Showing papers on "Intra-rater reliability published in 2012"

The reliability and concurrent validity of shoulder mobility measurements using a digital inclinometer and goniometer: a technical report.

Abstract: Purpose/Aim: This study investigated the intrarater reliability and concurrent validity of active shoulder mobility measurements using a digital inclinometer and goniometer.

Reliability, Maintainability and Risk

Abstract: Reliability, maintainability and risk , Reliability, maintainability and risk , کتابخانه دیجیتال جندی شاپور اهواز

Validity and reliability of the TGMD-2 for Brazilian children.

Abstract: The Test of Gross Motor Development (TGMD-2) is broadly used in research and clinical settings. The author aimed to translate and investigate the content, criteria, and construct validity and reliability of the TGMD-2 for Brazilian children. The study involved translators, experts, and 3,124 Brazilian children from several states of Brazil. Results confirmed language clarity and pertinence of the TGMD-2. Appropriate indices of the confirmatory factorial validity (root mean square error of approximation = .06; comparative fit index = .88; Tucker-Lewis index = .83; normed fit index = .09; goodness-of-fit index = .98; adjusted goodness-of-fit index = .95), test-retest (values from .83 to .91) and inter- and intrarater reliability were found. Concurrent validity between TGMD-2 and Movement Assessment Battery for Children was weak. The TGMD-2 is a validity and reliability instrument for Brazilian children.

Quantitative Paraspinal Muscle Measurements: Inter-Software Reliability and Agreement Using OsiriX and ImageJ

Abstract: Background Variations in paraspinal muscle cross-sectional area (CSA) and composition, particularly of the multifidus muscle, have been of interest with respect to risk of, and recovery from, low back pain problems. Several investigators have reported on the reliability of such muscle measurements using various protocols and image analysis programs. However, there is no standard protocol for tissue segmentation, nor has there been an investigation of reliability or agreement of measurements using different software. Objective The purpose of this study was to provide a detailed muscle measurement protocol and determine the reliability and agreement of associated paraspinal muscle composition measurements obtained with 2 commonly used image analysis programs: OsiriX and ImageJ. Design This was a measurement reliability study. Methods Lumbar magnetic resonance images of 30 individuals were randomly selected from a cohort of patients with various low back conditions. Muscle CSA and composition measurements were acquired from axial T2-weighted magnetic resonance images of the multifidus muscle, the erector spinae muscle, and the 2 muscles combined at L4–L5 and S1 for each participant. All measurements were repeated twice using each software program, at least 5 days apart. The assessor was blinded to all earlier measurements. Results The intrarater reliability and standard error of measurement (SEM) were comparable for most measurements obtained using OsiriX or ImageJ, with reliability coefficients (intraclass correlation coefficients [ICCs]) varying between .77 and .99 for OsiriX and .78 and .99 for ImageJ. There was similarly excellent agreement between muscle composition measurements using the 2 software applications (inter-software ICCs=.81–.99). Limitations The high degree of inter-software measurement reliability may not generalize to protocols using other commercial or custom-made software. Conclusion The proposed method to investigate paraspinal muscle CSA, composition, and side-to-side asymmetry was highly reliable, with excellent agreement between the 2 software programs.

Overview of Reliability Testing

Abstract: This paper presents an overview of reliability testing, reliability estimation, and prediction models. It also presents approaches for the design of test plans which result in providing failure data and/or degradation data in a limited test duration. Equivalence of different test plans which result in similar reliability estimates is also discussed. Use of degradation data for reliability estimates and maintenance decisions are presented.

Test-retest and intrarater reliability of 2-dimensional ultrasound measurements of distance between rectus abdominis in women.

Abstract: Study Design Single-group test-retest reliability study. Objectives To evaluate the test-retest intraobserver reliability of 2-dimensional ultrasound measurement of the distance between the rectus abdominis muscles, the interrectus distance (IRD). Background Diastasis recti is defined as the separation of the 2 rectus abdominis muscles, with a reported prevalence of between 30% and 70% in women during pregnancy and in the postpartum period. The condition is difficult to measure, and ultrasound imaging has been suggested as a useful method to quantify the diastasis. However, to date, no studies have investigated intratester or intertester reliability of ultrasound to measure the distance between the rectus abdominis muscles during rest and contraction. Methods Ultrasound images from the rectus abdominis were recorded in 24 healthy female volunteers at rest and under 2 conditions of abdominal contraction: abdominal crunch and drawing-in exercises. The probe was positioned at 2 locations: below and above the...

The reliability and concurrent validity of scapular plane shoulder elevation measurements using a digital inclinometer and goniometer.

Abstract: This study investigated the reliability and concurrent validity of active shoulder elevation in the scapular plane (scaption) using a digital inclinometer and goniometer. Two investigators used a goniometer and digital inclinometer to measure scaption on 30 asymptomatic participants in a blinded repeated measures design. Good reliability was present with intraclass correlation coefficients (ICCs) for intrarater reliability of goniometry = 0.87, intrarater digital inclinometry = 0.88, interrater goniometry = 0.92, and interrater digital inclinometry = 0.89. The minimal detectable change (MDC95) for the interrater analysis indicated that a change equal to or greater than 8 degrees for goniometry and 9 degrees for inclinometry is required to be 95% certain that the change is not due to intertrial variability or measurement error. The concurrent validity between goniometry and digital inclinometry was excellent with an ICC value of 0.94 for both raters. The 95% limits of agreement suggest that the difference between these two measurement instruments can be expected to vary by up to ±11 degrees. The results support the interchangeable use of goniometry and digital inclinometer for measuring scaption. Clinicians and researchers should consider the MDC values presented when interpreting change during subsequent measurement sessions.

A METHOD and RESOURCES for ASSESSING the Reliability of Simulation Evaluation Instruments

Abstract: Aim. This article describes a successfully piloted method for facilitating rapid psychometric assessments of three simulation evaluation instruments: the Lasater Clinical Judgment Rubric, the Seattle University Evaluation Tool, and the Creighton-Simulation Evaluation InstrumentTM. Background. To provide valid and reliable evaluations of student performance in simulation activities, it is important to assess the psychometric properties of evaluation instruments. Method. This novel method incorporates the use of a database of validated, video-archived simulations depicting nursing students performing at varying levels of proficiency. A widely dispersed sample of 29 raters viewed and scored multiple scenarios over a six-week period. Analyses are described including inter- and intrarater reliability, internal consistency, and validity assessments. Results and Conclusion. Descriptive and inferential statistics supported the validity of the leveled scenarios. The inter- and intrarater reliability and internal c...

Measuring the severity of infantile hemangiomas: Instrument development and reliability

Abstract: Objectives To develop instruments that measure the severity of infantile hemangiomas (Hemangioma Severity Scale [HSS]) and the complications of infantile hemangiomas for longitudinal use (Hemangioma Dynamic Complication Scale [HDCS]). Design Instrument development and reliability study. Setting Academic research. Participants The HSS and the HDCS were developed through the collaborative effort of members of the Hemangioma Investigator Group Research Core, an expert multi-institutional research group. After development of the scales, 13 pediatric dermatologists used the HSS to score 20 different hemangiomas. In addition, 12 pediatric dermatologists used the HDCS to score hemangioma-related complications for 24 clinical scenarios. Interrater and intrarater reliability was measured for both scales. Main Outcome Measures Interrater and intrarater reliability. Results For the HSS, interrater reliability and intrarater reliability exceeded 99%. Similarly, the HDCS had a high rate of interrater agreement; for individual items, agreement among raters was 67% to 100%, with most clinical scenarios demonstrating greater than 90% agreement. Intrarater reliability was excellent for all individual items of the HDCS. Conclusion The HSS and the HDCS are reliable scales that can be used to measure the severity of infantile hemangiomas, including the severity of complications for longitudinal use.

Intrarater reliability of pain intensity, tissue blood flow, thermal pain threshold, pressure pain threshold and lumbo-pelvic stability tests in subjects with low back pain.

Abstract: Purpose: This preliminary study aimed to determine the intrarater reliability of the quantitative tests for the study of non-specific low back pain. Methods: Test-retest reliability of the measurements of ratio data was determined by an intraclass correlation coefficient (ICC), standard error of measurements (SEMs), coefficient of variation (CV), and one-way repeated measures ANOVA using the values collected from 13 young individuals (25.8 ± 6.2 years) with chronic non-specific low back pain on two occasions separated by 2 days. Percent agreement of the ordinal data was also determined by Cohen’s Kappa statistics (kappa). The measures consisted of tissue blood flow (BF), average pain visual analog scales (VAS), pressure pain threshold (PPT), cold pain threshold (CPT), heat pain threshold (HPT) and lumbo-pelvic stability test (LPST). An acceptable reliability was determined as the ICC values of greater than 0.85, SEMs less than 5%, CV less than 15%, the kappa scores of greater than 80% and no evidence of systematic error (ANOVA, P > 0.05). Results: ICC of all measures in the lumbo-sacral area were greater than 0.87. The kappa was also greater than 83%. Most measures demonstrated a minimal error of measurements and less potential of systemic error in nature. Only the SEMs and the CV of the CPT exceeded the acceptable level. Conclusions: It is concluded that most of the quantitative measurements are reliable for the study of non-specific low back pain, however the CPT should be applied with care as it has a great variation among individuals and potential of measurement error.

Validated assessment scale for neck volume.

Abstract: Background Sagging of the neck aesthetic area is an important indicator of age. The development of complex and globally accepted tools for proper assessment of the change in neck volume is an essential contribution to aesthetic research and the routine clinical setting. Objective To develop a grading scale for the objective assessment of the neck volume and to establish the reliability of this scale for clinical research and practice. Materials and Methods A 5-point rating scale was developed to assess neck volume objectively. Twelve experts rated frontal and lateral neck photographs of 50 subjects in two separate rating cycles using the neck volume scale. Responses of raters were analyzed to assess inter- and intrarater reliability. Results Interrater reliability for the neck volume scale was almost perfect, with intraclass correlation coefficients for the first and second rating cycles of 0.85 and 0.84, respectively. Intrarater reliability for the neck volume scale was high (0.90) and Pearson correlation coefficients ranged between 0.88 and 0.95 and were statistically significant. Conclusion The neck volume scale demonstrates optimal reliability for clinical research and practice.

Intra-rater reliability of the Modified Modified Ashworth Scale (MMAS) in the assessment of upper-limb muscle spasticity.

Abstract: The aim of this study was to investigate the intra-rater reliability of the Modified Modified Ashworth Scale (MMAS) in the upper limb of patients with hemiparesis and to determine the effect of pain and contracture presence on the reliability of the MMAS. For this test-retest study 30 patients with hemiparesis were included. One physiotherapist using the MMAS, randomly rated the spasticity of shoulder adductors, elbow flexors, and wrist flexors in the affected upper limb of each patient with hemiparesis twice with at least a 1 week interval between testing sessions. The presence of pain and contracture during passive stretch was recorded. The magnitude of the contracture was measured by a goniometer. The quadratic weighted kappa statistics was very good for the upper limb spasticity (κw= 0.84). Intra-rater reliability was good for shoulder adductors (κw=0.75), and very good for elbow flexors and wrist flexors (κw 0.86 and 0.90, respectively). There were no differences between the weighted kappa values for muscle groups (p>0.05). The intra-rater reliability was also good in the presence of pain or contracture. The MMAS had very good intra-rater reliability in the assessment of upper limb spasticity in patients with hemiparesis. The presence of pain during shoulder abduction or contracture of the shoulder adductors had no influence on the reliability of the MMAS (κ w=0.75, 0.77, respectively).

Validity and Reliability of a Korean Version of the National Institutes of Health Stroke Scale

Abstract: Background and PurposezzThe National Institutes of Health Stroke Scale (NIHSS) is a clinical assessment tool that is widely used in clinical trials and practice to evaluate stroke-related neurological deficits. The aim of this study was to determine the validity and reliability of the Korean version of the NIHSS (K-NIHSS) for evaluating Korean stroke patients. MethodszzThe K-NIHSS was translated and adapted with regard to cultural and linguistic peculiarities. To examine its content validity, we quantified the Content Validity Index (CVI), which was rated by 11 stroke experts. The validity of the K-NIHSS was assessed by comparison with the Glasgow Coma Scale (GCS), the modified Rankin Scale (mRS), and the Barthel Index. The reliability of the K-NIHSS was evaluated using the unweighted kappa statistics for multiple raters and an intraclass correlation coefficient (ICC). ResultszzThe CVI of the K-NIHSS reached 0.91-1.00. The median K-NIHSS score at baseline was 3 (interquartile range, 2-7), and the mean±SD score was 6.0±6.6. The baseline K-NIHSS had a significantly negative correlation with the GCS at baseline and the Barthel Index after 90 days. The K-NIHSS also had a significantly positive correlation with the mRS after 90 days. Facial paresis and dysarthria had moderate interrater reliability (unweighted kappa, 0.41-0.60); kappa values were substantial to excellent (unweighted kappa, >0.60) for all the other items. The ICC for the overall K-NIHSS score was 0.998. The intrarater reliability was acceptable, with a median kappa range of 0.524-1.000. ConclusionszzThe K-NIHSS is a valid and reliable tool for assessing neurological deficits in Korean acute stroke patients. J Clin Neurol 2012;8:177-183 Key Wordszz NIH Stroke Scale, validity, reliability.

The Persian version of the Berg Balance Scale: inter and intra-rater reliability and construct validity in elderly adults

Abstract: Purpose: As a well-known measure for quantifying functional mobility in elderly persons, Berg Balance Scale (BBS) was used in the present study to evaluate its psychometric properties among a sample of 106 elderly individuals speaking Persian language. Method: After forward-backward translation process, videotapes were recorded from all participants while performing 14 tasks of the BBS. The volunteers were also asked to perform the Timed Up and Go (TUG) test at the same session. To determine inter and intra-rater reliability, the videotapes were viewed by two experienced therapists while one of the raters assessed the videotaped performance of the subjects on a second occasion. Results: Intraclass correlation coefficients (95% confidence interval) of 0.93 (0.87 0.96) and 0.95 (0.92 0.97) were obtained for inter and intra-rater reliability, respectively. Cronbach’s alpha was 0.62 which is marginally lower than the cut-off point of 0.70. Furthermore, there were no ceiling and floor effects for the Persian v...

Test-retest reliability of Motricity Index strength assessments for lower extremity in post stroke hemiparesis

Abstract: Background: The Motricity Index was used to measure strength in upper and lower extremities after stroke. The weighted score based on the ordinal 6 point scale of Medical Research Council was used to measure maximal isometric muscle strength. There is dearth of articles dealing with the reliability of this method. Therefore, the aim of this study was to determine the test retest reliability of Motricity Index strength assessments for paretic lower limb in 20 chronic stroke patients with one week interval. Methods: In a cross sectional study, intrarater reliability of lower extremity Motricity Index strength assessments with one week interval were measured. Result: The SPSS 18 was used for analysis of data. Two-way random-consistency model of ICC was used for assessment of test-retest reliability. The ICC values showed high reliability of strength measurement of Motricity Index (ICC=0.93). Conclusion: The Motricity Index can be a reliable instrument for measuring the strength of involved lower extremity when assessment is done by one rater following chronic stroke.

Reliability of "Modified timed up and go" test in children with cerebral palsy.

Abstract: Background: Timed up and go (TUG) is a quick test used in clinical practice as an outcome measure to assess functional ambulatory mobility or dynamic balance in adults. However, little information is available on TUG test used in cerebral palsy. Hence, the purpose of our study was to assess the intra-rater reliability of TUG test in cerebral palsy children. Aim and Objective: To assess within-session and test-retest reliability after 1 week of TUG test in cerebral palsy children. Setting and Design: It was an a cross-sectional observational study conducted in a neurorehabilitation unit, with 30 cerebral palsy children of 4-12 years, within Gross Motor Function Classification System (GMFCS) level I, II, III, and with an IQ ≥50.The sampling technique used was purposive sampling excluding children with cognitive deficit. Materials and Methods: Subjects performed TUG on three occasions - Initial assessment (time 1), 30 min after initial assessment (time 2), and 1 week after initial assessment (time 3). Three trails were conducted for each of the three occasions. The mean score of three trials was documented as the final score. Within-session and test-retest reliability were analyzed using scores of time 1 and 2, and time 1 and 3, respectively. Statistical Analysis: The documented data were analyzed for within-session and test-retest reliability after 1 week of TUG test by using intraclass correlation coefficient (ICC). Results: Reliability of TUG test was high, with ICC of 0.99 for within-session reliability and 0.99 for test-retest reliability. Conclusion: Intra-rater reliability of TUG test in cerebral palsy children was found to be high.

Reliability of Measuring Thoracic Kyphosis Angle, Lumbar Lordosis Angle and Straight Leg Raise with an Inclinometer

Abstract: Purpose: Several non-invasive measurement methods have been described in the literature for recording thoracic kyphosis, lumbar lordosis and straight leg raise (SLR). However, attempts to quantify the reliability of the inclinometer in these measurements are scarce. In addition, existing reliability studies within the literature were found to use small sample sizes. The aim of this investigation was to examine the intra-rater reliability of the chief investigator (SM), in order to provide clinicians with data that will allow them to better measure sagittal spinal posture and SLR. A blinded test-retest design was performed to determine the intra-rater reliability of thoracic kyphosis, lumbar lordosis and SLR when assessed using an Isomed inclinometer in normals. Methods. Thirty asymptomatic subjects were assessed on two occasions separated by a time interval of 1 hour to reduce investigator memory bias. Thoracic and lumbar measurements were recorded in a relaxed standing position using an inclinometer; SLR of the dominant leg was assessed with subjects in the supine position. Intraclass correlation coefficients (ICC), 95% confidence intervals (CI), and standard errors of measurement (SEM) were analysed to determine measurement reliability. Results. The chief investigator demonstrated excellent intra-rater reliability in the measurements of thoracic kyphosis, lumbar lordosis and SLR. ICC (2,3) values for all three variables exceeded the 0.90 threshold suggesting that the reliability of these measures are acceptable for clinical application. Conclusions. The inclinometer technique employed in this study to record thoracic kyphosis, lumbar lordosis and SLR is a reliable measurement method.

Intrarater reliability of assessing strength of the shoulder and scapular muscles.

Abstract: Context: Handheld dynamometry (HHD) is considered an objective method of measuring strength, but the reliability of the procedure can be compromised by inadequate tester strength and insufficient stabilization of the dynamometer especially, for the scapular muscles. Objective: Primarily, to determine the intrarater reliability of HHD when testing shoulder and scapular muscle strength, and secondarily, to report reliability when corrected for body-mass index (BMI). Design: Technical report. Setting: University physiotherapy department. Participants: 57 adults (17 men, 40 women; mean age = 35.05 ± 13.5 y), both healthy individuals and patients with shoulder impingement. Intervention: HHD. Main Outcome Variables: Muscle strength of the upper, middle, and lower trapezius; anterior deltoid; serratus anterior; supraspinatus; and latissimus dorsi determined by HHD. Each muscle was assessed 3 times, and the mean value was calculated. The subjects were divided into 3 groups according to BMI. Group 1: BMI ≤ 20 kg/m 2 (n = 22); Group 2: BMI ≤ 24.9 kg/ m 2 (n = 54); and Group 3: BMI ≤ 29.9 kg/m 2 (n = 38). Results: Correlations were calculated for each pair of strength scores. Intraclass correlation coefficients (ICCs) ranged from .77 to .99 in healthy subjects and from .75 to .99 in patients, for all muscle groups except the upper trapezius (P < .05). Reliability values ranged from good to high in healthy subjects but were less consistent for the upper trapezius (ICC .45–.65). The relationship with BMI and muscle strength illustrates that as BMI increases, there is a decrease in reliability values of the lower trapezius (ICC = .35–.65). Conclusion: The study demonstrates that evaluating the strength of scapular and shoulder muscles using HHD presents reliable results for both patients with impingement syndrome and healthy subjects. Reliability values were compressed when testing the trapezius in subjects with higher BMI. This is likely a result of the examiner’s difficulty in overcoming the patients with this maneuver.

Reliability of Bucholz and Ogden Classification for Osteonecrosis Secondary to Developmental Dysplasia of the Hip

Abstract: Osteonecrosis is perhaps the most important serious complication after treatment of developmental dysplasia of the hip (DDH). The classification by Bucholz and Ogden has been used most frequently for grading osteonecrosis in this context, but its reliability is not established and unreliability could affect the validity of studies reporting the outcome of treatment. We established the interrater and intrarater reliabilities of this classification and analyzed the frequency and nature of disagreements. Three pediatric hip surgeons, a musculoskeletal pediatric radiologist, and three orthopaedic trainees graded 39 radiographs (hips) according to the Bucholz and Ogden classification, blinded to any clinical data. Ratings were repeated after 2 weeks. Interrater reliability and intrarater reliability were determined using the simple kappa statistic. Grading was compared among raters, the nature and frequency of disagreements established, and subgroup analyses performed. Interrater reliability was 0.34 (95% CI = 0.28, 0.40) for all raters, and 0.31 (0.20 to 0.43) for the three surgeons. The best interrater reliability was observed between the radiologist and a surgeon with a kappa of 0.51 (0.30, 0.72). Intrarater reliability estimates ranged from 0.44 to 0.69. Raters disagreed regarding the grade of osteonecrosis in 26 of 39 hips (67%), with seven of 26 disagreements (27%) involving confusion between Grades I and II. The interrater reliability was lower than expected, considering the raters’ experience. Distinguishing between Grades I and II was the most frequently observed problem. We believe that the low reliability was a result of an ambiguous classification scheme rather than the variability among the raters. Outcome studies of DDH based on this classification should be interpreted with caution. We recommend the development of a new classification with better prognostic ability. Level III, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.

Development of the Persian version of the Modified Modified Ashworth Scale: translation, adaptation, and examination of interrater and intrarater reliability in patients with poststroke elbow flexor spasticity

Abstract: Purpose: Development of the Persian version of the Modified Modified Ashworth Scale (MMAS), and to investigate the interrater and intrarater reliability of the Persian MMAS when used to quantify elbow flexor spasticity in patients after stroke. Methods: The Persian MMAS was developed by the forward and backward translation procedure, a final review by an expert committee, and testing for acceptability and the clarity of item wording so that the scale could be used by Persian-speaking examiners. Psychometric testing included interrater and intrarater reliability. Elbow flexor spasticity was examined by two raters in 30 patients after stroke twice on two occasions using the Persian MMAS. The weighted κ was used for the statistical analysis. Results: The interrater and intrarater reliability was very good for the Persian MMAS (weighted κ: 0.81–0.91; 95% CI 0.68–0.98) with statistically significant agreement between raters and within raters (all p < 0.001). Conclusions: The Persian version of the MMAS was suc...

The reliability to determine "healing" in osteochondritis dissecans from radiographic assessment.

Abstract: Background Current literature supporting treatment strategies for osteochondritis dissecans (OCD) has limited prognostic utility. Presently, there is no gold standard for an OCD "healing" outcome. Accurate and reliable determination of the OCD healed status on the basis of radiographs would be valuable to provide a guide for evidence-based treatment of OCD. The purpose of this study was to determine interrater and intrarater reliability of radiographic assessment of OCD lesion healing in the knee. Methods A hospital database identified 39 consecutive patients with OCD in 42 knees, who were treated conservatively for at least 6 months. Patients were an average age of 11.9 years (±2.4 y). A total of 102 presentation slides were prepared, each containing 2 similar radiographic views from the same patient taken 6 months (±1 mo) apart. These slides were then categorized by 4 reviewers (1 orthopaedic surgeon, 1 orthopaedic fellow, and 2 musculoskeletal radiologists) blinded to patient data, as healed, not healed, or unable to evaluate the OCD lesion. Reviewers repeated their assessment at a minimum of 3 weeks after their first read. Intrarater and interrater reliability were measured with the Cohen κ coefficient and Randolph's free-marginal multirater κ, respectively, and with the percent agreement. Results OCD lesion categorization demonstrated insufficient interrater reliability with a κ of 0.44 and 63% agreement. The notch view had the highest interrater reliability with a κ of 0.63% and 76% agreement, and the lateral view had the lowest interrater reliability with a κ of 0.29% and 53% agreement. The OCD lesion categorization demonstrated substantial intrarater reliability with a κ of 0.68% and 81% agreement. Conclusions Reviewers did not consistently agree on the "healing" status of the OCD lesions on the basis of radiographic assessments. Standard criteria to assess healing are needed to consistently evaluate OCD knee lesions in children. Level of evidence Not applicable.

Reliability and predictive validity of Inlow's 60-Second Diabetic Foot Screen Tool.

Abstract: Objective : The purpose of this study was to assess Inlow's 60-Second Diabetic Foot Screen Tool to ascertain consistency of risk recognition for development of ulceration independent of specific assessor and practice setting. Screening tools that assist clinicians in identifying risk require validation. The objectives were to determine the intrarater reliability, interrater reliability, and predictive validity of Inlow's 60-Second Diabetic Foot Screen Tool in 2 healthcare settings. Design : Following ethics board approval, a prospective observational study was completed. Setting and participants : A convenience sample of 69 persons with diabetes was recruited: n = 26 from an acute care setting (dialysis) and n = 43 from long-term-care (LTC) setting. Main outcome measures : The screening tool was administered by 2 assessors independently to determine interrater reliability and later the same day by one of the assessors to determine intrarater reliability. Occurrence of foot ulcers or amputation was noted 1 to 5 months later to determine predictive validity. Main results : Reliability is reported per setting using the intraclass correlation coefficient (2.1) and 95% confidence intervals. Intrarater reliability: LTC 0.96 (0.93-0.98) right foot, 0.97 (0.95-0.98) left foot; dialysis 1.00 right and 1.00 left foot. Interrater reliability: LTC 0.92 (0.86-0.96) right foot, 0.93 (0.87-0.96) left foot; dialysis 0.83 (0.65-0.92) right foot and left foot. Predictive validity: Two subjects had events-1 ulcer and 1 amputation-that were associated with high Inlow's screening tool scores. Conclusion : This study demonstrates excellent interrater and intrarater reliability and provides preliminary information about predictive validity.