Clinical Accuracy of the MedGem Indirect Calorimeter for Measuring Resting Energy Expenditure in Cancer Patients

OBJECTIVE: To compare, in patients with cancer and in healthy subjects, measured resting energy expenditure (REE) from traditional indirect calorimetry to a new portable device (MedGem) and predicted REE. DESIGN: Cross-sectional clinical validation study. SETTING: Private radiation oncology centre, Brisbane, Australia. SUBJECTS: Cancer patients (n = 18) and healthy subjects (n = 17) aged 37-86 y, with body mass indices ranging from 18 to 42 kg/m(2). INTERVENTIONS: Oxygen consumption (VO(2)) and REE were measured by VMax229 (VM) and MedGem (MG) indirect calorimeters in random order after a 12-h fast and 30-min rest. REE was also calculated from the MG without adjustment for nitrogen excretion (MGN) and estimated from Harris-Benedict prediction equations. Data were analysed using the Bland and Altman approach, based on a clinically acceptable difference between methods of 5%. RESULTS: The mean bias (MGN-VM) was 10% and limits of agreement were -42 to 21% for cancer patients; mean bias -5% with limits of -45 to 35% for healthy subjects. Less than half of the cancer patients (n = 7, 46.7%) and only a third (n = 5, 33.3%) of healthy subjects had measured REE by MGN within clinically acceptable limits of VM. Predicted REE showed a mean bias (HB-VM) of -5% for cancer patients and 4% for healthy subjects, with limits of agreement of -30 to 20% and -27 to 34%, respectively. CONCLUSIONS: Limits of agreement for the MG and Harris Benedict equations compared to traditional indirect calorimetry were similar but wide, indicating poor clinical accuracy for determining the REE of individual cancer patients and healthy subjects.

Survey design: Insights from a public sector ERP success story

Research on the impact of Information Systems (IS) reported in both academic literature and popular press has reported confounding results. Some studies have reported encouraging results of IS, while others have reported nil or detrimental results. The contradictory results of these research studies can be partially attributed to the weaknesses in survey instruments. In an attempt to increase the validity of conclusions of IS assessment studies, survey instrument design should follow a rigorous and scientific procedure. This paper illustrates key validity and reliability issues in measuring Information Systems performance, using examples from a study designed to assess Enterprise Resource Planning systems success. The article emphasizes on the importance of the survey method and the theoretical considerations of item derivation, scale development and item evaluation. Examples are provided from the ERP assessment study to supplement the readers understanding of the theoretical concepts of survey design.

Key performance indicators for measuring construction success

The construction industry is dynamic in nature. The concept of project success has remained ambiguously defined in the construction industry. Project success is almost the ultimate goal for every project. However, it means different things to different people. While some writers consider time, cost and quality as predominant criteria, others suggest that success is something more complex. The aim of this paper is to develop a framework for measuring success of construction projects. In this paper, a set of key performance indicators (KPIs), measured both objectively and subjectively are developed through a comprehensive literature review. The validity of the proposed KPIs is also tested by three case studies. Then, the limitations of the suggested KPIs are discussed. With the development of KPIs, a benchmark for measuring the performance of a construction project can be set. It also provides significant insights into developing a general and comprehensive base for further research.

Measuring Consumer Loyalty : the loyalty orientation scale

Reflecting its importance to thc financial success of organisations, interest in consumer loyalty continues unabated. However, there are still many unanswered questions about its conceptualisation and measurement.These questions must he resolved before academics and practitioners can usefully apply the concept. We argue that consumer loyalty is best conceptualised as a multi-dimensional phenomenon. Based on this multi-dimensional view, we develop and test a new measure of consumer loyalty. We hypothesise a threedimensional structure containing affective, temporal and instrumental dimensions, Results from a preliminary test are reported. The results indicate that the construct can be reprcxeuted with two dimensions: affective and temporal loyally. As an additional check on the reliability of our results, we find significant correlations between these two dimensions and a measure of behavioural loyalty.