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PubMed1994

Reliability and validity of the grading of heterotopic ossification.

The purpose of this study is to assess the reliability and validity of the Brooker grading of heterotopic ossification. Anteroposterior hip radiographs of 77 patients, taken 6 months following total hip arthroplasty, were blindly evaluated twice by two surgeons using the Brooker scale. Patients were also evaluated with the Harris hip scale, and range of motion of the hip was determined. All inconsistencies in heterotopic ossification grading were reviewed by the same two surgeons who developed six points of clarification to minimize ambiguities in the Brooker grading criteria. A second set of 76 radiographs were reviewed by the two surgeons using this modified Brooker index. The intraobserver reliability of the two readers was good, with agreements of 77 and 86% and weighted kappa values of 0.63 and 0.69, respectively. The two surgeons demonstrated fair interobserver reliability on the first reading (agreement of 68% and weighted kappa of 0.57) that improved to a good level of reliability (agreement of 77% and weighted kappa of 0.68) using the revised Brooker index. The grade of heterotopic ossification was correlated (r = -.25, P = .005) with the aggregate range of hip motion, but had no relationship to the patient's Harris rating. In conclusion, the grading of heterotopic ossification is reliable. Although the severity of heterotopic ossification did not correlate with the Harris scale, the relationship between heterotopic ossification and range of motion indicates that the Brooker index is also a valid measurement.

Hip Joint↗
PubMedDate not supplied

Factor validity and reliability for the Aberrant Behavior Checklist-Community in a Japanese population with mental retardation.

To assess the factor validity and reliability for the Japanese version of the Aberrant Behavior Checklist-Community (ABC-Community), 322 subjects with moderate to profound mental retardation (188 males and 134 females, mean age 29.79 +/- 12.45) were rated by the staff at the residential facilities in Wakayama Prefecture, Japan. Rating data were analyzed by factor analysis using the principal factoring method with iteration, followed by oblique rotation. The internal consistency was estimated by Cronbach's alpha. Of these subjects, 43 were rated twice with an interval of 4 weeks to confirm the test-retest reliability and 33 were rated by pairs of raters for interrater reliability. Forty-eight of 58 items loaded most heavily on the same factors as in the original factor solution. Coefficient alpha raged from .85 to .95 across five subscales. The test-retest reliability was high with Spearman's rank correlation coefficient ranging from .84 to .90. Although the correlation coefficients for interrater reliability tests were somewhat lower (.58 to .78), they were all statistically significant (p < .001). The Japanese version of ABC Community was comparative to the original and was useful for assessing behavior problems in Japanese persons with mental retardation.

Adolescent↗
PubMed1990

Reliability of estimates of changes in mental status test performance in senile dementia of the Alzheimer type.

The concept of the reliability of a measure can also be applied to its change over time. In this study we consider the growth curve approach to estimating the reliability of change, in the context of cognitive status as measured by the Mini-Mental State Examination (MMSE) and the Blessed and Tomlinson Dementia Rating Scale (DRS) in patients with senile dementia of the Alzheimer type (SDAT). The reliability of the estimates of change is shown to depend primarily upon the length of time of observation, not the number of observations made. The estimated reliability coefficient for the change in MMSE (or DRS) at 6 months is 0.16 (or 0.08); at 2 years is 0.75 (or 0.57). The concept of signal-to-noise ratio is introduced to compare reliabilities in change scores.

Alzheimer Disease↗
PubMed1991

The Toronto Breast Self-Examination Instrument (TBSEI): its development and reliability and validity data.

The Toronto Breast Self-Examination Instrument (TBSEI) was developed out of the need for a self-administered survey that is reliable and valid. This article describes the development of the TBSEI, its dimensions, and reliability and validity data to support its continued use. To analyze the reliability and validity properties of the three TBSEI scales, we surveyed 729 Toronto, Ontario women. The TBSEI was found to have good face and content validity, internal consistency reliability (0.91, 0.69, 0.85), and test-retest reliability (0.89). Age norms for each of the three scales are also provided. These results are consistent with previous research findings in breast cancer and breast self-examination research.

Adult↗
PubMed1995

Reliability of post-mortem chart diagnoses of schizophrenia and dementia.

The reliability of psychiatric diagnosis has a direct effect on the validity of post-mortem analyses of neuropathological data, yet little is known about the reliability of retrospective diagnostic procedures which rely on review of medical records. In this paper, we report on the reliability of DSM-III-R psychiatric diagnoses assigned by a pool of 8 raters to a set of 106 state hospital charts of elderly, chronic patients who had died while institutionalized and were autopsied. Diagnoses were grouped by general diagnostic class, and Kappa coefficients computed for agreement among raters, as well as for agreement between ultimate consensus diagnoses and those made while subjects were living. Interrater agreement for those diagnoses that occurred most frequently in this sample (e.g. Schizophrenia and Dementia) was excellent, and comparable to the the agreement observed for ratings of live patients. Interrater agreement for less frequently occurring diagnoses (e.g. Mental Retardation, Mood Disorders, other non-Schizophrenic Psychoses) ranged from excellent to poor. We found high agreement between our rates diagnoses and those assigned by state hospital personnel while patients were living, although post-mortem review produced lower rates of diagnosis of both schizophrenia and Alzheimer-type dementias. Overall, results suggest that the reliability of chart review diagnosis is comparable to that obtained from interviews of live patients when experienced raters are used and diagnostic base rates are high enough to produce stable estimates of reliability.

Aged↗
PubMed2006

Interrater reliability in assessing quality of diagnostic accuracy studies using the QUADAS tool. A preliminary assessment.

RATIONALE AND OBJECTIVES: Quality Assessment of Diagnostic Accuracy Studies (QUADAS) is a new tool to measure the methodological quality of diagnostic accuracy studies in systematic reviews. We used data from a systematic review of magnetic resonance spectroscopy (MRS) in the characterization of suspected brain tumors to provide a preliminary evaluation of the inter-rater reliability of QUADAS. MATERIALS AND METHODS: A structured literature search identified 19 diagnostic accuracy studies. These publications were distributed randomly to primary and secondary reviewers for dual independent assessment. Reviewers recorded methodological quality by using QUADAS on a custom-designed spreadsheet. We calculated correlation, percentage of agreement, and kappa statistic to assess inter-rater reliability. RESULTS: Most studies in our review were judged to have used an accurate reference standard. Conversely, the MRS literature frequently failed to specify the length of time between index and reference tests or that the clinicians were unaware of the index test findings when reporting the reference standard. There was good correlation (rho = 0.78) between reviewers in assessment of the overall number of quality criteria met. However, mean agreement for individual QUADAS questions was only fair (kappa = 0.22) and ranged from no agreement beyond chance (kappa < 0) to moderate agreement (kappa = 0.58). CONCLUSION: Inter-rater reliability in our study was relatively low. Nevertheless, we believe that QUADAS potentially is a useful tool for highlighting the strengths and weaknesses of existing diagnostic accuracy studies. Low reliability suggests that different reviewers will reach different conclusions if QUADAS is used to exclude "low-quality" articles from meta-analyses. We discuss methods for improving the validity and reliability of QUADAS.

Brain Neoplasms↗
PubMed2006

Reliability of serum assays of iron status in postmenopausal women.

PURPOSE: The aim of the study is to determine the reliability during a 2-year period of several newly developed iron-related assays to assess their potential for use in prospective epidemiologic studies. METHODS: We assessed the temporal reliability of several iron-related assays by using three serum samples collected at yearly intervals from 50 postmenopausal participants in a large prospective study. RESULTS: We observed high reliability coefficients for ferritin (0.78; 95% confidence interval [CI], 0.67-0.86), soluble transferrin receptor (sTfR; 0.79; 95% CI, 0.69-0.87), sTfR/ferritin ratio (0.74; 95% CI, 0.62-0.83), and hepcidin (0.89; 95% CI, 0.84-0.94). In a subset of 30 women, lower reliability was observed for serum iron (0.50; 95% CI, 0.29-0.70), unsaturated iron-binding capacity (0.55; 95% CI, 0.34-0.73), total iron-binding capacity (0.60; 95% CI, 0.40-0.76), and serum transferrin saturation rate (0.44; 95% CI, 0.22-0.65). The reliability of anti-5-hydroxymethyl-2'-deoxyuridine autoantibody titers, a biomarker of oxidized DNA damage, one of the mechanisms by which iron is thought to impact disease risk, was very high (0.97, 95% CI, 0.5-0.99). CONCLUSIONS: Our results show that some newly developed iron-related assays could be useful tools to assess iron-disease associations in prospective cohorts that collect a single blood sample.

Adult↗
PubMed2006

[Validity and reliability of Spinal Mouse to assess lumbar flexion].

OBJECTIVES: To evaluate the validity and reliability of the Spinal Mouse model to assess lumbar spine flexion. MATERIAL AND METHODS: For the validity study, patients with low-back pain underwent radiography to produce 2 lateral radiographs, first from the neutral position, and then with full trunk flexion. The correlation between mobility as assessed by radiography and the Spinal Mouse were evaluated by use of Spearman's correlation coefficient (SCC) for segmental mobility (L1-L2, L2-L3, L3-L4, L4-L5 and L5-S1) and global mobility (L1-L5 and L1-S1). Reliability was studied in healthy volunteers by the intraclass correlation coefficient (ICC). RESULTS: A total of 20 patients (8 women) aged 41.6+/-8.6 (range 24-63), were included in the validity study. The SCC between radiography and Spinal Mouse measures were 0.55; 0.64; 0.69; 0.54; 0.19; 0.7; and 0.86 for flexion mobility of the L1-L2, L2-L3, L3-L4, L4-L5, L5-S1, L1-L5 and L1-S1, respectively. A total of 45 subjects aged 24.2+/-3.7 (range 20-29) were included for the reliability study. For intrarater reliability, the ICC was 0.84; 0.89; 0.96; 0.97; 0.63; 0.95 and 0.83 for the L1-L2, L2-L3, L3-L4, L4-L5, L5-S1, L5-S1, L1-L5 and L1-S1, respectively. For interrater reliability, the ICC was 0.75; 0.81; 0.79; 0.60; 0.83; 0.85, respectively. CONCLUSION: The Spinal Mouse has acceptable metrological properties to assess segmental and global lumbar mobility during trunk flexion. Its metrological properties are not acceptable to assess mobility of L5-S1.

Adult↗
PubMed2004

Reliability of maximal strength testing in older adults.

OBJECTIVES: To determine (1) the reliability of a maximal strength test (1 repetition maximum) [1-RM] in older adults and (2) the impact of differing periods of familiarization. DESIGN: Within-subject, repeated trials of maximal strength. SETTING: Community-based senior center. PARTICIPANTS: Forty-seven independently living men (n=16) and women (n=31), with a mean age of 75.4+/-4.7 years. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Systematic error (shift in mean) and random error (% coefficient of variation [%CV]) was assessed between consecutive pairs of 1-RM trials. RESULTS: For the bench press, systematic error was virtually eliminated for men between trials 2 and 3 (0.7%; 95% confidence interval [CI], -2.7% to 4.3%). The CV was stable (4.7%-7.3%) across all trials in both genders. For the leg press, a significant but clinically small systematic error (3.6%, P<.05; 95% CI, 0.8-6.6) was evident for women between trials 2 to 3. The CV was reduced across trial pairs by 3.3% for men and 0.9% for women. Three versus 6 or more sessions of familiarization produced small clinical differences in systematic error (< or =4.1%) and CV (< or =0.2%) between trials 2 and 3 for both lifts. CONCLUSIONS: Reliability is an indispensable requirement for valid test outcomes. Our results show that, in this group of older adults, 3 familiarization sessions and 2 to 3 test trials produced highly reliable 1-RM measures. Additional periods of familiarization added little to test reliability. Effective reliability testing for 1-RM is a practical and attainable goal for outcomes based practitioners.

Aged↗
PubMed2004

The intra- and interrater reliability of hip muscle strength assessments using a handheld versus a portable dynamometer anchoring station.

OBJECTIVE: To compare the inter- and intrarater reliability of a portable dynamometer anchoring station (DAS) to a handheld dynamometer (HHD). DESIGN: Repeated-measures design. SETTING: Human performance and movement analysis laboratory. PARTICIPANTS: Fifteen healthy participants, ages 23 to 44 years. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Three consecutive measures of peak bilateral isometric strength were obtained for hip abduction, extension, and flexion by 2 investigators by using the DAS and the HHD after a 1-hour rest period. This testing scenario was repeated 1 week later. Intraclass correlation coefficients (ICCs) were used to determine reliability. RESULTS: Interrater ICCs of average peak strength ranged from.84 to.92 (hip flexors),.69 to.88 (hip abductors), and.56 to.80 (hip extensors). Intrarater ICCs ranged from.59 to.89 for tester A and from.72 to.89 for tester B using the DAS, and from.67 to.81 for the HHD across muscle groups. CONCLUSIONS: The DAS showed good intrarater reliability for hip flexion and abduction, whereas the HHD demonstrated higher reliability for hip extension. The results support the use of dynamometers that are quick and reliable and that reduce tester bias during hip strength assessment.

Adult↗
PubMed2004

Between-days reliability of H-reflexes in human flexor carpi radialis.

OBJECTIVES: To assess between-day reliability of the latency and peak-to-peak amplitude of a technique to elicit the H-reflex and M response of the flexor carpi radialis (FCR) and the ratio of maximum H-reflex and M-response amplitude (Hmax/Mmax). DESIGN: Test-retest reliability study. SETTING: Electrophysiology laboratory at a university. PARTICIPANTS: Fifteen consecutively recruited healthy volunteers (8 men, 7 women; age range, 22-65y). INTERVENTION: Volunteers were tested on 2 separate days at the same time of day for H-reflex and M response by stimulating the median nerve in the cubital fossa in the presence of a standardized voluntary contraction of the FCR muscle. MAIN OUTCOME MEASURES: Onset latencies, peak-to-peak amplitudes, and Hmax/Mmax. RESULTS: Latency measurements of H-reflex and M response showed excellent reliability between days, as did the maximum amplitude of the M response. The maximum amplitudes of the H-reflex and Hmax/Mmax ratio were less reliable but still within acceptable limits. CONCLUSIONS: The H-reflex and M response can be reliably elicited in the FCR. This technique provides a useful clinical tool for diagnostic purposes during the course of neurologic disorders and in preclinical and postclinical intervention studies.

Adult↗
PubMed2005

A new shoulder range of motion screening measurement: its reliability and application in the assessment of the prevalence of shoulder contractures in patients with impaired consciousness caused by severe brain damage.

OBJECTIVES: To determine the reliability of a new shoulder joint range of motion (ROM) measurement for unconscious patients and to assess the prevalence of shoulder joint contractures in such patients. DESIGN: Prospective cohort survey. SETTING: An early rehabilitation center for adult persons with neurologic disorders. PARTICIPANTS: Fifty patients with impaired consciousness caused by severe cerebral damage of various etiologies. In addition, reference values were measured in 60 healthy adults. INTERVENTION: Shoulder ROM was assessed by measuring the distance between the olecranon and underlay while the patient lay supine on a solid surface and the patient's hands were passively positioned behind the neck. Distances between the olecranon and underlay were measured, first, manually by the rater and, second, for control, digitally by a blinded person from a digital photo taken while a constant force was applied to the elbow. MAIN OUTCOME MEASURES: Prevalence of contractures defined as increased distance between the olecranon and underlay or impossibility of positioning the hands passively behind the neck, and intra- and interrater-reliability of the 2 shoulder ROM measurements with the interclass correlation coefficient (ICC). RESULTS: Measurement of shoulder ROM showed high intra-(ICC range, .78-.91) and interrater reliability (ICC range, .77-.90) for manual measurement, high intra- (ICC range, .91-.95) and interrater reliability (ICC range, .90-.94) for the digital analysis, and a high ICC for both methods (ICC=.87). The prevalence of shoulder contractures was 56% in the patients and 50% of all shoulder joints. CONCLUSIONS: The described method provided a reliable measurement for reduced shoulder ROM and appears to be a useful screening method to show the prevalence of shoulder joint contracture in these patients.

Adult↗
PubMed2005

Validity and reliability of an internet-based temporal gait assessment tool with healthy adults: a pilot study.

OBJECTIVES: To assess in healthy adults the validity and the inter- and intrarater reliability of the Internet-based Shaw Gait Assessment (SGA). DESIGN: Concurrent test-retest reliability and validity study with participants, 4 raters, and the Elite motion analysis system (used as the criterion standard). SETTING: Motion analysis laboratory in a university physical therapy department. PARTICIPANTS: Convenience sample of 16 healthy men and women (age range, 28-53y). INTERVENTION: Each subject performed 2 consecutive walks "at a comfortable pace" on a 6-m walkway. A video camera from the Elite motion analysis system filmed reflective markers, which were attached to subjects' shoes, and the reflective markers provided the criterion standard. Four raters simultaneously recorded each walk by using laptop computers and the SGA. MAIN OUTCOME MEASURES: Paired t test (5% level) for average differences between each test and retest for raters and the Elite; Pearson correlations, limits of agreement, and coefficients of variation (CVs) for validity of the tool; intraclass correlation coefficients (ICCs) for inter- and intrarater reliability. RESULTS: Pearson product moment correlation coefficients between each of the raters and the Elite ranged from .92 to .95 for speed, from .85 to .97 for cadence, from .87 to .92 for step length, from .61 to .84 for left advance limb time, and from .68 to .83 for right advance limb time. Pooled CVs for all variables were below 8% for all raters and the Elite. Pooled ICCs for intrarater reliability were .89 for speed, .99 for cadence, .84 for step length, .76 for left limb advance time, and .84 for right limb advance time. Interrater ICCs were .89 for speed, .82 for cadence, .76 for step length, .66 for left limb advance time, and .81 for right limb advance time. CONCLUSIONS: The SGA is a valid and reliable tool for several key temporal measures of gait in a healthy adult population.

Adult↗
PubMed2006

An accurate and reliable method of thermal data analysis in thermal imaging of the anterior knee for use in cryotherapy research.

OBJECTIVE: To develop an anatomic marker system (AMS) as an accurate, reliable method of thermal imaging data analysis, for use in cryotherapy research. DESIGN: Investigation of the accuracy of new thermal imaging technique. SETTING: Hospital orthopedic outpatient department in England. PARTICIPANTS: Consecutive sample of 9 patients referred to anterior knee pain clinic. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Thermally inert markers were placed at specific anatomic locations, defining an area over the anterior knee of patients with anterior knee pain. A baseline thermal image was taken. Patients underwent a 3-minute thermal washout of the affected knee. Thermal images were collected at a rate of 1 image per minute for a 20-minute re-warming period. A Matlab (version 7.0) program was written to digitize the marker positions and subsequently calculate the mean of the area over the anterior knee. Virtual markers were then defined as 15% distal from the proximal marker, 30% proximal from the distal markers, 15% lateral from the medial marker, and 15% medial from the lateral marker. The virtual markers formed an ellipse, which defined an area representative of the patella shape. Within the ellipse, the mean value of the full pixels determined the mean temperature of this region. Ten raters were recruited to use the program and interrater reliability was investigated. RESULTS: The intraclass correlation coefficient produced coefficients within acceptable bounds, ranging from .82 to .97, indicating adequate interrater reliability. CONCLUSIONS: The AMS provides an accurate, reliable method for thermal imaging data analysis and is a reliable tool with which to advance cryotherapy research.

Analysis of Variance↗
PubMed2007

Test-retest reliability of heart rate variability and respiration rate at rest and during light physical activity in normal subjects.

BACKGROUND: A variable that remains stable over repeated measurements (in stable conditions) is ideal for tracking modifications of the clinical state. The aim of the present study is to examine test-retest reliability of time-domain heart rate variability and respiration rate measurements using a portable device on normal subjects during rest and light physical activity. METHODS: Twenty-six normal subjects [18 females and 8 males aged 28 +/- 6 years and 34 +/- 12 years (mean +/- SD), respectively] underwent two measurements for time-domain heart rate variability (SDNN and RMSSD) and respiration rate, with 7 days in between. Measurements took place under three conditions: lying down in a laboratory, cycling in a laboratory and sleeping in an ambulatory surrounding. Reliability was assessed statistically by calculating intra-class correlation coefficients (ICC). RESULTS: Reliability was found to be good to excellent for both time-domain heart rate variability (SDNN: ICC values between 0.74 and 0.85, RMSSD: ICC values between 0.75 and 0.98) and for respiration rate (ICC values between 0.77 and 0.96). CONCLUSIONS: Both time-domain heart rate variability and respiration rate can be reliably assessed. However, we advise reliability research in a clinical setting before using the device for tracking modifications in a clinical state.

Adult↗
PubMed2006

Intraobserver and interobserver reliability of the assessment of the patellar articular cartilage in osteoarthritic patients undergoing total knee arthroplasty.

This study was performed to investigate intraobserver and interobserver reliability of the intraoperative assessment of patellar cartilage status and the decision on patellar resurfacing based on the cartilage assessment in osteoarthritic patients undergoing total knee arthroplasty. Photographs of patellar cartilage were taken in 80 knees of 53 patients undergoing total knee arthroplasty. Three investigators assessed the depth and size of the cartilage lesion and made a decision on patellar resurfacing, using the photographs twice. Intraobserver and interobserver reliabilities were calculated with the kappa coefficient. Cartilage assessment had substantial intraobserver (kappa = 0.77 for depth and 0.71 for size) and moderate interobserver (kappa = 0.54 for depth and 0.45 for size) reliabilities. Decision on patellar resurfacing had almost perfect intraobserver and substantial interobserver reliabilities (kappa = 0.88 and 0.68, respectively). We found that intraoperative assessment of the patellar articular cartilage and the decision for patellar resurfacing are reliable.

Aged↗
PubMed2004

Quantitative assessment of the reliability of identification by high-performance liquid chromatography-mass spectrometry.

At present, mass spectrometry (MS) is the most reliable method for identification but there is not yet a quantitative equation describing this fact. In this investigation an approach to the quantitative assessment of the reliability of identification by MS is proposed which is useful for determination of the selectivity and the validation of analytical methods. Mass spectra of the analytes are presented as maps in which the characteristic ions and their intensities are used for identification. A formula for the quantitative expression of the significance of these parameters to the reliability and the identification is given. The contribution of the resolution of MS instruments or their possibilities of a multiple fragmentation to the reliability of the identification is shown. This approach makes it possible to compare the reliability of identification with different MS instruments. Despite the small contribution of the separation of the chromatographic column compared to the MS separation, the role of the column in the identification is very important to distinguish isomers because their MS spectra are similar.

Acetonitriles↗
PubMed2004

Lateral ankle sprain: isokinetic test reliability and comparison between invertors and evertors.

OBJECTIVE: Evaluate reliability of isokinetic tests for inversion and eversion in individuals with recurrent lateral ankle sprain and compare inversion to eversion muscle performance in the same ankles. DESIGN: Reliability was evaluated by comparing the results of two ankle inversion/eversion isokinetic tests. Inversion and eversion were compared with the results presented by the tests. BACKGROUND: Previous studies showed reliable isokinetic tests for ankles with no sprain history. It is unknown if such tests can also be performed in lateral sprained ankles. It is unclear whether there is difference between invertors and evertors in these ankles. METHODS: Eleven men with recurrent ankle lateral sprain in one limb were tested using an isokinetic dynamometer. The tests consisted of 5 cycles of maximal contraction in 30 degrees /s and 120 degrees /s. Both injured and noninjured ankles were tested. Peak torque was recorded for analysis. RESULTS: The tests are reliable and intraclass coefficient correlation varied from 0.71 to 0.95. Invertors generated higher peak torques than evertors (P = 0.03) when injured ankles were tested at 120 degrees /s. CONCLUSIONS: Isokinetic inversion/eversion tests showed to be reliable. A decrease in peak torques can be seen during higher velocity tests. The only difference between invertors and evertors was seen when injured ankles were tested at 120 degrees /s. In this case invertors showed higher peak torques.

Adolescent↗