Evaluation of Journal Management Through Dialogic Communication: A Content Analysis of Agrivita International Journal of Agricultural Science Website

Development of the assessment of physiotherapy practice - a standardised and validated approach to assessment of professional competence in physiotherapy

Interrater reliability of quantitative ultrasound measures of muscle in critically ill patients.

Inter-rater reliability of a reflective rubric to assess pharmacy students’ reflective thinking

Can a reflective rubric be applied consistently with raters globally? A study across three countries

Category:Ankle; Ankle ArthritisIntroduction/Purpose:Even as its popularity increases, there remain many unanswered questions regarding total ankle arthroplasty. One debate considers the proper rotation of the talar component to restore native, non-osteoarthritic anatomy. The foot center axis is a unique anatomic concept that considers the position of the native foot relative to the ankle. The present pilot study sought to evaluate the reproducibility of axial alignment measurements, including the foot center on weight-bearing CT in patients without ankle osteoarthritis.Methods:Following IRB approval, charts were reviewed to identify patients without ankle osteoarthritis, trauma or other deformity who received a weightbearing CT scan. A pilot group of n=8 patients were included for a total of n=10 limbs. Average age was 50.1 +/- 14 and there were 38% female patients. All measurements were made on MPR (multiplanar reformation) axial reconstructions. Cobb angle measurements between the anatomic foot center, the second, the fourth metatarsal and the gutter bisector or medial gutter line were recorded by n=4 observers. Intraclass correlation (ICC) was produced using a two-way random effects model with absolute agreement and other statistical testing was performed by IBM SPSS Statistics for Windows, Version 27.0. Armonk, NY.Results:The average gutter bisector angle was 6.2 deg +/- 2.0 and the average angle between the medial base of the 1st metatarsal head, lateral base of the 5th metatarsal head and the posterior calcaneus was 33.0 deg +/- 2.6. Amongst the observers, the ICC for these landmarks were 0.95 and 0.96 respectively. The average cobb angle measurement between the gutter bisector angle and the second metatarsal was 8.3 deg +/- 7.3, with a corresponding ICC of 0.96. The average cobb angle measurement between the gutter bisector angle and the anatomic foot center was 5.6 deg +/- 4.3 and the average cobb angle measurement between the medial gutter line and the anatomic foot center was 6.23 deg +/- 6. Amongst the observers, the ICC for these measurements were 0.81 and 0.81 respectively.Conclusion:In a small pilot study of patients without osteoarthritis who underwent weight-bearing CT scans there was good (ICC>0.75-0.90) to excellent (ICC>0.90) agreement amongst observers for measurements of foot center axis and ankle rotation. These findings validate the reproducibility and agreement of these manually constructed measurements for assessing the relationship between the foot center axis and ankle rotation. Future studies will expand upon the use of these measurements to define non-arthritic anatomy. The anatomic foot center may be a useful guide for establishing intra-operative foot orientation when performing total ankle arthroplasty.

Validity and reliability of an objective structured assessment tool for performance of ultrasound-guided regional anaesthesia

Aims The predicting abusive head trauma (PredAHT) clinical prediction tool has been derived and validated. Based on the presence or absence of six clinical features (long-bone fractures/ rib fractures/retinal haemorrhage/head or neck bruising/apnoea/ seizures) this electronic calculator estimates the probability of abusive head trauma (AHT) in young children with intracranial injury. We aimed to explore the impact of this tool on clinicians’ own probability estimates of AHT. Methods A study of six clinical vignettes was conducted in two teaching and two district general hospitals with 29 clinicians: community(15), general(9) and emergency(2) paediatricians, radiologists(2) and one neurosurgical nurse. One vignette was designed as probable AHT, another was designed with a history and clinical features representing accidental head injury, and four were more indeterminate, designed to introduce uncertainty into the clinical decision. Clinicians were asked to estimate the probability of AHT in each vignette; they were then presented with the probability estimate from the PredAHT calculation and asked whether this altered their initial probability estimate. The impact of the tool in each vignette was analysed using linear modelling and linear mixed effects modelling. Interrater reliability of clinicians’ probability estimates was assessed with Intraclass correlation (ICC) based on single rating, absolute agreement, two-way random effects models. Results The tool significantly influenced clinicians’ probability estimates in all six vignettes. The greatest impact was demonstrated in a vignette with few concerning features in the history, but several concerning clinical features (tool score high). The least impact was demonstrated in a vignette with a history incompatible with the child’s motor development, but no additional clinical features (tool score low). The tool had the greatest impact for clinicians with the least paediatric experience. Agreement between clinicians was improved by the PredAHT; interrater reliability ranged from ‘poor’ to ‘good’ prior to using the tool (ICC.593, 95% CI.347 .899) and ‘poor’ to ‘excellent’ (ICC.661, 95% CI.417 .922) after using the tool. Conclusions PredAHT a numerical, electronic, evidence-based clinical prediction tool encourages clinicians to critically consider their probability estimates of AHT in light of the calculated score, and reduces variability in their estimates. The impact of the tool should be tested in clinical practice.

Within- and between-session test-retest reliability of pain-free grip strength in individuals with lateral elbow tendinopathy

IntroductionEvaluation of left ventricular (LV) global systolic function is clinically important for patients with atrial fibrillation (AF); however, the rhythm irregularity inherent to AF poses challenges for assessing novel LV systolic function parameters, such as global myocardial work (MW). This study aimed to validate the feasibility of using the single index beat method to quantify LV MW during echocardiography in patients with AF, compared with the traditional 10-beat average method.MethodsA prospective study was performed in 120 patients with AF at the time of the index echocardiography. Global longitudinal strain was assessed using speckle tracking echocardiography from a triplane dataset, followed by MW analysis to calculate global myocardial work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE). A total of 10 consecutive beats were evaluated, with both the average value and the maximal difference among the 10 beats recorded. The index beat was defined as on in which the ratio of the preceding to the pre-preceding R-R interval was approximately 1 (0.96–1.04). MW parameters from the index beat were extracted for analysis. Inter-method consistency was assessed using the intra-class correlation coefficient (ICC) with a single-rater, absolute agreement, two-way random effects model. Inter- and intra-observer reproducibility was also assessed.ResultsGlobal MW derived from the index beat was comparable with the average of 10 beats: GWI, 1,157.19 ± 416.83 vs. 1,188.98 ± 452.96 mmHg% (p < 0.05); GCW, 1,721.46 ± 524.69 vs. 1,732.46 ± 524.24 mmHg% (p > 0.05); GWW, 237.95 (183.60) vs. 207.50 (207.25) mmHg% (p < 0.001); and GWE, 85.80% (11.05) vs. 86.50% (12.75) (p < 0.001). Consistency analysis showed that ICCs for all assessed MW parameters were >0.87. Satisfactory inter- and intra-observer reproducibility of the measurements by the index beat method was also found.ConclusionsGlobal MW measured using the index beat method demonstrated good agreement with the average over 10 beats in patients with AF, supporting its reliability as a surrogate for the traditional method in clinical practice.

Primary Objective: To compare child- and parent-report ratings on the Health Behavior Inventory, Revised Child Anxiety and Depression Scale-Short Version (anxiety subscale), Patient Health Questionnaire-9, and Pediatric Quality of Life InventoryTM among children with persistent post-concussive symptoms following a sports- or recreation-related concussion, overall and by child age and gender. Research Design: Cross-sectional study examining baseline data from a randomized, comparative effectiveness trial. Methods and Procedures: Inter-rater reliability was assessed using two-way random effects model (absolute agreement) intraclass correlations, correlations were examined using Spearman’s rho, mean differences were determined using paired t-tests, and agreement was examined using Bland–Altman plots. Main Outcomes and Results: The final analytic sample was 200 parent–child dyads [child Mage = 14.7 (95% CI: 14.5, 15.0)]. Reliability and correlations were modest overall. When considering child age and gender, reliability ranged from poor to excellent (−1.01–0.95) and correlations ranged from weak to strong (−0.64–0.94). Overall, children reported more symptoms but better functioning than parents, and mean differences in scores were greater among females (versus males) and ages 16–18 (versus younger groups). Conclusions: Findings should inform the use and interpretation of psychosocial measures when developing appropriate youth concussion treatment plans.

BackgroundThe Systemic Lupus Erythematosus Disease Activity Score (SLE-DAS) has been recently developed and validated, providing improved accuracy and sensitivity for changes in SLE disease activity in comparison to SLE Disease...

Accurate assessment of a patient's functional status is crucial for determining the need for treatment and evaluating outcomes. Objective functional impairment (OFI) measures, alongside patient-reported outcome measures (PROMs), have been proposed for spine diseases. The Timed-Up and Go (TUG) test, typically administered by healthcare professionals, is a well-studied OFI measure. This study investigates whether patient self-measurement of TUG is similarly reliable. In a prospective, observational study, patients with spinal diseases underwent two TUG assessments: one measured by a healthcare professional and one self-measured by the patient. Interrater reliability was assessed using the intraclass correlation coefficient (ICC) with a two-way random-effects model, considered excellent between 0.75 - 1.00. Paired t-tests directly compared both measurements. The impact of variables such as age, sex, disease type, symptom severity (via PROMs), comorbidities, and frailty on reliability was also analysed. Seventy-four patients were included, with a mean age of 62.9years (SD 17.8); 29 (39.2%) were female. The majority (64.9%) were treated for degenerative disc disease. The lumbo-sacral region was most affected (71.6%), and 47.3% had previous surgeries. Patient self-measurement reliability was excellent (ICC 0.8740, p < 0.001), and the difference between healthcare professional (19.3 ± 9.4s) and patient measurements (18.4 ± 9.7s) was insignificant (p = 0.116). Interrater reliability remained high in patients > 65years (ICC 0.8584, p < 0.001), patients with ASA grades 3&4 (ICC 0.7066, p < 0.001), patients considered frail (ICC 0.8799, p < 0.001), and in patients not using any walking aid (ICC 0.8012, p < 0.001). High symptom severity still showed strong reliability (ICC 0.8279, p < 0.001 for Oswestry Disability Index > 40; ICC 0.8607, p = 0.011 for Neck Disability Index > 40). Patients with spine diseases can reliably self-measure OFI using the TUG test. The interrater reliability between self-measurements and those by healthcare professionals was excellent across all conditions. These findings could optimize patient assessments, especially in resource-limited settings.

O016 / #589Topic:AS23 - SLE-Diagnosis, Manifestations, &amp; OutcomesABSTRACT CONCURRENT SESSION 02: SLE METRICS – IMPROVING OUTCOMES &amp; MEASURES22-05-2025 1:40 PM - 2:40 PMBackground/PurposeReliability measures the consistency of an instrument’s assessments. Instruments intended for clinical and research use must exhibit high reliability. There is a need for studies that evaluate and compare the reliability of different instruments used to measure SLE disease activity. This study aims to estimate the intrarater and interrater reliability of 3 SLE disease activity measurement tools as assessed by lupus experts: the SLE Disease Activity Score (SLE-DAS), the SLE Disease Activity Index 2000 (SLEDAI-2K), and the Physician Global Assessment (PGA).[1,2]MethodsA group of 19 lupus experts from 12 countries (Europe, North America, South America, and Asia) evaluated 24 clinical case vignettes of SLE covering a wide spectrum of organ manifestations and disease severity. All raters completed a training on scoring rules for SLE-DAS, SLEDAI-2K and PGA before assessing the clinical vignettes. Raters scored each clinical vignette with SLE-DAS, SLEDAI-2K, and PGA twice, with at least a 10-day interval between rounds. The clinical vignettes were randomly ordered and assessed through an online survey. Intrarater and interrater reliability were assessed using the Intraclass Correlation Coefficient (ICC) and reported with 95% CI. For this analysis, ICC estimates were derived from a two-way random effects model (single rater). All calculations were performed using the Stata Statistical Software (Release 17) with the kappaetc module. The Coefficient of Variation (CV) was also used as a measure of reliability.[3] The CV was calculated for each vignette, based on the 19 measurements from each rater, for SLE-DAS, SLEDAI-2K, and PGA. Then, for each disease activity measure, the mean of the CV values across the 24 vignettes was used as a summary measure of within-subject variability and is expressed as a percentage.ResultsThe 24 clinical vignettes represented a wide variety of active SLE manifestations, including skin rash (20.8%), arthritis (12.5%), renal involvement (12.5%), thrombocytopenia (12.5%), cardiac/pulmonary involvement (12.5%), mucocutaneous vasculitis (8.3%), serositis (8.3%), and neuropsychiatric SLE (8.3%). Systemic vasculitis, myositis, alopecia, hemolytic anemia, and leukopenia were each present in 4.2% of the vignettes. Hypocomplementemia and/or positive anti-dsDNA were present in 75.0%. All the 19 lupus experts completed 2 rounds of assessment of the 24 clinical vignettes, totaling 912 case assessments. Scores ranged from 0.37 to 27.37 in SLE-DAS, 0 to 21 in SLEDAI-2K, and 0.0 to 3.0 in PGA. The interrater ICCs were 0.93, 0.91, and 0.74, and the intrarater ICCs were 0.94, 0.93, and 0.88 for SLE-DAS, SLEDAI-2K, and PGA, respectively. The CVs (first rating round) were 8.2%, 19.7%, and 41.1% for SLE-DAS, SLEDAI-2K, and PGA, respectively. The ICCs (95% CI) and CVs for SLE-DAS, SLEDAI-2K, and PGA are detailed in Table 1 and Table 2.Table 1.Inter-rater and intra-rater Intraclass Correlation Coefficient (ICC) of SLE-DAS, SLEDAI-2K and PGA.Table 2.Coefficient of Variation (CV) of SLE-DAS, SLEDAI-2K and PGA.ConclusionsThis study demonstrates that both SLE-DAS and SLEDAI-2K presented good to excellent interrater reliability, indicating strong consistency in scoring across different experts. Notably, SLE-DAS achieved excellent intrarater reliability, reflecting a high degree of stability in individual assessments between assessments at different times. Both SLEDAI-2K and PGA exhibited good to excellent intrarater reliability, while PGA showed moderate to good interrater reliability. Furthermore, SLE-DAS exhibited the lowest within-subject variability, as evidenced by its lower CV values compared to SLEDAI-2K and PGA.

Author response: Robust group- but limited individual-level (longitudinal) reliability and insights into cross-phases response prediction of conditioned fear

Cerebral perfusion evaluation using CT or MR perfusion is the gold standard modality to select large vessel occlusion (LVO) stroke patients presenting &gt;6 hours from symptom onset. The availability of cone beam C-arm CT perfusion (CBCTP) in angiography suites could reduce time to endovascular revascularization. We aimed to evaluate the reliability of using CBCTP when compared to multidetector CT perfusion (MDCTP). In this prospective, single-arm, interventional study, 14 LVO anterior circulation thrombectomy patients underwent both a 128 slice MDCTP in the ED and a CBCTP &lt;30 minutes apart prior to groin puncture. CBCTP was acquired using a prototype acquisition mode enabling 10 consecutive C-Arm rotations with nearly continuous data acquisition. A total of 60 cc of contrast layered with 60 cc of saline were injected covering arterial inflow, parenchymal phase and venous outflow. Image data was reconstructed into CBF, CBV, MTT and TTP maps. Three types of measurements were used to compare modalities. In measurement 1, 6 circular regions of interest (ROI) (400mm 2 ) were placed in the anterior arterial territory. In measurement 2, circular ROIs were placed in the ASPECTS regions (cortical 300mm 2 , subcortical 200mm 2 ). In measurement 3, a ROI was drawn around the entire affected area. All ROIs were placed in the basal ganglia and supraganglionic level of both brain sides. Rates (unaffected/affected area) between MDCTP and CBCTP were compared for all sequences. The intraclass correlation coefficient (ICC) was calculated using a single rater, consistency, two-way random-effects model. Measurement 1 found a moderate degree of agreement between MDCTP and CBCTP in CBF, CBV, MTT and TTP rates with ICCs of 0.58 (CI 0.42 - 0.69), 0.65 (CI 0.53 - 0.74), 0.77 (CI 0.68 - 0.83) and 0.52 (CI 0.35 - 0.65). In measurement 2, moderate agreement was found in CBF, CBV and MTT rates; with ICCs of 0.51 (CI 0.32 - 0.65), 0.57 (CI 0.4 - 0.69) and 0.62 (CI 0.47 - 0.73). The results of measurement 3 found an excellent (ICC=0.95, CI 0.88 - 0.98), good (ICC=0.83, CI 0.62 - 0.9) and moderate (ICC=0.7, CI 0.34 - 0.87), degree of agreement in the CBV, MTT and CBF rates, respectively. These results demonstrate promising accuracy of CBCTP in the evaluating ischemic tissue in patient presenting with LVO acute stroke.