scholarly journals Interobserver variability of ventilatory anaerobic threshold in asymptomatic volunteers

2019 ◽  
Vol 14 ◽  
Author(s):  
Sabine Kaczmarek ◽  
Dirk Habedank ◽  
Anne Obst ◽  
Marcus Dörr ◽  
Henry Völzke ◽  
...  
Keyword(s):  
Anaerobic Threshold ◽  
Interobserver Variability ◽  
Intraclass Correlation ◽  
Heart Association ◽  
Data Sets ◽  
Cross Sectional ◽  
Preoperative Risk Assessment ◽  
Medical Assistants ◽  
Ventilatory Anaerobic Threshold ◽  
Asymptomatic Volunteers

Background: The ventilatory anaerobic threshold (VO2@AT) has been used in preoperative risk assessment and rehabilitation for many years. Our aim was to determine the interobserver variability of AT using cardiopulmonary exercise (CPET) data from a large epidemiological study (SHIP, Study of Health in Pomerania). Methods: VO2@AT was determined from CPET of 1,079 cross-sectional volunteers, according to American Heart Association guidelines. VO2@AT determinations were compared between two experienced physicians, between physicians and qualified medical assistants, and between physicians or medical assistants and software-based algorithms. For the first 522 data sets, the two physicians discussed discrepant readings to reach consensus; the remaining data sets were analyzed without consensus discussion. Results: VO2@AT was detectable in 1,056 data sets. The physicians recorded identical VO2@AT values in 319 out of 522 cases before consensus discussion (61.1%; intraclass correlation coefficient [ICC]: 0.90; 95% confidence interval [CI]: 0.88–0.92) and in 700 out of 1,056 cases overall (66.3%; ICC: 0.95; 95% CI: 0.95–0.96), with an interobserver difference of 0 ± 8% (95% limits of agreement [LOA]: ±161 mL/min). The interobserver difference was − 2 ± 18% (95% LOA: ±418 mL/min) between a physician and medical assistants, and − 19 ± 24% to − 22 ± 26% (95% LOAs: ±719–806 mL/min) between physicians or medical assistants and software-based algorithms. Conclusions: Experienced physicians show high agreement when determining AT in asymptomatic volunteers. However, agreement between physicians and qualified medical assistants is lower, and there is substantial deviation in AT determination between physicians or medical assistants and software-based algorithms. This must be considered when using AT as a decision tool.

scholarly journals Interobserver variability of ventilatory anaerobic threshold in asymptomatic volunteers

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Sabine Kaczmarek ◽  
Dirk Habedank ◽  
Anne Obst ◽  
Marcus Dörr ◽  
Henry Völzke ◽  
...  
Keyword(s):  
Anaerobic Threshold ◽  
Interobserver Variability ◽  
Ventilatory Anaerobic Threshold ◽  
Asymptomatic Volunteers

Nerve ultrasound

Neurology ◽  
2018 ◽  
Vol 92 (5) ◽  
pp. e443-e450 ◽  
Author(s):  
Johan A. Telleman ◽  
Ingrid J.T. Herraets ◽  
H. Stephan Goedee ◽  
Camiel Verhamme ◽  
Stavros Nikolakopoulos ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Random Effects ◽  
Interobserver Variability ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Random Effects Model ◽  
Nerve Ultrasound ◽  
Cross Sectional ◽  
Intraclass Correlation Coefficients ◽  
Time Image

ObjectiveTo determine interobserver variability of nerve ultrasound in peripheral neuropathy in a prospective, systematic, multicenter study.MethodsWe enrolled 20 patients with an acquired chronic demyelinating or axonal polyneuropathy and 10 healthy controls in 3 different centers. All participants underwent an extensive nerve ultrasound protocol, including cross-sectional area measurements of median, ulnar, fibular, tibial, and sural nerves, and brachial plexus. Real-time image acquisition was performed blind by a local and a visiting investigator (reference). Five patients were investigated using different types of sonographic devices. Intraclass correlation coefficients were calculated, and a random-effects model was fitted to identify factors with significant effect on interobserver variability.ResultsSystematic differences between measurements made by different investigators were small (mean difference 0.11 mm2 [95% confidence interval 0.00–0.23 mm2]). Intraclass correlation coefficients were generally higher in arm nerves (0.48–0.96) than leg nerves (0.46–0.61). The hospital site and sonographic device did not contribute significantly to interobserver variability in the random-effects model.ConclusionsInterobserver variability of nerve ultrasound in peripheral neuropathy is generally limited, especially in arm nerves. Different devices and a multicenter setting have no effect on interobserver variability. Therefore, nerve ultrasound is a reproducible tool for diagnostics in routine clinical practice and (multicenter) research.

scholarly journals Comparison of the Mayo Endoscopy Score and the Ulcerative Colitis Endoscopy Index of Severity and the Ulcerative Colitis Colonoscopy Index of Severity

2021 ◽  
Vol 09 (02) ◽  
pp. E130-E136
Author(s):  
María Belvis Jiménez ◽  
Pedro Hergueta-Delgado ◽  
Blas Gómez Rodríguez ◽  
Belén Maldonado Pérez ◽  
Luisa Castro Laria ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Interobserver Variability ◽  
Intraclass Correlation ◽  
Weighted Kappa ◽  
Clinical Situation ◽  
Kappa Index ◽  
Perfect Correlation ◽  
Index Of Severity ◽  
Severity Of The Disease ◽  
Normal Clinical Practice

Abstract Background and study aims: Endoscopy plays an essential role in managing patients with ulcerative colitis (UC), as it allows us to visualize and assess the severity of the disease. As such assessments are not always objective, different scores have been devised to standardize the findings. The main aim of this study was to assess the interobserver variability between the Mayo Endoscopy Score (MES), Ulcerative Colitis Endoscopy Index of Severity (UCEIS) and Ulcerative Colitis Colonoscopy Index of Severity (UCCIS) analyzing the severity of the endoscopic lesions in patients with ulcerative colitis. Patients and methods: This was a single-cohort observational study in which a colonoscopy was carried out on patients with UC, as normal clinical practice, and a video was recorded. The results from the video were classified according to the MES, UCEIS and UCCIS by three endoscopic specialists independently, and they were compared to each other. The Mayo Endoscopy Score (MES) was used to assess the clinical situation of the patient. The therapeutic impact was analyzed after colonoscopy was carried out. Results: Sixty-seven patients were included in the study. The average age was 51 (SD ± 16.7) and the average MES was 3.07 (SD ± 2.54). The weighted Kappa index between endoscopists A and B for the MES was 0.8; between A and C 0.52; and between B and C 0.49. The intraclass correlation coefficient for UCEIS was 0.92 among the three endoscopists (CI 95 %: 0.83–0.96) and 0.96 for UCCIS among the three endoscopists (CI 95 % 0.94–0.97). A change in treatment for 34.3 % of the patients was implemented on seeing the results of the colonoscopy. Conclusions: There was an adequate, but not perfect, correlation between the different endoscopists for MES, UCEIS, UCCIS. This was higher with the last two scores. Thus, there is still some subjectivity to be minimized through special training, on assessing the seriousness of the endoscopic lesions in patients with UC.

scholarly journals The measurement performance of the EQ-5D-5L versus EQ-5D-3L in patients with hidradenitis suppurativa

2021 ◽  
Author(s):  
Alex Bató ◽  
Valentin Brodszky ◽  
L. Hunor Gergely ◽  
Krisztián Gáspár ◽  
Norbert Wikonkál ◽  
...  
Keyword(s):  
Convergent Validity ◽  
Hidradenitis Suppurativa ◽  
Clinical Care ◽  
Intraclass Correlation ◽  
Life Quality ◽  
Measurement Properties ◽  
Economic Evaluations ◽  
Health State ◽  
Cross Sectional Survey ◽  
Cross Sectional

Abstract Purpose Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that affects up to 1% of the population in Europe. The EQ-5D is the most commonly used generic instrument for measuring health-related quality of life among HS patients. This study aims to compare the measurement properties of the two adult versions of EQ-5D (EQ-5D-3L and EQ-5D-5L) in patients with HS. Methods We recruited 200 consecutive patients with HS (mean age 37 years, 38% severe or very severe HS) to participate in a multicentre cross-sectional survey. Patients completed the EQ-5D-3L, EQ-5D-5L, Dermatology Life Quality Index (DLQI) and Skindex-16 questionnaires. Results More than twice as many different health state profiles occurred in the EQ-5D-5L compared to the EQ-5D-3L (101 vs. 43). A significant reduction in ceiling effect was found for the mobility, self-care and usual activities dimensions. A good agreement was established between the EQ-5D-3L and EQ-5D-5L with an intraclass correlation coefficient of 0.872 (95% CI 0.830–0.903; p < 0.001) that was confirmed by a Bland-Altman plot. EQ-5D-5L improved both the absolute and relative informativity in all dimensions except for anxiety/depression. EQ-5D-3L and EQ-5D-5L demonstrated similar convergent validity with DLQI and Skindex-16. EQ-5D-5L was able to better discriminate between known groups of patients based on the number of comorbidities and disease severity (HS-Physician's Global Assessment). Conclusion In patients with HS, the EQ-5D-5L outperformed the EQ-5D-3L in feasibility, ceiling effects, informativity and known-groups validity for many important clinical characteristics. We recommend using the EQ-5D-5L in HS patients across various settings, including clinical care, research and economic evaluations.

scholarly journals Association of cardiovascular health and epigenetic age acceleration

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Tess D. Pottinger ◽  
Sadiya S. Khan ◽  
Yinan Zheng ◽  
Wei Zhang ◽  
Hilary A. Tindle ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Cardiovascular Health ◽  
Heart Association ◽  
The United States ◽  
Cross Sectional ◽  
Epigenetic Age ◽  
Younger Age ◽  
Cardiovascular Morbidity And Mortality ◽  
Epigenetic Age Acceleration ◽  
Linear Regression Modeling

Abstract Background Cardiovascular health (CVH) has been defined by the American Heart Association (AHA) as the presence of the “Life’s Simple 7” ideal lifestyle and clinical factors. CVH is known to predict longevity and freedom from cardiovascular disease, the leading cause of death for women in the United States. DNA methylation markers of aging have been aggregated into a composite epigenetic age score, which is associated with cardiovascular morbidity and mortality. However, it is unknown whether poor CVH is associated with acceleration of aging as measured by DNA methylation markers in epigenetic age. Methods and results We performed a cross-sectional analysis of racially/ethnically diverse post-menopausal women enrolled in the Women’s Health Initiative cohort recruited between 1993 and 1998. Epigenetic age acceleration (EAA) was calculated using DNA methylation data on a subset of participants and the published Horvath and Hannum methods for intrinsic and extrinsic EAA. CVH was calculated using the AHA measures of CVH contributing to a 7-point score. We examined the association between CVH score and EAA using linear regression modeling adjusting for self-reported race/ethnicity and education. Among the 2,170 participants analyzed, 50% were white and mean age was 64 (7 SD) years. Higher or more favorable CVH scores were associated with lower extrinsic EAA (~ 6 months younger age per 1 point higher CVH score, p < 0.0001), and lower intrinsic EAA (3 months younger age per 1 point higher CVH score, p < 0.028). Conclusions These cross-sectional observations suggest a possible mechanism by which ideal CVH is associated with greater longevity.

scholarly journals The Effect of Eight-Week Sprint Interval Training on Aerobic Performance of Elite Badminton Players

2021 ◽  
Vol 18 (2) ◽  
pp. 638
Author(s):  
Haochong Liu ◽  
Bo Leng ◽  
Qian Li ◽  
Ye Liu ◽  
Dapeng Bao ◽  
...  
Keyword(s):  
Oxygen Uptake ◽  
Anaerobic Threshold ◽  
Aerobic Capacity ◽  
Interval Training ◽  
Lactate Clearance ◽  
Aerobic Performance ◽  
Sprint Interval Training ◽  
Control Groups ◽  
Ventilatory Anaerobic Threshold ◽  
And Control

This study was aimed to: (1) investigate the effects of physiological functions of sprint interval training (SIT) on the aerobic capacity of elite badminton players; and (2) explore the potential mechanisms of oxygen uptake, transport and recovery within the process. Thirty-two elite badminton players volunteered to participate and were randomly divided into experimental (Male-SIT and Female-SIT group) and control groups (Male-CON and Female-CON) within each gender. During a total of eight weeks, SIT group performed three times of SIT training per week, including two power bike trainings and one multi-ball training, while the CON group undertook two Fartlek runs and one regular multi-ball training. The distance of YO-YO IR2 test (which evaluates player’s ability to recover between high intensity intermittent exercises) for Male-SIT and Female-SIT groups increased from 1083.0 ± 205.8 m to 1217.5 ± 190.5 m, and from 725 ± 132.9 m to 840 ± 126.5 m (p < 0.05), respectively, which were significantly higher than both CON groups (p < 0.05). For the Male-SIT group, the ventilatory anaerobic threshold and ventilatory anaerobic threshold in percentage of VO2max significantly increased from 3088.4 ± 450.9 mL/min to 3665.3 ± 263.5 mL/min (p < 0.05),and from 74 ± 10% to 85 ± 3% (p < 0.05) after the intervention, and the increases were significantly higher than the Male-CON group (p < 0.05); for the Female-SIT group, the ventilatory anaerobic threshold and ventilatory anaerobic threshold in percentage of VO2max were significantly elevated from 1940.1 ± 112.8 mL/min to 2176.9 ± 78.6 mL/min, and from 75 ± 4% to 82 ± 4% (p < 0.05) after the intervention, which also were significantly higher than those of the Female-CON group (p < 0.05). Finally, the lactate clearance rate was raised from 13 ± 3% to 21 ± 4% (p < 0.05) and from 21 ± 5% to 27 ± 4% for both Male-SIT and Female-SIT groups when compared to the pre-test, and this increase was significantly higher than the control groups (p < 0.05). As a training method, SIT could substantially improve maximum aerobic capacity and aerobic recovery ability by improving the oxygen uptake and delivery, thus enhancing their rapid repeated sprinting ability.

scholarly journals Augmenting the Clinical Data Sources for Enigmatic Diseases: A Cross-Sectional Study of Self-Tracking Data and Clinical Documentation in Endometriosis

2020 ◽  
Vol 11 (05) ◽  
pp. 769-784
Author(s):  
Ipek Ensari ◽  
Adrienne Pichon ◽  
Sharon Lipsky-Gorman ◽  
Suzanne Bakken ◽  
Noémie Elhadad
Keyword(s):  
Additional Data ◽  
Intraclass Correlation ◽  
Management Strategies ◽  
The Self ◽  
Self Management ◽  
Cross Sectional ◽  
Two Samples ◽  
Data Source ◽  
Daily Function ◽  
Over Time

Abstract Background Self-tracking through mobile health technology can augment the electronic health record (EHR) as an additional data source by providing direct patient input. This can be particularly useful in the context of enigmatic diseases and further promote patient engagement. Objectives This study aimed to investigate the additional information that can be gained through direct patient input on poorly understood diseases, beyond what is already documented in the EHR. Methods This was an observational study including two samples with a clinically confirmed endometriosis diagnosis. We analyzed data from 6,925 women with endometriosis using a research app for tracking endometriosis to assess prevalence of self-reported pain problems, between- and within-person variability in pain over time, endometriosis-affected tasks of daily function, and self-management strategies. We analyzed data from 4,389 patients identified through a large metropolitan hospital EHR to compare pain problems with the self-tracking app and to identify unique data elements that can be contributed via patient self-tracking. Results Pelvic pain was the most prevalent problem in the self-tracking sample (57.3%), followed by gastrointestinal-related (55.9%) and lower back (49.2%) pain. Unique problems that were captured by self-tracking included pain in ovaries (43.7%) and uterus (37.2%). Pain experience was highly variable both across and within participants over time. Within-person variation accounted for 58% of the total variance in pain scores, and was large in magnitude, based on the ratio of within- to between-person variability (0.92) and the intraclass correlation (0.42). Work was the most affected daily function task (49%), and there was significant within- and between-person variability in self-management effectiveness. Prevalence rates in the EHR were significantly lower, with abdominal pain being the most prevalent (36.5%). Conclusion For enigmatic diseases, patient self-tracking as an additional data source complementary to EHR can enable learning from the patient to more accurately and comprehensively evaluate patient health history and status.

scholarly journals Is T2 mapping reliable in evaluation of native and repair cartilage tissue of the knee?

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Hasan Banitalebi ◽  
Christian Owesen ◽  
Asbjørn Årøen ◽  
Hang Thi Tran ◽  
Tor Åge Myklebust ◽  
...  
Keyword(s):  
T2 Mapping ◽  
Intraclass Correlation ◽  
Cartilage Tissue ◽  
Intraobserver Agreement ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Repair Tissue ◽  
Native Cartilage ◽  
Link Type ◽  
Imaging Plane

Abstract Purpose To evaluate the effect of imaging plane and experience of observers on the reliability of T2 mapping of native and repair cartilage tissue of the knee. Methods Fifteen consecutive patients from two randomised controlled trials (RCTs) were included in this cross-sectional study. Patients with an isolated knee cartilage lesion were randomised to receive either debridement or microfracture (RCT 1) or debridement or autologous chondrocyte implantation (RCT 2). T2 mapping was performed in coronal and sagittal planes two years postoperatively. A musculoskeletal radiologist, a resident of radiology and two orthopaedic surgeons measured the T2 values independently. Intraclass Correlation Coefficient (ICC) with 95% Confidence Intervals was used to calculate the inter- and intraobserver agreement. Results Mean age for the patients was 36.8 ± 11 years, 8 (53%) were men. The overall interobserver agreement varied from poor to good with ICCs in the range of 0.27– 0.76 for native cartilage and 0.00 – 0.90 for repair tissue. The lowest agreement was achieved for evaluations of repair cartilage tissue. The estimated ICCs suggested higher inter- and intraobserver agreement for radiologists. On medial femoral condyles, T2 values were higher for native cartilage on coronal images (p < 0.001) and for repair tissue on sagittal images (p < 0.001). Conclusions The reliability of T2 mapping of articular cartilage is influenced by the imaging plane and the experience of the observers. This influence may be more profound for repair cartilage tissue. This is important to consider when using T2 mapping to measure outcomes after cartilage repair surgery. Trial registration ClinicalTrials.gov, NCT02637505 and NCT02636881, registered December 2015. Level of evidence II, based on prospective data from two RCTs.

Sonographic Assessment of Renal Volume in Normotensive Pregnant Women and Women With Pregnancy-Induced Hypertension in Enugu Metropolis

2021 ◽  
pp. 875647932110210
Author(s):  
Idigo Felicitas Ugochinyere ◽  
Nwankwo Sylvia Chiamaka ◽  
Abonyi Everistus Obinna ◽  
Anakwue Angel-Mary Chukwunyelu ◽  
Agbo Julius Amechi
Keyword(s):  
Reference Range ◽  
Interobserver Variability ◽  
Correct Diagnosis ◽  
Negative Relationship ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Renal Volume ◽  
Cross Sectional ◽  
Significant Difference ◽  
Induced Hypertension

Objective: Renal volume (RV) assessment during obstetric sonography is rarely considered in our locality. Understanding the changes in RV in both normotensive pregnant (NP) and pregnancy-induced hypertensive (PIH) women is important in making correct diagnosis regarding pregnancy outcome. This study is aimed at determining the RV in NP and PIH women and correlating RV with fetal gestational age (FGA), body mass index (BMI), and parity in NP women. Materials and Methods: This cross-sectional study involved 450 patients recruited at a Tertiary Hospital. A pilot study was done to determine the interobserver variability in RV measurement. RV was calculated using the following formula: L × W × AP × 0.523. Parity, BMI, and blood pressure were documented, while FGA was calculated as an average of FGAs obtained from the measurements of fetal biometric parameters. Results: Mean RV of PIH women was significantly higher than that of NP women ( P < .05). RV shows a positive significant relationship with BMI and FGA, while it shows a negative relationship with parity in NP ( P < .05). Conclusion: Reference range values of RV were generated for clinical use in our locality, while there is statistically significant difference between RV in NP and PIH women.

scholarly journals The Iranian version of theory-based intention for cesarean section (IR-TBICS) scale: development and first evaluation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Seyed Abolhassan Naghibi ◽  
Maryam Khazaee-Pool ◽  
Mahmood Moosazadeh
Keyword(s):  
Cesarean Section ◽  
Content Validity ◽  
Intraclass Correlation ◽  
Quality Criteria ◽  
Factor Analyses ◽  
Validity And Reliability ◽  
Delivery Method ◽  
Northern Iran ◽  
Cross Sectional ◽  
Confirmatory Factor Analyses

Abstract Background The rate at which mothers experience a cesarean section in the absence of medical signs is growing worldwide. Women’s beliefs and intentions play an essential role in the request or choice of a delivery method. At present, there is no comprehensive, validated scale for assessing pregnant women’s beliefs about cesarean section in the Iranian population. This study was performed to develop and assess the validity and reliability of the intention-based cesarean section scale using the theory of reasoned action (TRA) constructs as a theoretical framework for measuring intention toward the selection of a delivery method. Methods In this cross-sectional validation study, 480 pregnant women were recruited from Sari, in northern Iran, through a multistage random sampling approach. Content validity was examined using the content validity index (CVI) and content validity ratio (CVR). Furthermore, both exploratory factor analyses (EFA) and confirmatory factor analyses (CFA) were applied to assess the construct validity of the developed scale. Reliability was measured by internal consistency and the intraclass correlation coefficient (ICC). Quality criteria for floor and ceiling effects were derived from existing guidelines and consensus within our research group. Results The results obtained from the factor analysis showed that the data were fit to the model (χ2 = 2298.389, P < 0.001). The TRA comprised 24 items assessing five domains, which described 62.46% of the common variance. The CFA showed a model with suitable fitness for the data. Cronbach’s alpha coefficient for the domains of the scale ranged from 0.609 to 0.843, and the ICC value ranged from 0.71 to 0.84, which is within the satisfactory range. The IR-TBICS scale had no floor or ceiling effect on the total score or any of the dimensions. Conclusions The belief-based cesarean section scale appears to be a reliable instrument. It is considered suitable and can be applied in other research in Iran.

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