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PubMed1983

Improvement of reliability of an oral examination by a structured evaluation instrument.

The main purposes of this study were to estimate the reliability of oral examinations administered to medical students during a clinical clerkship and to improve the reliability of this evaluation technique. In the first part of the study, the reliability of oral examinations as traditionally administered was estimated. The average intraclass reliability coefficient for these examinations was .48. Cassette recordings of these oral examinations were also rated by the faculty members. The average intraclass reliability coefficient of the ratings of the taped performances was .82. In the second part of the study, the reliability of oral examinations was investigated with the raters using a newly developed evaluation form. The average intraclass reliability of the oral examination using the evaluation form was .67, a noticeable increase over the .48 obtained without the form. The average intraclass reliability of ratings made from tape recordings of these oral examinations was .62.

Clinical Clerkship↗
PubMed1993

Reliability of the Glasgow Coma Scale when used by emergency physicians and paramedics.

We sought to determine the reliability of the Glasgow Coma Scale (GCS) when used by emergency physicians and paramedics. We performed a prospective sequential trial in a classroom setting, with subjects blinded to others' scoring. Nineteen university-affiliated emergency physicians and 41 professional paramedics from an urban EMS system voluntarily participated. Participants viewed four videotaped scenes in which a patient is assessed by a paramedic. The first three scenes represented severe, intermediate, and no/mild alteration in level of consciousness (LOC). The findings in the fourth scene were identical to the first, allowing determination of intrarater reliability. The Kappa statistic was used to determine interrater reliability; the reliability coefficient determined intrarater reliability. Kappa was significant (p < 0.0001) for severe (kappa = 0.48), intermediate (kappa = 0.34), and no/mild (kappa = 0.85) conditions. Intrarater reliability (r1,2) for emergency physicians was 0.66 (p < 0.01) and for paramedics was 0.63 (p < 0.01). The GCS shows statistically significant reliability (i.e., significant agreement) between emergency physicians and emergency medical technician-paramedics. It also has a significant level of intrarater reliability.

Allied Health Personnel↗
PubMed1998

Interrater and intrarater reliability in the measurement of kyphosis in postmenopausal women with osteoporosis.

STUDY DESIGN: A reliability study was performed using repeated random measurements involving three observers, 26 subjects and three instruments. OBJECTIVES: To determine the most reliable, cost-effective, noninvasive, and clinically feasible method of measuring spinal kyphosis. SUMMARY OF BACKGROUND DATA: The most clinically useful, noninvasive and reliable method of measuring postural deformity in spinal osteoporosis (kyphosis) remains unqualified. Despite traditional use of costly, invasive roentgenographs for the evaluation of spinal kyphosis, the reliability of this method remains questionable. METHODS: Twenty-six postmenopausal women with known bone mineral density and a diagnosis of osteoporosis were recruited from the Osteoporosis Program at Women's College Hospital, Toronto, Canada. Non-invasive measurements of thoracic kyphosis were obtained by three trained examiners using the DeBrunner's kyphometer and the flexicurve ruler. The intrarater and interrater reliability of and between each method was compared, using roentgenographic films obtained in the sagittal plane. Spinal posture was classified according to the method of Itoi (1990). Statistical computations were performed using SAS statistical software. RESULTS: Consistent measurements were obtained with the DeBrunner's kyphometer and the flexicurve ruler by each observer, according to the results of critical two-way analysis of variance (Intraclass Correlation Coefficient 2, 1). Measurements in two subgroups, healthy backs (n = 11) and rounded backs (n = 13), showed consistent use of each noninvasive instrument with some examiner preference for specific tools. There was marginally better intrarater and interrater reliability using the DeBrunner's kyphometer compared with that obtained with the flexicurve ruler. Two-way analysis of variance (Intraclass Correlation Coefficient 2, 1) of collapsed data showed no significant difference in the reliability of the kyphometer, flexicurve ruler, or roentgenographs in the measurement of thoracic kyphosis. CONCLUSIONS: The flexicurve ruler and DeBrunner's kyphometer had the closest agreement in the measurement of spinal kyphosis. The kyphometer demonstrated the least variation in intrarater and interrater reliability when compared with the flexicurve ruler and roentgenographs. The flexicurve ruler permits qualitative assessment of posture, however, and is the most cost-effective instrument. The results of this study challenge the traditional belief that roentgenographic analysis is the best method for evaluating spinal kyphosis. The DeBrunner's kyphometer and flexible ruler may represent viable, cost-effective and noninvasive alternatives to roentgenographic evaluation of spinal kyphosis.

Aged↗
PubMed2001

Range of motion and lordosis of the lumbar spine: reliability of measurement and normative values.

STUDY DESIGN: Repeated measures for intratester reliability were performed. OBJECTIVES: To investigate the intratester reliability of a new measurement technique that evaluates lumbar range of motion in three planes using a pelvic restraint device, and to examine the reliability of lumbar lordosis measurement by inclinometer technique. Preliminary normative data on lumbar range of motion and lumbar lordosis were collected for comparison with the findings of previous studies. SUMMARY OF BACKGROUND DATA: Various noninvasive measurement methods have been developed for recording lumbar range of motion. However, pelvic movement was not effectively restricted during the use of these measurement techniques. The use of the pelvic restraint device to measure lumbar range of motion has not been investigated previously. Very few studies have investigated the reliability of quantifying lumbar lordosis by the inclinometer technique. METHODS: Normative values were measured in 35 healthy men, and 12 of these subjects were included for the reliability study. Pelvic motion was limited by the pelvic restraint device during lumbar range of motion measurement in standing. An inclinometer was used for evaluation of lumbar flexion, extension, lateral flexion, and lumbar lordosis, whereas a lumbar rotameter was used to measure axial rotation. RESULTS: Good intratester reliability was shown in the lumbar range of motion and lordosis measurement. Most of the intraclass correlation coefficient and Pearson's r values (accompanied with nonsignificant paired t tests) were greater than 0.9, and most of the intrasubject coefficients of variation were less than 10%. The values of lumbar range of motion in three planes and lumbar lordosis found in the current study were comparable with those from most of the previous studies on these measurements in the normal population. CONCLUSIONS: Inclinometer and lumbar rotameter measurements with the use of a pelvic restraint device are reliable for measuring lumbar spine range of motion. Use of the inclinometer technique to record lumbar lordosis also is a reliable measure.

Adult↗
PubMed1995

Shoulder abduction strength measurement in football players: reliability and validity of two field tests.

Musculoskeletal and neurologic injuries affecting shoulder strength are common in contact sports. Full-strength recovery is desired before resumption of competition. On-field assessment of shoulder strength is usually done by manual muscle testing, which lacks sensitivity and reliability. Our objective was to determine the reliability and validity of two field instruments capable of quantifying shoulder abduction strength. Twenty junior football players underwent bilateral isokinetic (60 degrees/s) and isometric shoulder abduction strength measurements using a Cybex 340 isokinetic dynamometer. Test-retest measurements of both shoulders of each player were made using strain gauge (SG) and handheld dynamometer (HHD) instruments. Players were tested during rested and competition conditions. Within and between session reliabilities were calculated using the intraclass coefficient, and validity was assessed using Pearson's correlation coefficient. Overall reliability for each device was calculated using Lisrel analysis. SG was found to be superior to HHD in overall reliability and validity. Within-session reliability in the rested and competition states was 0.75 and 0.78, respectively, for SG and 0.60 and 0.81, respectively, for HHD. Between-session reliability in the rested and competition states dropped to 0.51 and 0.63, respectively, for SG and 0.55 and 0.70, respectively, for HHD. Validity was 0.41 and 0.70 for SG when correlated with Cybex at 0 degree and 60 degrees/s respectively. Validity for HHD was 0.28 and 0.42 for Cybex speeds of 0 degree and 60 degrees/s, respectively. SG reliability and validity were similar when testing was done one shoulder at a time or both shoulders concurrently.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Lifetime DSM-IV diagnosis of alcohol, cannabis, cocaine and opiate dependence: six-month reliability in a multi-site clinical sample.

Psychiatric research increasingly emphasizes the diagnosis of symptoms and syndromes on a longitudinal basis. This study tests the reliability of lifetime DSM-IV diagnoses of alcohol, cannabis, cocaine and opiate dependence. The CIDI-SAM was administered at intervals not less than six months apart to a multi-site sample of 201 clinical respondents. The reliability of lifetime diagnosis of the syndromes, of the criteria which constitute the syndromes, and of the ages of onset reported for the criteria and for the dependence syndromes as a whole, were studied and the effects of patient characteristics suspected to degrade reliability were examined. There was generally good agreement, statistically, at both the syndrome and criterion level between the two interviews. Lifetime diagnoses for three of the drugs--alcohol, cannabis and opiates--were made at or near levels of agreement generally considered excellent under less strict testing conditions, and cocaine dependence was only marginally below this level. Most criteria showed good reliability and all delivered about equal results when averaged across the four substances, although a relationship between reliability and centrality of the symptom to the individual drug abuse pattern was found. Age of onset was almost uniformly highly reliable. Most patient characteristics bore no detectable relationship to reliability, although patients with multiple drug use patterns may warrant more careful probing by interviewers. Overall, these data indicate that lifetime symptoms and diagnoses can be queried reliably, although they must be reported with less confidence than current state diagnoses.

Age of Onset↗
PubMed1994

Determinants of reliability in psychiatric surveys of children aged 6-12.

The reliability of young children's self reports of psychiatric information is a concern of epidemiologists and clinicians alike. This paper explores the determinants of test-retest reliability in a sample of children from the general population using reliability coefficients constructed from a kappa statistic. Age, cognitive ability, and gender are related to consistency of reports in a test-retest paradigm. Controlling for age, cognitive ability and gender, children report more reliably on observable behaviors, and less reliably on questions involving unspecified time, reflections of one's own thoughts, and comparison of themselves with others. The reliability of reports of emotions lies between these two extremes. Surprisingly, sentence length of up to 40 words and psychiatric impairment of the child as measured by the Child Global Assessment Scale did not influence reliability. As might be expected, parents' reports of their children are more reliable than their children's reports.

Affective Symptoms↗
PubMed1993

Effects of cognitive impairment on the reliability of geriatric assessments in nursing homes.

OBJECTIVE: To explore the relationship between an elderly subject's cognitive status and the reliability of multidimensional assessment data. DESIGN: Survey, with cognitive status as the independent variable and interrater reliability as dependent variable. SETTING: Medicare/Medicaid-certified nursing homes. PARTICIPANTS: 147 residents age 65 or older. MEASUREMENTS: Dual assessments of elderly nursing home residents were performed by nurse assessors using the Health Care Financing Administration's new Minimum Data Set for Nursing Home Resident Assessment and Care Screening (MDS). Assessments were classified on the basis of residents' cognitive status, and levels of disagreement between assessors were analyzed. MAIN RESULTS: Overall assessment reliability, agreement concerning a resident's activities of daily living status, and the reliability of estimates of his or her communication skills and sensory abilities were significantly affected by a resident's cognitive status. The presence of cognitive impairment made these measurements less reliable--especially those related to communication skills, vision, and hearing. CONCLUSIONS: Assessments of residents suffering from cognitive impairment were significantly less reliable than assessments of cognitively intact residents. However, these differences in reliability were not uniform across all assessment domains. When treating the cognitively impaired elderly, clinicians must exercise caution in their reliance on standardized measurements that may be less reliable for this population.

Activities of Daily Living↗
PubMed1993

Reliability of a standardized and expanded Brief Psychiatric Rating Scale: a replication study.

This study aimed to determine the replicability of the interrater reliability coefficients obtained with a standardized and expanded Brief Psychiatric Rating Scale (BPRS-E) in a 1991 psychometric evaluation. Furthermore, intrarater reliability was assessed. At item level, interrater concordance turned out to be satisfactory for most of the BPRS-E items. However, only a few of the items reached acceptable chance-corrected coefficients. In contrast to the previous study, the anxiety-depression subscale met the standard of acceptable interrater reliability in the present study. As in the 1991 study, the 10-item psychotic disintegration scale as well as BPRS-18 global scores met (or closely approximated) this standard. The 6 additional items of BPRS-E did not contribute to the scale's reliability. Joining the samples of the 1991 and replication studies (to cover the range of symptoms' severity and heterogeneity more fully) did not improve interrater reliability. Intrarater reliability coefficients were globally comparable to interrater reliability coefficients. In all, the results of this replication study suggest that only the anxiety-depression subscale, the 10-item psychotic disintegration scale and the BPRS-18 global scale can be used reliably in unselected groups of psychiatric inpatients in acute distress.

Adolescent↗
PubMed1988

Factors affecting reliability coefficients of health attitude scales.

This study determined the minimum number of health attitude items and minimum sample size required to achieve maximum scale reliability coefficients, using different methods of estimating reliability. A 54-item alcohol attitude scale was administered to 700 participants. The scale produced .96 and .91 reliability coefficients, using the Cronbach Alpha (CA) and the Split-half (S-B) methods, respectively. A computer program randomly selected groups of participants and items from the pool of participants and items using different increments. A matrix of coefficients of reliability for both methods was calculated for different groups of items and sample size. To replicate the study, a 30-item cancer attitude scale was administered to more than 1,000 representative participants and produced reliability coefficients of .94 (using CA) and .82 (using S-B). The same computer and statistical procedures were repeated for the second data set. Results from both analyses consistently demonstrated that sample size has an insignificant effect on the coefficient values of reliability. Reliability increased as the number of items reached 18. Adding more items only negligibly increased the coefficients. Overall, the CA method consistently produced higher coefficient values of reliability compared to the S-B method.

Attitude to Health↗
PubMed1997

Reliability of the National Institutes of Health Stroke Scale. Extension to non-neurologists in the context of a clinical trial.

BACKGROUND AND PURPOSE: The reliability of the National Institutes of Health Stroke Scale (NIHSS) has been established through testing its use in live and videotaped patients. This reliability testing has primarily focused on the use of the scale by neurologists. We sought to determine the reliability of the NIHSS as used by non-neurologists in the context of a clinical trial. METHODS: In anticipation of the initiation of a randomized trial of a new therapy for patients with acute ischemic stroke, 30 physician investigators (30% of whom were not neurologists) and 29 non-physician study coordinators were trained in the use of the NIHSS at an informational and training conference using standardized videotaped patient examinations. A series of 4 patients were rated initially. After 3 months, the same 4 patients were rerated, providing a measure of intraobserver reliability. An additional series of 4 new patients were also rated after 3 months and, with the initial 4 ratings, provided data for assessment of interobserver reliability. RESULTS: Overall, 28% of the raters had previous experience with the NIHSS, and 22% had previously used the videotapes as used in the present trial. The coefficients of determination (r2) were each greater than .95 when the means of the two ratings of the same 4 cases were compared between (1) neurologists and other types of physicians, (2) physicians and study coordinators, (3) raters who had prior experience with the NIHSS and those without prior experience, and (4) raters who had used the videotapes in the past and those who had never viewed the tapes. The calculated r2s were greater than .98 for the initial rating of the first 4 cases and for the later rating of the 4 new cases. The slopes of the regression lines were all near 1, indicating that the raters were similarly calibrated. The intraclass correlation coefficients were .93 and .95, reflecting high levels of intraobserver and interobserver reliability. CONCLUSIONS: These data extend the previously demonstrated reliability of the NIHSS to non-neurologists and show that both a variety of physician investigators and nurse study coordinators can be rapidly trained to reliably apply the scale in the context of an actual clinical trial.

Cerebrovascular Disorders↗
PubMed1988

Reliability of visual analog and verbal descriptor scales for "objective" measurement of temporomandibular disorder pain.

Eight dentists viewed standardized videotapes showing palpations of the temporomandibular joint and muscles of mastication and recorded their judgments concerning the amount of pain the patient was experiencing. Judgments were recorded using a four-point verbal descriptor scale (VDS) ("none", "mild", "moderate", "severe" pain) or a 100-mm visual analog scale (VAS) anchored with the terms "no pain" and "worst pain possible". Test/re-test reliability over a one-week period and interjudge reliabilities were calculated for each scale; reliabilities of the two scales were directly compared based on the statistical equivalence of weighted kappa and the Intraclass Correlation Coefficient. Neither scale showed satisfactory reliability. Median test/re-test reliabilities were k = 0.590 for the VDS and r = 0.822 for the VAS. Interjudge reliabilities averaged k = 0.394 for the VDS and r = 0.735 for the VAS. Direct comparison of reliabilities for the two scales showed no clear advantage for either scale. The marginal reliabilities of these scales, when used by dentists to quantify the patient's pain, suggest that neither scale should be regarded as an "objective" pain measure.

Decision Making↗
PubMed1998

The reliability of the Diabetes Care Profile for African Americans.

The Diabetes Care Profile (DCP) is an instrument used to assess social and psychological factors related to diabetes and its treatment. The reliability of the DCP was established in populations consisting primarily of Caucasians with type 2 diabetes. This study tests whether the DCP is a reliable instrument for African Americans with type 2 diabetes. Both African American (n = 511) and Caucasian (n = 235) patients with type 2 diabetes were recruited at six sites located in the metropolitan Detroit area. Scale reliability was calculated by Cronbach's coefficient alpha. The scale reliabilities ranged from .70 to .97 for African Americans. These reliabilities were similar to those of Caucasians, whose scale reliabilities ranged from .68 to .96. The Feldt test was used to determine differences between the reliabilities of the two patient populations. No significant differences were found. The DCP is a reliable survey instrument for African American and Caucasian patients with type 2 diabetes.

Black or African American↗
PubMed2000

Reliability of a measure of post-stroke shoulder pain in patients with and without aphasia and/or unilateral spatial neglect.

OBJECTIVE: To determine the inter/intra-rater reliability of expert physiotherapists (PTs) measuring post-stroke shoulder pain with 100 mm vertical visual analogue scales (VAS; intensity, frequency and affective response) and a categorical site-of-pain scale. DESIGN: Three PTs independently rated subjects (normal clinical procedure but with a standardized starting position) on three days, at the same time of day, during one week in a randomized order determined by a nested latin square. Reliability for VAS scores was determined with the intraclass correlation coefficient (ICC) and for site-of-pain with the kappa statistic (kappa). Acceptable reliability was set at 0.75. The limits of agreement were also calculated. SETTING: Community. SUBJECTS: Thirty-three patients, mean time post stroke 42 months (range 7-360). RESULTS: Mean inter-rater reliability was 0.79 for intensity, 0.75 for frequency and 0.62 for affective response (ICC). The limits of agreement were wide and rater bias was significant for 6/27 ratings. Mean intra-rater reliability was 0.70 for intensity, 0.77 for frequency and 0.69 for affective response (ICC). For site-of-pain inter-rater reliability ranged from 0.156 (kappa) to 0.385 (kappa) and intrarater reliability ranged from 0.300 (kappa) to 0.559 (kappa). CONCLUSIONS: Although inter-rater reliability was acceptable for intensity and frequency there was a consistently large systematic bias between pairs of raters. Agreement might be improved if a standardized assessment procedure was used and/or if training in pain behaviour interpretation was provided.

Aged↗
PubMed1998

Reliability of assessment tools in rehabilitation: an illustration of appropriate statistical analyses.

OBJECTIVE: To provide a practical guide to appropriate statistical analysis of a reliability study using real-time ultrasound for measuring muscle size as an example. DESIGN: Inter-rater and intra-rater (between-scans and between-days) reliability. SUBJECTS: Ten normal subjects (five male) aged 22-58 years. METHOD: The cross-sectional area (CSA) of the anterior tibial muscle group was measured using real-time ultrasonography. MAIN OUTCOME MEASURES: Intraclass correlation coefficients (ICCs) and the 95% confidence interval (CI) for the ICCs, and Bland and Altman method for assessing agreement, which includes calculation of the mean difference between measures (d), the 95% CI for d, the standard deviation of the differences (SDdiff), the 95% limits of agreement and a reliability coefficient. RESULTS: Inter-rater reliability was high, ICC (3,1) was 0.92 with a 95% CI of 0.72 --> 0.98. There was reasonable agreement between measures on the Bland and Altman test, as d was -0.63 cm2, the 95% CI for d was -1.4 --> 0.14 cm2, the SDdiff was 1.08 cm2, the 95% limits of agreement -2.73 --> 1.53 cm2 and the reliability coefficient was 2.4. Between-scans repeatability was high, ICCs (1,1) were 0.94 and 0.93 with 95% CIs of 0.8 --> 0.99 and 0.75 --> 0.98, for days 1 and 2 respectively. Measures showed good agreement on the Bland and Altman test: d for day 1 was 0.15 cm2 and for day 2 it was -0.32 cm2, the 95% CIs for d were -0.51 --> 0.81 cm2 for day 1 and -0.98 --> 0.34 cm2 for day 2; SDdiff was 0.93 cm2 for both days, the 95% imits of agreement were -1.71 --> 2.01 cm2 for day 1 and -2.18 --> 1.54 cm2 for day 2; the reliability coefficient was 1.80 for day 1 and 1.88 for day 2. The between-days ICC (1,2) was 0.92 and the 95% CI 0.69 --> 0.98. The d was -0.98 cm2, the SDdiff was 1.25 cm2 with 95% limits of agreement of -3.48 --> 1.52 cm2 and the reliability coefficient 2.8. The 95% CI for d (-1.88 --> -0.08 cm2) and the distribution graph showed a bias towards a larger measurement on day 2. CONCLUSIONS: The ICC and Bland and Altman tests are appropriate for analysis of reliability studies of similar design to that described, but neither test alone provides sufficient information and it is recommended that both are used.

Adult↗
PubMed1999

The effect of training on rater reliability on the scoring of the NART.

OBJECTIVES: This study investigates whether the accuracy of judging National Adult Reading Test (NART) words known to have lower inter-rater reliability can be improved by training and use of the pronunciation guide. DESIGN: Two groups (Experimental and Control), were compared with three repeated measures: Occasion (first and second i.e. 'post-training'), Word Reliability (high and low) and Pronunciation Guide (without and with guide). METHODS: Ten words were selected from the NART: five lower reliability and five high reliability words. These were presented aurally in correct and incorrect form to participants (N = 20) who judged correctness of pronunciation without or with a pronunciation guide. Each group repeated the task again, the Experimental group having received training. RESULTS: Accuracy was significantly worse for the low reliability words. The experimental group's accuracy was significantly better after training than the control group's and their own performance prior to training. The use of the guide enhanced accuracy, particularly for the low reliability words. CONCLUSION: Training in administration of the NART improves raters' accuracy and use of the pronunciation guide. This offers an alternative to the suggestion of improving the NART's reliability by replacing lower reliability words and therefore would avoid the need to re-standardize a modified test.

Adult↗
PubMed1997

The reliability of Form 90: an instrument for assessing alcohol treatment outcome.

OBJECTIVE: Project MATCH is a randomized clinical trial consisting of five outpatient and five aftercare units at nine sites. Of importance in this multisite trial examining the efficacy of client-treatment matching was the cross- and within-site reliability of the structured interview used to assess alcohol treatment outcomes, the Form 90. Evaluation of the reliability of Form 90 is the subject of this article. METHOD: The reliability of Form 90 was evaluated in two test-retest studies. The cross-site reliability study consisted of 70 paired test-retest interviews conducted by different interviewers. Clients for this study were recruited from inpatient, outpatient and college settings. The within-site reliability study had a total of 108 paired test-retest interviews, with 54 of the retests conducted by different interviewers and 54 by the same interviewer. Clients for this study were most often presenting for alcohol treatment at the nine sites and were selected to be representative of the larger Project MATCH sample. RESULTS: Good-to-excellent reliability was found for all key summary measures of alcohol consumption and psychosocial functioning, and most frequently used illicit drugs had moderate reliability. No decay in consistency of self-reported drinking was found at more distal points from dates of test-retest interviews. Application of 68% confidence intervals for primary alcohol consumption measures suggests that trained researchers and clinicians can obtain consistent information regarding client drinking. CONCLUSIONS: Form 90 appears to be a reliable instrument for alcohol treatment assessment research when interviewers have received careful training and supervision in its use.

Adult↗
PubMed1988

Testing reliability of plaque and gingival indices. Two methods.

This investigation was undertaken to compare two methods of interexaminer and intraexaminer reliability in the evaluation of Plaque and Gingival Indices prior to a study of toothbrushing. Inter-/intraexaminer reliabilities were compared using a projected slide series consisting of 40 slides of clinical examples of gingival inflammation and plaque accumulation. Time between assessments was three weeks. Using the slide technique, intraexaminer reliability was established for: (1) Gingival Indices and (2) Plaque Indices. Interexaminer reliability was also established for Gingival Indices. Interexaminer reliability could not be established for Plaque Indices on the first assessment but was established on the post-assessment. Intraexaminer reliability was also determined through clinical examinations of patients. A third clinician was used to manipulate the tissue while investigators evaluated bleeding on provocation and plaque accumulation. Significant results were established for the Gingival Indices and Plaque Indices. Results of this investigation suggest that significant inter-/intraexaminer reliabilities may be obtained for gingival indices using the slide technique. In addition, the clinic technique appeared useful for assessing interexaminer reliability for Gingival Indices. Plaque Indices using the slide technique required more practice than those using the clinic technique.

Dental Health Surveys↗