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PubMed1987

Inter- and intra-examiner reliability of palpation for sacroiliac joint dysfunction.

The purpose of this study was to operationally define and evaluate inter- and intra-examiner reliability of the standing sacroiliac mobility (Gillet) test on 53 college students. Both inter- and intra-examiner reliability data showed high mean percentages of agreement (85.3% and 89.2%, respectively.) Cohen's unweighted kappa statistic for concordance was applied yielding "fair" concordance for aggregate intra-examiner data and "slight" concordance for aggregate inter-examiner data. The intra-examiner reliability data suggests that the Gillet test is clinically useful for a single examiner in assessing the sacroiliac joint for mobility dysfunction, especially at upper sacroiliac contact points. Linear regression analyses suggest that the test is sensitive, in that reliability improves with increasing perceived abnormality. Further revisions to the operational definition may improve both inter- and intra-examiner reliability of the Gillet test.

Adult↗
PubMed1984

A study of the reliability of reported premorbid adjustment in schizophrenic patients.

A study was conducted to determine the interrater reliability and the inter-informant reliability of two rating scales commonly used with schizophrenic patients. Both scales were completed by two informants for each of 45 schizophrenics. The Levels of Functioning Scale, which measures current social functioning, gave consistent results both between raters and between informants. The Premorbid Asocial Adjustment Scale, which measures social functioning during childhood and adolescence, produced very high reliability between raters but very poor reliability between informants. This suggests that much of the data collected about premorbid adjustment of schizophrenic patients are not accurate and that attempts to correlate reported premorbid adjustment with biological measures may be invalid. Ways of increasing the reliability and validity of premorbid adjustment measures are discussed.

Adult↗
PubMed1981

The physician's determination of personnel reliability in sensitive occupations.

The Air Force Medical Officer through AFR 35-99 (Personnel Reliability Program) is responsible for the medical evaluation, psychological assessment, and surveillance of persons who will work in sensitive occupations. This paper addresses various personality factors which indicate poor personnel reliability and suggest an interviewing technique of open-ended questions and developmental history assessment to help determine reliability. Once a person is selected into a Personnel Reliability Program, the physician must be alert to the importance of social stress on personnel reliability and performance.

Aerospace Medicine↗
PubMed1978

Absolute and relative reliability of several response parameters used in vestibular assessment.

This experiment investigated the reliability of five indices used to express the magnitude of induced vestibular nystagmus. The investigation was undertaken because information concerning the reliability of the various response parameters when caloric testing is repeated on the same subject is limited. Electronystagmographic assessments of the nystagmus response to the Fitzgerald-Hallpike test were obtained from 16 subjects on three occasions with equal intervals of time between occasions. The data were statistically treated with an analysis of variance technique that allows the generation of correlation coefficients. The findings showed that speed of the slow phase, total beats, culmination frequency, and total amplitude reliably express the magnitude of induced nystagmus on repeated tests. Duration of the induced reaction was not as reliable as the other indices on repeated testing. In addition, difference scores were more repeatable than absolute scores and the caution that must be maintained when using correlation coefficient analyses to estimate reliability is highlighted.

Adolescent↗
PubMed1980

Research design: measurement, reliability, and validity.

The concept of measuring constructs is discussed. An explanation of reliability and validity of measures is presented. Reliability is consistency in measurement over repeated measures. Reliable measures are those with low random (chance) errors. Reliability is assessed by one of four methods: retest, alternative-form test, split-halves test, or internal consistency test. Validity is measuring what is intended to be measured. Valid measures are those with low nonrandom (systematic) errors. Validity is assessed by one of three methods: content validation, criterion-related validation, and construct validation. It is particularly important for the researcher in the behavioral or social sciences to assure himself that measures used are both reliable and valid.

Models, Theoretical↗
PubMed1980

Functional Status Index: reliability of a chronic disease evaluation instrument.

The reliability of 3 methods of assessing respondents' perceptions of their functional ability was tested. The Functional Status Index defines function as including 3 distinct but related dimensions: the degree of dependence, the degree of difficulty and the amount of pain experienced in performing specific activities of daily living. A total of 149 adults with rheumatoid arthritis were studied. Exploratory factor analyses of scores on 18 specific daily activities across the 3 hypothesized dimensions yielded the following functional categories: gross mobility, hand activities, personal care, home chores and interpersonal activities. The resultant indexes achieve internal consistency reliability levels ranging from 0.66 to 0.91 across all but 1 functional category. Average test-retest and interobserver reliability values range from 0.65 to 0.81. Levels of interobserver reliability generally equal or surpass levels of test-retest reliability. The findings suggest that it is feasible to quantify level of function using self-report methods. The Functional Status Index is recommended for use in investigations where changes in functional ability are of interest.

Activities of Daily Living↗
PubMed1995

Reliability of in-bed weighing procedures for critically ill infants.

The purpose of this study was to describe the intra- and interexaminer reliability of weight measurements obtained from critically ill infants on an in-bed electronic scale. Weight measurements were obtained using the in-bed scale (Smart Model 35, Olympic Medical, Seattle, Washington) for 32 infants; 16 were in an incubator, and 16 were under a radiant warmer. Two nurses each obtained two weight measurements for each infant for three consecutive days, for a total of 96 data collection sessions. The nurses were blinded to their own and to the other nurse's weight measurements. The average mean absolute difference for individual nurses' weight measurements (interexaminer reliability) was 12.58 gm for weights obtained in the incubator and 19.19 gm for weights obtained under the radiant warmer. The average mean absolute difference for pairs of nurses' weight measurements (interexaminer reliability) was 14.29 gm for weights obtained in the incubator and 24.42 gm for weights obtained under the radiant warmer. The average mean absolute differences for weights obtained in the two bed types differed significantly for both intra- (Z = -2.46, p = .0141) and interexaminer (Z = -3.11, p = .0019) reliability. The number of pieces of equipment that had to be held during the weight measurement was weakly correlated with both the intra- (rs = .1878, p = .0091) and interexaminer (rs = .1600, p = .0266) mean absolute differences. These findings suggest that weight measurements of critically ill infants obtained using the Smart Model 35 in-bed electronic scale are sufficiently reliable for calculation of medication, parenteral fluid, blood replacement, and nutritional requirements.(ABSTRACT TRUNCATED AT 250 WORDS)

Anthropometry↗
PubMed1995

The reliability and accuracy of a standard method of tissue compliance assessment.

OBJECTIVE: To assess the reliability and the accuracy of a common method of tissue compliance measurement using a series of non-biological test surfaces (foam). Currently, tissue compliance measurement is most commonly obtained with a hand-held instrument known as a tissue compliance meter (TCM). DESIGN: Descriptive study. SETTING: Human Performance Laboratory, University of Calgary. INTERVENTION: A TCM was tested on four surfaces (three test and one control) with five different input forces resulting in 20 unique surface/force combinations. For each combination of surface/force, ten trials were obtained in a random order by each of five examiners, yielding a total of 1000 separate measurements of surface compliance. MAIN OUTCOME MEASURE: Millimeters of surface displacement per Newtons of input force. RESULTS: Intraclass correlation coefficients were calculated for each of the 20 surface/force combinations to judge interexaminer reliability. The median of these 20 coefficients was 0.005: the greatest single value tending toward complete reliability was 0.22. Trials obtained from the control surface (assumed to be incompressible), demonstrated a range of displacements from 0.00 to 2.00 mm. CONCLUSIONS: Within the design of this experiment, the reliability and accuracy of the hand-held tissue compliance meter was poor. We would suggest that the adequacy of this instrument in clinical practice or scientific work must be seriously questioned. Although the assessment of tissue compliance may be useful in the characterization of the musculoskeletal system and particularly in the assessment of treatment outcome, we surmise that a more reliable and accurate instrument is needed for the quantification of tissue compliance.

Chiropractic↗
PubMed1995

Muscle strength assessment in polymyositis and dermatomyositis evaluation of the reliability and clinical use of a new, quantitative, easily applicable method.

OBJECTIVE: To evaluate the feasibility and the reliability of a quantitative method of maximal isometric strength measurement for the assessment of patients with myositis in clinical practice and research. METHODS: Three observers independently examined the strength of 13 muscle groups of 7 patients with stable polymyositis and dermatomyositis (PM/DM) using a handheld pull-gauge. Reliability was assessed following a balanced random 3-way cross classification with interactions and using the analysis of variance method. Serial followup strength data for 2 patients were compared to change in creatinine kinase (CK) levels. RESULTS: All measurements could be performed without causing pain to the patients. One single test including 13 muscle groups was done in 7 min or less. Both intra and interobserver correlations were strong and significant for all muscle groups. The intraobserver reliability ranged from 0.88 for elbow extensors to 0.98 for knee extensors and cervical spine flexors. The interobserver reliability ranged from 0.81 for elbow flexors to 0.98 for knee extensors and cervical spine flexors. The followup of 2 cases yielded moderate to strong correlations of serial strength measurements with CK levels. CONCLUSION: Serial measurement of isometric muscle strength with a handheld pull-gauge is a feasible, inexpensive, time efficient and reliable method and may provide additional quantitative information in the clinical assessment of patients with myositis.

Adult↗
PubMedDate not supplied

Validity and reliability of medical and surgical oncology patient acuity tools.

PURPOSE/OBJECTIVES: To develop valid and reliable medical and surgical acuity tools as part of an overall classification system for patients with cancer. SETTING: An acute care, tertiary, research, academic oncology hospital in the southeastern United States. SAMPLE: Clinical nursing experts in medical and surgical oncology; 125 patient observations for the surgical oncology acuity tool, and 75 patient observations for the medical oncology acuity tool. METHOD: The nursing division developed a medical oncology acuity tool and a surgical oncology acuity tool using the Johns Hopkins Oncology Patient Classification System as a model. They then studied the validity of developed tools using content validity indexes (CVIs). Two independent raters studied the interrater reliability of each tool. FINDINGS: CVIs for items on the surgical tool ranged from 0.57-1.0; the overall CVI for this tool was 0.86. CVIs for items on the medical tool ranged from 0.25-1.0. The overall CVI for this tool was 0.88. Pearson correlation coefficients were r = 0.95 (p < 0.001) for the surgical oncology acuity tool and r = 0.92 (p < 0.001) for the medical tool. Interrater reliability, tested continually for four years, was greater than 95%. CONCLUSIONS: The tools are reliable and valid. IMPLICATIONS FOR NURSING PRACTICE: Medical and surgical oncology acuity tools that are nursing diagnosis based, interface with nursing standards of care, are easy to use, and require no calculation provide reliable quantification of nursing work loads based on the care needs of patients with cancer. Supervisors use data from these tools to determine variable nursing hours per patient per day, establish productivity for units, make staffing and scheduling decisions, assign patients, work on budgets, and, ultimately, establish charges for nursing services. As the needs of medical and surgical oncology patients evolve, continued refinement of indicators and acuity levels will be needed. As other medical and surgical oncology tools are developed, further comparison will be warranted. Additional study would determine if the tools could be modified for these nursing uses in other cancer centers as well as in designated medical and surgical oncology units of other types of hospitals. Oncology acuity systems also could be established in the future as the basis for third-party reimbursement.

Cancer Care Facilities↗
PubMed1994

Reliability of quantitating proliferative cell nuclear antigen in epithelial ovarian tumors.

Sources of variability in quantitating proliferative cell nuclear antigen (PCNA) by image analysis were evaluated in paraffin sections of 18 ovarian tumors of low malignant potential (LMP) and grade 1 (G1) carcinomas. The correlation coefficient of reliability (R) was calculated to determine how reliable a single observation was for representing a "true" tumor value. Reliability of 61% was obtained when interobserver and intraobserver variability were assessed. Threshold settings for positive nuclear and antibody signals minimally affected the overall reliability. The reliability of a single block of tumor for representing true tumor value was R = 0.61. These sources of variability render this technique impractical for evaluating proliferative characteristics in LMP and G1 common epithelial ovarian tumors with PCNA staining.

Analysis of Variance↗
PubMed1993

[Evaluation of the design and reliability of a questionnaire to identify elderly individuals in need for social and health services].

BACKGROUND: To assess the construction of a short screening questionnaire designed for the detection of elderly people living in the community and in need of social and health care, and to test the reliability of the scores obtained on the scales of Activities of Daily Living (ADL) and mobility through its application. METHODS: A short screening questionnaire of 11 items was designed to score elderly community dwellings on the scales of ADL and mobility of the International Classification of Impairments, Disabilities and Handicaps of the WHO (ICIDH). A random sample of 1,000 people aged 65 and over from the community of a geographical area of Catalonia (Spain) were interviewed in 1989, either by telephone or in-home personal interview, by non-professional trained interviewers on the basis of the mentioned schedule, and scored on the ICIDH ADL and Mobility scales. The design of the screening questionnaire was evaluated on the construction, content and wording through a 16 opinion statements questionnaire upon which 12 professionals, familiarized with questionnaire construction, expressed agreement or disagreement. To test reliability, each interviewer re-scored, one month apart, 20 subjects based on the information they had registered on the questionnaires, and following the same procedure, a gold standard observer re-scored all 1,000 interviews. In addition, a number of interviews were tape recorded, with previous consent of the subjects, and re-scored by 9 different observers. Interobserver and intraobserver reliability was measured with Cohen's weighted kappa coefficient. RESULTS: The average time of questionnaire administration was approximately 10 +/- 5 min. Although the instrument was said to be a good tool for the interviewer to score the subjects on the scales, wording of some items of the questionnaire need to be reviewed. Both intraobserver and interobserver reliability were high: kappa coefficients of 0.79-0.97 and > 0.75 respectively. CONCLUSIONS: The use of a simple and reliable ADL and mobility questionnaire is a practical way to obtain information on the functional status of elderly people living at home, and to select elderly people for a further comprehensive assessment of their social and health care needs for planning the appropriate services in the community.

Activities of Daily Living↗
PubMed1993

[Are blood glucose controls performed with portable dosimeters valid? A comparison of the reliability and validity of 3 commonly used models].

OBJECTIVE: To evaluate and compare the reliability and validity for both normal and high glycaemia values of three models of glycaemia self-analysers: Reflolux, Glucocard and One Touch. DESIGN: Descriptive and crossover study. Validation of a measuring appliance through its comparison with a standard appliance. PARTICIPANTS: The sample was composed of 90 blood specimens chosen by suitability sampling. MEASUREMENTS AND MAIN RESULTS: The glycaemia in the specimens was measured simultaneously by each one of the self-analysers and the central laboratory. There was high reliability (reproducibility) among the self-analysers, with correlation coefficients of 0.98, 0.97 and 0.98, with no statistically significant differences. As to intra-instrument reliability (repeatability), tested by analysing the variances of the differences, no statistically significant differences were found, except in the Glucocard self-analyser which lost precision at high glycaemia levels. Validity or accuracy, measured by the method of taking the average of the differences, showed a systematic bias in the Reflolux model, which had a value of 22.3 mg/dl above the reference model, and in the One Touch of -16.3 mg/dl. The Glucocard was the most accurate with a value of -1.78 mg/dl. CONCLUSIONS: Portable glycaemia dosimeters are very useful in following up diabetic patients because of their high reliability, but are not useful in the diagnosis of diabetes because of their lack of accuracy. Before beginning to use a portable dosimeter, its characteristics in terms of reliability and validity must be known, in order to evaluate correctly its findings.

Adult↗
PubMed1993

Reliability of grading scales for individual radiographic features of osteoarthritis of the knee. The Baltimore longitudinal study of aging atlas of knee osteoarthritis.

RATIONALE AND OBJECTIVES: The authors present an atlas of individual radiographic features of osteoarthritis of the knee and evaluate the inter- and intra-reader reliability of trained readers using this atlas. METHODS: Four trained readers graded 30 standing anterior-posterior knee radiographs for eight selected features of osteoarthritis (medial and lateral osteophytes, joint space narrowing, and sclerosis; osteophytes of the tibial spines and chondrocalcinosis) as well as the Kellgren-Lawrence global scale. Inter- and intra-reader reliability were calculated using intraclass correlation coefficients. RESULTS: For all features except sclerosis and osteophytes of the tibial spines, inter-reader reliability ranged from 0.63 to 0.83, whereas intra-reader reliability ranged from 0.82 to 0.95. CONCLUSION: Using this atlas, trained readers are reliable in measuring the presence and severity of individual radiographic features of osteoarthritis of the knee. This atlas should be useful in clinical and epidemiologic studies of osteoarthritis of the knee.

Adult↗
PubMed1993

Reliability of B-mode ultrasonic measurements of subcutaneous adipose tissue and intra-abdominal depth: comparisons with skinfold thicknesses.

Adipose tissue deposits, particularly intra-abdominal adipose tissue, are associated with health risks such as diabetes mellitus and cardiovascular disease. Anthropometric techniques currently in use can measure subcutaneous adipose tissue (SAT) with skinfold calipers, but are limited to certain sites and cannot measure intra-abdominal adipose tissue (IAAT). Radiography, computerized tomography (CT) and magnetic resonance imaging (MRI) have been used, but they are expensive and some involve exposure to radiation. This study, which investigated the utility of B-mode ultrasound for measuring adipose tissue, found that ultrasonic measurements of SAT were as reliable as skinfold caliper measurements. Intra-observer and inter-observer coefficients of reliability for five of six ultrasonic measurements of SAT ranged from 91-98%, in comparison with coefficients of reliability ranging from 93-98% for three skinfold measurements. Coefficients of reliability for ultrasonic measurements of SAT at the paraspinal site were below 90%. Ultrasonic measurements of intra-abdominal depth (IAD), an index of IAAT, yielded an inter-observer coefficient of reliability of 64%. Ultrasound is recommended for measurement of subcutaneous adipose tissue but not for measurement of IAD.

Abdomen↗
PubMed1977

Response reliability in a longitudinal survey in Thailand.

The two rounds of the National Longitudinal Study in Thailand provide a useful opportunity to explore response reliability in a large-scale social and demographic survey in a developing country. The results indicate that nonrandom reliability at the individual level ranged from quite high (for several straightforward, facual questions) to quite low (for most attitudinal questions). There was considerable distributional stability, however, even for many of the variables with low individual-level reliability. In terms of its response reliability, the Thai study compares reasonably well with several leading US fertility surveys. However, in both countries response reliability at the individual level for attitudinal questions is distressingly low. This clearly should be a matter of major concern for social scientists using survey results.

Demography↗
PubMed1995

Reliability of body fat distribution measurements. The ARIC Study baseline cohort results. Atherosclerosis Risk in Communities Study.

OBJECTIVE: To estimate the reliability of skinfold and girth measurements, and ratios involving these measurements, commonly used in epidemiological and clinical studies as measures of body fat distribution. DESIGN: Repeated measurements of body fat distribution measures were scheduled on randomly selected participants at the baseline clinical examination of the ARIC Cohort Study, by the same or by different technicians. SETTING: Probability sample of 45-65 year old residents selected from four US communities. MEASUREMENTS: Subscapular and triceps skinfolds were taken twice using a Lange caliper on standardized right-side locations. Waist and hip girths were measured using an anthropometric tape applied at the level of umbilicus and of the maximal protrusion of the gluteal muscles, respectively. Repeated measurements were taken 1-2 h apart. RESULTS: Inter-technician measurements of triceps skinfolds, subscapular skinfolds, waist girth, hip girth, and waist/hip ratio each had high reliability (R > 0.91). The reliability coefficient for triceps/subscapular ratio (R = 0.81) was somewhat lower. For skinfold measures, intra-observer coefficient of variations are lower than the ones observed in previous studies, and inter-technician coefficient of variations are comparable. CONCLUSIONS: These results confirm previous findings which indicate that the reliability of girth measurements is greater than for skinfold measurements. As a consequence, the waist to hip ratio is less affected by measurement error than the skinfold ratio. Moreover, the expected gain in reliability from using the average of two skinfold measures, taken in succession, was not realized, indicating that when measurements are taken in rapid succession by the same technician, statistical independence between measures is questionable.

Analysis of Variance↗
PubMed1995

The reliability of examination for tenderness in patients with myofascial pain, chronic fibromyalgia and controls.

OBJECTIVE: To establish the reliability with which tenderness could be evaluated in patients with chronic myalgias, using dolorimetry and palpation. METHODS: Three blinded examiners using pressure dolorimetry and digital palpation compared 19 paired tender points and 8 paired control points in 4 matched groups of 6 patients with fibromyalgia (FM), myofascial pain, pain controls, and healthy controls. RESULTS: Good interrater and test-retest reliability were found for dolorimetry scores. There were significant differences in tenderness ratings by dolorimetry between the diagnostic groups, with the patients with FM and myofascial pain having the greatest tenderness, the normals having the least tenderness, and the pain controls having tenderness levels midway between the patients with FM or myofascial pain and the normals. In all patients, control points had higher pain thresholds than tender points. One-third of patients with localized pain complaints demonstrated a significant relationship between region of clinical pain complaint and measured tenderness thresholds by dolorimetry. In ratings of tenderness by digital palpation, there was very good intrarater reliability over 26 of 27 paired points, and good interrater reliability at 75% of the points. One-half of patients with localized pain complaints demonstrated a significant relationship between region of clinical pain complaint and number of tender points by palpation. CONCLUSION: Both dolorimetry and palpation are sufficiently reliable to discriminate control patients from patients with myofascial pain and FM, but may not discriminate patients with myofascial pain from those with FM. Neither method appears to correlate well with the location of the clinical pain complaint, regardless of diagnosis.

Adult↗