Topic
Intra-rater reliability
About: Intra-rater reliability is a research topic. Over the lifetime, 2073 publications have been published within this topic receiving 140968 citations.
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TL;DR: The rating scale correlated with Global clinical impression of change (GCIC) scored by neurologists and declined with time, indicating its sensitivity to change, and ALSFRS-R(Japanese version) is considered to be highly reliable enough for clinical use.
Abstract: Amyotrophic lateral sclerosis(ALS) is progressive, degenerative, fatal disease of the motor neuron. No efficacious therapy is available to slow the progressive loss of function, but several new approaches including neurotrophic factors, antioxidants and glutamate antagonists, are currently being evaluated as potential therapies. Mortality, and/or time to tracheostomy, muscle strength and pulmonary function are used as primary endpoints in clinical trials for treatment of ALS. The effect of new therapies on the quality of patients' lives are also important, so we sought to develop a rating scale to measure it. The revised ALS Functional Rating Scale(ALSFRS-R), which has addition of items to ALSFRS to enhance the ability to assess respiratory symptoms, is an assessment determining the degree of impairment in ALS patients' abilities to function independently in activities of daily living. It consists of 12 items to evaluate bulbar function, motor function and respiratory function and each item is scored from 0(unable) to 4(normal). We translated the English score into Japanese one with minor modification considering the inter cultural difference. And we examined reliability of the translated scale. As a measure of reliability, the intraclass correlation coefficient(ICC) was evaluated for total score and the Kappa coefficient proposed by Cohen and Kraemer was calculated for each item. Moreover, we examined sensitivity to clinical change over time and carried out the factor analysis to analyze the factorial structure. The subjects were 27 ALS patients and each was scored twice for reliability or three times for sensitivity by 2 to 5 neurologists and if possible, nurses. The ICC for total score was 0.97(95% C. I.; 0.94-0.98). Extension of the Kappa coefficients were 0.48 to 1.00 for inter-rater reliability and the averaged Kappa coefficients were 0.63 to 1.00 for intra rater reliability, respectively. Concerning the factorial structure, the contribution of the first factor(the first principal component) were 53.5% principal factor solution. The factor loadings of items were 0.52-0.91 except "salivation" and this factor almost equal to the simple sum of all items was interpreted as the general degree of deterioration. The promax votation revealed the riginally supposed factor structure with 3 factors(groups of items): neuromuscuclar function, respiratory function and bulbar function. The rating scale correlated with Global clinical impression of change(GCIC) scored by neurologists and declined with time, indicating its sensitivity to change. On the bases of these results, ALSFRS-R(Japanese version) is considered to be highly reliable enough for clinical use.
52 citations
52 citations
TL;DR: The poor interrater reliability suggests that if digital ulceration is to be used as an end point in multicenter clinical trials of SSc, then strict definitions must be developed.
Abstract: OBJECTIVE: To test the intra- and interobserver variability, among clinicians with an interest in systemic sclerosis (SSc), in defining digital ulcers. METHODS: Thirty-five images of finger lesions, incorporating a wide range of abnormalities at different sites, were duplicated, yielding a data set of 70 images. Physicians with an interest in SSc were invited to take part in the Web-based study, which involved looking through the images in a random sequence. The sequence differed for individual participants and prevented cross-checking with previous images. Participants were asked to grade each image as depicting "ulcer" or "no ulcer," and if "ulcer," then either "inactive" or "active." Images of a range of exemplar lesions were available for reference purposes while participants viewed the test images. Intrarater reliability was assessed using a weighted kappa coefficient with quadratic weights. Interrater reliability was estimated using a multirater weighted kappa coefficient. RESULTS: Fifty individuals (most of them rheumatologists) from 15 countries participated in the study. There was a high level of intrarater reliability, with a mean weighted kappa value of 0.81 (95% confidence interval [95% CI] 0.77, 0.84). Interrater reliability was poorer (weighted kappa = 0.46 [95% CI 0.35, 0.57]). CONCLUSION: The poor interrater reliability suggests that if digital ulceration is to be used as an end point in multicenter clinical trials of SSc, then strict definitions must be developed. The present investigation also demonstrates the feasibility of Web-based studies, for which large numbers of participants can be recruited over a short time frame.
52 citations
TL;DR: MMT of the hip may be performed with high reliability by examiners of different strength, and a preferred hip-extension-testing technique appears to provide mechanical advantages to the examiner compared with the alternative techniques.
Abstract: Context: Hip-muscle impairments are associated with a variety of lower-extremity dysfunctions. Accurate assessment in the clinical setting can be challenging due to the strength of hip muscles relative to examiner strength. Objective: To examine the influence of examiner strength and technique on manual hip-strength testing using a handheld dynamometer. Design: Repeated measures. Setting: Research laboratory. Participants: 30 active adults (age 24 ± 1.4 y). Interventions: Three examiners of different strength performed manual muscle tests (MMT) in 2 different positions for hip extension, abduction, and external rotation using a MicroFet handheld dynamometer. Examiner strength was quantified via a 1-repetition-maximum leg press and chest press with a Keiser A420 pneumatic resistance machine. Main Outcome Measures: Intrarater reliability (ICC3,1), interrater reliability (ICC2,1), and measured torque values. Results: Intrarater reliability for all measurements ranged from .82 to .97. Interrater reliability r...
52 citations
TL;DR: In this paper, the reliability assessment model jointly developed by Commonwealth Edison and ABB was used to evaluate the reliability of more than 3300 feeders in a typical distribution system, and an intelligent system is used to automatically identify potential reliability problems and recommend reliability improvement projects based on expected benefits and costs.
Abstract: Since a typical distribution system accounts for 40% of the cost to deliver power and 80% of customer reliability problems, distribution system design and operation is critical for financial success and customer satisfaction. To address this situation, Commonwealth Edison is integrating reliability assessment techniques into distribution planning and engineering. Just as equipment loading and voltage regulation are treated with analytical rigor with power flow models, interruptions and outages can be treated with analytical rigor with reliability models. This is made possible through the use of predictive reliability assessment tools that are able to predict customer reliability characteristics based on system topology and component reliability data. Reliability software predicts expected interruption frequencies and duration in a manner analogous to current and voltage evaluations in traditional power flow models. This article describes the distribution system's reliability assessment model jointly developed by Commonwealth Edison and ABB. This effort modeled, calibrated, and assessed the reliability of more than 3300 feeders. After completing the model, an intelligent system was used to automatically identify potential reliability problems and recommend reliability improvement projects based on expected benefits and costs.
52 citations