Clinician Scores Research Articles

Clinical characteristics of mite allergen specific-lymphocytes stimulation test-positive Japanese cases with adult type atopic dermatitis

To identify the correlation between the house dust mite-specific lymphocytes proliferation and other clinical parameters and clinical features, we conducted a lymphocytes stimulation test in 37 patients with atopic dermatitis. A total of 12 patients showed positive reactions (positive patients) and 25 showed no reaction (negative patients). Both the number and percentage of peripheral blood eosinophils were significantly lower in positive patients than in negative patients. Stimulation index measured by lymphocytes stimulation test showed no correlation with the total IgE level, nor the number and percentage of eosinophils. Stimulation index weakly correlated with mite-specific IgE-RAST scores both in positive patients and in negative patients. Only in positive patients, stimulation index weakly correlated with the severity measured by the clinician score method. Three out of four positive patients showed an increased stimulation index in accordance with increased clinician scores during their clinical course. These results could suggest that, in positive patients, a house dust mite allergy might be an active cause that exacerbates clinical symptoms at the time of their clinical course. Therefore, the stimulation index of the lymphocytes stimulation test might become one of the effective parameters that reflect the involvement of a house dust mite allergy in adult atopic patients.

Evaluation of mild lameness in horses trotting on a treadmill by clinicians and interns or residents and correlation of their assessments with kinematic gait analysis

Abstract Objective To estimate sensitivity and accuracy of subjective evaluation of mild lameness in horses during treadmill locomotion and to correlate subjective evaluation with kinematic analysis. Animals 19 lame and 5 clinically normal horses. Procedure Lameness was evaluated by subjective score and kinematic analysis before and after palmar digital nerve block (PDNB). Evaluations were made by 6 clinicians and 7 interns or residents. Within- and between-observer agreement analyses (κ values) were calculated and compared, using a Student’s t-test. Pearson’s product-moment correlation coefficients were calculated between clinician’s change in score and the change in kinematic variables after PDNB. Results Within-observer agreement was within the range expected for conditions of moderate diagnostic difficulty. Within-observer agreement was higher for clinicians than for interns or residents. Between-observer agreement was acceptable for scores within 1 value of each other. Between-observer agreement of change in lameness score after PDNB was poor. When kinematic variables were ranked with each clinician’s subjective change in score, only 2 were among the top 3 for the majority of clinicians. Asymmetry of vertical head movement between contralateral forelimb stance phases and the point of maximum hoof height during swing decreased as lameness subjectively improved. Conclusion Mild lameness may be difficult to evaluate during treadmill locomotion. Although clinicians were more repeatable in their subjective evaluation of lameness than interns or residents, they were not more reliable at detecting the true state of lameness. Clinical Relevance Lack of agreement between clinician scoring of mild lameness emphasizes the need to use more objective measures for quantifying lameness. (Am J Vet Res 1998;59:1370–1377)

Parental Severity Scaling of Early Stuttered Speech: Four Case Studies

Some distinctive characteristics of cases of early stuttering suggest that a recurring, convenient and unobtrusive measurement procedure might be beneficial during clinical management. The present study investigated the reliability of a parent-based 10-point scale for measuring stuttering severity in four preschool-age stuttering children. For each child, listening tapes were constructed that consisted of around 24 speech samples, from everyday speaking situations, over a period of six days. Each parent used the severity scale to rate the speech samples on their child's listening tape. A clinician also scored the severity of the samples on the listening tapes using the same scale. Results indicated that, for two parents, extremely high agreement with the clinician's severity scores was achieved. Extremely high consistency scores were achieved by one of the parents, and also by the clinician when rating the speech samples of two of the children. To a considerable extent, clinician and parent severity score...