scholarly journals Assessing Physical Activities Occurring on Sidewalks and Streets: Protocol for a Cross-Sectional Study

10.2196/12976 ◽  
2019 ◽  
Vol 8 (7) ◽  
pp. e12976
Author(s):  
Richard Robert Suminski Jr ◽  
Gregory Dominick ◽  
Philip Saponaro
Keyword(s):  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Video Camera ◽  
Cross Sectional Study ◽  
Video Data ◽  
Considerable Proportion ◽  
High Definition ◽  
Deep Convolutional Neural Networks ◽  
Cross Sectional ◽  
Number Of Individuals

Background A considerable proportion of outdoor physical activity (PA) is done on sidewalks and streets, necessitating the development of a reliable measure of PA performed in these settings. The Block Walk Method (BWM) is one of the more common approaches for this purpose. Although it utilizes reliable observation techniques and displays criterion validity, it remains relatively unchanged since its introduction in 2006. It is a nontechnical, labor-intensive, first generation method. Advancing the BWM would contribute significantly to our understanding of PA behavior. Objective This study will develop and test a new BWM that utilizes a wearable video device (WVD) and computer video analysis to assess PAs performed on sidewalks and streets. The specific aims are to improve the BWM by incorporating a WVD (eyeglasses with a high-definition video camera in the frame) into the methodology and advance this WVD-enhanced BWM by applying machine learning and recognition software to automatically extract information on PAs occurring on the sidewalks and streets from the videos. Methods Trained observers (1 wearing and 1 not wearing the WVD) will walk together at a set pace along predetermined 1000 ft sidewalk and street observation routes representing low, medium, and high walkable areas. During the walks, the non-WVD observer will use the traditional BWM to record the numbers of individuals standing, sitting, walking, biking, and running in observation fields along the routes. The WVD observer will continuously video the observation fields. Later, 2 investigators will view the videos to determine the number of individuals performing PAs in the observation fields. The video data will then be analyzed automatically using multiple deep convolutional neural networks (CNNs) to determine the number of humans in the observation fields and the type of PAs performed. Bland Altman methods and intraclass correlation coefficients (ICCs) will be used to assess agreement. Potential sources of error such as occlusions (eg, trees) will be assessed using moderator analyses. Results Outcomes from this study are pending; however, preliminary studies supporting the research protocol indicate that the BWM is reliable for determining the PA mode (Cramer V=.89; P<.001), the address where the PA occurred (Cohen kappa=.85; P<.001), and the number engaged in an observed PA (ICC=.85; P<.001). The number of individuals seen walking along routes was correlated with several environmental characteristics such as sidewalk quality (r=.39; P=.02) and neighborhood aesthetics (r=.49; P<.001). Furthermore, we have used CNNs to detect cars, bikes, and pedestrians as well as individuals using park facilities. Conclusions We expect the new approach will enhance measurement accuracy while reducing the burden of data collection. In the future, the capabilities of the WVD-CNN system will be expanded to allow for the determination of other characteristics captured in videos such as caloric expenditure and environmental conditions. International Registered Report Identifier (IRRID) PRR1-10.2196/12976

A cutting edge approach to assessing physical activities occurring on sidewalks/streets (Preprint)

2018 ◽  
Author(s):  
Richard Robert Suminski Jr ◽  
Gregory Dominick ◽  
Philip Sapanaro
Keyword(s):  
Physical Activity ◽  
Environmental Conditions ◽  
Intraclass Correlation ◽  
Physical Activity Behavior ◽  
Physical Activities ◽  
Video Data ◽  
Considerable Proportion ◽  
High Definition ◽  
Deep Convolutional Neural Networks ◽  
Number Of Individuals

BACKGROUND A considerable proportion of outdoor physical activity is done on sidewalk/streets. For example, we found that ~70% of adults who walked during the previous week used the sidewalks/streets around their homes. Interventions conducted at geographical levels (e.g., community) and studies examining relationships between environmental conditions (e.g., traffic) and walking/biking, necessitate a reliable measure of physical activities performed on sidewalks/streets. The Block Walk Method (BWM) is one of the more common approaches available for this purpose. Although it utilizes reliable observation techniques and displays criterion validity, it remains relatively unchanged since its introduction in 2006. It is a non-technical, labor-intensive, first generation method. Advancing the BWM would contribute significantly to our understanding of physical activity behavior. OBJECTIVE Therefore, the objective of the proposed study is to develop and test a new BWM that utilizes a wearable video device (WVD) and computer video analysis to assess physical activities performed on sidewalks/streets. The following aims will be completed to accomplish this objective. Aim 1: Improve the BWM by incorporating a WVD into the methodology. The WVD is a pair of eyeglasses with a high definition video camera embedded into the frames. We expect the WVD to be a viable option for improving the acquisition and accuracy of data collected using the BWM. Aim 2: Advance the WVD-enhanced BWM by applying machine learning and recognition software to automatically extract information on physical activities occurring on the sidewalks/streets from the videos. METHODS Trained observers (one wearing and one not wearing the WVD) will walk together at a set pace along predetermined, 1000 ft. sidewalk/street observation routes representing low, medium, and high walkable areas. During the walks, the non-WVD observer will use the traditional BWM to record the number of individuals standing/sitting, walking, biking, and running along the routes. The WVD observer will only record a video while walking. Later, two investigators will view the videos to determine the numbers of individuals performing physical activities along the routes. For aim 2, the video data will be analyzed automatically using multiple deep convolutional neural networks (CNNs) to determine the number of humans along an observation route as well as the type of physical activities being performed. Bland Altman methods and intraclass correlation coefficients will be used to assess agreement. Potential sources of error such as occlusions (e.g., trees) will be assessed using moderator analyses. RESULTS Outcomes from this study are pending; however, preliminary studies supporting the research protocol indicate that the BWM is reliable and the number of individuals were seen walking along routes are correlated with several environmental characteristics (e.g., traffic, sidewalk defects). Further, we have used CNNs to detect cars, bikes, and pedestrians as well as individuals using park facilities. CONCLUSIONS We expect the new approach will enhance measurement accuracy while reducing the burden of data collection. In the future, the capabilities of the WVD-CNNs system will be expanded to allow for the determination of other characteristics captured by the videos such as caloric expenditure and environmental conditions.

scholarly journals The Reliability of Iodine Concentration in Diaper-Retrieved Infant Urine Using Urine Collection Pads, and in Their Mothers’ Breastmilk

Biomolecules ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 295
Author(s):  
Kjersti Sletten Bakken ◽  
Ingvild Oma ◽  
Synne Groufh-Jacobsen ◽  
Beate Stokke Solvik ◽  
Lise Mette Mosand ◽  
...  
Keyword(s):  
Intraclass Correlation ◽  
Urinary Iodine ◽  
Correlation Coefficients ◽  
Iodine Concentration ◽  
Cross Sectional Study ◽  
Iodine Intake ◽  
Public Healthcare ◽  
Urinary Iodine Concentration ◽  
Childbearing Age ◽  
Cross Sectional

Mild to moderate iodine deficiency is common among women of childbearing age. Data on iodine status in infants are sparse, partly due to the challenges in collecting urine. Urinary iodine concentration (UIC) is considered a good marker for recent dietary iodine intake and status in populations. The aim of this study was to investigate the reliability of iodine concentration measured in two spot-samples from the same day of diaper-retrieved infant urine and in their mothers’ breastmilk. We collected urine and breastmilk from a sample of 27 infants and 25 mothers participating in a cross-sectional study at two public healthcare clinics in Norway. The reliability of iodine concentration was assessed by calculating the intraclass correlation coefficients (ICC) and the coefficient of variation (CV). The ICC for infants’ urine was 0.64 (95% confidence interval (CI) 0.36–0.82), while the ICC for breastmilk was 0.83 (95% CI 0.65–0.92) Similarly, the intraindividual CV for UIC was 0.25 and 0.14 for breastmilk iodine concentration (BIC). Compared to standard methods of collecting urine for measuring iodine concentration, the diaper-pad collection method does not substantially affect the reliability of the measurements.

scholarly journals A Quantitative Comparison of Multispectral Refraction Topography and Autorefractometer in Young Adults

2021 ◽  
Vol 8 ◽  
Author(s):  
Yunru Liao ◽  
Zhenlan Yang ◽  
Zijing Li ◽  
Rui Zeng ◽  
Jing Wang ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Pearson Correlation ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
High Agreement ◽  
Intraclass Correlation Coefficients ◽  
Repeatability And Reproducibility ◽  
The Mean

Purpose: Purpose of this study is to evaluate the measuring consistency of central refraction between multispectral refraction topography (MRT) and autorefractometry.Methods: This was a descriptive cross-sectional study including subjects in Sun Yat-sen Memorial Hospital from September 1, 2020, to December 31, 2020, ages 20 to 35 years with a best corrected visual acuity of 20/20 or better. All patients underwent cycloplegia, and the refractive status was estimated with autorefractometer, experienced optometrist and MRT. We analyzed the central refraction of the autorefractometer and MRT. The repeatability and reproducibility of values measured using both devices were evaluated using intraclass correlation coefficients (ICCs).Results: A total of 145 subjects ages 20 to 35 (290 eyes) were enrolled. The mean central refraction of the autorefractometer was −4.69 ± 2.64 diopters (D) (range −9.50 to +4.75 D), while the mean central refraction of MRT was −4.49 ± 2.61 diopters (D) (range −8.79 to +5.02 D). Pearson correlation analysis revealed a high correlation between the two devices. The intraclass correlation coefficient (ICC) also showed high agreement. The intrarater and interrater ICC values of central refraction were more than 0.90 in both devices and conditions. At the same time, the mean central refraction of experienced optometrist was −4.74 ± 2.66 diopters (D) (range −9.50 to +4.75D). The intra-class correlation coefficient of central refraction measured by MRT and subjective refraction was 0.939.Conclusions: Results revealed that autorefractometry, experienced optometrist and MRT show high agreement in measuring central refraction. MRT could provide a potential objective method to assess peripheral refraction.

scholarly journals Is the BESTest at Its Best? A Suggested Brief Version Based on Interrater Reliability, Validity, Internal Consistency, and Theoretical Construct

2012 ◽  
Vol 92 (9) ◽  
pp. 1197-1207 ◽  
Author(s):  
Parminder K. Padgett ◽  
Jesse V. Jacobs ◽  
Susan L. Kasser
Keyword(s):  
Interrater Reliability ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Test Items ◽  
Intraclass Correlation Coefficients ◽  
Eyes Closed ◽  
Functional Reach ◽  
Hip Abductor

Background The Balance Evaluation Systems Test (BESTest) and Mini-BESTest are clinical examinations of balance impairment, but the tests are lengthy and the Mini-BESTest is theoretically inconsistent with the BESTest. Objective The purpose of this study was to generate an alternative version of the BESTest that is valid, reliable, time efficient, and founded upon the same theoretical underpinnings as the original test. Design This was a cross-sectional study. Methods Three raters evaluated 20 people with and without a neurological diagnosis. Test items with the highest item-section correlations defined the new Brief-BESTest. The validity of the BESTest, the Mini-BESTest, and the new Brief-BESTest to identify people with or without a neurological diagnosis was compared. Interrater reliability of the test versions was evaluated by intraclass correlation coefficients. Validity was further investigated by determining the ability of each version of the examination to identify the fall status of a second cohort of 26 people with and without multiple sclerosis. Results Items of hip abductor strength, functional reach, one-leg stance, lateral push-and-release, standing on foam with eyes closed, and the Timed “Up & Go” Test defined the Brief-BESTest. Intraclass correlation coefficients for all examination versions were greater than .98. The accuracy of identifying people from the first cohort with or without a neurological diagnosis was 78% for the BESTest versus 72% for the Mini-BESTest or Brief-BESTest. The sensitivity to fallers from the second cohort was 100% for the Brief-BESTest, 71% for the Mini-BESTest, and 86% for the BESTest, and all versions exhibited specificity of 95% to 100% to identify nonfallers. Limitations Further testing is needed to improve the generalizability of findings. Conclusions Although preliminary, the Brief-BESTest demonstrated reliability comparable to that of the Mini-BESTest and potentially superior sensitivity while requiring half the items of the Mini-BESTest and representing all theoretically based sections of the original BESTest.

scholarly journals Test-Retest Reliability of the King-Devick Test in an Adolescent Population

2017 ◽  
Vol 52 (5) ◽  
pp. 439-445 ◽  
Author(s):  
Tyler J. Oberlander ◽  
Bernadette L. Olson ◽  
Lee Weidauer
Keyword(s):  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Cross Sectional Study ◽  
Testing Time ◽  
Cross Sectional ◽  
Healthy Adolescent ◽  
Retest Reliability ◽  
Intraclass Correlation Coefficients ◽  
Adolescent Population ◽  
Test Retest Reliability

Context:  The King-Devick (KD) test is a screening tool designed to assess cognitive visual impairments, namely saccadic rhythm, postconcussion. Test-retest reliability of the KD in a healthy adolescent population has not yet been established. Objective:  To investigate the overall test-retest reliability of the KD among a sample of healthy adolescents. Additionally, we sought to determine if sex and age influenced reliability. Design:  Cross-sectional study. Setting:  Secondary school. Patients or Other Participants:  Sixty-eight healthy adolescents, 41 boys (age = 15.4 ± 1.9 years) and 27 girls (age = 15.4 ± 1.9 years). Main Outcome Measure(s):  Participants completed the KD (version 1) at 3 testing sessions (days 1, 30, and 45) following standard instructions. We recorded total time to complete the reading of 3 cards for each participant during each testing session. Two-way random-effects intraclass correlation coefficients (ICCs) using single measurements repeated over time and repeatability coefficients were calculated. Linear mixed models were used to determine whether differences existed at each testing time and to examine whether changes that took place among visits were different by sex or age. Results:  Adolescents who completed the KD demonstrated acceptable reliability (ICC = 0.81; 95% confidence interval = 0.73, 0.87); however, the repeatability coefficient was large (±8.76 seconds). The sample demonstrated improvements between visits 1 and 2 (mean ± standard error = 4.3 ± 0.5 seconds, P &lt; .001) and between visits 2 and 3 (2.4 ± 0.5 seconds, P &lt; .001) for a total improvement of 6.9 seconds over 3 tests. No significant visit-by-sex or visit-by-age interactions were observed. Conclusions:  Despite the ICC being clinically acceptable, providers using the KD test for serial assessment of concussion in adolescents should be cautious in interpreting the results due to a large learning effect. Incorporating multiple measures can ensure accurate detection of sport concussion.

Development and Initial Validation of the Adolescents’ Ageism Toward Older Adults Scale

2021 ◽  
Author(s):  
Anna Marchetti ◽  
Marzia Lommi ◽  
Claudio Barbaranelli ◽  
Michela Piredda ◽  
Maria Grazia De Marinis ◽  
...  
Keyword(s):  
Older Adults ◽  
Factor Analysis ◽  
Psychometric Properties ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Positive Attitudes ◽  
New Instrument ◽  
Design And Methods

Abstract Background and Objectives Ageism toward older adults, prevalent in contemporary societies, seems to be internalized during childhood and consolidated during adolescence. Although several instruments have been developed to measure adolescents’ ageism, they present a number of limitations. The study aimed at developing a new instrument, the Adolescents’ Ageism Toward Older Adults Scale, and testing its psychometric properties. Research Design and Methods A 3-phase process was followed: the instrument’s items were developed empirically from focus groups of adolescents; its content validity was evaluated; and finally, its psychometric properties were tested through a multicenter cross-sectional study involving 575 adolescents. Results Exploratory factor analysis of the new scale retained 33 items grouped into six factors: Moodiness, Traditionalism, Physical deterioration, Anti-technologism, Sageness and Sociability. Confirmatory factor analysis evidenced a second-order factor structure. Omega coefficients measuring internal consistency were above the cut-off of 0.60 for the six factors except for Anti-technologism. Intraclass correlation coefficients for the entire scale and for the six factors were greater than 0.70, again excepting Anti-technologism. Discussion and implications The Adolescents’ Ageism Toward Older Adults Scale is a promising measure of adolescents’ negative and positive attitudes toward older adults. Its validation highlighted some criticalities that can be resolved by a few modifications. Further testing of the scale should be conducted after these modifications.

Pellucid marginal degeneration versus keratoconus: distinction with wide-field SD-OCT corneal sublayer pachymetry

2020 ◽  
pp. bjophthalmol-2020-316496
Author(s):  
Niklas Mohr ◽  
Mehdi Shajari ◽  
Daniel Krause ◽  
Stefan Kassumeh ◽  
Jakob Siedlecki ◽  
...  
Keyword(s):  
Intraclass Correlation ◽  
Area Under The Curve ◽  
Correlation Coefficients ◽  
Cross Sectional Study ◽  
Wide Field ◽  
Good Reliability ◽  
Cross Sectional ◽  
Intraclass Correlation Coefficients ◽  
Calculated Ratio ◽  
Sd Oct

PurposeTo evaluate the capability of wide-field spectral-domain optical coherence tomography (SD-OCT) corneal sublayer pachymetry to distinguish between keratoconus and pellucid marginal degeneration (PMD).MethodsThis prospective cross-sectional study included 69 eyes (59 with keratoconus and 10 with PMD) of 69 patients. All patients were examined three subsequent times with the RTVue XR system. Pachymetry maps of the total cornea (CT), the epithelium (ET) and the stroma were generated using the onboard software. For analysis of reliability, the coefficients of variation and intraclass correlation coefficients (ICC) were calculated. Receiver operating characteristic analyses were performed to elaborate the most accurate pachymetric parameters for distinguishing between PMD and keratoconus.ResultsOverall repeatability of (sublayer) pachymetry was comparably good in both keratoconus (ICC ranging between 0.827 and 0.986) and PMD (ICC ranging between 0.753 and 0.998). Measurement reliability in keratoconic eyes was a negative function of Kmax (p<0.05). As compared with keratoconus, PMD exhibited higher CT (526±31 µm vs 503±30 µm; p=0.02) and ET (56±7 µm vs 51±5 µm; p=0.02) in the inferotemporal 2–5 mm sector as well as lower ET in the inferior 7–9 mm sector (52±5 µm vs 57±5 µm; p<0.01). The calculated ratio between CT in the inferotemporal 2–5 mm and in the inferior 7–9 mm sector yielded the highest diagnostic accuracy for distinguishing between PMD and keratoconus with an area under the curve of 0.977 and an optimal cut-off value of 0.90.ConclusionWide-field SD-OCT corneal sublayer pachymetry showed good reliability in PMD and keratoconus and may be useful to differentiate between the two ectatic diseases.

Mobility levels of acute medical patients: Is behavioural mapping comparable to accelerometry?

2020 ◽  
pp. 026921552097034
Author(s):  
Yizhou Wu ◽  
Esther J Smits ◽  
Peter Window ◽  
Alice Beningfield ◽  
Venerina Johnston ◽  
...  
Keyword(s):  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Cross Sectional Study ◽  
Inpatient Setting ◽  
Medical Patients ◽  
Cross Sectional ◽  
Financial Investment ◽  
Intraclass Correlation Coefficients ◽  
Mean Differences ◽  
Medical Wards

Objective: To (1) determine agreement between behavioural mapping and accelerometry for measuring mobility levels in an acute medical inpatient setting and to (2) explore and compare the required resources and costs for both methods. Design: Observational cross-sectional study Setting: Tertiary referral teaching hospital in Brisbane, Australia. Subjects: Adult patients admitted to two acute medical wards. Main measures: Mobility levels were recorded by behavioural mapping, and thigh and chest-worn accelerometers (ActivPAL). The level of agreement between the two methods was evaluated using the Intraclass Correlation Coefficients for each mobility level (i.e. lying, sitting, upright, standing and walking). Results: Nineteen patients (10 male (53%); mean(SD) age of 72(14) years) were included in the agreement analysis. The Intraclass Correlation Coefficients were high for ‘lying’ (ICC = 0.87), ‘sitting’ (ICC = 0.84) and ‘upright’ (ICC = 0.93), indicating good to excellent agreement between the two methods. For these mobility levels, mean differences between the two methods were small (<2%), with large standard deviations (up to 18%). Agreement was poor for ‘standing’ (ICC = 0.00) and ‘walking’ (ICC = 0.35). Both methods were labour-intensive, with labour costs of A$1,285/€798 (34 hours) for behavioural mapping and A$1,055/€655 (28 hours) for accelerometry. No further costs were involved in behavioural mapping, but clinical backfill was required. Accelerometry involved a financial investment for accelerometers (A$11,100/€6,894 for 22 ActivPAL devices). Conclusion: Agreement between behavioural mapping and accelerometry was good for measuring ‘lying’, ‘sitting’ and ‘upright’, but poor for ‘standing’ and ‘walking’ in an acute inpatient setting. Both behavioural mapping and accelerometry were labour-intensive, with high costs for the accelerometry equipment.

scholarly journals Anatomical sacral slope, a new pelvic parameter, is associated with lumbar lordosis and pelvic incidence in healthy Japanese women: A retrospective cross-sectional study

2019 ◽  
Vol 28 (1) ◽  
pp. 230949901988880
Author(s):  
Hayato Suzuki ◽  
Norio Imai ◽  
Asami Nozaki ◽  
Yuki Hirano ◽  
Naoto Endo
Keyword(s):  
Lumbar Lordosis ◽  
Pelvic Incidence ◽  
Intraclass Correlation ◽  
Three Dimensional ◽  
Correlation Coefficients ◽  
Normal Subjects ◽  
Cross Sectional Study ◽  
Sacral Slope ◽  
Cross Sectional ◽  
Pelvic Parameters

Purpose: Anatomical sacral slope (a-SS), a pelvic anatomical parameter that does not require the center of the femoral head, strongly correlates with pelvic incidence (PI) during three-dimensional measurements in normal subjects. Sagittal alignment of spinal and pelvic parameters is typically evaluated using two-dimensional radiographs; however, the relationship between a-SS and PI has not been evaluated using radiographs. This study aimed to evaluate the correlation between a-SS and other spinal and pelvic parameters using radiographs. Methods: We evaluated 144 healthy women. Using sagittal radiographs, we measured lumbar lordosis (LL), thoracic kyphosis, PI, SS, pelvic tilt, and a-SS, which were defined as the angle between the superior end plate of S1 and a line perpendicular to the anterior pelvic plane. Pearson coefficients were used to determine correlations, and intraobserver and interobserver intraclass correlation coefficients (ICCs) were used for validation. Results: There was a strong correlation between PI and a-SS ( r = 0.756). Moreover, correlations between a-SS and LL and between PI and LL were similar ( r = 0.661 and r = 0.554, respectively). The intraobserver ICCs were 0.884 for a-SS and 0.840 for PI. The interobserver ICCs were 0.856 for a-SS and 0.653 for PI. Conclusion: a-SS was strongly correlated with PI. The correlation between a-SS and LL was equivalent to the correlation between PI and LL. Moreover, the ICC for a-SS was larger than that of PI. This study suggests that a-SS is a useful new pelvic anatomical parameter that can be used instead of PI.

scholarly journals Reliability of a rapid hematology stain for sputum cytology

2014 ◽  
Vol 40 (3) ◽  
pp. 250-258 ◽  
Author(s):  
Jéssica Gonçalves ◽  
Emilio Pizzichini ◽  
Marcia Margaret Menezes Pizzichini ◽  
Leila John Marques Steidle ◽  
Cristiane Cinara Rocha ◽  
...  
Keyword(s):  
Interobserver Agreement ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Standard Technique ◽  
Cross Sectional Study ◽  
Induced Sputum ◽  
Cell Counting ◽  
Kappa Statistics ◽  
Cross Sectional ◽  
Intraclass Correlation Coefficients

Objective: To determine the reliability of a rapid hematology stain for the cytological analysis of induced sputum samples. Methods: This was a cross-sectional study comparing the standard technique (May-Grünwald-Giemsa stain) with a rapid hematology stain (Diff-Quik). Of the 50 subjects included in the study, 21 had asthma, 19 had COPD, and 10 were healthy (controls). From the induced sputum samples collected, we prepared four slides: two were stained with May-Grünwald-Giemsa, and two were stained with Diff-Quik. The slides were read independently by two trained researchers blinded to the identification of the slides. The reliability for cell counting using the two techniques was evaluated by determining the intraclass correlation coefficients (ICCs) for intraobserver and interobserver agreement. Agreement in the identification of neutrophilic and eosinophilic sputum between the observers and between the stains was evaluated with kappa statistics. Results: In our comparison of the two staining techniques, the ICCs indicated almost perfect interobserver agreement for neutrophil, eosinophil, and macrophage counts (ICC: 0.98-1.00), as well as substantial agreement for lymphocyte counts (ICC: 0.76-0.83). Intraobserver agreement was almost perfect for neutrophil, eosinophil, and macrophage counts (ICC: 0.96-0.99), whereas it was moderate to substantial for lymphocyte counts (ICC = 0.65 and 0.75 for the two observers, respectively). Interobserver agreement for the identification of eosinophilic and neutrophilic sputum using the two techniques ranged from substantial to almost perfect (kappa range: 0.91-1.00). Conclusions: The use of Diff-Quik can be considered a reliable alternative for the processing of sputum samples.

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