Reproducibility of 6-minute walking test in patients with COPD

The reproducibility of the 6-min walking test (6MWT) needs to be more solidly studied. This study aimed to investigate the reproducibility of two 6MWTs performed on subsequent days in a large and representative sample of patients with chronic obstructive pulmonary disease (COPD), and to quantify the learning effect between the two tests, as well as its determinants.In a retrospective observational study, 1,514 patients with COPD performed two 6MWTs on subsequent days. Other measurements included body composition (dual X-ray absorptiometry), dyspnoea (Medical Research Council scale) and comorbidity (Charlson index).Although the 6MWT was reproducible (intraclass correlation coefficient=0.93), patients walked farther in the second test (391 m, 95% CI 155-585 m versus 418 m, 95% CI 185-605 m; p < 0.0001). on average, the second 6MWT increased by 27 m (or 7%), and 82% of patients improved in the second test. Determinants of improvement >= 42 m in the second test (upper limit of the clinically important change) were as follows: first 6MWT < 350 m, Charlson index < 2 and body mass index < 30 kg.m(-2) (OR 2.49, 0.76 and 0.60, respectively).The 6MWT was statistically reproducible in a representative sample of patients with COPD. However, the vast majority of patients improved significantly in the second test by an average learning effect of 27 m.

Reproducibility and accuracy of the ICDAS-II for occlusal caries detection

Objectives:The aim of this in vitro study was to assess the inter- and intra-examiner reproducibility and the accuracy of the International Caries Detection and Assessment System-II (ICDAS-II) in detecting occlusal caries.Methods:One hundred and sixty-three molars were independently assessed twice by two experienced dentists using the 0- to 6-graded ICDAS-II. The teeth were histologically prepared and classified using two different histological systems [Ekstrand et al. (1997) Caries Research vol. 31, pp. 224-231; Lussi et al. (1999) Caries Research vol. 33, pp. 261-266] and assessed for caries extension. Sensitivity, specificity, accuracy and area under the ROC curve (A(z)) were obtained at D(2) and D(3) thresholds. Unweighted kappa coefficient was used to assess inter- and intra-examiner reproducibility.Results:For the Ekstrand et al. histological classification the sensitivity was 0.99 and 1.00, specificity 1.00 and 0.69 and accuracy 0.99 and 0.76 at D(2) and D(3), respectively. For the Lussi et al. histological classification the sensitivity was 0.91 and 0.75, specificity 0.47 and 0.62 and accuracy 0.86 and 0.68 at D(2) and D(3), respectively. The A(z) varied from 0.54 to 0.73. The inter- and intra-examiner kappa values were 0.51 and 0.58, respectively.Conclusions:ICDAS-II presented good reproducibility and accuracy in detecting occlusal caries, especially caries lesions in the outer half of the enamel.

Influence of examiner's clinical experience on the reproducibility and accuracy of radiographic examination in detecting occlusal caries

The aim of this in vitro study was to assess the influence of varying examiner's clinical experience on the reproducibility and accuracy of radiographic examination for occlusal caries detection. Standardized bitewing radiographs were obtained from 166 permanent molars. Radiographic examination was performed by final-year dental students from two universities (A, n=5; B, n=5) and by dentists with 5 to 7 years of experience who work in two different countries (C, n=5; D, n=5). All examinations were repeated after 1-week interval. The teeth were histologically prepared and assessed for caries extension. For intraexaminer reproducibility, the unweighted kappa values were: A (0.11-0.40), B (0.12-0.33), C (0.47-0.58), and D (0.42-0.71). Interexaminer reproducibility statistics were computed based on means +/- SD of unweighted kappa values: A (0.07 +/- 0.05), B (0.12 +/- 0.09), C (0.24 +/- 0.08), and D (0.33 +/- 0.10). Sensitivity, specificity, and accuracy were calculated at D(1) and D(3) thresholds and compared by performing McNemar test (p=0.05). D(1) sensitivity ranged between 0.29 and 0.75 and specificity between 0.24 and 0.85. D(3) specificity was moderate to high (between 0.62 and 0.95) for all groups, with statistically significant difference between the dentists groups (C and D). Sensitivity was low to moderate (between 0.21 and 0.57) with statistically significant difference for groups B and D. Accuracy was similar for all groups (0.55). Spearman's correlations were: A (0.12), B (0.24), C (0.30), and D (0.38). In conclusion, the reproducibility of radiographic examination was influenced by the examiner's clinical experience, training, and dental education as well as the accuracy in detecting occlusal caries.

Validity and reproducibility of a laser fluorescence system for detecting the activity of white-spot lesions on free smooth surfaces in vivo

The aim of the study was to determine the reproducibility and validity of DIAGNOdent in detecting active and arrested caries lesions on free smooth surfaces. Volunteers were selected from state schools of Piracicaba, São Paulo, Brazil. Overall, 220 lesions were clinically examined. Two specially trained ('calibrated') examiners performed both clinical and laser evaluations independently, and after a 1-week interval, the examinations were repeated, the intra-examiner agreement for the laser evaluation was substantial (kappa(ex1) = 0.79, kappa(ex2) = 0.71). There was almost perfect agreement between the two examiners for the clinical examination (kappa(ex1) = 0.95, kappa(ex2) = 0.85). The inter-examiner agreement showed substantial reproducibility (kappa = 0.77) for the laser examination and almost perfect agreement (kappa = 0.85) for the clinical evaluation. The validation criterion was the clinical examination of white spots, recorded as active or arrested. The sensitivity was 0.72 and the specificity was 0.73, which indicates that the DIAGNOdent was a good auxiliary method for detecting incipient caries lesions on free smooth surfaces. The utilization of both methods can improve the efficacy of caries diagnosis. Copyright (C) 2002 S. Karger AG, Basel.

Reproducibility and validity of self-perceived oral health conditions

The reproducibility and validity of self-perceived periodontal, dental, and temporomandibular joint (TMJ) conditions were investigated. A questionnaire was applied in interview to 200 adults aged from 35 to 44, who were attending as casual patients at Araraquara School of Dentistry, Sauo Paulo State University, Sauo Paulo, Brazil. Clinical examination was based on the guidelines of the World Health Organization manual. The interview and the clinical examination were performed in two occasions, by a calibrated examiner. Reproducibility and validity were, respectively, verified by kappa statistics (kappa) and sensitivity (Sen) and specificity (Spec) values, having clinical examination as the validation criterion. The results showed an almost perfect agreement for self-perceived TMJ (kappa=0.85) and periodontal conditions (kappa=0.81), and it was substantial for dental condition (kappa=0.69). Reproducibility according to clinical examination showed good results (kappa=0.73 for CPI index, kappa=0.96 for dental caries, and kappa=0.74 for TMJ conditions). Sensitivity and specificity values were higher for self-perceived dental (Sen=0.84, Spec=1.0) and TMJ conditions (Sen=1.0, Spec=0.8). With regard to periodontal condition, specificity was low (0.43), although sensitivity was very high (1.0). Self-perceived oral health was reliable for the examined conditions. Validity was good to detect dental conditions and TMJ disorders, and it was more sensitive than specific to detect the presence of periodontal disease.

Influence of image filters on the reproducibility of measurements of alveolar bone loss

The reproducibility of measurements of alveolar bone loss on radiographs may be a problem on epidemiologic studies, as they are based on comparisons of the diagnosis of various examiners. The aim of the present research paper was to assess the inter- and intra-examiner reproducibility of measurements of the interproximal alveolar bone loss on non-manipulated digital radiographs and after the application of image filters. Five Oral Radiologists measured the distance between the cementoenamel junction (CEJ) to the alveolar crest or to the deepest point of the bony defect on 12 interproximal digital radiographs of molars and bicuspids of a dry human skull. The digital manipulation and the linear measurements were obtained with the Trophy Windows software (Throphy®). For each image, six different versions were created: 1) non-manipulated; 2) bright-contrast adjustment; 3) negative; 4) negative with brightness-contrast adjustment; 5) pseudo-colored; 6) pseudo-colored with brightness-contrast adjustment. In order to prevent interpretation bias because of the repetition of measurements, the examiners measured the radiographs in a random sequence. The two-way ANOVA test at 5% level of significance to compare the means of readings of the same operator with each filter indicated p<0.05 for the majority of operators, while the comparison between the mean values of operators using the same filter indicated p>0.05 for all filters. Based on the results, we concluded that linear measurements of interproximal alveolar bone loss on digital radiographs are highly reproducible among examiners. Nevertheless, the application of image filters significantly influenced the degree of intra-examiner reproducibility. Some filters even reduced the reproducibility of intra-examiner readings.

Effect of drying on the reproducibility of DIAGNOdent to detect caries-like lesions

The aim of this study was to verify the drying effect on the reproducibility of DIAGNOdent (Dd) devices to detect caries-like lesions. Three areas were created in each of the 34 bovine incisors: sound (S), demineralized (DE) and remineralized (RE). One examiner measured each area with two Dd devices (denominated X and Y), twice under humid, and twice under dry condition. Intra-rater agreement according each device and inter-device agreement were estimated by kappa statistics (κ). Intra-rater agreement for device Y was substantial under humid (κ DE=0.68 and κ RE+S=0.68) and dry condition (κ DE=0.64 and κ RE+S=0.67). For device X, it was substantial under humid condition (κ DE=0.57 and κ RE+S=0.49), and it was almost perfect after air drying (κ DE=1.0 and κRE+S=1.0). Inter-device agreement was slight (κ =0.17) under humid condition, and it was substantial under dry condition (κ =0.62). As reproducibility increased under dry condition, drying is advised to detect caries-like lesions on free smooth surfaces when different devices are used.

New alternative for human identification. Investigator IDplex Kit - QIAGEN® reproducibility: Latin American interlaboratory study

In 2010 QIAGEN® launched to eight kits of different combinations of STRs, including the Investigator IDplex Kit. This kit allows amplification in one PCR 16 markers. The aim of this study was to evaluate the reproducibility of Investigator IDplex Kit among Latin America laboratories. In the framework of the 'III International Theoretical-Practice Course in Populations Genetic and Biologicals Filiations' in Medellín-Colombia, all participants were invited to evaluate the reproducibility of this kit, they were provided of the necessary materials for the study. The results reported by participating were tabulated for the study the reproducibility. Results and comments were received on the agreed date of 12 of the 22 laboratories registered, one participant submits comments only. Some laboratories reported greater sensitivity Investigator IDplex Kit compared with other kits containing similar markers, also highlight the easy adaptability to existing conditions in laboratories, without involving major changes to its implementation. This paper shows the high reproducibility of Investigator IDplex Kit, a new tool offered by QIAGEN® for all laboratories that perform human identification testing and biological relationship testing using DNA markers. © 2011 Elsevier B.V.

Reproducibility of microhandeness measurements in different surfices

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Intra-examiner reproducibility of the agar plate method for estmation of phospholipase activity in candida albicans

Although measurement errors can impair statistical analysis, reliability analysis has been neglected in applied microbiology. This study assessed the intra-rater reproducibility of the Agar-based method for estimation of phospholipase activity (Pz). Pz readings were performed twice by two examiners (E1, E2), either directly on plates or in photos, and both black and white backgrounds were used. Pz values were taken from one or triplicate colonies from each sample (n=30). Intra-examiner reproducibility was estimated using Intraclass Correlation Coefficient (ICC). For both examiners, reading triplicate (ICCE1=0.91, ICCE2=0.86) was better than one colony (ICCE1=0.86, ICCE2=0.80). E1 had an excellent concordance when measurements were performed on photos using a white background (ICC=0.95) and a good concordance in the other conditions

Reproducibility of heart rate and rating of perceived exertion values obtained from different incremental treadmill tests

Objective The present study aimed to examine the reproducibility of heart rate (HR) and rating of perceived exertion (RPE) values obtained during different incremental treadmill tests. Equipment and methods Twenty male, recreational, endurance-trained runners (10-km running pace: 10–15 km·h−1) performed, in a counterbalanced order, three continuous incremental exercise tests with different speed increments (0.5 km·h−1, 1 km·h−1 and 2 km·h−1). Thereafter, each participant performed the three tests again, maintaining the same order as before. The reproducibility of the HR and RPE values were analyzed for all protocols during submaximal intensities (8, 10, 12, and 14 km·h−1). In addition, it was examined the reproducibility of maximal HR (HRmax) and peak RPE (RPEpeak). Results The variability of both the HR and RPE values showed a tendency to decrease over the stages during the incremental test and was not or slightly influenced by the incremental test design. The HR at 14 km·h−1 and HRmax presented the highest reproducibility (CV < 2%). In contrast, the submaximal RPE values showed higher variability indices (i.e., CV > 5.0%). In conclusion, the HR values were highly reproducible during the stages of the incremental test, in contrast to the RPE values that presented limited reproducibility.

Reproducibility of South American precipitation due to subtropical South Atlantic SSTs

This work investigates the eproducibility of precipitation simulated with an atmospheric general circulation model (AGCM) forced by subtropical South Atlantic sea surface temperature (SST) anomalies. This represents an important test of the model prior to investigating the impact of SSTs on regional climate. A five-member ensemble run was performed using the National Center for Atmospheric Research (NCAR) Community Climate Model, version 3 (CCM3). The CCM3 was forced by observed monthly SST over the South Atlantic from 20 to 60 S. The SST dataset used is from the Hadley Centre covering the period of September 1949-October 2001; this covers more than 50 yr of simulation. A statistical technique is used to determine the reproducibility in the CCM3 runs and to assess potential predictability in precipitation. Empirical orthogonal function analysis is used to reconstruct the ensemble using the most reproducible forced modes in order to separate the atmospheric response to local SST forcing from its internal variability. Results for reproducibility show a seasonal dependence, with higher values during austral autumn and spring. The spatial distribution of reproducibility shows that the tropical atmosphere is dominated by the underlying SSTs while variations in the subtropical-extratropical regions are primarily driven by internal variability. As such, changes in the South Atlantic convergence zone (SACZ) region are mainly dominated by internal atmospheric variability while the ITCZ has greater external dependence, making it more predictable. The reproducibility distribution reveals increased values after the reconstruction of the ensemble.

12 item Allodynia Symptom Checklist/Brasil: cross-cultural adaptation, internal consistency and reproducibility

Since there was no Portuguese questionnaire to evaluate cutaneous allodynia, which has been pointed out as a risk factor of migraine, we aimed to perform the cross-cultural adaptation of the 12 item Allodynia Symptom Checklist for the Brazilian population and to test its measurement properties. It consisted in six stages: translation, synthesis, back translation, revision by a specialist committee, pretest and submission the documents to the committee. In the pretest stage, the questionnaire was applied to 30 migraineurs of both sexes, who had some difficulty in understanding it. Thus, a second version was applied to 30 additional subjects, with no difficulties being reported. The mean filling out time was 3'36", and the internal consistency was 0.76. To test reproducibility, 15 other subjects filled out the questionnaire at two different times, it was classified as moderate (weighted kappa=0.58). We made available to Brazilian population an easy, quick and reliable questionnaire.