The interrater reliability of the pulmonary embolism severity index

RésuméLe PESI (Pulmonary Embolism Severity Index) est un score clinique pronostique s'appliquant à des patients présentant un diagnostic d'embolie pulmonaire. Notre objectif était de démontrer la reproductibilité de ce score entre différents médecins chez des patients présentant une embolie pulmonaire. Nous avons donc identifié, de façon prospective, des patients présentant une embolie pulmonaire nouvellement diagnostiquée aux urgences d'un Hôpital Universitaire (CHUV, Lausanne). Pour tous ces patients, le médecin assistant en charge ainsi que le chef de clinique superviseur ont individuellement collecté les différentes variables permettant d'établir le score selon le PESI. Ils ont, ensuite, de façon indépendante, classifié les patients dans 5 classes de risque (1-V) ainsi qu'en deux groupes à bas risque versus haut risque, respectivement les classes i-ll et les classes III à V.Nous avons examiné la reproductibilité des données entre deux groupes de médecins (médecins assistants vs chefs de clinique), pour chacune des variables constituant le PESI, pour le score total en points, pour l'attribution aux 5 classes de risque ainsi que pour la classification en deux groupes à haut risque versus bas risque. Cette évaluation de la reproductibilité des résultats obtenus par les différents médecins s'est basée sur le calcul du Kappa (K) ainsi sur les Coefficients de Corrélation Intra-classe (ICC).Parmi les 48 patients présentant une Embolie Pulmonaire inclus dans notre étude, les coefficients de reproductibilité entre médecins assistants et chefs de clinique étaient supérieurs à 0.60 pour 10 des 11 variables du PESI. La reproductibilité entre les 2 groupes de médecins, pour le total des points, pour l'attribution à une classe de risque I à V, ainsi que pour la classification en bas versus haut risque était presque parfaite.Nos résultats démontrent la haute reproductibilité du PESI, et appuient donc l'intérêt de son utilisation pour la stratification du risque chez des patients présentant une embolie pulmonaire.

Computer-aided volume measurement of posttraumatic orbits reconstructed with AO titanium mesh plates: accuracy and reliability

PURPOSE: To prospectively evaluate the accuracy and reliability of "freehand" posttraumatic orbital wall reconstruction with AO (Arbeitsgemeinschaft Osteosynthese) titanium mesh plates by using computer-aided volumetric measurement of the bony orbits. METHODS: Bony orbital volume was measured in 12 patients from coronal CT scan slices using OsiriX Medical Image software. After defining the volumetric limits of the orbit, the segmentation of the bony orbital region of interest of each single slice was performed. At the end of the segmentation process, all regions of interest were grouped and the volume was computed. The same procedure was performed on both orbits, and thereafter the volume of the contralateral uninjured orbit was used as a control for comparison. RESULTS: In all patients, the volume data of the reconstructed orbit fitted that of the contralateral uninjured orbit with accuracy to within 1.85 cm3 (7%). CONCLUSIONS: This preliminary study has demonstrated that posttraumatic orbital wall reconstruction using "freehand" bending and placement of AO titanium mesh plates results in a high success rate in re-establishing preoperative bony volume, which closely approximates that of the contralateral uninjured orbit.

Reliability of the density functional approximation to describe the charge transfer and electrostatic complexes involved in the modeling of organic conducting polymers

Both the intermolecular interaction energies and the geometries for M ̄ thiophene, M ̄ pyrrole, M n+ ̄ thiophene, and M n+ ̄ pyrrole ͑with M = Li, Na, K, Ca, and Mg; and M n+ = Li+ , Na+ , K+ , Ca2+, and Mg2+͒ have been estimated using four commonly used density functional theory ͑DFT͒ methods: B3LYP, B3PW91, PBE, and MPW1PW91. Results have been compared to those provided by HF, MP2, and MP4 conventional ab initio methods. The PBE and MPW1PW91 are the only DFT methods able to provide a reasonable description of the M ̄ complexes. Regarding M n+ ̄ ␲ complexes, the four DFT methods have been proven to be adequate in the prediction of these electrostatically stabilized systems, even though they tend to overestimate the interaction energies.

Using time and stochastic models for software reliability forecasting and analysis

Tämä työ luo katsauksen ajallisiin ja stokastisiin ohjelmien luotettavuus malleihin sekä tutkii muutamia malleja käytännössä. Työn teoriaosuus sisältää ohjelmien luotettavuuden kuvauksessa ja arvioinnissa käytetyt keskeiset määritelmät ja metriikan sekä varsinaiset mallien kuvaukset. Työssä esitellään kaksi ohjelmien luotettavuusryhmää. Ensimmäinen ryhmä ovat riskiin perustuvat mallit. Toinen ryhmä käsittää virheiden ”kylvöön” ja merkitsevyyteen perustuvat mallit. Työn empiirinen osa sisältää kokeiden kuvaukset ja tulokset. Kokeet suoritettiin käyttämällä kolmea ensimmäiseen ryhmään kuuluvaa mallia: Jelinski-Moranda mallia, ensimmäistä geometrista mallia sekä yksinkertaista eksponenttimallia. Kokeiden tarkoituksena oli tutkia, kuinka syötetyn datan distribuutio vaikuttaa mallien toimivuuteen sekä kuinka herkkiä mallit ovat syötetyn datan määrän muutoksille. Jelinski-Moranda malli osoittautui herkimmäksi distribuutiolle konvergaatio-ongelmien vuoksi, ensimmäinen geometrinen malli herkimmäksi datan määrän muutoksille.

Reliability of P-drive in occupational therapy following a short training session: A promising instrument measuring seniors' on-road driving competencies

Introduction Occupational therapists could play an important role in facilitating driving cessation for ageing drivers. This, however, requires an easy-to-learn, standardised on-road evaluation method. This study therefore investigates whether use of P-drive' could be reliably taught to occupational therapists via a short half-day training session. Method Using the English 26-item version of P-drive, two occupational therapists evaluated the driving ability of 24 home-dwelling drivers aged 70 years or over on a standardised on-road route. Experienced driving instructors' on-road, subjective evaluations were then compared with P-drive scores. Results Following a short half-day training session, P-drive was shown to have almost perfect between-rater reliability (ICC2,1=0.950, 95% CI 0.889 to 0.978). Reliability was stable across sessions including the training phase even if occupational therapists seemed to become slightly less severe in their ratings with experience. P-drive's score was related to the driving instructors' subjective evaluations of driving skills in a non-linear manner (R-2=0.445, p=0.021). Conclusion P-drive is a reliable instrument that can easily be taught to occupational therapists and implemented as a way of standardising the on-road driving test.

Inter-rater Reliability of Criteria-Based Content Analysis of Children's Statements of Abuse.

The evaluation of children's statements of sexual abuse cases in forensic cases is critically important and must and reliable. Criteria-based content analysis (CBCA) is the main component of the statement validity assessment (SVA), which is the most frequently used approach in this setting. This study investigated the inter-rater reliability (IRR) of CBCA in a forensic context. Three independent raters evaluated the transcripts of 95 statements of sexual abuse. IRR was calculated for each criterion, total score, and overall evaluation. The IRR was variable for the criteria, with several being unsatisfactory. But high IRR was found for the total CBCA scores (Kendall's W = 0.84) and for overall evaluation (Kendall's W = 0.65). Despite some shortcomings, SVA remains a robust method to be used in the comprehensive evaluation of children's statements of sexual abuse in the forensic setting. However, the low IRR of some CBCA criteria could justify some technical improvements.

Reliability of maximal grip strength measurements and grip strength recovery following a stroke.

STUDY DESIGN: Clinical measurement. PURPOSE: The test-retest reliability of maximal grip strength measurements (MGSM) is examined in subjects for 12 weeks post-stroke together with maximal grip strength recovery and the maximal-grip and upper-extremity strength measurements' relationship with capacity and performance test scores. METHODS: A Jamar dynamometer and the Motricity Index (MI) were used for strength measurements. The Chedoke Arm and Hand Activity Inventory and ABILHAND questionnaire for evaluating capacities and performances. RESULTS: MGSM were reliable (Intraclass Correlation Coefficients = 0.97-0.99, Minimal Detectable Differences = 2.73-4.68 kg). Among the 34 participants, 47% did not have a measurable grip strength one week post-stroke but 50% of these recovered some strength within the first eight weeks. The MGSM and MI scores were correlated with scores of tests of capacity and performance (Spearman's Rank Correlation Coefficients = 0.69-0.94). CONCLUSIONS: MGSM are reliable in the first weeks after a stroke. LEVEL OF EVIDENCE: N/A.

Reliability and validity of nonverbal thin slices in social interactions

Four studies investigated the reliability and validity of thin slices of nonverbal behavior from social interactions including (1) how well individual slices of a given behavior predict other slices in the same interaction; (2) how well a slice of a given behavior represents the entirety of that behavior within an interaction; (3) how long a slice is necessary to sufficiently represent the entirety of a behavior within an interaction; (4) which slices best capture the entirety of behavior, across different behaviors; and (5) which behaviors (of six measured behaviors) are best captured by slices. Notable findings included strong reliability and validity for thin slices of gaze and nods, and that a 1.5 min slice from the start of an interaction may adequately represent some behaviors. Results provide useful information to researchers making decisions about slice measurement of behavior.

Operational Reliability Analysis of a Three-Tiered Thin-Client ERP-system in an International Corporate Environment

Internationalization and the following rapid growth have created the need to concentrate the IT systems of many small-to-medium-sized production companies. Enterprise Resource Planning systems are a common solution for such companies. Deployment of these ERP systems consists of many steps, one of which is the implementation of the same shared system at all international subsidiaries. This is also one of the most important steps in the internationalization strategy of the company from the IT point of view. The mechanical process of creating the required connections for the off-shore sites is the easiest and most well-documented step along the way, but the actual value of the system, once operational, is perceived in its operational reliability. The operational reliability of an ERP system is a combination of many factors. These factors vary from hardware- and connectivity-related issues to administrative tasks and communication between decentralized administrative units and sites. To accurately analyze the operational reliability of such system, one must take into consideration the full functionality of the system. This includes not only the mechanical and systematic processes but also the users and their administration. All operational reliability in an international environment relies heavily on hardware and telecommunication adequacy so it is imperative to have resources dimensioned with regard to planned usage. Still with poorly maintained communication/administration schemes no amount of bandwidth or memory will be enough to maintain a productive level of reliability. This thesis work analyzes the implementation of a shared ERP system to an international subsidiary of a Finnish production company. The system is Microsoft Dynamics Ax, currently being introduced to a Slovakian facility, a subsidiary of Peikko Finland Oy. The primary task is to create a feasible base of analysis against which the operational reliability of the system can be evaluated precisely. With a solid analysis the aim is to give recommendations on how future implementations are to be managed.

Flash Memory Cells Reliability Parameters Investigation

The present work is a part of the large project with purpose to qualify the Flash memory for automotive application using a standardized test and measurement flow. High memory reliability and data retention are the most critical parameters in this application. The current work covers the functional tests and data retention test. The purpose of the data retention test is to obtain the data retention parameters of the designed memory, i.e. the maximum time of information storage at specified conditions without critical charge leakage. For this purpose the charge leakage from the cells, which results in decrease of cells threshold voltage, was measured after a long-time hightemperature treatment at several temperatures. The amount of lost charge for each temperature was used to calculate the Arrhenius constant and activation energy for the discharge process. With this data, the discharge of the cells at different temperatures during long time can be predicted and the probability of data loss after years can be calculated. The memory chips, investigated in this work, were 0.035 μm CMOS Flash memory testchips, designed for further use in the Systems-on-Chips for automotive electronics.

Efficiency and reliability enhancement of silicon nanocrystal field-effect luminescence from nitride-oxide gate stacks

We report on a field-effect light emitting device based on silicon nanocrystals in silicon oxide deposited by plasma-enhanced chemical vapor deposition. The device shows high power efficiency and long lifetime. The power efficiency is enhanced up to 0.1 %25 by the presence of a silicon nitride control layer. The leakage current reduction induced by this nitride buffer effectively increases the power efficiency two orders of magnitude with regard to similarly processed devices with solely oxide. In addition, the nitride cools down the electrons that reach the polycrystalline silicon gate lowering the formation of defects, which significantly reduces the device degradation.

Reliability of digital panoramic radiography in the diagnosis of carotid artery calcifications

Objective The present study evaluated the reliability of digital panoramic radiography in the diagnosis of carotid artery calcifications. Materials and Methods Thirty-five patients under high-risk for development of carotid artery calcifications who had digital panoramic radiography were referred to undergo ultrasonography. Thus, 70 arteries were assessed by both methods. The main parameters utilized to evaluate the panoramic radiography reliability in the diagnosis of carotid artery calcifications were accuracy, sensitivity, specificity and positive predictive value of this method as compared with ultrasonography. Additionally, the McNemar's test was utilized to verify whether there was a statistically significant difference between digital panoramic radiography and ultrasonography. Results Ultrasonography demonstrated carotid artery calcifications in 17 (48.57%) patients. Such individuals presented with a total of 29 (41.43%) carotid arteries affected by calcification. Radiography was accurate in 71.43% (n = 50) of cases evaluated. The degree of sensitivity of this method was 37.93%, specificity of 95.12% and positive predictive value of 84.61%. A statistically significant difference (p < 0.001) was observed between the methods evaluated in their capacity to diagnose carotid artery calcifications. Conclusion Digital panoramic radiography should not be indicated as a method of choice in the investigation of carotid artery calcifications.