Excellent Inter-rater Reliability Research Articles

Video Motion Analysis as a Quantitative Evaluation Tool for Essential Tremor during Magnetic Resonance-Guided Focused Ultrasound Thalamotomy.

The Clinical Rating Scale for Tremor (CRST) is commonly used to evaluate essential tremor (ET) during focused ultrasound (FUS) thalamotomy. However, it faces challenges such as the ceiling effect and test-retest variability. This study explored the utility of videographic motion analysis as an evaluation index for ET. Forty-three patients with ET performed postural tremor and line-drawing tasks recorded on video, and the data were analyzed using motion analysis software. The test-retest and inter-rater reliability, correlations with the CRST and tremor scores, and pre/post-FUS treatment comparisons were analyzed. The video motion analysis showed excellent test-retest and inter-rater reliability. In the postural tremor tasks, video parameter amplitude significantly correlated with the CRST and tremor scores. Similarly, for the line-drawing task, video parameter amplitude showed significant correlations with CRST and tremor scores, effectively addressing the ceiling effect. Regarding post-FUS treatment improvements, changes in the CRST and tremor scores were significantly associated with changes in video parameter amplitude. In conclusion, quantitative analysis of the video motion of ET enables precise evaluation of kinematic characteristics and effectively resolves the ceiling effect and test-retest variability. The video motion analysis score accurately reflected the tremor severity and treatment effects, demonstrating its high clinical utility.

Dissemination of a Pediatric Musculoskeletal POCUS Scoring System via Virtual Education: A Proof-of-Concept Study

Point of care pediatric musculoskeletal POCUS scanning and scoring protocols for childhood arthritis have emerged in recent years. However, pediatric musculoskeletal POCUS curricula in rheumatology fellowship programs are limited due to availability of trained faculty and resources. This proof-of-concept study investigated the effectiveness of educational methods for a pediatric musculoskeletal POCUS scoring protocol among fellows and physicians of differing subspecialties. Educational methods assessed included recorded videos and virtual review sessions. Effectiveness was assessed by calculating interrater reliability for the musculoskeletal POCUS scoring systems using the intra-class correlation coefficient (ICC). Following training sessions, participants then underwent scoring exercise(s) until the goal of an excellent ICC ≥ 0.75 was reached. Four participants completed two rounds of virtual education, review, and scoring sessions. Excellent interrater reliability was achieved for most views. This proof-of-concept study demonstrated virtual education covering advanced concepts of pediatric musculoskeletal POCUS provides a knowledge base for physicians from different subspecialties and various experience.

Reliability of the safety threats and adverse events in trauma (STAT) taxonomy using trauma video review.

The STAT (Safety Threats and Adverse Events in Trauma) taxonomy was developed through expert consensus, and groups 65 identified trauma resuscitation adverse events (AEs) into nine distinct categories. It provides a framework for standardized analysis of trauma resuscitations and creates a foundation for targeted quality improvement and patient safety initiatives. This study aims to evaluate the reliability of the STAT taxonomy in identifying AEs during video-recorded trauma resuscitations. High-definition audiovisual data from 30 trauma resuscitations were reviewed. Videos were assessed and scored by four independent reviewers (two trainees and two staff). The STAT taxonomy was used to identify AEs based on binary responses: yes and no. Inter-rater reliability was calculated using Gwet's AC1. The frequencies of AEs were tallied and reported as counts and percentages. The most common AEs identified in the videos were failure to measure temperature (86.7%) and inadequate personal protective equipment (86.7%), followed by inability to use closed-loop communication (76.7%). The agreement on all AEs between reviewers was 0.94 (95% CI: 0.93-0.95). The Gwet's AC1 agreement across the 9 AE categories was paramedic handover (0.82), airway and breathing (0.99), circulation (0.95), assessment of injuries (0.91), management of injuries (0.96), procedure-related (0.97), patient monitoring and IV access (0.99), disposition (0.98), team communication and dynamics (0.87). The STAT taxonomy demonstrated excellent inter-rater reliability between reviewers and can be used to identify AEs in video-recorded trauma resuscitations. These results provide a foundation for adapting video review to objectively quantify and assess AEs in the trauma bay.

ARTHROSCOPIC AND RADIOLOGICAL FINDINGS AT TIME OF LATARJET SCREW REMOVAL

The Latarjet procedure is a well described method to stabilize anterior shoulder instability. There are concerns of high complication rates, one of these being a painful shoulder without instability due to screw irritation. The arthroscopic changes in the shoulder at time of screw removal compared to those pre-Latarjet have not been described in the literature.We conducted a retrospective review of arthroscopic videos between 2015 and 2022 of 17 patients at the time of their Latarjet screw removal and where available (n=13) compared them to arthroscopic findings at time of index Latarjet. Instability was an exclusion criterion. X-rays prior to screw removal were assessed independently by two observers blinded to patient details for lysis of the graft. Arthroscopic assessment of the anatomy and pathological changes were made by two shoulder surgeons via mutual consensus. An intraclass correlation coefficient (ICC) was analyzed as a measure for the inter-observer reliability for the radiographs.Our cohort had an average age of 21.5±7.7 years and an average period of 16.2±13.1 months between pre- and post-arthroscopy. At screw removal all patients had an inflamed subscapularis muscle with 88% associated musculotendinous tears and 59% had a pathological posterior labrum. Worsening in the condition of subscapularis muscle (93%), humeral (31%) and glenoid (31%) cartilage was found when compared to pre-Latarjet arthroscopes. Three failures of capsular repair were seen, two of these when only one anchor was used. X-ray review demonstrated 79% of patients had graft lysis. Excellent inter-rater reliability was observed with an ICC value of 0.82.Our results show a high rate of pathological change in the subscapularis muscle, glenoid labrum and articular cartilage in the stable but painful Latarjet. 79% of patients had graft lysis with prominent screws on X-ray.

Abstract 14080: Broadening Indications for Neonatal Balloon Atrial Septostomy in Dextro-Transposition of the Great Arteries Reduce Predictive Value of Fetal Echocardiography

Introduction: Neonates with dextro-transposition of the great arteries (d-TGA) require adequate mixing at the atrial level. If not present, these infants experience severe cyanosis, necessitating an urgent balloon atrial septostomy (BAS). Multiple studies have identified various fetal echocardiography (FE) findings as risk factors for postnatal BAS. Anecdotally, the predictive value of these findings remains poor in clinical use. Hypothesis: We aimed to determine the relationship between inter-rater reliability (IRR) of FE BAS predictors and need for postnatal BAS, hypothesizing that IRR would be poor and perhaps contributing to limited predictive value of FE findings. Methods: We identified d-TGA pregnancies followed at our institution between 2012 and 2022, excluding fetuses with large ventricular septal defects and pregnancies that were either terminated or lost to follow up. Three independent readers blinded to BAS outcome assessed 7 FE predictors: pulmonary vein Doppler velocity > 41 cm/sec, reverse flow in patent ductus arteriosus (PDA), restrictive PDA, restrictive patent foramen ovale (PFO), bidirectional PFO flow, flat septum primum, and hypermobile septum primum. IRR was determined with the S metric. Clinical information immediately before BAS was collected to evaluate postnatal physiology. A multivariable logistic regression was used to determine significant associations between FE findings and postnatal BAS. Results: Fifty-six fetuses were included in this study, of whom 25 (45%) underwent BAS. IRR was lowest for PFO flow direction and highest for restrictive PDA, likely due to its rarity. The remainder of FE predictors had either a moderate or substantial level of IRR. The last pre-BAS range of PaO 2 (24-49 mmHg), O 2 saturation (56-86%) and pH (7.18-7.52) reflected variable physiology. Of the 5 FE characteristics that could be included in the regression analysis, none were found to be significantly associated with odds of a BAS. Conclusions: Our results demonstrate substantial but not excellent IRR for current FE BAS predictors, but no significant association between these predictors and postnatal BAS in d-TGA patients. Poor predictive value of FE for postnatal BAS could be impacted by broadening indications for BAS.

Comparing the reliability of the Goniometer Pro application and flexicurve for measuring thoracic kyphosis: a cross-sectional study

Aims/Background The most common spinal anomaly is thoracic kyphosis, which frequently occurs in adolescents and older people. The flexicurve is an instrument commonly used by physiotherapists to assess spinal curvature. However, advancing technology, particularly the rise of mobile applications, has resulted in the replacement of traditional methods. This study aimed to investigate and compare the intra-rater and inter-rater reliability of the smartphone-based Goniometer Pro application and the flexicurve in measuring the thoracic kyphosis angle among healthy university students. Methods A total of 30 participants were assessed by two independent raters using the flexicurve and the Goniometer Pro App to measure the thoracic kyphosis angle. Agreement was assessed using intraclass correlation coefficients, standard error of measurement and minimal detectable change. Results The flexicurve demonstrated excellent intra-rater reliability (intraclass correlation coefficients=0.87 and intraclass correlation coefficients=0.85 for two raters) and good inter-rater reliability (intraclass correlation coefficients=0.60). Additionally, the standard error of measurement and the minimal detectable change values indicated small measurement errors for the flexicurve. Similarly, the Goniometer Pro application exhibited excellent intra-rater reliability (intraclass correlation coefficients=0.90 and intraclass correlation coefficients=0.89 for two raters) and inter-rater reliability (intraclass correlation coefficients=0.87), along with small measurement errors indicated by the standard error of the measurement and minimal detectable change values. Conclusions The Goniometer Pro app demonstrated higher inter-rater reliability than the flexicurve when measuring the thoracic kyphosis angle. Consequently, it stands out as a recommended, user-friendly, and time-efficient tool for clinicians involved in the assessment and monitoring of thoracic kyphosis.

Objective documentation of hypospadias anatomy with three-dimensional scanning

The absence of a standardized classification of hypospadias hinders understanding of the anatomic differences among patients and the evaluation of outcomes following surgical repair. In working towards a standardized, objective method of recording patients' hypospadias anatomy, we describe our initial experience using a non-invasive three-dimensional scanner. An Artec3D Space Spider scanner was used to obtain 3D scans in 29 patients undergoing hypospadias repair. Measurements of the urethral plate width, urethral plate length, glans width, penile shaft length, and penile shaft width were made by 2 pediatric urology attendings and 1 pediatric urology fellow. Measurements were compared and inter-rater reliability was calculated. A total of 435 measurements were made on 29 successfully generated 3D scans, ranging from distal to proximal hypospadias. The inter-rater reliability of measurements from the generated 3D models shown good inter-rater reliability of urethral plate width (ICC0.87 [95%CI:0.76,0.93]), penile shaft length (ICC0.87 [95%CI:0.70,0.94]) and glans width (ICC0.83 [95%CI:0.68,0.92]), excellent inter-rater reliability of urethral plate length (ICC0.96) and moderate inter-rater reliability of penile shaft width (ICC0.69 [95%CI:0.44,0.84]). There was a high degree of reliability of measurements made across multiple users. Calculation of the ratio of the urethral plate length/total penile shaft length objectively defined the initial position of the urethral meatus. When compared to the 3-dimensional volume of the glans, a more proximally positioned urethral meatus was associated with a lower glans volume. 3D scanning offers a rapid, reproducible, and non-invasive method of documenting hypospadias anatomy. The ability to evaluate three dimensional features (i.e. glans volume) offers an exciting opportunities for robust investigation of hypospadias outcomes and further understanding of the relationship between a patient's genotype and phenotype.

Development and testing of the green schoolyard evaluation tool (GSET)

Gradually, schools are greening their schoolyard because it is believed that green schoolyards can support child development, biodiversity, and climate resilience. However, the extent to which current green schoolyards support aforementioned benefits differs considerably. This study aimed to create a green schoolyard evaluation tool (GSET) that supports the design and evaluation of green schoolyards. A first draft of the GSET was developed based on existing assessment tools and literature. GSET was further developed through a two-round Delphi study. Dutch academic, practice, and policy experts were invited to participate in online surveys. In Round 1, 40 experts participated (response rate 37 %). The panel considered 82 % of the proposed GSET items relevant, but there was little consensus about the clarity, comprehensibility, and applicability. Based on panelists’ comments, changes were made to the formulation of the items and measurement scales of the GSET. In Round 2, 32 experts participated (response rate 63 %). The panel was satisfied with 79 % of the proposed items. Items for which there was no consensus were modified or removed based on panelists’ comments. The 20-item GSET was then pilot-tested at 19 schoolyards to evaluate its interrater reliability and usability. Findings showed good to excellent interrater reliability (ICC = 0.82, 95 % CI = 0.80 – 0.97). The GSET can support schools, designers, and others in designing green schoolyards that promote child development, biodiversity, and climate resilience. The GSET can also be used by researchers to assess the design of green schoolyards, which may improve the generalizability of future studies.

Pediatric Balance Scale: Translation and Cross-Cultural Adaptation Into Greek.

Cross-cultural adaptation of the Pediatric Balance Scale (PBS) into Greek. The PBS was forward-back translated and evaluated for content equivalence. The Greek PBS (PBSGR) was administered to children with movement impairments by 2 pediatric physical therapists. The scale was readministered to the same children after 3 weeks (test-retest reliability) and to children with typical development for discriminant validity. The 1-minute walk test was administered to test the scale's concurrent validity. Psychometric testing was completed on 26 children with movement impairments. The scale had excellent interrater and test-retest reliability and internal consistency. Moderate correlation was observed between PBSGR and 1-minute walk. Children with movement impairment had significantly lower PBSGR scores than children with typical development. Acceptable reliability, concurrent validity, and discriminant validity were observed for the PBSGR.

Adaptation and Reliability of the Cinderella Story Retell Task in Canadian French Persons Without Brain Injury.

Main concept (MC) analysis is a well-documented method of discourse analysis in adults with and without brain injury. This study aims to develop a MC checklist that is culturally and linguistically adapted for Canadian French speakers and examine its reliability. We also documented microstructural properties and provide a normative reference in persons not brain injured (PNBIs). Discourse samples from 43 PNBIs were collected. All participants completed the Cinderella story retell task twice. Manual transcription was performed for all samples. The 34 MCs for the Cinderella story retell task were adapted into Canadian French and used to score all transcripts. In addition, microstructural variables were extracted using Computerized Language Analysis (CLAN). Intraclass correlation coefficients were computed to assess interrater reliability for MC codes and microstructural variables. Test-retest reliability was assessed using intraclass correlations, Spearman's rho correlations, and the Wilcoxon signed-ranks test. Bland-Altman plots were used to examine the agreement of the discourse measures between the two sessions. The MC checklist for the Cinderella story retell task adapted for Canadian French speakers is provided. Good-to-excellent interrater reliability was obtained for most MC codes; however, reliability ranged from poor to excellent for the "inaccurate and incomplete" code. Microstructural variables demonstrated excellent interrater reliability. Test-retest reliability ranged from poor to excellent for all variables, with the majority falling between moderate and excellent. Bland-Altman plots illustrated the limits of agreement between test and retest. This study provides the MC checklist for clinicians and researchers working with Canadian French speakers when assessing discourse with the Cinderella story retell task. It also addresses the gap in available psychometric data regarding test-retest reliability in PNBIs. https://doi.org/10.23641/asha.24171087.

CheckPOINT: a simple tool to measure Surgical Safety Checklist implementation fidelity

IntroductionThe WHO Surgical Safety Checklist (SSC) is a communication tool that improves teamwork and patient outcomes. SSC effectiveness is dependent on implementation fidelity. Administrative audits fail to capture most aspects...

Reliability and validity of the supine-to-stand test in people with stroke.

To investigate the psychometric properties of the supine-to-stand test in people with stroke. Cross-sectional design. Fifty-two people with stroke (mean (standard deviation) age 63.13 (6.09) years; time post-stroke 93.13 (61.36) months) and 49 healthy older adults (61.90 (7.29) months). Subjects with stroke were recruited from the community dwelling in Hong Kong and assessed with the supineto- stand test, Fugl-Meyer Motor Assessment, ankle muscle strength test, Berg Balance Scale, limit of stability test, Timed Up-and-Go Test, Six-Minute Walk Test, Chinese version of Activities-specific Balance Confidence scale, Community Integration Measure (CIM-C), and 12-item Short-Form Health Survey (SF-12) in a university-based rehabilitation laboratory. The supine-to-stand test completion time demonstrated excellent intra-rater, inter-rater and test-retest reliability (intraclass correlation coefficient 0.946-1.000) for the people with stroke. The completion time was significantly negatively correlated with Berg Balance Scale, Six-Minute Walk Test, limit of stability - maximal excursion, and limit of stability - endpoint excursion results (r = -0.391 to -0.507), whereas it was positively correlated with the Timed Up-and-Go test results (r = 0.461). The optimal cut-off supine-to-stand test completion time of 5.25 s is feasible for a clinical measure to distinguish the performance of people with stroke from healthy older adults (area under the curve = 0.852, sensitivity = 81.1%, specificity = 84.0%). The supine-to-stand test is a reliable, sensitive, specific and easy-to-administer clinical test for assessing the supine-to-stand ability of people with stroke.

Upright Tomosynthesis of the Lumbar Spine

This experimental study investigates the potential of lumbar spine tomosynthesis to offset the traditional limitations of radiographic and computed tomography imaging, that is, superimposition of anatomy and disregard of physiological load-bearing. A gantry-free twin robotic scanner was used to obtain lateral radiographs and tomosyntheses of the lumbar spine under weight-bearing conditions in eight body donors. Tomosynthesis protocols varied in terms of sweep angle (20 versus 40°), scan time (2.4 versus 4.8seconds), and framerate (16 versus 30 fps). Image quality and vertebral endplate assessability were evaluated by five radiologists with 4-8 years of skeletal imaging experience. Aiming to identify potential diagnostic deterioration near the scan volume margins, readers additionally determined the craniocaudal extent of clinically acceptable image quality. Tomosynthesis scans effectuated a substantial dose reduction compared to standard radiographs (3.8±0.2 to 15.4±0.8 dGy*cm2 versus 77.7±34.8 dGy*cm2; p≤0.021). Diagnostic image quality and endplate assessability were deemed highest for the 30 fps wide-angle tomosynthesis protocol with good to excellent interrater reliability (intraclass correlation coefficients: 0.846 and 0.946). Accordingly, the craniocaudal extent of acceptable image quality was substantially larger compared to radiography (26.9 versus 18.9cm; p<0.001), whereas no significant difference was ascertained for the tomosynthesis protocols with 16 fps (15.3-22.1cm; all p≥0.058). Combining minimal radiation dose with superimposition-free visualization, 30 fps wide-angle tomosynthesis superseded radiography in all evaluated aspects. With superior diagnostic assessability despite significant dose reduction, load-bearing tomosynthesis appears promising as an alternative for first-line lumbar spine imaging in the future.

Beyond SEP-1 Compliance: Assessing the Impact of Antibiotic Overtreatment and Fluid Overload in Suspected Septic Patients

BackgroundThe Centers for Medicare and Medicaid Services (CMS) developed the Severe Sepsis and Septic Shock Performance Measure bundle (SEP-1) metric to improve sepsis care, but evidence supporting this bundle is limited and harms secondary to compliance have not been investigated. ObjectiveThis study investigates the effect of an emergency department (ED) sepsis quality-improvement (QI) effort to improve CMS SEP-1 compliance, looking specifically at antibiotic overtreatment and harm from fluid resuscitation. MethodsThis was a retrospective observational study conducted between March and July 2021 with patients for whom a sepsis order set was initiated. The primary outcomes included the number of patients treated with antibiotics who were ultimately deemed nonseptic and the number of patients who developed pulmonary edema, with or without need for positive pressure ventilation (PPV), within 48 h of receiving a 30 mL/kg fluid bolus. Data were collected via nonblinded chart reviews, with a free marginal κ-calculation indicating excellent interrater reliability. ResultsThe study cohort included 273 patients, 170 (62.3%) who were ultimately determined to be septic and 103 (37.7%) who were nonseptic. Of the 103 nonseptic patients, 82 (79.6%) received antibiotics in the ED. Of the 121 patients (44.3%) who received a 30 mL/kg bolus, 5 patients (4.1%) developed pulmonary edema and 0 of 121 patients required PPV within 48 h. ConclusionsThe QI effort led to moderate rates of antibiotic overtreatment and very few patients developed pulmonary edema due to a 30 mL/kg fluid bolus.

The Reliability and Validity of the Modified Four Square Step Test in Individuals with Anterior Cruciate Ligament Reconstruction.

The modified four square step test (mFSST) is frequently used in the evaluation of dynamic balance in individuals with balance problems. However, the reliability of the mFSST has not been examined in individuals undergoing anterior cruciate ligament reconstruction (ACLR) surgery. The aim of this study was to examine the test-retest reliability of the mFSST in individuals undergoing ACLR surgery. Forty-eight patients who had ACLR surgery were included in this study. Patients performed a total of four mFSSTs, two times each, by two different raters over seven days. In the current study, the mFSST demonstrated excellent test-retest and inter-rater reliability. The intraclass correlation coefficient for mFSST was 0.92. The standard error of measurement and minimal detectable change for mFSST were 0.15 and 0.41, respectively. The mFSST has excellent test-retest and inter-rater reliability in patients with ACLR. It is a valid and reliable tool for evaluating dynamic balance in patients with ACLR. We think that mFSST, which is a clinical evaluation test, can be preferred because it is easy to score and does not require special equipment.

Psychometric Properties and Clinical Usefulness of the Spanish Version of the Toe Walking Tool.

The Toe Walking Tool (TWT) was developed in Australia as a valid and reliable screening tool for children who toe-walk. However, psychometric properties of the Spanish version of the TWT have not been studied. The aim of this study was to assess psychometric properties and clinical usefulness of the Spanish version of the TWT. A cross-sectional study was conducted. Twelve children were assessed with the TWT. Intrarater and interrater reliability and agreement were calculated using the intraclass correlation coefficient (ICC) and the Fleiss kappa method for multiple raters. Internal consistency and construct validity were assessed with the Kuder-Richardson formula 20 coefficient and known-group methods, respectively. Sensitivity and specificity were analyzed using the receiver operating characteristic curve. The Content Validity Index was calculated to determine clinical usefulness. An excellent intrarater (ICC = 1) and interrater reliability (ICC = 0.8), moderate interrater agreement (Fleiss kappa, 0.6), strong internal consistency (Kuder-Richardson formula 20 coefficient, 0.86), and very good construct validity were found. Sensitivity and specificity results were appropriate (area under the curve, 0.845). The Content Validity Index was 0.906, suggesting high usefulness. The Spanish version of the TWT was found to be a valid, reliable and useful screening tool for children who toe-walk, providing evidence for its recommendation.

Conventional clock drawing tests have low to moderate reliability and validity for detecting subtle cognitive impairments in community-dwelling older adults.

Early identification of subtle cognitive decline in community-dwelling older adults is critical, as mild cognitive impairment contributes to disability and can be a precursor to dementia. The clock drawing test (CDT) is a widely adopted cognitive screening measure for dementia, however, the reliability and validity of paper-and-pencil CDT scoring scales for mild cognitive impairment in community samples of older adults is less well established. We examined the reliability, sensitivity and specificity, and construct validity of two free-drawn clock drawing test scales-the Rouleau System and the Clock Drawing Interpretation Scale (CDIS)-for subtle cognitive decline in community-dwelling older adults. We analyzed Rouleau and CDIS scores of 310 community-dwelling older adults who had MoCA scores of 20 or above. For each scale we computed Cronbach's alpha, receiver operating characteristic curves (ROC) for sensitivity and specificity using the MoCA as the index measure, and item response theory models for difficulty level. Our sample was 75% female and 85% Caucasian with a mean education of 16 years. The Rouleau scale had excellent interrater reliability (94%), poor internal consistency [0.37 (0.48)], low sensitivity (0.59) and moderate specificity (0.71) at a score of 9. The CDIS scale had good interrater reliability (88%), moderate internal consistency [0.66 (0.09)], moderate sensitivity (0.78) and low specificity (0.45) at a score of 19. In the item response models, both scales' total scores gave the most information at lower cognitive levels. In our community-dwelling sample, the CDIS's psychometric properties were better in most respects than the Rouleau for use as a screening instrument. Both scales provide valuable information to clinicians screening older adults for cognitive change, but should be interpreted in the setting of a global cognitive battery and not as stand-alone instruments.

Translation, reliability, and validity of the Brazilian-Portuguese version of the Brachial Plexus Outcome Measure scale (BPOM-Br)

Purpose To translate and investigate inter-rater reliability, internal consistency, content validity, and construct validity of the Brazilian-Portuguese Version of the Brachial Plexus Outcome Measure Scale (BPOM-Br). Material and methods The translation followed international guidelines. Inter-rater reliability was tested with 51 individuals with Neonatal Brachial Plexus Palsy (NBPP), aged between 4 to 16 years old. To determine concurrent construct validity, children were also assessed with the Mallet Scale. Statistical analysis included Bland-Altman, Intraclass Correlation Coefficient (ICC), Floor and Ceiling and effect, and Pearson correlation. Results The majority of the sample consisted of children with upper NBPP (75.2%), mean age of 8.9 years old. BPOM-Br showed appropriate content validity (comprehensiveness) according to rehabilitation professionals. It also showed excellent inter-rater reliability (ICC = 0.90) and internal consistency (α = 0.91). Bland-Altman analysis showed bias close to zero. Finally, BPOM-Br showed overall significant positive correlations with the Mallet scale items (rs= 0.31 to 0.78 p < 0.05), indicating adequate concurrent validity. Conclusions BPOM-Br is a consistent, reliable, and valid instrument to assess activity of school-aged children with NBPP. IMPLICATIONS FOR REHABILITATION The Brazilian-Portuguese Version of the Brachial Plexus Outcome Measure Scale (BPOM-Br) presents understandable items and no ceiling and floor effects. The BPOM-Br provides a valid and reliable version for use in Brazilian school-aged children with neonatal brachial plexus palsy. It is important to promote its use both in clinical practice and in research as a specific evaluation of activity domain.

Navigating young minds: reliability and validity of the Greek version of kiddie – schedule for affective disorders and schizophrenia – present and lifetime DSM-5 version (K-SADS-PL-GR-5)

BackgroundThe Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL) is one of the most popular semi-structured psychiatric interviews for children and adolescents. Its latest DSM-5 version (K-SADS-PL DSM-5) has only recently been adapted and validated in various languages. In the present study, we aimed to investigate the reliability and validity of the Greek version of the K-SADS-PL DSM-5.MethodsA total of 137 patients consecutively referred for admission, aged 7–17, were included. The K-SADS-PL DSM-IV was translated and adapted to correspond to DSM-5 categories. Convergent and divergent validity were assessed against two self-report rating scales, Children’s Depression Inventory (CDI) and Screen for Child Anxiety Related Emotional Disorders (SCARED). Inter-rater reliability was calculated exclusively for instances where a diagnosis involved three or more patients.ResultsOur findings revealed good to excellent inter-rater reliability and good to excellent consensual validity across most psychiatric diagnoses, except for panic disorder. Diagnostic efficiency, measured by sensitivity, specificity, positive and negative predictive values, consistently showed high specificity and negative predictive validity across all diagnostic categories.ConclusionsThese findings support the applicability of the Greek version of the K-SADS-PL DSM-5 as a reliable and valid diagnostic tool in Greek-speaking populations.

Psychometric features of Acoustic Voice Quality Index, version 03.01, in Persian language

ABSTRACT The goal of this study was to investigate the psychometric features of the Acoustic Voice Quality Index, in Persian, as an objective and multi-parameter tool for evaluating the overall voice quality. Three hundred and ten Persian-speaking individuals, 155 with various types and severity of dysphonia, and 155 healthy individuals, performed two tasks: reading a phonetically balanced text and a sustained vowel /a/. Voice recordings were made. Perceptual evaluation with the G score of the GRBAS scale was completed by five raters, and intra-rater reliability and inter-rater reliability were calculated. The Acoustic Voice Quality Index was calculated with standard syllables corresponding to 3 s of voiced speech and 3 s of vowels. Concurrent validity, construct validity, test–retest reliability, and diagnostic accuracy of the AVQI were analyzed. The results suggest that the number of syllables corresponding to 3 s of voiced speech was 23. Perceptual evaluation demonstrated excellent intra-rater and inter-rater reliability. The AVQI demonstrated a strong correlation with perceptual evaluation (rs = 0.877, P < 0.001), as well as high construct validity. In addition, the index had very good test–retest reliability (icc = 0.992). The cut-off point of the index was 3.62 in Persian. The area under the ROC curve was 0.815, indicating that the index had the ability to differentiate between dysphonic and non-dysphonic voices. And it can be stated that the AVQI 03.01 is a reliable objective tool for distinguishing dysphonic from non-dysphonic voice in Persian that can be utilized in clinical and research settings.