20 resultados para Interobserver Agreement
em Repositório Institucional UNESP - Universidade Estadual Paulista "Julio de Mesquita Filho"
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Pós-graduação em Ciências Odontológicas - FOAR
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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To validate a model for investigating the effects of analgesic drugs on mechanical, thermal and electrical stimulation testing. To investigate repeatability, sensitivity and specificity of nociceptive tests. Randomised experiment with 2 observers in 2 phases. Mechanical (M), thermal (TL) and electrical (E) stimuli were applied to the dorsal metacarpus (M-left and TL-right) and coronary band of the left thoracic limb (E) and a thoracic thermal stimulus (TT) was applied caudal to the withers in 8 horses (405 ± 43 kg). Stimuli intensities were increased until a clear avoidance response was detected without exceeding 20 N (M), 60°C (TL and TT) and 15 V (E). For each set of tests, 3 real stimuli and one sham stimulus were applied (32 per animal) using a blinded, randomised, crossover design repeated after 6 months. A distribution frequency and, for each stimulus, Chi-square and McNemar tests compared both the proportion of positive responses detected by 2 observers and the 2 study phases. The κ coefficients estimated interobserver agreement in determining endpoints. Sensitivity (384 tests) and specificity (128 tests) were evaluated for each nociceptive stimulus to assess the evaluators' accuracy in detecting real and sham stimuli. Nociceptive thresholds were 3.1 ± 2 N (M), 8.1 ± 3.8 V (E), 51.4 ± 5.5°C (TL) and 55.2 ± 5.3°C (TT). The level of agreement after all tests, M, E, TL and TT, was 90, 100, 84, 98 and 75%, respectively. Sensitivity was 89, 100, 89, 98 and 70% and specificity 92, 97, 88, 91 and 94%, respectively. The high interobserver agreement, sensitivity and specificity suggest that M, E and TL tests are valid for pain studies in horses and are suitable tools for investigating antinociceptive effects of analgesics in horses.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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The aim of this study was to evaluate the intraexaminer agreement in the detection of the mandibular canal roof (MCR) and mental foramen (MF) in panoramic radiographs. Forty panoramic radiographs of edentulous patients were used. Two calibrated examiners (A and B) read the images 2 times, for both sides independently, under blind conditions. The interval between the readings was 10 days. The intraexaminer agreement in the interpretation of MCR and MF was performed by kappa statistics with linear weighting (x). The intraexaminer agreement for the detection of MCR, in the left side, was good for both examiners (A: kappa = 0.67; B: kappa = 0.71). Related to the right side, it was found to be kappa = 0.47 and kappa = 0.62, respectively to A and B. The intraexaminer agreement for the detection of MF was good for both examiners interpreting the left side (A: kappa = 0.61; B: kappa = 0.63), and in relation to the right side, it was moderate (A: kappa = 0.51) and fair (B: kappa = 0.38). The intraexaminer agreement in the detection of MCR was good and from good to fair in the detection of MF.
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Statistical analysis of data is crucial in cephalometric investigations. There are certainly excellent examples of good statistical practice in the field, but some articles published worldwide have carried out inappropriate analyses. Objective: The purpose of this study was to show that when the double records of each patient are traced on the same occasion, a control chart for differences between readings needs to be drawn, and limits of agreement and coefficients of repeatability must be calculated. Material and methods: Data from a well-known paper in Orthodontics were used for showing common statistical practices in cephalometric investigations and for proposing a new technique of analysis. Results: A scatter plot of the two radiograph readings and the two model readings with the respective regression lines are shown. Also, a control chart for the mean of the differences between radiograph readings was obtained and a coefficient of repeatability was calculated. Conclusions: A standard error assuming that mean differences are zero, which is referred to in Orthodontics and Facial Orthopedics as the Dahlberg error, can be calculated only for estimating precision if accuracy is already proven. When double readings are collected, limits of agreement and coefficients of repeatability must be calculated. A graph with differences of readings should be presented and outliers discussed.
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INTRODUCTION: Visual analysis is widely used to interpret regional cerebral blood flow (rCBF) SPECT images in clinical practice despite its limitations. Automated methods are employed to investigate between-group rCBF differences in research Studies but have rarely been explored in individual analyses.OBJECTIVES: To compare visual inspection by nuclear physicians with the automated statistical parametric mapping program using a SPECT dataset of patients with neurological disorders and normal control images.METHODS: Using statistical parametric mapping, 14 SPECT images from patients with various neurological disorders were compared individually with a databank of 32 normal images using a statistical threshold of p<0.05 (corrected for multiple comparisons at the level of individual voxels or clusters). Statistical parametric mapping results were compared with Visual analyses by a nuclear physician highly experienced in neurology (A) as well as a nuclear physician with a general background of experience (B) who independently classified images as normal or altered, and determined the location of changes and the severity.RESULTS: of the 32 images of the normal databank, 4 generated maps showing rCBF abnormalities (p<0.05, corrected). Among the 14 images from patients with neurological disorders, 13 showed rCBF alterations. Statistical parametric mapping and physician A completely agreed on 84.37% and 64.28% of cases from the normal databank and neurological disorders, respectively. The agreement between statistical parametric mapping and ratings of physician B were lower (71.18% and 35.71%, respectively).CONCLUSION: Statistical parametric mapping replicated the findings described by the more experienced nuclear physician. This finding suggests that automated methods for individually analyzing rCBF SPECT images may be a valuable resource to complement visual inspection in clinical practice.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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The aim of this study was to evaluate the diagnostic agreement of conventional panoramic radiographs and their inverted scanned images in the detection of the mandibular canal and mental foramen. A total of 77 panoramic radiographs obtained from the files of totally edentulous patients were used. Digitization was done by means of a scanner with brightness and contrast adjustment, as well as image inversion. The extension of mandibular canal was divided into anterior, middle, and posterior regions, and the presence of a radiopaque line that characterized the mandibular canal was classified according to a 5-point confidence scale. The mental foramen was classified in 4 types: continuous, separated, diffuse, and unidentified. Both conventional and inverted scanned panoramic radiographs were evaluated by 3 calibrated implantologists at 2 distinct moments with a minimum interval of 10 days between them. Intraexaminer agreement was evaluated by Kappa statistics by point and by 95% confidence interval. Because the intraexaminer level of agreement was low, interexaminer agreements could not be carried out. The results showed a substantial (in 2 situations), moderate (in 16 situations), and fair (in 18 situations) intraexaminer agreement for mandibular canal and a substantial (in 1 situation), fair (in 1 situation), and moderate (in 10 situations) intraeaminer agreement for mental foramen. There were no statistically significant differences in most instances. In conclusion, the diagnostic agreement of conventional and inverted scanned panoramic radiographs for detection of mandibular canal and mental foramen was low.