Scoring Methods for Ordinal Multidimensional Forced-Choice Items

In most psychological tests and questionnaires, a test score is obtained bytaking the sum of the item scores. In virtually all cases where the test orquestionnaire contains multidimensional forced-choice items, this traditionalscoring method is also applied. We argue that the summation of scores obtained with multidimensional forced-choice items produces uninterpretabletest scores. Therefore, we propose three alternative scoring methods: a weakand a strict rank preserving scoring method, which both allow an ordinalinterpretation of test scores; and a ratio preserving scoring method, whichallows a proportional interpretation of test scores. Each proposed scoringmethod yields an index for each respondent indicating the degree to whichthe response pattern is inconsistent. Analysis of real data showed that withrespect to rank preservation, the weak and strict rank preserving methodresulted in lower inconsistency indices than the traditional scoring method;with respect to ratio preservation, the ratio preserving scoring method resulted in lower inconsistency indices than the traditional scoring method

Scoring Methods for Ordinal Multidimensional Forced-Choice Items

In most psychological tests and questionnaires, a test score is obtained by taking the sum of the item scores. In virtually all cases where the test or questionnaire contains multidimensional forced-choice items, this traditional scoring method is also applied. We argue that the summation of scores obtained with multidimensional forced-choice items produces uninterpretable test scores. Therefore, we propose three alternative scoring methods: a weak and a strict rank preserving scoring method, which both allow an ordinal interpretation of test scores; and a ratio preserving scoring method, which allows a proportional interpretation of test scores. Each proposed scoring method yields an index for each respondent indicating the degree to which the response pattern is inconsistent. Analysis of real data showed that with respect to rank preservation, the weak and strict rank preserving method resulted in lower inconsistency indices than the traditional scoring method; with respect to ratio preservation, the ratio preserving scoring method resulted in lower inconsistency indices than the traditional scoring method

Páros összehasonlításon alapuló pontozási eljárások monotonitása: önkonzisztencia és önkonzisztens monotonitás. Adalékok a pontozási eljárások axiomatikus tárgyalásához = Monotonicity of paired comparison-based ranking methods: self-consistency and self-consistent monotonicity. Contributions to an axiomatic analysis of scoring methods

A cikk a páros összehasonlításokon alapuló pontozási eljárásokat tárgyalja axiomatikus megközelítésben. A szakirodalomban számos értékelő függvényt javasoltak erre a célra, néhány karakterizációs eredmény is ismert. Ennek ellenére a megfelelő módszer kiválasztása nem egy-szerű feladat, a különböző tulajdonságok bevezetése elsősorban ebben nyújthat segítséget. Itt az összehasonlított objektumok teljesítményén érvényesülő monotonitást tárgyaljuk az önkonzisztencia és önkonzisztens monotonitás axiómákból kiindulva. Bemutatásra kerülnek lehetséges gyengítéseik és kiterjesztéseik, illetve egy, az irreleváns összehasonlításoktól való függetlenséggel kapcsolatos lehetetlenségi tétel is. A tulajdonságok teljesülését három eljárásra, a klasszikus pontszám eljárásra, az ezt továbbfejlesztő általánosított sorösszegre és a legkisebb négyzetek módszerére vizsgáljuk meg, melyek mindegyike egy lineáris egyenletrendszer megoldásaként számítható. A kapott eredmények új szempontokkal gazdagítják a pontozási eljárás megválasztásának kérdését. _____ The paper provides an axiomatic analysis of some scoring procedures based on paired comparisons. Several methods have been proposed for these generalized tournaments, some of them have been also characterized by a set of properties. The choice of an appropriate method is supported by a discussion of their theoretical properties. In the paper we focus on the connections of self-consistency and self-consistent-monotonicity, two axioms based on the comparisons of object's performance. The contradiction of self-consistency and independence of irrel-evant matches is revealed, as well as some possible reductions and extensions of these properties. Their satisfiability is examined through three scoring procedures, the score, generalised row sum and least squares methods, each of them is calculated as a solution of a system of linear equations. Our results contribute to the problem of finding a proper paired comparison based scoring method.

Additive and multiplicative properties of scoring methods for preference aggregation

The paper reviews some additive and multiplicative properties of ranking procedures used for generalized tournaments with missing values and multiple comparisons. The methods analysed are the score, generalised row sum and least squares as well as fair bets and its variants. It is argued that generalised row sum should be applied not with a fixed parameter, but a variable one proportional to the number of known comparisons. It is shown that a natural additive property has strong links to independence of irrelevant matches, an axiom judged unfavourable when players have different opponents.

The accuracy of the Clock Drawing Test compared to that of standard screening tests for Alzheimer`s disease: results from a study of Brazilian elderly with heterogeneous educational backgrounds

Background: Although the Clock Drawing Test (CDT) is the second most used test in the world for the screening of dementia, there is still debate over its sensitivity specificity, application and interpretation in dementia diagnosis. This study has three main aims: to evaluate the sensitivity and specificity of the CDT in a sample composed of older adults with Alzheimer`s disease (AD) and normal controls; to compare CDT accuracy to the that of the Mini-mental State Examination (MMSE) and the Cambridge Cognitive Examination (CAMCOG), and to test whether the association of the MMSE with the CDT leads to higher or comparable accuracy as that reported for the CAMCOG. Methods: Cross-sectional assessment was carried out for 121 AD and 99 elderly controls with heterogeneous educational levels from a geriatric outpatient clinic who completed the Cambridge Examination for Mental Disorder of the Elderly (CAMDEX). The CDT was evaluated according to the Shulman, Mendez and Sunderland scales. Results: The CDT showed high sensitivity and specificity. There were significant correlations between the CDT and the MMSE (0.700-0.730; p < 0.001) and between the CDT and the CAMCOG (0.753-0.779; p < 0.001). The combination of the CDT with the MMSE improved sensitivity and specificity (SE = 89.2-90%; SP = 71.7-79.8%). Subgroup analysis indicated that for elderly people with lower education, sensitivity and specificity were both adequate and high. Conclusions: The CDT is a robust screening test when compared with the MMSE or the CAMCOG, independent of the scale used for its interpretation. The combination with the MMSE improves its performance significantly, becoming equivalent to the CAMCOG.

Ruling out coronary heart disease in primary care patients with chest pain : a clinical prediction score

ABSTRACT: BACKGROUND: Chest pain raises concern for the possibility of coronary heart disease. Scoring methods have been developed to identify coronary heart disease in emergency settings, but not in primary care. METHODS: Data were collected from a multicenter Swiss clinical cohort study including 672 consecutive patients with chest pain, who had visited one of 59 family practitioners' offices. Using delayed diagnosis we derived a prediction rule to rule out coronary heart disease by means of a logistic regression model. Known cardiovascular risk factors, pain characteristics, and physical signs associated with coronary heart disease were explored to develop a clinical score. Patients diagnosed with angina or acute myocardial infarction within the year following their initial visit comprised the coronary heart disease group. RESULTS: The coronary heart disease score was derived from eight variables: age, gender, duration of chest pain from 1 to 60 minutes, substernal chest pain location, pain increases with exertion, absence of tenderness point at palpation, cardiovascular risks factors, and personal history of cardiovascular disease. Area under the receiver operating characteristics curve was of 0.95 with a 95% confidence interval of 0.92; 0.97. From this score, 413 patients were considered as low risk for values of percentile 5 of the coronary heart disease patients. Internal validity was confirmed by bootstrapping. External validation using data from a German cohort (Marburg, n = 774) revealed a receiver operating characteristics curve of 0.75 (95% confidence interval, 0.72; 0.81) with a sensitivity of 85.6% and a specificity of 47.2%. CONCLUSIONS: This score, based only on history and physical examination, is a complementary tool for ruling out coronary heart disease in primary care patients complaining of chest pain.

Implementation study of a clinical prediction score to rule out cardiogenic chest pain in community: Cluster randomized trial

1.1 Fundamentals Chest pain is a common complaint in primary care patients (1 to 3% of all consultations) (1) and its aetiology can be miscellaneous, from harmless to potentially life threatening conditions. In primary care practice, the most prevalent aetiologies are: chest wall syndrome (43%), coronary heart disease (12%) and anxiety (7%) (2). In up to 20% of cases, potentially serious conditions as cardiac, respiratory or neoplasic diseases underlie chest pain. In this context, a large number of laboratory tests are run (42%) and over 16% of patients are referred to a specialist or hospitalized (2).¦A cardiovascular origin to chest pain can threaten patient's life and investigations run to exclude a serious condition can be expensive and involve a large number of exams or referral to specialist -­‐ often without real clinical need. In emergency settings, up to 80% of chest pains in patients are due to cardiovascular events (3) and scoring methods have been developed to identify conditions such as coronary heart disease (HD) quickly and efficiently (4-­‐6). In primary care, a cardiovascular origin is present in only about 12% of patients with chest pain (2) and general practitioners (GPs) need to exclude as safely as possible a potential serious condition underlying chest pain. A simple clinical prediction rule (CPR) like those available in emergency settings may therefore help GPs and spare time and extra investigations in ruling out CHD in primary care patients. Such a tool may also help GPs reassure patients with more common origin to chest pain.

Ruling out coronary heart disease in primary care patients with chest pain: a clinical prediction score.

ABSTRACT: BACKGROUND: Chest pain raises concern for the possibility of coronary heart disease. Scoring methods have been developed to identify coronary heart disease in emergency settings, but not in primary care. METHODS: Data were collected from a multicenter Swiss clinical cohort study including 672 consecutive patients with chest pain, who had visited one of 59 family practitioners' offices. Using delayed diagnosis we derived a prediction rule to rule out coronary heart disease by means of a logistic regression model. Known cardiovascular risk factors, pain characteristics, and physical signs associated with coronary heart disease were explored to develop a clinical score. Patients diagnosed with angina or acute myocardial infarction within the year following their initial visit comprised the coronary heart disease group. RESULTS: The coronary heart disease score was derived from eight variables: age, gender, duration of chest pain from 1 to 60 minutes, substernal chest pain location, pain increases with exertion, absence of tenderness point at palpation, cardiovascular risks factors, and personal history of cardiovascular disease. Area under the receiver operating characteristics curve was of 0.95 with a 95% confidence interval of 0.92; 0.97. From this score, 413 patients were considered as low risk for values of percentile 5 of the coronary heart disease patients. Internal validity was confirmed by bootstrapping. External validation using data from a German cohort (Marburg, n = 774) revealed a receiver operating characteristics curve of 0.75 (95% confidence interval, 0.72; 0.81) with a sensitivity of 85.6% and a specificity of 47.2%. CONCLUSIONS: This score, based only on history and physical examination, is a complementary tool for ruling out coronary heart disease in primary care patients complaining of chest pain.

TCRep 3D: an automated in silico approach to study the structural properties of TCR repertoires.

TCRep 3D is an automated systematic approach for TCR-peptide-MHC class I structure prediction, based on homology and ab initio modeling. It has been considerably generalized from former studies to be applicable to large repertoires of TCR. First, the location of the complementary determining regions of the target sequences are automatically identified by a sequence alignment strategy against a database of TCR Vα and Vβ chains. A structure-based alignment ensures automated identification of CDR3 loops. The CDR are then modeled in the environment of the complex, in an ab initio approach based on a simulated annealing protocol. During this step, dihedral restraints are applied to drive the CDR1 and CDR2 loops towards their canonical conformations, described by Al-Lazikani et. al. We developed a new automated algorithm that determines additional restraints to iteratively converge towards TCR conformations making frequent hydrogen bonds with the pMHC. We demonstrated that our approach outperforms popular scoring methods (Anolea, Dope and Modeller) in predicting relevant CDR conformations. Finally, this modeling approach has been successfully applied to experimentally determined sequences of TCR that recognize the NY-ESO-1 cancer testis antigen. This analysis revealed a mechanism of selection of TCR through the presence of a single conserved amino acid in all CDR3β sequences. The important structural modifications predicted in silico and the associated dramatic loss of experimental binding affinity upon mutation of this amino acid show the good correspondence between the predicted structures and their biological activities. To our knowledge, this is the first systematic approach that was developed for large TCR repertoire structural modeling.

Remote Observation of Radioactive Permit-Required Confined Spaces – Case: Posiva Oy’s Fuel Handling Cell

Posiva Oy’s final disposal facility’s encapsulation plant will start to operate in the 2020s. Once the operation starts, the facility is designed to run more than a hundred years. The encapsulation plant will be first of its kind in the world, being part of the solution to solve a global issue of final disposal of nuclear waste. In the encapsulation plant’s fuel handling cell the spent nuclear fuel will be processed to be deposited into the Finnish bedrock, into ONKALO. In the fuel handling cell, the environment is highly radioactive forming a permit-required enclosed space. Remote observation is needed in order to monitor the fuel handling process. The purpose of this thesis is to map (Part I) and compare (Part II) remote observation methods to observe Posiva Oy’s fuel handling cell’s process, and provide a possible theoretical solution for this case. Secondary purpose for this thesis is to provide resources for other remote observation cases, as well as to inform about possible future technology to enable readiness in the design of the encapsulation plant. The approach was to theoretically analyze the mapped remote observation methods. Firstly, the methods were filtered by three environmental challenges. These are the high levels of radiation, the permit-required confined space and the hundred year timespan. Secondly, the most promising methods were selected by the experts designing the facility. Thirdly, a customized feasibility analysis was created and performed on the selected methods to rank the methods with scores. The results are the mapped methods and the feasibility analysis scores. The three highest scoring methods were radiation tolerant camera, fiberscope and audio feed. A combination of these three methods was given as a possible theoretical solution for this case. As this case is first in the world, remote observation methods for it had not been thoroughly researched. The findings in this thesis will act as initial data for the design of the fuel handling cell’s remote observation systems and can potentially effect on the overall design of the facility by providing unique and case specific information. In addition, this thesis could provide resources for other remote observation cases.

Le défi de l’intégration de l’approche par compétences lors de la sélection : conception d’un test de jugement situationnel ciblant le rôle CanMEDS de collaborateur pour la sélection au niveau postdoctoral en médecine

Introduction : L’approche par compétences est maintenant bien ancrée dans l’enseignement au niveau de la formation médicale postdoctorale. Dans ce contexte, un système de sélection également axé sur les compétences pourrait être avantageux. L’objectif principal de ce projet était de concevoir un TJS ciblant le rôle CanMEDS de collaborateur pour la sélection au niveau postdoctoral en médecine interne (MI) et en médecine familiale (MF). Méthodologie : Des entrevues d’incidents critiques ont été réalisées auprès de résidents juniors en MI ou en MF afin de générer les items du TJS. Trois leaders de l’approche par compétences ont révisé le contenu du test. Les items ont été analysés pour identifier la compétence principale du rôle CanMEDS de collaborateur, le contexte ainsi que les membres de l’équipe interprofessionnelle représentés dans les vignettes. La clé de correction a été déterminée par un panel composé de 11 experts. Cinq méthodes de notation ont été comparées. Résultats : Sept entrevues ont été réalisées. Après révision, 33 items ont été conservés dans le TJS. Les compétences clés du rôle CanMEDS de collaborateur, les contextes et les divers membres de l’équipe interprofessionnelle étaient bien distribués au travers des items. La moyenne des scores des experts variait entre 43,4 et 75,6 % en fonction des différentes méthodes de notation. Le coefficient de corrélation de Pearson entre les cinq méthodes de notation variait entre 0,80 et 0,98. Conclusion : Ce projet démontre la possibilité de concevoir un TJS utilisant le cadre CanMEDS comme trame de fond pour l’élaboration de son contenu. Ce test, couplé à une approche globale de sélection basée sur les compétences, pourrait éventuellement améliorer le pouvoir prédictif du processus de sélection au niveau de la formation médicale postdoctorale.

Sensibilidad del cuestionario anamnésico de síntomas de miembro superior y columna desarrollado por la unidad de investigación de ergonómica de postura y movimiento (EPM) desde la perspectiva de la fisioterapia en Colombia

El propósito de este estudio es evaluar la sensibilidad, especificidad y valores predictivos del Cuestionario Anamnésico de Síntomas de Miembro Superior y Columna (CASMSC) desarrollado por la Unidad de Investigación de Ergonomía de Postura y Movimiento (EPM). Se realizó un estudio descriptivo de tipo correlacional, mediante el análisis de datos secundarios de una base de datos con registros de trabajadores de la industria de alimentos (n=401) en el año 2013, a quienes se les había aplicado el CASMSC, así como una evaluación clínica fisioterapéutica enfocada en los mismos segmentos corporales; esta última utilizada como prueba de oro. Para analizar si existían diferencias estadísticas por edad, antigüedad y género se aplicó el análisis de varianza de una vía. La sensibilidad, especificidad y valores predictivos del CASMSC se informan con sus respectivos intervalos de confianza (95%). La prevalencia de umbral positivo para sospecha de Desorden Músculo Esquelético (DME) tanto de miembro superior como de columna se encontró muy por encima de la media nacional para el sector. La sensibilidad del CASMSC para miembro superior estuvo en el rango de un 80% a 94,57% y para columna cervical y lumbar fue de 36,4% y 43,4%, respectivamente. Para la región dorsal fue casi del doble de las otras dos regiones (85,7%). El CASMSC es recomendable en su apartado para miembro superior dado a su alto nivel de sensibilidad.

Rilievi anatomo-patologici e batteriologici condotti sull’apparato gastroenterico di una metapopolazione di cinghiali (Sus scrofa)

Nell’ambito della patologia gastroenterica del suino sono comprese alcune malattie sostenute da batteri spirillari gram negativi, di cui sono disponibili numerose trattazioni riguardanti, soprattutto, l'aspetto epidemiologico e patogenetico. Per alcuni di questi agenti microbici, e per le relative manifestazioni patologiche, poco si conosce nel cinghiale selvatico, animale correlato filogeneticamente al suino domestico, ma compreso in un’ecologia completamente differente. Da queste premesse è nato un approccio di ricerca e studio del comportamento di questi microrganismi in una metapopolazione di cinghiali, abbattuti durante il piano di controllo della popolazione densità-dipendente nel Parco dei Gessi e Calanchi dell’Abbadessa (BO), cercando di rapportare le conoscenze riportate in letteratura sul suino domestico con quanto è scaturito dalle indagini condotte sul cinghiale selvatico. In particolare è stata indagata con metodica immunoistochimica la presenza di Lawsonia intracellularis, patogeno del suino responsabile di Enterite Proliferativa (EP), in secondo luogo sono state condotte indagini batteriologiche e istologiche da stomaco e intestino, finalizzate all’isolamento di microrganismi spirillari dei generi Campylobacter e Helicobacter, da correlare all’eventuale presenza di lesioni infiammatorie e ulcerative gastriche o enteriche valutate secondo sistemi a punteggio ottenuti dalla bibliografia o realizzati in base alla tipologia di infiltrato cellulare e alla sua localizzazione. In ultimo, a fini comparativi con uno studio condotto nel 2002-2004 nello steso Parco Regionale, sono stati monitorati i livelli di antibioticoresistenza di indicatori fecali usando metodiche internazionali standardizzate (Escherichia coli e Enterococcus faecium.) nonché su un numero significativo di isolati di Campylobacter lanienae, per ottenere indicazioni preliminari sull’andamento nei 10 anni trascorsi dello stato di inquinamento da farmaco del Parco stesso. I risultati ottenuti permettono di ampliare le conoscenze sulla flora enterica del cinghiale selvatico e pongono questioni di sicurezza pubblica sulla gestione dei mammiferi selvatici.

Predicting functional capacity outcome 12 months after hospitalized injury

Background: There is a recognized need to move from mortality to morbidity outcome predictions following traumatic injury. However, there are few morbidity outcome prediction scoring methods and these fail to incorporate important comorbidities or cofactors. This study aims to develop and evaluate a method that includes such variables. Methods: This was a consecutive case series registered in the Queensland Trauma Registry that consented to a prospective 12-month telephone conducted follow-up study. A multivariable statistical model was developed relating Trauma Registry data to trichotomized 12-month post-injury outcome (categories: no limitations, minor limitations and major limitations). Cross-validation techniques using successive single hold-out samples were then conducted to evaluate the model's predictive capabilities. Results: In total, 619 participated, with 337 (54%) experiencing no limitations, 101 (16%) experiencing minor limitations and 181 (29%) experiencing major limitations 12 months after injury. The final parsimonious multivariable statistical model included whether the injury was in the lower extremity body region, injury severity, age, length of hospital stay, pulse at admission and whether the participant was admitted to an intensive care unit. This model explained 21% of the variability in post-injury outcome. Predictively, 64% of those with no limitations, 18% of those with minor limitations and 37% of those with major limitations were correctly identified. Conclusion: Although carefully developed, this statistical model lacks the predictive power necessary for its use as a basis of a useful prognostic tool. Further research is required to identify variables other than those routinely used in the Trauma Registry to develop a model with the necessary predictive utility.