Testing the reliability of a new ultrasonic cardiac output monitor, the USCOM, by using aortic flowprobes in anesthetized dogs

We have used an animal model to test the reliability of a new portable continuous-wave Doppler ultrasonic cardiac output monitor, the USCOM. In six anesthetized dogs, cardiac output was measured with a high-precision transit time ultrasonic flowprobe placed on the ascending aorta. The dogs' cardiac output was increased with a dopamine infusion (0-15 mug (.) kg(-1) (.) min(-1)). Simultaneous flowprobe and USCOM cardiac output measurements were made. Up to 64 pairs of readings were collected from each dog. Data were compared by using the Bland and Altman plot method and Lin's concordance correlation coefficient. A total of 319 sets of paired readings were collected. The mean (+/-SD) cardiac output was 2.62 +/- 1.04 L/min, and readings ranged from 0.79 to 5.73 L/min. The mean bias between the 2 sets of readings was -0.01 L/min, with limits of agreement (95% confidence intervals) of -0.34 to 0.31 L/min. This represents a 13% error. In five of six dogs, there was a high degree of concordance, or agreement, between the 2 methods, with coefficients >0.9. The USCOM provided reliable measurements of cardiac output over a wide range of values. Clinical trials are needed to validate the device in humans.

Modelling the effects of row configuration on sorghum yield reliability in north-eastern Australia

In recent years, many sorghum producers in the more marginal (

Appraising the quality of randomized controlled trials: inter-rater reliability for the OTseeker evidence database

Rationale and aims 'OTseeker' is an online database of randomized controlled trials (RCTs) and systematic reviews relevant to occupational therapy. RCTs are critically appraised and rated for quality using the 'PEDro' scale. We aimed to investigate the inter-rater reliability of the PEDro scale before and after revising rating guidelines. Methods In study 1, five raters scored 100 RCTs using the original PEDro scale guidelines. In study 2, two raters scored 40 different RCTs using revised guidelines. All RCTs were randomly selected from the OTseeker database. Reliability was calculated using Kappa and intraclass correlation coefficients [ICC (model 2,1)]. Results Inter-rater reliability was 'good to excellent' in the first study (Kappas >= 0.53; ICCs >= 0.71). After revising the rating guidelines, the reliability levels were equivalent or higher to those previously obtained (Kappas >= 0.53; ICCs >= 0.89), except for the item, 'groups similar at baseline', which still had moderate reliability (Kappa = 0.53). In study 2, two PEDro scale items, which had their definitions revised, 'less than 15% dropout' and 'point measures and variability', showed higher reliability. In both studies, the PEDro items with the lowest reliability were 'groups similar at baseline' (Kappas = 0.53), 'less than 15% dropout' (Kappas

Test-retest reliability and practice effects of a rapid screen of mild traumatic brain injury

Test-retest reliabilities and practice affects of measures from the Rapid Screen of Concussion (RSC), in addition to the Digit Symbol Substitution Test (Digit Symbol), were examined. Twenty five male participants were tested three times; each testing session scheduled a week apart. The test-retest reliability estimates for most measures were reasonably good, ranging from .79 to .97. An exception was the delayed word recall test, which has had a reliability estimate of .66 for the first retest, and .59 for the second retest. Practice effects were evident from Times 1 to 2 on the sentence comprehension and delayed recall subtests of the RSC, Digit Symbol and a composite score. There was also a practice effect of the same magnitude found from Time 2 to Time 3 on Digit Symbol, delayed recall and the composite score. Statistics on measures for both the first and second retest intervals, with associated practice affects, are presented to enable the calculation of reliable change indices (RCI). The RCI may be used to assess any improvement in cognitive functioning after mild Traumatic Brain Injury.

The reliability and validity of the Therapeutic activity index

Purpose To assess the psychometric properties of the Simplified Therapeutic Intervention Scoring System (TISS 28) scale. Materials and Methods A prospective observational design was used. Patients were recruited from a medical-surgical intensive care unit (ICU) and 4 rehabilitation wards of 2 university-affiliated hospitals in Hong Kong. Results Data necessary for the calculation of the TISS 28, the Therapeutic Intervention Scoring System (TISS 76), and severity of illness scoring system (Simplified Acute Physiology Score [SAPS II]) were recorded for each patient during the first 24 hours after his/her admission to an ICU. A significant positive correlation was found between the TISS 76 and the TISS 28 scores as well as the TISS 28 and the SAPS II scores. There was a significant difference between the TISS 28 scores among ICU patients and patients in rehabilitation wards. A significant correlation was found between the TISS 28 scores of the first and second set of TISS 28 scores. Conclusions Although the findings supported the validity and reliability of the TISS 28, there were limitations of the TISS 28 in measuring nursing workload in ICUs. Hence, continued amendment and validation of the TISS 28 on larger samples in different ICUs would be required so as to provide clinical nurses with a valid and reliable assessment of nursing workload.

Reliability and validity of the medical outcomes study social support survey (Chinese version)

No Abstract

Measuring mobility in frail older people: reliability and validity of the Physical Mobility Scale

Objectives: The study was designed to show the validity and reliability of scoring the Physical Mobility Scale (PMS). PMS was developed by physiotherapists working in residential aged care to specifically show resident functional mobility and to provide information regarding each resident's need for supervision or assistance from one or two staff members and equipment during position changes, transfers, mobilising and personal care. Methods: Nineteen physiotherapists of varying backgrounds and experience scored the performances of nine residents of care facilities from video recordings. The performances were compared to scores on two 'gold standard' assessment tools. Four of the physiotherapists repeated the evaluations. Results: The PAIS showed excellent content validity and reliability. Conclusions: The PAIS provides graded performance of physical mobility, including level of dependency on staff and equipment. This is a major advantage over existing functional assessment tools. There is no need for specific training for physiotherapists to use the tool.

Treating dysarthria following traumatic brain injury: Investigating the benefits of commencing treatment during post-traumatic amnesia in two participants

Primary objective: The aims of this preliminary study were to explore the suitability for and benefits of commencing dysarthria treatment for people with traumatic brain injury (TBI) while in post-traumatic amnesia ( PTA). It was hypothesized that behaviours in PTA don't preclude participation and dysarthria characteristics would improve post-treatment. Research design: A series of comprehensive case analyses. Methods and procedures: Two participants with severe TBI received dysarthria treatment focused on motor speech deficits until emergence from PTA. A checklist of neurobehavioural sequelae of TBI was rated during therapy and perceptual and motor speech assessments were administered before and after therapy. Main outcomes and results: Results revealed that certain behaviours affected the quality of therapy but didn't preclude the provision of therapy. Treatment resulted in physiological improvements in some speech sub-systems for both participants, with varying functional speech outcomes. Conclusions: These findings suggest that dysarthria treatment can begin and provide short-term benefits to speech production during the late stages of PTA post-TBI.

An Internet-based telerehabilitation system for the assessment of motor speech disorders: A pilot study

Purpose: This pilot study explored the feasibility and effectiveness of an Internet-based telerehabilitation application for the assessment of motor speech disorders in adults with acquired neurological impairment. Method: Using a counterbalanced, repeated measures research design, 2 speech-language pathologists assessed 19 speakers with dysarthria on a battery of perceptual assessments. The assessments included a 19-item version of the Frenchay Dysarthria Assessment (FDA; P. Enderby, 1983), the Assessment of Intelligibility of Dysarthric Speech (K. M. Yorkston & D. R. Beukelman, 1981), perceptual analysis of a speech sample, and an overall rating of severity of the dysarthria. One assessment was conducted in the traditional face-to-face manner, whereas the other assessment was conducted using an online, custom-built telerehabilitation application. This application enabled real-time videoconferencing at 128 kb/s and the transfer of store-and-forward audio and video data between the speaker and speech-language pathologist sites. The assessment methods were compared using the J.M.Bland and D.G.Altman (1986, 1999) limits-of-agreement method and percentage level of agreement between the 2 methods. Results: Measurements of severity of dysarthria, percentage intelligibility in sentences, and most perceptual ratings made in the telerehabilitation environment were found to fall within the clinically acceptable criteria. However, several ratings on the FDA were not comparable between the environments, and explanations for these results were explored. Conclusions: The online assessment of motor speech disorders using an Internet-based telerehabilitation system is feasible. This study suggests that with additional refinement of the technology and assessment protocols, reliable assessment of motor speech disorders over the Internet is possible. Future research methods are outlined.

Product warranty and reliability

Product warranty is an important part of new product marketing and sales. Offering warranty implies additional costs in the form of warranty servicing cost. Product reliability has a serious impact on the warranty servicing cost. As such, effective management of product reliability must take into account the link between warranty and reliability. This paper deals with this topic and develops a framework needed for effective management of product reliability. It reviews the relevant literature and defines topics for future research.

Reliability and validity of arm volume measurements for assessment of lymphedema

Background and Purpose. Arm lymphedema following breast cancer In this study, we assessed the surgery is a continuing problem. reliability and validity of circumferential measurements and water displacement for measuring upper-limb volume. Subjects. Participants included subjects who had had breast cancer surgery, including axillary dissection-19 with and 22 without a diagnosis of arm lymphedema-and 25 control subjects. Methods. Two raters measured each subject by using circumferential tape measurements at specified distances from the fingertips and in relation to anatornic landmarks and by using water displacement. Interrater reliability was calculated by analysis of variance and multilevel modeling. Volumes from circumferential measurements were compared with those from water displacement by use of means and correlation coefficients, respectively. The standard error of measurement, minimum detectable change (MDC), and limits of agreement (LOA) for volumes also were calculated. Results. Arm volumes obtained with these methods had high reliability. Compared with volumes from water displacement, volumes from circumferential measurements had high validity, although these volumes were slightly larger. Expected differences between subjects with and without clinical lymphedema following breast cancer were found. The MDC of volumes or the error associated with a single measure for data based oil anatomic landmarks was lower than that based oil distance from fingertips. The mean LOA with water displacement were lower for data based on anatomic landmarks than for data based on distance from fingertips. Discussion and Conclusion. Volumes calculated from anatomic landmarks are reliable, valid, and more accurate than those obtained from circumferential measurements based on distance from fingertips.

Reliability of a measure of prediagnosis physical activity for cancer survivors

Purpose: This study was conducted to examine the test-retest reliability of a measure of prediagnosis physical activity participation administered to colorecial cancer survivors recruited from a population-based state cancer registry. Methods: A total of 112 participants completed two telephone interviews. I month apart, reporting usual weekly physical activity in the year before their cancer diagnosis. Intraclass correlation coefficients (ICC) and standard en-or of measurement (SEM) were used to describe the test-retest reliability of the measure across the sample: the Bland-Altman approach was used to describe reliability at the individual level. The test-retest reliability for categorized total physical activity (active, insufficiently active, sedentary) was assessed using the kappa statistic. Results: When the complete sample was considered, the ICC ranged from 0.40 (95% Cl: 0.24, 0.55) for vigorous gardening to 0.77 (95% Cl: 0.68, 0.84) for moderate physical activity. The SEM, however, were large. indicating high measurement error. The Bland-Altman plots indicated that the reproducibility of data decreases as the aniount of physical activity reported each week increases The kappa coefficient for the categorized data was 0.62 (95% Cl: 0.48, 0.76). Conclusion: Overall. the results indicated low levels of repeatability for this measure of historical physical activity. Categorizing participants as active, insufficiently active, or sedentary provides a higher level of test-retest reliability.

The diagnostic interview for psychoses (DIP): development, reliability and applications

Background. We describe the development, reliability and applications of the Diagnostic Interview for Psychoses (DIP), a comprehensive interview schedule for psychotic disorders. Method. The DIP is intended for use by interviewers with a clinical background and was designed to occupy the middle ground between fully structured, lay-administered schedules, and semi-structured., psychiatrist-administered interviews. It encompasses four main domains: (a) demographic data; (b) social functioning and disability; (c) a diagnostic module comprising symptoms, signs and past history ratings; and (d) patterns of service utilization Lind patient-perceived need for services. It generates diagnoses according to several sets of criteria using the OPCRIT computerized diagnostic algorithm and can be administered either on-screen or in a hard-copy format. Results. The DIP proved easy to use and was well accepted in the field. For the diagnostic module, inter-rater reliability was assessed on 20 cases rated by 24 clinicians: good reliability was demonstrated for both ICD-10 and DSM-III-R diagnoses. Seven cases were interviewed 2-11 weeks apart to determine test-retest reliability, with pairwise agreement of 0.8-1.0 for most items. Diagnostic validity was assessed in 10 cases, interviewed with the DIP and using the SCAN as 'gold standard': in nine cases clinical diagnoses were in agreement. Conclusions. The DIP is suitable for use in large-scale epidemiological studies of psychotic disorders. as well as in smaller Studies where time is at a premium. While the diagnostic module stands on its own, the full DIP schedule, covering demography, social functioning and service utilization makes it a versatile multi-purpose tool.