Showing papers on "Intra-rater reliability published in 2007"

The Assisting Hand Assessment: current evidence of validity, reliability, and responsiveness to change.

Abstract: The Assisting Hand Assessment (AHA) provides a new perspective of hand function evaluation relevant for children with unilateral upper limb disabilities. It measures how effectively the involved hand is actually used for bimanual activity, which, for these children, might be the most important aspect of their hand function. The aim of this paper is to report the conceptual framework and the evidence for validity, reliability, and responsiveness to change for the measures. Previously, the AHA has been evaluated for children aged 18 months to 5 years and excellent inter- and intrarater reliability was demonstrated. This paper reports further evidence of construct validity and reliability for the AHA measures involving an extended age range of children with hemiplegic cerebral palsy or obstetric brachial plexus palsy from 18 months to 12 years of age (mean age 4y 11mo [SD 2y 9mo] range 18mo-12y 8mo). A Rasch measurement model was used to analyze 409 assessments from 303 children (170 males, 133 females). The analysis generated a scale demonstrating large capacity to reliably separate and spread personal ability measures, indicating sensitivity to change and a hierarchy of the items ranging them from easy to hard. Aspects of item fit, relationship between age and ability measures, and development of assisting hand function are discussed.

The subaxial cervical spine injury classification system: a novel approach to recognize the importance of morphology, neurology, and integrity of the disco-ligamentous complex.

Abstract: Study design The classification system was derived through a literature review and expert opinion of experienced spine surgeons. In addition, a multicenter reliability and validity study of the system was conducted on a collection of trauma cases. Objectives To define a novel classification system for subaxial cervical spine trauma that conveys information about injury pattern, severity, treatment considerations, and prognosis. To evaluate reliability and validity of this system. Summary of background data Classification of subaxial cervical spine injuries remains largely descriptive, lacking standardization and prognostic information. Methods Clinical and radiographic variables encountered in subaxial cervical trauma were identified by a working section of the Spine Trauma Study Group. Significant limitations of existing systems were defined and addressed within the new system. This system, as well as the Harris and Ferguson & Allen systems, was applied by 20 spine surgeons to 11 cervical trauma cases. Six weeks later, the cases were randomly reordered and again scored. Interrater reliability, intrarater reliability, and validity were assessed. Results Each of 3 main categories (injury morphology, disco-ligamentous complex, and neurologic status) identified as integrally important to injury classification was assigned a weighted score; the injury severity score was obtained by summing the scores from each category. Treatment options were assigned based on threshold values of the severity score. Interrater agreement as assessed by intraclass correlation coefficient of the DLC, morphology, and neurologic status scores was 0.49, 0.57, and 0.87, respectively. Intrarater agreement as assessed by intraclass correlation coefficient of the DLC, morphology, and neurologic status scores was 0.66, 0.75, and 0.90, respectively. Raters agreed with treatment recommendations of the algorithm in 93.3% of cases, suggesting high construct validity. The reliability compared favorably to the Harris and Ferguson & Allen systems. Conclusion The Sub-axial Injury Classification and Severity Scale provides a comprehensive classification system for subaxial cervical trauma. Early validity and reliability data are encouraging.

Assessment of interrater and intrarater reliability of the Fahn–Tolosa–Marin Tremor Rating Scale in essential tremor

Abstract: The purpose of this study was to evaluate interrater and intrarater reliability of the Fahn-Tolosa-Marin Tremor Rating Scale (TRS) in essential tremor (ET). Proper treatment of ET is contingent upon correct assessment of the severity, loss of function, and disability related to tremor. Videotape recordings of 17 subjects with ET evaluated with the TRS were produced and sent to 59 raters. Once the raters returned the videotape and completed the score sheet, they were mailed a second tape with the same recordings presented in a different order. In the interrater reliability evaluation, modified Kappa statistics for seven tremor type composites ranged from 0.10 to 0.65 in the first videotape and 0.17 to 0.62 in the second videotape. Interrater reliabilities were greater for Part A items (magnitude of tremor in different body parts) than for Part B items (tremor in writing and drawings) of the TRS. The average Spearman correlation was 0.87, indicating very good consistency between the two videotapes, but correlations for Part A were somewhat better than for Part B. It is best when the same rater performs repeated measures of tremor on a patient, particularly when judging tremor in handwriting and drawings. Training of raters on use of the TRS would help standardize judgement.

Reliability and limits of agreement of circumferential, water displacement, and optoelectronic volumetry in the measurement of upper limb lymphedema.

Abstract: We conducted a reliability comparison study to determine the intrarater and inter-rater reliability and the limits of agreement of the volume estimated by circumferential measurements using the frustum sign method and the disk model method, by water displacement volumetry, and by infrared optoelectronic volumetry in the assessment of upper limb lymphedema. Thirty women with lymphedema following axillary lymph node dissection surgery for breast cancer surgery were enrolled. In each patient, the volumes of the upper limbs were estimated by three physical therapists using circumference measurements, water displacement and optoelectronic volumetry. One of the physical therapists performed each measure twice. Intraclass correlation coefficients (ICCs), relative differences, and limits of agreement were determined. Intrarater and interrater reliability ICCs ranged from 0.94 to 1. Intrarater relative differences were 1.9% for the disk model method, 3.2% for the frustum sign model method, 2.9% for water displacement volumetry, and 1.5% for optoelectronic volumetry. Intrarater reliability was always better than interrater, except for the optoelectronic method. Intrarater and interrater limits of agreement were calculated for each technique. The disk model method and optoelectronic volumetry had better reliability than the frustum sign method and water displacement volumetry, which is usually considered to be the gold standard. In terms of low-cost, simplicity, and reliability, we recommend the disk model method as the method of choice in clinical practice. Since intrarater reliability was always better than interrater reliability (except for optoelectronic volumetry), patients should therefore, ideally, always be evaluated by the same therapist. Additionally, the limits of agreement must be taken into account when determining the response of a patient to treatment.

Reliability and Validity of the Tinetti Mobility Test for Individuals With Parkinson Disease

Abstract: Background and Purpose: This study examined the interrater and intrarater reliability, concurrent validity, and criterion validity of the Tinetti Mobility Test (TMT) as a fall risk screening tool in individuals with Parkinson disease (PD). Subjects: Thirty individuals with PD voluntarily participated in the study, and data from a retrospective review of 126 patient records were included. Methods: Physical therapists and physical therapist students rated live and videotaped performances of the TMT. Tinetti Mobility Test scores were correlated with Unified Parkinson's Disease Rating Scale (UPDRS) motor scores and comfortable gait speed. The ability of the TMT to accurately assess fall risk was determined. Results: Interrater and intrarater reliability was good to excellent (intraclass correlation coefficient of >.80). Tinetti Mobility Test scores correlated with UPDRS motor scores ( r s=−.45) and gait speed ( r s=.53). The sensitivity and specificity of the TMT to identify fallers were 76% and 66%, respectively. Discussion and Conclusion: The TMT is a reliable and valid tool for assessing the mobility status of and fall risk for individuals with PD.

Ultrasound imaging assessment of abdominal muscle function during drawing-in of the abdominal wall: an intrarater reliability study.

Abstract: Study Design Test-retest intrarater reliability study. Objective To examine reliability of abdominal musculature measurements across a broad range of conditions for a physical therapist newly trained in assessment using rehabilitative ultrasound imaging (RUSI). Background RUSI has previously been used to assess abdominal muscle function during a drawing-in maneuver of the anterior abdominal wall, and measurements conducted by an experienced assessor have been validated by comparison with magnetic resonance imaging. Few studies have examined the reliability of less experienced operators, and only in isolated measurement conditions. Methods and Measures Nineteen subjects (11 female, 8 male) without a history of low back pain performed the abdominal drawing-in maneuver in a supine hook-lying position. RUSI was used bilaterally to assess the thickness of the internal oblique (10) and transversus abdominis (TrA) muscles at rest and on contraction, as well as changes in the length of the TrA muscle (indicated b...

Reliability of movement control tests in the lumbar spine

Abstract: Background: Movement control dysfunction [MCD] reduces active control of movements. Patients with MCD might form an important subgroup among patients with non specific low back pain. The diagnosis is based on the observation of active movements. Although widely used clinically, only a few studies have been performed to determine the test reliability. The aim of this study was to determine the inter- and intra-observer reliability of movement control dysfunction tests of the lumbar spine. Methods: We videoed patients performing a standardized test battery consisting of 10 active movement tests for motor control in 27 patients with non specific low back pain and 13 patients with other diagnoses but without back pain. Four physiotherapists independently rated test performances as correct or incorrect per observation, blinded to all other patient information and to each other. The study was conducted in a private physiotherapy outpatient practice in Reinach, Switzerland. Kappa coefficients, percentage agreements and confidence intervals for inter- and intra-rater results were calculated. Results: The kappa values for inter-tester reliability ranged between 0.24 – 0.71. Six tests out of ten showed a substantial reliability [k > 0.6]. Intra-tester reliability was between 0.51 – 0.96, all tests but one showed substantial reliability [k > 0.6]. Conclusion: Physiotherapists were able to reliably rate most of the tests in this series of motor control tasks as being performed correctly or not, by viewing films of patients with and without back pain performing the task.

Interrater and intrarater reliability of the Assisting Hand Assessment

Abstract: OBJECTIVE. The aim of this study was to evaluate interrater and intrarater reliability for the Assisting Hand Assessment. METHOD. For interrater reliability, two designs were used: 2 occupational therapists rated the same 18 children, and 20 occupational therapists rated the same 8 children. For intrarater reliability, 20 raters each rated one child twice. Both English and Swedish versions of the instrument were used. Intraclass correlation coefficients (ICCs) and standard error of measurement (SEM) were calculated. RESULTS. ICCs for the sum score for the interrater were 0.98 (two raters) and 0.97 (20 raters) and for the intrarater 0.99. SEM was 1.5 for interrater and 1.2 for the intrarater study, which gave an error interval of ± 3 raw scores for interrater and ± 2.4 raw scores for intrarater. CONCLUSION. This study shows excellent interrater and intrarater reliability for sum scores.

The pectoralis minor length test: a study of the intra-rater reliability and diagnostic accuracy in subjects with and without shoulder symptoms

Abstract: Background Postural abnormality and muscle imbalance are thought to contribute to pain and a loss of normal function in the upper body. A shortened pectoralis minor muscle is commonly identified as part of this imbalance. Clinical tests have been recommended to test for shortening of this muscle. The aim of this study was to evaluate the intra-rater reliability and diagnostic accuracy of the pectoralis minor length test.

Reliability of the Welling Scale (WS1) for Rating Temporal Bone Dissection Performance

Abstract: Objective: To determine the inter- and intrarater reliability of using a new scale (Welling scale) for resident evaluation of temporal bone dissection performance. Study Design: Prospective, double-blinded, randomized trial. Methods: Twelve residents in otolaryngology (postgraduate year [PGY] 2–5) drilled 26 temporal bones (21 cadaveric, 5 plastic) with the objective to perform a complete mastoidectomy with facial recess approach. These bones were then rated using the Welling scale by six independent raters on two separate occasions (4–6 wk apart). Raters were blinded to PGY year. The Kappa statistic was calculated for inter- and intrarater reliability. Results: Intrarater agreement was high for all raters, ranging from κ = 0.65 to 0.72 (all P < .001), whereas the interrater agreement scores were more moderate (range, κ = 0.49–0.64; all P < .01). Conclusion: The Welling scale can be used reliably to assess temporal bone dissection performance where performance is measured by assessment of end product (mastoidectomy with facial recess approach).

Measuring edema in irradiated head and neck cancer patients

Abstract: Objectives: Edema is a common side effect of radiotherapy for head and neck cancer. Systems have been developed to record and monitor changes that occur after radiotherapy. These lack the sensitivity to record edema in specific laryngopharyngeal structures. The aim of this study was to develop a rating scale to measure edema in the larynx and pharynx. Methods: This was an exploratory study to develop a new measure, with the help of an expert panel, assessing interrater and intrarater reliability. A consensus group developed the rating scale. Eleven structures and 2 spaces were identified as areas sensitive to the development of edema. The terms no, mild, moderate, and severe were used to describe the degrees of edema. The scale was piloted and then tested for interrater and intrarater reliability on 5 speech and language therapists. They viewed 25 nasendolaryngoscopic images (23 patients who had had radiotherapy and 2 healthy volunteers). The images were rated with the scale. This process was repeated 1 week later. Results: Images were taken from patients with oral, oropharyngeal, nasopharyngeal, or laryngeal cancer. All had had radiotherapy or chemoradiotherapy. All raters were experienced in viewing larynges via nasendolaryngoscopy. The interrater reliability for scoring the edema rating scale was moderate (weighted kappa, 0.54). Lower levels of agreement were found for the tongue base, valleculae, pharyngeal walls, and anterior commissure. The intrarater reliability was very good (weighted kappa, 0.84). Conclusions: The edema rating scale can be scored with very good test-retest reproducibility and moderate levels of agreement between clinicians. Modifications to the method are suggested to increase interrater reliability.

Reliability of measuring long-standing lower extremity radiographs.

Abstract: The mechanical axis of the lower extremity was measured using preoperative long-standing radiographs in 56 patients undergoing total knee arthroplasty with the Stryker Navigation System (Stryker, Kalamazoo, Mich). Each radiograph was measured by four physicians, three times, in random order, and at delayed intervals. Measurements from each physician produced intraclass correlation coefficients of 0.9872, 0.9973, 0.9958, and 0.9839. An intraclass correlation coefficient of 0.9844 was noted between each of the raters. Pre- and postoperative axial alignments were determined with Stryker Navigation. Preoperatively, each rater overestimated deformity approximately 1 degrees (P>.05); however, postoperatively each rater underestimated the degree of deformity by approximately 1 degrees (P>.05). Measuring long-standing lower extremity radiographs provides significant inter- and intrarater reliability in determining lower extremity alignment.

Intra- and interrater reliability of the establishment of one repetition maximum on squat and seated knee extension.

Abstract: The purpose of the present study was to develop a systematic procedure for the establishment of 1 repetition maximum (1RM) in order to describe an easily accessible test procedure that is applicable for physical therapists and athletic trainers who manage strength training for healthy individuals and patients Another purpose was to investigate the intra- and interrater reliability of 1RM of squat on 1 leg and seated knee extension on 1 leg Estimates of leg strength and ratings of perceived exertion formed the basis of the amount of load selected The reliability of the procedure was assessed by a test-retest design One RM was established for 16 and 27 healthy individuals, for squat and knee extension, respectively The intrarater reliability of 1RM of squat on 1 leg was questionable (intraclass correlation [ICC] 064, measurement error 131 kg) The interrater reliability of 1RM of squat on 1 leg was clinically acceptable (ICC 094, measurement error 52 kg) The intrarater and interrater reliability of 1RM of seated knee extension on 1 leg was clinically acceptable (ICC 090, measurement error 51 kg and ICC 096, measurement error 32 kg, respectively) In conclusion, both exercises can be used to determine the load in exercise programs In addition, seated knee extension may be used to evaluate strength In contrast, squat on 1 leg is more uncertain to use at assessments between different days, which may be due to the complexity of this exercise The test, performed in the described manner, is suitable for physical therapists, athletic trainers, and strength and conditioning coaches in clinical practice working with strength training and rehabilitation

A quantitative and reproducible method to assess cord compression and canal stenosis after cervical spine trauma: a study of interrater and intrarater reliability.

Abstract: Study design Reliability study. Objective To assess the intrarater and interrater reliability of a recently described technique to measure of maximum canal compromise (MCC) and maximum spinal cord compression (MSCC) using digitized and magnified images in the setting of traumatic cervical spinal cord injury (SCI). Summary of background data The extent of MCC and MSCC is of clinical and prognostic value in the setting of traumatic cervical SCI. However, concerns remain regarding the accuracy of measurements based on hard copy images. We hypothesized that the interrater and intrarater reliability of these assessments would be enhanced using magnified digitized images and software-based measurement tools. Methods Midsagittal MRI and CT images of cervical spine were selected from 5 individuals with acute traumatic cervical SCI. Measurements of MCC using CT scan and T1-weighted MRI and measurements of MSCC based on T2-weighted MR images were independently estimated by 13 raters on 10 occasions. Results The intrarater reliability for CT-MCC, T1-weighted MRI-MCC and T2-weighted MRI-MSCC was high in the 10 rounds in each patient. In addition, the mean intrarater interclass correlation coefficient was 0.72 +/- 0.05 for the CT-MCC, 0.70 +/- 0.07 for the T1-weighted MRI-MCC, and 0.68 +/- 0.11 for the T2-weighted MRI-MSCC. The mean interrater interclass correlation coefficients were 0.43 +/- 0.02 for the CT-MCC, 0.61 +/- 0.03 for the T1-weighted MRI-MCC, and 0.55 +/- 0.05 for the evaluation of T2-weighted MRI-MSCC. Conclusion Our study has demonstrated that the intrarater reliability for the instrument to assess MCC and MSCC in the setting of traumatic SCI was high. The interrater ICCs at a moderate level of reliability combined with our results using analysis of variance with post hoc tests indicate that the measurements of MCC and MSCC are reproducible, which supports the use of these radiologic parameters in the clinical and research settings.

Reproducibility of the measurement of knee joint proprioception in patients with osteoarthritis of the knee

Abstract: Objective. To estimate the inter- and intrarater reliability and agreement of instrumented knee joint proprioception measurement in subjects with knee osteoarthritis (OA) and healthy subjects; to assess the effect of variations in the measurement procedure on agreement parameters. Methods. Proprioception was measured by a computer-controlled knee angular motion-detecting device in a movement-detecting task. The angular displacement between the starting position and the position at the instant of movement detection by the subject was recorded. Two raters independently assessed knee joint proprioception. After 14 days the assessment was repeated. Complete data were obtained from 24 subjects with knee OA and 26 healthy subjects. The inter-and intrarater reliability coefficients (intraclass correlation coefficients [ICC]) and inter- and intrarater agreement measures (standard error of measurement [SEM] and minimal detectable difference [MDD]) were calculated. Additionally, the effect of changing the velocity of angular displacement and applying headphone music during the measurement on the absolute error (i.e., SEM and MDD) was estimated at the second occasion. Results. Interrater reliability was good in subjects with knee OA and healthy subjects (ICC 0.91 and 0.89, respectively). Interrater agreement was higher in subjects with knee OA than in healthy subjects (SEM 2.13° versus 0.43°, MDD 5.90° versus 1.19°). Intrarater reliability was good in subjects with knee OA and healthy subjects (ICC 0.91 and 0.86, respectively). Intrarater agreement (SEM and MDD) was 2.26° and 6.26° in subjects with knee OA and 0.39° and 1.08° in healthy subjects. The original measurement and the 2 variations in measurement showed comparable measurement errors for subjects with knee OA and healthy subjects. Conclusion. In knee OA subjects and healthy subjects, knee proprioception measurement shows adequate intra- and interreliability. However, the absolute measurement error is rather high. Therefore, this measurement has limited value in the assessment of individual subjects, but can be recommended for scientific research in groups of individuals.

Artigo Original Precisão e acurácia da cirtometria em adultos saudáveis

Abstract: Objective: To determine the intrarater and interrater reliability of cirtometry (measurements of the circumference of the chest and abdomen taken during respiratory movements) as well as its correlation with pulmonary volumes measured by respiratory inductive plethysmography. Methods: A total of 40 healthy individuals were evaluated. The mean age was 28 years. The measurements were taken in the supine position at three different time points: at rest, at maximal inspiration, and at maximal expiration. Two trained investigators, each of whom was blinded as to the results obtained by the other, performed the measurements. The Friedman test was used to determine intrarater reliability, and the Wilcoxon test, together with the intraclass correlation coefficient, were used to determine interrater reliability. The correlation between the cirtometry measurements and the plethysmography results was obtained using Spearman’s correlation coefficient. The level of significance was set at 0.05 for all tests. Results: Intrarater reliability was satisfactory. Regarding interrater reliability, statistically significant differences (2.8 cm at the most) were found in all sets of measurements. However, through the analysis of the intraclass correlation coefficient, the investigators were found to be responsible only for a small portion of the variability (1.2-5.08%) found among the measurements. When the cirtometry measurements were compared to the volumes measured by respiratory inductive plethysmography, low correlations (range, r = 0.170-0.343) were found. Conclusions: The findings of this study suggest that, although cirtometry is a reliable measurement, it does not accurately measure pulmonary volumes.

Design and validation of 2 objective structured clinical examination stations to assess core undergraduate examination skills of the hand and knee.

Abstract: OBJECTIVE: To evaluate the development, validity, and reliability of 2 undergraduate Objective Structured Clinical Examination (OSCE) stations for core hand and knee examination skills. METHODS: Two OSCE stations for hand and knee based on core skills were developed, and qualitatively assessed for face and content validity by an expert consensus panel. Construct validity was evaluated by comparing the performance of third- (n = 21) and fifth-year (n = 50) medical students with 6 specialist registrars (SpR) in rheumatology. Concurrent validity was evaluated by correlating the scores of the fifth-year students with their eventual final examination scores. The fifth-year data were used to calculate the interrater and intrarater reliabilities of 2 examiners. Intrarater reliability analyzed repeat scores using videotapes of the examinations. RESULTS: Both stations were deemed to fulfil face and content validity criteria by the expert consensus panel. There was no significant difference in the mean scores of the third- and fifth-years. There were significant differences in the mean scores between both student groups and the SpR in both stations consistent with a valid construct theory. The fifth-year hand OSCE results correlated moderately with other indices of clinical skills, but not knowledge, and satisfied concurrent validity. Inter- and intrarater reliability for both stations was high. CONCLUSION: These OSCE stations are valid and reliable tools for testing competency in core hand and knee examination skills. They can be used in educational research as outcome measures of specific teaching interventions and can also be used as an early feedback tool when teaching joint examination.

Reliability and Risk Models: Setting Reliability Requirements

Abstract: This book presents new approaches for setting quantitative reliability requirements based on the cost of failure and specified minimum failure-free operation periods (MFFOPs). The cost-of-failure–based reliability analysis provides a real alternative to the current reliability analysis approach by considering the cost of the failures when setting reliability requirements. After an introduction to the reliability and risk analysis based on random variables, the author examines a new method for problem solving in the context of real reliability engineering applications and case studies and supplies algorithms that can be used for reliability analyses and for setting quantitative reliability requirements. The author also gives a comprehensive overview of basic Monte Carlo simulation techniques and algorithms for solving reliability engineering problems. In addition, the book provides a comprehensive introduction to loadstrength interference models for reliability and risk analysis by introducing the overstress reliability integral, a generalization of the load-strength interference integral with the time included. It also presents an efficient model for determining the probability of failure of loaded components and structures with integral flaws. The book comprises 16 chapters. Chapter 1 provides a general introduction to reliability (survival) functions, cumulative distributions and probability density functions of times to failure, and random events in reliability and risk modeling. Chapter 2 provides a general framework of the common reliability and risk models and their applications. Chapter 3 discusses reliability and risk models based on mixture distributions. Chapter 4 discusses general rules for reliability data analysis and also explores construction of reliability and risk models and estimation of the model parameters. Chapter 5 discusses load-strength (demand capacity) models and numerical methods for calculating the load-strength integral. Chapter 6 discusses Monte Carlo simulation algorithms for solving reliability and risk models, and Chapter 7 covers analysis of the properties of inhomogeneous media using Monte Carlo simulations. Chapter 8 discusses mechanisms of failure, including overstress failures, such as brittle fracture and ductile fracture; wear-out failures, such as fatigue and corrosion; and early-life failures, such as influence of the design. Chapter 9 discusses reliability associated with overstress failure mechanisms and damage factorization law. Chapter 10 introduces general equations related to the probability of failure of a stressed component with internal flaws and the individual probability of triggering failure with a single flaw. It also presents a stochastic model related to the fatigue life distribution of a component containing defects. Chapter 11 discusses the uncertainty and risk assessment associated with the location of the ductile-to-brittle transition region. Chapter 12 discusses modeling the kinetics of deterioration of protective coatings due to corrosion. Chapter 13 discusses physics-of-failure concepts that help improve the reliability of automotive suspension springs by delaying the fatigue failure mode. Chapter 14 discusses reliability governed by the relative locations of random variables in a finite domain. Chapter 15 discusses reliability based on minimum critical interval (MCI) and MFFOPs. It gives general equations related to random variables following a homogeneous Poisson process in a finite interval and some application examples. Chapter 16 provides a new methodology and models for reliability analysis and setting reliability requirements based on the cost of failure. Models and algorithms are introduced for determining the value from the reliability investment, the risk of premature failure, optimization models for minimizing the total losses, and models for limiting the risk of failure below a maximum acceptable level and for guaranteeing a minimum availability level. It is proved that the expected losses from failures of a repairable system in a specified time interval are equal to the expected number of failures times the expected cost given failure. Overall, this book examines the theory of reliability and risk analysis based on random variables. It also provides new methods for problem solving in the context of real reliability engineering problems. The book is ideal reading material for practicing engineers and consultants dealing with reliability and risk assessment. It also can be used as a reference by researchers and graduate students in reliability engineering and other quantitative disciplines such as actuarial science, economy, and applied probability and statistics.

Measurement properties of the L test for gait in hospitalized elderly.

Abstract: Objective: Evaluate the reliability, validity, and predictive value of the L test, a performance-based walk test, among older inpatients. Design: Cross-sectional study involving a consecutive sample of 50 older adults (mean age 84 ± 5 yrs) admitted to the geriatric unit of a tertiary care hospital. Application of the L test twice and single application of the timed "up and go" test (TUG), and the Frailty and Injuries Cooperative Studies of Intervention Techniques (FICSIT-4) balance scale, were conducted. Results: Interrater and intrarater reliability (two-way ANOVA intraclass correlation coefficients [ICC]) of the L test was 1.00 (95% confidence interval, Cl, 0.99-1.00) and 0.97, respectively (Cl, 0.95-0.98). Hypothesized associations with the TUG and FICSIT-4 were observed (Pearson product-moment correlation, r = 0.96 and r = -0.45, respectively; P < 0.01) with regard to magnitude and direction of the relationship. L test times demonstrated a small but statistically significant independent risk factor for discharge destination after hospitalization (odds ratio = 1.05; Cl, 1.01-1.09) after adjustment for age, sex, and cognitive status. Conclusions: The L test provides reliable, valid data when assessing basic walking skills among older adults in a hospital environment. The L test is potentially an important clinical and research tool to assess the mobility function of older inpatients as they transition back to the community.

The reliability of the ruins1

Abstract: “Other strangers had been there, wondering like ourselves. Their names were written on the walls.” (Stephens 293) In 1822, Henry Berthout, who translated into English the Spanish report on the anci...

Inter-Rater and Intra-Rater Reliability of the Bahasa Melayu Version of Rose Angina Questionnaire:

Abstract: The objective of the study is to translate the Rose Questionnaire (RQ) into a Bahasa Melayu version and adapt it cross-culturally, and to measure its inter-rater and intrarater reliability. This cross sectional study was conducted in the respondents' homes or workplaces in Kelantan, Malaysia. One hundred respondents aged 30 and above with different socio-demographic status were interviewed for face validity. For each inter-rater and intra-rater reliability, a sample of 150 respondents was interviewed. Inter-rater and intra-rater reliabilities were assessed by Cohen's kappa. The overall inter-rater agreements by the five pair of interviewers at point one and two were 0.86, and intrarater reliability by the five interviewers on the seven-item questionnaire at poinone and two was 0.88, as measured by kappa coefficient. The translated Malay version of RQ demonstrated an almost perfect inter-rater and intra-rater reliability and further validation such as sensitivity and specificity analysis of this translated questionnaire is highly recommended.