Haemonchus contortus in goats kept under smallholder conditions in a sub-humid area of Central Kenya. The objectives were: (1) to test the accuracy of the FAMACHA chart in identifying anaemic goats (PCV< or =18); (2) to quantify the proportion of goats left untreated at farm level when using the chart. On each of two farms, Small East African goats of various ages were allocated to two treatment groups; a FAMACHA group (F1 (n=34) and F2 (n=31) on farms 1 and 2, respectively) and a control group (C1 (n=34) and C2 (n=30)). In F1 and F2 goats with a FAMACHA score of 3, 4 or 5 were treated with anthelmintic after scoring. In C1 and C2 goats were treated every 4 weeks from 15 February to 20 July. Every 2 weeks all goats were scored with the FAMACHA chart and weighed. Furthermore, faecal samples were collected for faecal egg counts (FEC) and blood samples were collected for packed cell volume (PCV) determination. H. contortus was found to be the predominant nematode on both farms. The mean FECs were higher on farm 1 compared to farm 2, while in contrast the mean PCV levels were lowest on farm 2. The latter was most likely due to the presence of Fasciola spp., flea and tick infections on farm 2. The accuracy of the chart was evaluated by using PCV as the gold standard for anaemia (PCV< or =18%). The mean percentage of false-negative scorings per sampling was 0.7% on farm 1 and 1.6% on farm 2, while the mean percentage of false-positive scorings was 9.7% and 21.4%, respectively. It is most likely that the accuracy of the chart was negatively affected by the concurrent parasite infections on farm 2. The mean proportion of untreated goats per sampling was 89% and 77% on farm 1 and farm 2. It was concluded that the FAMACHA chart can be a valuable tool for decision-making in control of H. contortus in goats kept under smallholder conditions, without morbidity or mortality unacceptable to the farmer. The application may further reduce the risk of development of anthelmintic resistance by increasing refugia. However, caution should be taken under conditions where other anaemia-causing parasites are present (e.g. Fasciola spp. and ecto-parasites), since this possibly decreases the accuracy of the FAMACHA chart.

Anemia↗

PubMed2005

Two wrongs make a right: linear increase of accuracy of visually-guided manual pointing, reaching, and height-matching with increase in hand-to-body distance.

Measurements were made of the accuracy of open-loop manual pointing and height-matching to a visual target whose elevation was perceptually mislocalized. Accuracy increased linearly with distance of the hand from the body, approaching complete accuracy at full extension; with the hand close to the body (within the midfrontal plane), the manual errors equaled the magnitude of the perceptual mislocalization. The visual inducing stimulus responsible for the perceptual errors was a single pitched-from-vertical line that was long (50 degrees), eccentrically-located (25 degrees horizontal), and viewed in otherwise total darkness. The line induced perceptual errors in the elevation of a small, circular visual target set to appear at eye level (VPEL), a setting that changed linearly with the change in the line's visual pitch as has been previously reported (pitch: -30 degrees topbackward to 30 degrees topforward); the elevation errors measured by VPEL settings varied systematically with pitch through an 18 degrees range. In a fourth experiment the visual inducing stimulus responsible for the perceptual errors was shown to induce separately-measured errors in the manual setting of the arm to feel horizontal that were also distance-dependent. The distance-dependence of the visually-induced changes in felt arm position accounts quantitatively for the distance-dependence of the manual errors in pointing/reaching and height matching to the visual target: The near equality of the changes in felt horizontal and changes in pointing/reaching with the finger at the end of the fully extended arm is responsible for the manual accuracy of the fully-extended point; with the finger in the midfrontal plane their large difference is responsible for the inaccuracies of the midfrontal-plane point. The results are inconsistent with the widely-held but controversial theory that visual spatial information employed for perception and action are dissociated and different with no illusory visual influence on action. A different two-system theory, the Proximal/Distal model, employing the same signals from vision and from the body-referenced mechanism with different weights for different hand-to-body distances, accounts for both the perceptual and the manual results in the present experiments.

Adaptation, Ocular↗

PubMed2005

Role of feedback in the accuracy of perceived direction of motion-in-depth and control of interceptive action.

We quantified the accuracy of the perception of the absolute direction of motion-in-depth (MID) of a simulated approaching object using a perceptual task and compared those data with the accuracy of estimating the passing distance measured by means of a simulated catching task. For the simulated catching task, movements of the index finger and thumb of the observer's hand were tracked as participants tried to "catch" the simulated approaching object. A sensation of MID was created by providing monocular and/or binocular retinal image information. Visual stimuli were identical for perceptual and simulated catching tasks. We confirm previous reports that in the perceptual task, observers judged the object to pass wider of the head than indicated by the visual information provided. Although accuracy improved when auditory feedback was added to the perceptual (button pressing) task, consistent overestimates were still recorded. For the no-feedback simulated catching task, observers consistently overreached, i.e., the hand was further away from the midline than the simulated object at the time of hand closure. When auditory feedback was added to the simulated catching task successful catching was achieved. The relative accuracy in binocular and monocular conditions for individual observers could be partially explained by individual differences in sensitivity to unidirectional changes in angular size and changes in relative disparity. We conclude that catching an approaching ball requires that errors in the perceived direction of MID are corrected by feedback-driven learning in the motor system, and that this learning is more easily achieved for the catching action than for button pressing.

Auditory Perception↗

PubMed2006

Conventional energy and macronutrient variables distort the accuracy of children's dietary reports: illustrative data from a validation study of effect of order prompts.

OBJECTIVE: Validation-study data are used to illustrate that conventional energy and macronutrient (protein, carbohydrate, fat) variables, which disregard accuracy of reported items and amounts, misrepresent reporting accuracy. Reporting-error-sensitive variables are proposed which classify reported items as matches or intrusions, and reported amounts as corresponding or overreported. METHODS: 58 girls and 63 boys were each observed eating school meals on 2 days separated by > or =4 weeks, and interviewed the morning after each observation day. One interview per child had forward-order (morning-to-evening) prompts; one had reverse-order prompts. Original food-item-level analyses found a sex-x-order prompt interaction for omission rates. Current analyses compared reference (observed) and reported information transformed to energy and macronutrients. RESULTS: Using conventional variables, reported amounts were less than reference amounts (ps<0.001; paired t-tests); report rates were higher for the first than second interview for energy, protein, and carbohydrate (ps< or =0.049; mixed models). Using reporting-error-sensitive variables, correspondence rates were higher for girls with forward- but boys with reverse-order prompts (ps< or =0.041; mixed models); inflation ratios were lower with reverse- than forward-order prompts for energy, carbohydrate, and fat (ps< or =0.045; mixed models). CONCLUSIONS: Conventional variables overestimated reporting accuracy and masked order prompt and sex effects. Reporting-error-sensitive variables are recommended when assessing accuracy for energy and macronutrients in validation studies.

Bias↗

PubMed1987

Methodologies for the measurement of bone density and their precision and accuracy.

Radiographic methods of determining bone density have been available for many years, but recently most of the efforts in this field have focused on the development of instruments which would accurately and automatically measure bone density by absorption, or by the use of x-ray computed tomography (CT). Single energy absorptiometers using I-125 have been available for some years, and have been used primarily for measurements on the radius, although recently equipment for measuring the os calcis has become available. Accuracy of single energy measurements is about 3% to 5%; precision, which has been poor because of the difficulty of exact repositioning, has recently been improved by automatic methods so that it now approaches 1% or better. Dual energy sources offer the advantages of greater accuracy and the ability to measure the spine and other large bones. A number of dual energy scanners are now on the market, mostly using gadolinium-153 as a source. Dual energy scanning is capable of an accuracy of a few percent, but the precision when scanning patients can vary widely, due to the difficulty of comparing exactly the same areas; 2 to 4% would appear to be typical. Quantitative computed tomography (QCT) can be used to directly measure the trabecular bone within the vertebral body. The accuracy of single-energy QCT is affected by the amount of marrow fat present, which can lead to underestimations of 10% or more. An increase in marrow fat would cause an apparent decrease in bone mineral. However, the precision can be quite good, 1% or 2% on phantoms, and nearly as good on patients when four vertebrae are averaged. Dual energy scanning can correct for the presence of fat, but is less precise, and not available on all CT units. QCT of the femoral neck has recently been attempted, but presents difficulties that make it unlikely to become widely accepted. Recently there has been much interest in using gamma cameras for dual energy bone density measurements. Although this can present some difficulties, several groups reportedly have overcome them, and this technique may have more widespread application in the future.

Absorptiometry, Photon↗

PubMed1995

Diagnostic accuracy of heart rate-adjusted ST segments compared with standard ST-segment criteria.

We compared the accuracy of ST segment/heart rate (ST/HR) index with that of standard criteria (> or = 0.1 mV horizontal/downsloping ST depression 80 ms after the J point) in 121 patients who had undergone angiography (49 with > or = 1 lesion with > or = 50% stenosis) and 50 clinically normal subjects. All exercise tests used the Cornell protocol and computer measurements of maximal ST depression 80 ms after the J point. Thresholds with equal specificity to standard criteria were determined for ST/HR index using each of the 2 normal groups (those who were normal by angiography and those who were clinically normal). In using only patients who underwent angiography, we found that the ST/HR index had a sensitivity that was not significantly greater than that of standard criteria (standard criteria 51%, ST/HR index 59%; p = 0.21). However, the receiver-operating characteristic curve area increased from 64 +/- 4 to 68 +/- 4 (p < 0.02). When clinically normal subjects were used instead of patients without angiographic disease, there was a clearly discernible improvement in sensitivity of ST/HR index over standard criteria (standard criteria 51%, ST/HR index 69%; p < 0.05). The associated curve areas were 69 +/- 4 and 79 +/- 3 (p < 0.001). Therefore, accuracy of the ST/HR index was marginally better than standard criteria only in patients who underwent angiography. When clinically normal subjects were used, the accuracy of the ST/HR index was definitely better than standard criteria. We conclude that the demonstration of improved accuracy of the ST/HR index depends on the population being tested.

Adult↗