Excellent Inter-rater Reliability Research Articles

Development and implementation of self-supportive intervention on post-traumatic stress symptoms and quality of life among battered wives of Madhya Pradesh, India: A pilot study

Background: In India, intimate partner violence against women is a major problem that leads to terrible physical, sexual, emotional, psychological and economic consequences. In 55-92% of women who have a history of being abused wives, high levels of symptoms of post-traumatic stress disorder have been discovered. Therefore, the quality of life is significantly low among them regardless of regions and countries. The purpose of the current study was to create and evaluate the effectiveness of a self-supportive intervention on the quality of life and post-traumatic stress symptoms among abused wives in Madhya Pradesh, India. Methods: The post-traumatic Symptoms Scale Interview version for DSM-5 (PSS-I-5) and WHO Quality of Life-BREF (WHOQOL) were used in this study as assessment tools. The Need assessment results showed that 51% of battered wives met the criteria of PTSD symptoms from moderate to severe and 83% experienced low quality of life. This study utilized a mixed research method and was executed in three phases, based on the main three elements of Conklin’s (1997) program development model, namely (1) planning; (2) design and implementation; and (3) evaluation of the newly created Self-Supportive Intervention program (SSI). The SSI program consisted of six modules, focused on addressing the issues that emerged through qualitative data and need assessments. Results: Excellent inter-rater reliability (.845) was found in the expert evaluation's findings, which supported the recommendation to use the SSI as it is with minor modification. The SSI was further pilot-tested for its feasibility with 10 battered wives and validated through the paired sample t-test, which showed a substantial decrease in post-traumatic stress symptoms and enhanced quality of life at 0.05 level of significance. Conclusion: This is an indication that the SSI program can be recommended as a psychological intervention in eliminating the PTSD symptoms and improving the quality of life.

Evolution of a Plastic Surgery Summer Research Program: Lessons Learned from Programmatic Evaluation and Quality Enhancement.

From 2013 to 2016, a sole basic science research arm existed. In 2017, a clinical research arm was introduced, with several supplemental activities, including surgical skills curriculum. A formalized selection process was instituted in 2014. Participant feedback was analyzed annually. Long-term outcomes included continued research commitment, productivity, and residency match. The applicant pool reached 96 applicants in 2019, with 85% from outside institutions. Acceptance rate reached 7% in 2020. With adherence to a scoring rubric for applicant evaluation, good to excellent interrater reliability was achieved (intraclass correlation coefficient = 0.75). Long-term outcomes showed that on average per year, 28% of participants continued involvement in departmental research and 29% returned for dedicated research. Upon finishing medical school, participants had a mean of 7 ± 4 peer-reviewed publications. In total, 62% of participants matched into a surgical residency program, with 54% in integrated plastic surgery. A research program designed for first year medical students interested in plastic surgery can achieve academic goals. Students are provided with mentorship, networking opportunities, and tools for self-guided learning and career development.

Psychometric evaluation of the German version of the Yale-Brown Obsessive- Compulsive Scale Modified for Body Dysmorphic Disorder (BDD-YBOCS)

The Yale-Brown Obsessive-Compulsive Scale Modified for Body Dysmorphic Disorder (BDD-YBOCS) is a clinician-administered interview to assess symptom severity in individuals with a BDD diagnosis. It has been translated into German and disseminated into research and practice. However, the psychometric properties of the German version have not been thoroughly evaluated. Therefore, we investigated its psychometric properties, factor structure and provided normative data. Our study included a large pooled sample comprising 350 outpatients with a BDD diagnosis (mean age = 30.35 years, SD = 10.15; gender: 70.6% female, 28.9% male, 0.6% unspecified). Psychometric data supported a good internal consistency of the BDD-YBOCS total score (α = 0.81, ω = 0.86) and an excellent interrater-reliability (ICC = 0.96). The BDD-YBOCS correlated moderately with other measures of BDD symptom severity. Confirmatory factor analysis favored a two-factor structure representing obsessions versus compulsions over a one-factor structure, with the quality of the proposed two-factor structure still being poor. Normative data indicated that BDD-YBOCS scores between 21 and 34 can be considered as typical range in an outpatient sample with a wide range of BDD symptom severity. In conclusion, the German BDD-YBOCS is a brief and psychometrically supported clinician-rated instrument for the measurement of BDD severity.

Abstract TMP20: Performing The Pediatric National Institutions Of Health Stroke Scale Over Televideo: A Pilot Study

Introduction: Telestroke networks are widely used by stroke neurologists to rapidly assess adults presenting to remote facilities with suspected acute stroke. Televideo assessment of acute neurological deficits in children is potentially useful for children who live in remote areas, but has not been studied. This study tested the feasibility of assessing the pediatric National Institutes of Health stroke scale (PedNIHSS) by televideo in children. Methods: Children ages 2-17 years with and without strokes were recruited and examined in the outpatient neurology clinic. The PedNIHSS was performed on each child by separate neurologists; one by televideo and the other at the bedside. The total PedNIHSS, subscores and time to complete each exam were recorded. Intraclass correlation coefficients (ICC) were used to analyze inter-rater reliability. Results: Twenty children were recruited with an average range of 9.2 years (range 2-17 years). Six children had chronic stroke. By bedside exam, the total PedNIHSS score ranged from 0-8 with a mean of 1.65. By televideo, the PedNIHSS total score was identical to the bedside examination in 12/20 (60%) of the children and identical or within 1 point in 19/20 children (95%). All total PedNIHSS were scored higher by the bedside vs remote examiner in cases where there was a difference. There was excellent overall inter-rater reliability (ICC=0.92; 95% CI: 0.81, 0.97) for the total PedNIHSS when comparing bedside and video exams. In the subgroup of children less than 6 years of age, ICC was 0.88 (95% CI: 0.44-0.98). The PedNIHSS subscores with lowest reliability between exams were dysarthria, ataxia and sensory change. The average time to complete the bedside and remote examinations were 5 minutes and 7 minutes, respectively. Conclusions: It is feasible to perform the full PedNIHSS over televideo with reasonable accuracy and in a similar amount of time as compared to bedside evaluations. Limitations of this study include a small number of patients and overall low burden of neurologic deficits. Future studies focusing on children presenting with focal neurologic deficits in the acute care setting are needed to further determine the reliability of performing the PedNIHSS over televideo.

Development and evaluation of the Food Bank Health and Nutrition Assessment.

Efforts to improve the nutritional quality and health promotion in the charitable food system have been undertaken. Though methods exist to track these efforts in terms of food banks' inventory, there are not research-tested tools to assess, monitor and influence policy, systems and environmental (PSE) changes. The study objective was to develop and evaluate a novel assessment tool that could be used to evaluate a food bank's efforts to improve the promotion of health and nutritious foods. The study had five phases: (1) initial development; (2) iterative review and revisions; (3) pilot testing; (4) content validity assessment and (5) inter-rater and test-retest assessment. The Food Bank Health and Nutrition Assessment (FB-HANA) was drafted after reviewing existing policies, nutrition-focused charitable food systems guidance and similar tools for food pantries. Midwestern United States. Eleven food banks. Stakeholders and pilot testers provided initial feedback to refine the FB-HANA's flow, ease of completion and collection of contextual information. External experts rated the FB-HANA and each of the eight objectives as content valid. A set of two assessments completed by twenty-six community-based professionals, employed by Extension and fourteen food bank staff across eleven food banks, supported moderate to excellent inter-rater and test-retest reliability for the FB-HANA overall and each of its objectives. Evidence suggests that the FB-HANA can be used by either food bank or community-based professionals, such as Extension staff, to provide a perspective on ways food banks promote health and nutrition through PSE approaches.

Reliability of a Wearable Motion Tracking System for the Clinical Evaluation of a Dynamic Cervical Spine Function.

Neck pain is a common cause of disability worldwide. Lack of objective tools to quantify an individual's functional disability results in the widespread use of subjective assessments to measure the limitations in spine function and the response to interventions. This study assessed the reliability of the quantifying neck function using a wearable cervical motion tracking system. Three novice raters recorded the neck motion assessments on 20 volunteers using the device. Kinematic features from the signals in all three anatomical planes were extracted and used as inputs to repeated measures and mixed-effects regression models to calculate the intraclass correlation coefficients (ICCs). Cervical spine-specific kinematic features indicated good and excellent inter-rater and intra-rater reliability for the most part. For intra-rater reliability, the ICC values varied from 0.85 to 0.95, and for inter-rater reliability, they ranged from 0.7 to 0.89. Overall, velocity measures proved to be more reliable compared to other kinematic features. This technique is a trustworthy tool for evaluating neck function objectively. This study showed the potential for cervical spine-specific kinematic measurements to deliver repeatable and reliable metrics to evaluate clinical performance at any time points.

The Berlin Bimanual Test for Tetraplegia (BeBiTT): development, psychometric properties, and sensitivity to change in assistive hand exoskeleton application

BackgroundAssistive hand exoskeletons are promising tools to restore hand function after cervical spinal cord injury (SCI) but assessing their specific impact on bimanual hand and arm function is limited due to lack of reliable and valid clinical tests. Here, we introduce the Berlin Bimanual Test for Tetraplegia (BeBiTT) and demonstrate its psychometric properties and sensitivity to assistive hand exoskeleton-related improvements in bimanual task performance.MethodsFourteen study participants with subacute cervical SCI performed the BeBiTT unassisted (baseline). Thereafter, participants repeated the BeBiTT while wearing a brain/neural hand exoskeleton (B/NHE) (intervention). Online control of the B/NHE was established via a hybrid sensorimotor rhythm-based brain-computer interface (BCI) translating electroencephalographic (EEG) and electrooculographic (EOG) signals into open/close commands. For reliability assessment, BeBiTT scores were obtained by four independent observers. Besides internal consistency analysis, construct validity was assessed by correlating baseline BeBiTT scores with the Spinal Cord Independence Measure III (SCIM III) and Quadriplegia Index of Function (QIF). Sensitivity to differences in bimanual task performance was assessed with a bootstrapped paired t-test.ResultsThe BeBiTT showed excellent interrater reliability (intraclass correlation coefficients > 0.9) and internal consistency (α = 0.91). Validity of the BeBiTT was evidenced by strong correlations between BeBiTT scores and SCIM III as well as QIF. Wearing a B/NHE (intervention) improved the BeBiTT score significantly (p < 0.05) with high effect size (d = 1.063), documenting high sensitivity to intervention-related differences in bimanual task performance.ConclusionThe BeBiTT is a reliable and valid test for evaluating bimanual task performance in persons with tetraplegia, suitable to assess the impact of assistive hand exoskeletons on bimanual function.

1272 A PILOT ROUTINE ELECTRONIC HEALTH RECORD FUNCTIONAL TRACKING SCORE FOR OLDER PATIENTS IN HOSPITAL

Abstract Introduction Approximately one-third of older patients leave hospital with a new functional impairment. Tracking rehabilitation progress following acute illness could improve recognition and understanding of hospital-acquired disability. However, traditional mobility and functional scores include measures that are not part of routine rehabilitation therapy, adding a time burden for staff to report. Capturing data already recorded in routine electronic records could provide an efficient patient tracking measure of rehabilitation success. Methods A scoping literature review appraised existing scores of mobility and functional status. Analysis of 15 admissions through the Royal Infirmary of Edinburgh identified mobility and functional domains which were reliably recorded in free text electronic health records. A pilot score was drafted, comprising admission and discharge scores (0-30 points), medical progress (0-10), physiotherapy and occupational therapy tracking (0-30). Higher scores indicate greater functional independence. Expert feedback was obtained through focus group discussion with physiotherapists and occupational therapists. The approach was tested in a fresh set of six case studies. Two independent scorers applied the scoring schema and agreement was assessed using Cohen’s weighted-kappa coefficient. Results The selected electronic health records contained 438 medical, 352 nursing and 183 therapist entries. Existing measures such as the Barthel Index were not recorded for any patient. Focus group discussion identified value in the overall approach and informed item-weighting. The pilot functional score allowed visualisation of rehabilitation trajectories over the course of each admission. Excellent inter-rater reliability was demonstrated for the medical (Cohen’s Kappa 0.99, 95% confidence interval [CI] 0.96–1.00) and physiotherapy (Kappa 0.96, 95% CI 0.93–0.99) components. Conclusions A functional tracking score generated from routine health records proved feasible and reproducible in this pilot. Future development should assess validity, reliability and prognostic power in larger populations, exploring automation using natural language processing. Development of graphic visualisations may aid communication within multidisciplinary teams.

Clinimetric properties of the diagnostic criteria for psychosomatic research among the elderly.

Among the elderly, the availability of tool assessing psychosomatic syndromes is limited. The present study aims at testing inter-rater reliability and concurrent validity of the semi-structured interview for the Diagnostic Criteria for Psychosomatic Research (DCPR-R-SSI) in the elderly of the general population. One hundred eight subjects were recruited. Participants received a clinical assessment which included the DCPR-R-SSI, the Illness Attitude Scale (IAS), the Geriatric Depression Scale (GDS), the Psychosocial Index (PSI), the Toronto Alexithymia Scale-20 (TAS-20). Analyses of inter-rater reliability of DCPR-R-SSI and concurrent validity between DCPR-R-SSI and self-administered questionnaires were conducted. DCPR-R-SSI showed excellent inter-rater reliability with a percent of agreement of 90.7% (K Cohen: 0.856 [SE = 0.043], 95% CI: 0.77-0.94). DCPR-R demoralization showed fair concurrent validity with GDS; concurrent validity was also fair between DCPR-R Alexithymia and TAS-20, and between DCPR-R allostatic overload and PSI allostatic load, while the concurrent validity between DCPR-R Disease Phobia and IAS was moderate. DCPR-R-SSI represents a reliable and valid tool to assess psychosomatic syndromes in the elderly. DCPR-R is in need of being implemented in the elderly clinical evaluation.

Validity and reliability of an assessment instrument of track start in swimming

Background and Study Aim. The development and validation of assessment instruments are essential procedures for any professional intervention, including in physical education and sports contexts. This study aimed to provide a component-based assessment instrument for track start in swimming. It refers to the act of starting the competitive swim by diving into the water from a raised block (platform) at the edge of the pool.&#x0D; Material and Methods. The content validity involved the participation of sixty-three experienced swimming coaches. They completed a questionnaire about their degree of agreement (Likert scale) with the initial position, impulsion, flight, and entry into the water as the track start's components. Reliability and construct validity involved the participation of seven experienced swimming coaches. The first was verified through test-retest (intrarater) and reproducibility (interrater) procedures. The latter was tested by considering the instrument's ability to assess different track start performances.&#x0D; Results. The concordant answers (strongly agree and agree) ranged from 63% to 95%, with most components above 80%. The Intraclass Correlation Coefficients (ICC) results show from good to excellent interrater and intrarater reliabilities. Specifically, the interrater correlations in the test and intrarater correlations in track start 1 were revealed excellent. In addition, the interrater correlations in the retest and intrarater correlations in track start 2 were revealed good.&#x0D; Conclusions. The obtained validities and reliabilities made possible a component-based assessment instrument that allows: (i) a clear and standardized structure of track start in swimming involving the initial position, impulsion, flight, and entry into the water; (ii) accessing to the practitioners’ states in relation to desired start performance; and (iii) a reference for coaches and teachers to provide instruction and feedback for learning and performance improvement.

Psychometric properties of a new occupational therapy cognitive outcome measure for Thai older adults with cognitive impairments

Background: Occupational therapy (OT) cognitive interventions requires a standardised cognitive outcome measure to help explain the effectiveness of the interventions. Now, there is a lack of measures to use for Thai older adults with cognitive impairments. Therefore, a new Occupational Therapy Cognitive Outcome Measure (OTCOM) for Thai older adults with cognitive impairments was developed to support evidence-based OT cognitive interventions. Objectives: To examine the psychometric properties including internal consistency, inter-rater and intra-rater reliability, known-group construct validity, concurrent validity, and responsiveness of the OTCOM. Materials and methods: A prospective cohort design was used in this study. One hundred and ten older adults; sixty-one older adults with cognitive impairments and forty-nine older adults without cognitive impairments, were recruited. The Cronbach’s alpha coefficient was calculated for internal consistency. Intraclass correlation coefficient (ICC) was used to analyse rater reliability. Analyses of concurrent and known-group construct validity were done using Pearson correlation and independent t-test, respectively. Both effect size (ES) and standardised response mean (SRM) were calculated for responsiveness of the OTCOM. Results: The results showed good internal consistency (α=0.88), and excellent inter-rater and intra-rater reliability (ICC=0.99). A high correlation between the OTCOM and the Dynamic Lowenstein Occupational Therapy Cognitive Assessment-Geriatric (DLOTCA-G) and the Thai Cognitive-Perceptual Test (Thai-CPT) was found, indicating good concurrent validity. There was a significant difference between older adults with cognitive impairments and without cognitive impairments, suggesting good construct validity by the known-group method. Responsiveness was shown as large ES and SRM in the total score. Conclusion: The OTCOM showed good psychometric properties, making it useful in OT practice after revisions

Development of a Checklist to Identify Injury Hazards on Row Crop Farms in the Midwestern United States.

Agriculture is among the most dangerous industries in the U.S., yet routine surveillance of injury hazards is not currently being conducted on a national level. The objectives of this study were to describe a new tool, called the Hazard Assessment Checklist (HAC), to identify and characterize farm hazards that increase injury risk to farmers and farm workers, and (2) report the inter-rater reliability of the new tool when administered on row-crop farms in Iowa. Based on a literature review and a consensus of expert opinion, the HAC included hazards related to self-propelled vehicles, powered portable implements, fixed machinery and equipment, farm buildings and structures, fall risks, and portable equipment associated with fall risk. A scoring metric indicating the extent of compliance with recommended safety guidelines and standards was developed for each item of the HAC, which included compliant, minimal improvement needed, substantial improvement needed, and not compliant. Inter-rater reliability was assessed from data collected by research staff on 52 row crop farms in Iowa. Cohen's weighted Kappa values demonstrated high inter-rater reliability, ranging between 0.86 and 0.94, for all HAC sections. The HAC can be completed in 1.5-2 hours on each farm and requires about three hours of training, two hours of which are spent in field training. The ability to monitor injury-related hazards over time using an empirically driven tool will contribute significantly to injury prevention efforts in an industry with consistently high rates of fatal and nonfatal injury.

Reliability of the Reflective Essay Marking Scale (REMS): a scale for marking of students’ reflective essays

Abstract Personal practice (PP) is widely practised and a requirement across major psychology and psychotherapy organizations and modalities. However, one of the challenges for training institutions is how to assess the quality of such PP. The Reflective Essay Marking Scale (REMS) was developed to improve standardization of marking reflective essays in cognitive behavioural psychotherapy (CBT) training. A small sample of 16 expert CBT participants recruited by email used the REMS to rate two mock reflective essays in a within-subjects design. The internal consistency of REMS was acceptable (Cronbach’s α=.73) with excellent inter-rater reliability. Across the raters, it sufficiently differentiated quality (t12=4.91; p&lt;.0001). Although these are the results of a preliminary and very small study with a small sample using mock essays, the REMS may be a useful scale, allowing CBT courses to account for students’ reflective work in a standardized way. A larger validation study is required in the future. Key learning aims (1) To improve the thinking about what raters should focus on when rating the reflective essays of trainee therapists. (2) To describe the development of the scale and how its reliability was tested. (3) To improve the transparency and objectivity in assessing and rating reflective practice.

Reliability of Upright Chest Radiography as a Diagnostic Screening Tool for Acromioclavicular Joint Dislocations.

The standard radiographic view for diagnosing acromioclavicular joint (ACJ) dislocations is the Zanca view of both shoulders to assess superior displacement of the distal clavicle by measuring the coracoclavicular distance (CCD) and comparing it with the uninjured shoulder; however, there is no consensus on a gold standard for diagnostic measures to classify acute ACJ injuries. To compare the CCD from an upright chest radiograph with a standard Zanca view of both shoulders in patients with an ACJ dislocation. Cohort study (diagnosis); Level of evidence, 3. We reviewed the records of 70 patients with an ACJ dislocation between 2010 and 2021 who had both an upright chest radiograph and a Zanca view. An ACJ dislocation was classified as low grade (Rockwood types 1-3) or high grade (Rockwood type 5). The CCD was measured on the upright chest radiograph and the Zanca view by 2 independent reviewers, and the percentage of the CCD difference compared with the unaffected side (ΔCCD) was calculated and compared between the upright chest radiograph and the Zanca view. Interrater and intrarater reliability were determined using the intraclass correlation coefficient. Included were 70 patients (55 male and 15 female; mean age, 46 years). There were 29 patients (41.43%) with a low-grade injury and 41 patients (58.57%) with a high-grade injury. In the overall analysis, the ΔCCD on the upright chest radiograph and Zanca view was significantly different (130.25% ± 88.42% vs 152.69% ± 106.56%, respectively; mean difference, 22.44% [95% CI, 2.40% to 42.48%]; P = .029). The subgroup analysis revealed that the ΔCCD on the upright chest radiograph and Zanca view was significantly different for patients with a low-grade injury (60.71% ± 25.79% vs 91.46% ± 68.54%, respectively; mean difference, 30.76% [95% CI, 7.18% to 54.33%]; P = .012) but not different for patients with a high-grade injury (179.45% ± 83.87% vs 196.00% ± 107.97%, respectively; mean difference, 16.56% [95% CI, -14.06% to 47.18%]; P = .281). The intraclass correlation coefficients for the ΔCCD measurements indicated good to excellent interrater and intrarater reliability. The study findings indicated that upright chest radiography can be used as a diagnostic screening tool for high-grade ACJ dislocations, but not for low-grade ACJ injuries, compared with the Zanca view.

Reliability and Validity of the Double Inclinometer Method for Assessing Thoracolumbar Joint Position Sense and Range of Movement in Patients with a Recent History of Low Back Pain.

The study was aimed at examining the reliability of the Double Inclinometer (DI) method for the assessment of thoracolumbar Range of Movement (ROM) and Joint Position Sense (JPS) in patients with a recent history of Low Back Pain (LBP). Twenty patients with a history of LBP in the last three months participated. The thoracolumbar ROM and JPS were examined from a standing position by using both the DI and the tape measure method. The DI method was found to have moderate to good intra-rater (ICC = 0.68-0.79, SEM = 2.20-2.77°, SDD = 6.09-7.67°), moderate inter-rater (ICC = 0.59-0.62, SEM = 2.96-3.35°, SDD = 8.19-9.27°) and poor test-retest reliability (ICC = 0.13-0.17, SEM = 3.98-4.32°, SDD = 11.02-11.96°) for the assessment of thoracolumbar JPS. For the assessment of thoracolumbar ROM, the DI method was found to have good to excellent intra-rater (ICC = 0.88-0.94, SEM = 4.25-6.20°, SDD = 11.77-17.17°), excellent inter-rater (ICC = 0.90-0.91, SEM = 7.26-7.74°, SDD = 20.11-21.43°) and excellent test-retest reliability (ICC = 0.91-0.93, SEM = 6.03-6.87°, SDD = 16.70-19.02°). The concurrent validity of the DI method with the tape measure method was found to be very weak for the assessment of thoracolumbar JPS (r = 0.02, p = 0.93) and strong for the assessment of thoracolumbar ROM (r = 0.66, p = 0.001). The DI method seems to be a very reliable method for the assessment of thoracolumbar ROM in individuals with a recent history of LBP.

A Landmark-Based Technique for Determining an Isometric Femoral Attachment Site for Lateral Extraarticular Tenodesis is Inaccurate

To evaluate the reliability and accuracy of a method of placing the femoral fixation location for lateral extra-articular tenodesis (LET) within a safe isometric area using anatomic landmarks. Using a pilot cadaveric specimen, the center of the radiographic safe isometric area for femoral fixation of LET, defined as a 1 cm (proximal-distal) area located proximal to the metaphyseal flare and posterior to the posterior cortical extension line (PCEL), was located using fluoroscopy and found to be 20 mm directly proximal to the center of the fibular collateral ligament (FCL) origin. Using 10 additional specimens, the center of the FCL origin and a location 20 mm directly proximal was identified. K-wires were placed at each location. A lateral radiograph was obtained, and distances of the proximal K-wire relative to the PCEL and metaphyseal flare were measured. The location of the proximal K-wire relative to the radiographic safe isometric area was assessed by 2 independent observers. Intrarater and inter-rater reliability was calculated for all measurements using intraclass coefficients (ICCs). There was excellent intrarater and inter-rater reliability for all radiographic measurements (.908 to .975 and .968 to .988, respectively). In 5/10 specimens, the proximal K-wire was outside of the radiographic safe isometric area, with 4/5 anterior to the PCEL. Overall, the mean distance from the PCEL was 1 mm ± 4 mm (anterior), and the mean distance from the metaphyseal flare was 7.4 mm ± 2.9 mm (proximal). A landmark-based technique referencing the FCL origin was inaccurate in the placement of femoral fixation within a radiographic safe isometric area for LET. Therefore intraoperative imaging should be considered to ensure accurate placement. These findings may help to decrease the likelihood of misplacement of femoral fixation during LET by showing that landmark-based methods without intraoperative image guidance may be unreliable.

INTERRATER RELIABILITY OF AN ADVANCED NONCONTACT WOUND MEASUREMENT SYSTEM USING ARTIFICIAL INTELLIGENCE

Abstract Venous leg ulcers (VLU) are recurring, disabling wounds that develop primarily in older adults with comorbidities. In an ongoing clinical trial testing a nutritional intervention researchers use advanced technology (Swift Skin and Wound) to measure VLU healing over time. This noncontact wound measurement system uses artificial intelligence to automatically calculate wound measurements and track healing progress. However, a subjective component of the Swift system involves delineating wound perimeters on photographs captured with a tablet or smartphone. To evaluate interrater reliability of the system in the current study, measurements of 11 wounds by two independent raters were assessed using an intraclass correlation coefficient (ICC). ICC estimates and their 95% confidence intervals were calculated using SPSS statistical package version 27 based on a mean-rating (k = 2), consistency, 2-way mixed-effects model. For area measures, ICC = 0.99 with 95% confidence interval = 0.998-1.0, indicating the Swift measurement system has excellent interrater reliability.

Reliability, Validity, and Predictive Validity of Cutaneous Functional Units Predicted to Scar Following Palmar Burn Injury in Young Children.

Identification of children at risk of palmar burn scar is important for early initiation of scar management. This study determined the interrater reliability of face-to-face and photographic assessments of 29 palmar cutaneous functional units (CFUs) predicted to scar following palmar burn. The validity of photographic compared to face-to-face assessment, and the predictive validity of both assessment types to identify scarring at 3 to 6 months following burn, was also established. Thirty-nine children (40 hands) post burn injury were assessed face-to-face in the clinical setting, following healing of their palmar burn, by three burn therapists. Photographs of the children's hands at initial assessment were assessed by the same therapists a minimum of 6 months later. To determine which CFUs scarred, children were reassessed face-to-face in the clinical setting 3 to 6 months following their burn. For analysis, 29 CFUs were merged into eight separate groups to determine the number of CFUs predicted to scar per CFU group for face-to-face and photographic assessments. The range of agreement for individual CFUs within CFU groups was also calculated for both assessment types. Excellent interrater reliability was established for face-to-face assessment in all eight CFU groups (ICC2,1 0.83-0.96). Photographic assessment demonstrated good to excellent interrater reliability in six CFU groups (ICC2,1 0.69-0.90) and validity in seven CFU groups (ICC2,1 0.66-0.87). Good to excellent predictive validity was established for both assessment types in seven CFU groups (face-to-face ICC2,1 0.60-0.95, photographic ICC2,1 0.69-0.89). Experienced therapists can reliably assess CFUs face-to-face or via photographs and predict future scar development.

Construct validity and reliability of the 2-Minute Step Test (2MST) in individuals with low back pain

BackgroundFunctional tests are important clinical tools, since they are non-invasive methods, with simple applicability, and low cost. However, there are few tests adapted for individuals with chronic low back pain. Thus, our objective was to evaluate the test-retest and inter-rater reliability of the 2-Minute Step Test in individuals with chronic low back pain and to correlate the test score with measures of pain and physical activity.MethodsWe included patients aged between 18 and 45 years, of both sexes, and with low back pain. The interval between the test and retest was 7 days. We analyzed the data via intra-class correlation coefficient (ICC), confidence interval at 95%, standard error of measurement, and minimum detectable change for reliability. We used the Spearman’s correlation coefficient to verify the correlation between 2-Minute Step Test and measures of pain and physical activity (Numerical Pain Scale, Roland-Morris Disability Questionnaire, Pain-Related Catastrophizing Thoughts Scale, Tampa Scale of Kinesiophobia, and Baecke Habitual Physical Activity Questionnaire).ResultsSample is composed of 37 individuals, most of them female, with overweight and low back pain > 60 months. 2-Minute Step Test showed excellent test-retest (ICC = 0.903) and inter-rater (ICC = 0.925) reliability. Sport domain of the Baecke showed a significant correlation with the 2-Minute Step Test (rho = 0.444).Conclusion2-Minute Step Test is a reliable measure to measure the functional capacity of patients with chronic low back pain considering different times and examiners, as well as being positively correlated with sports practice.

Agreement between tele-assessment and face-to-face assessment of 30-s sit-to-stand test in patients with type 2 diabetes mellitus.

The globalization of healthcare systems, and the aim to lower healthcare costs have all contributed to the growth of telehealth technology in recent years. However, before these systems are put into use, their efficacy should be verified. To the best of our knowledge, this is the first study focusing on the evaluation of functional exercise capacity using the 30-s sit-to-stand (30-s STS) test as a tele-assessment method in patients with type 2 diabetes mellitus (T2DM). The purpose of the study is to investigate the level of agreement between tele-assessment and face-to-face assessment of 30-s STS test in patients with T2DM. Fifty participants performed two times 30-s STS tests separated by 1h: a face-to-face and an Internet-connected video call examination (tele-assessment). Two physiotherapists conduct these evaluations; each was blinded to the other. The order of the evaluations was designated at random for each participant and physiotherapist. There was a good level of agreement between tele-assessment and face-to-face assessment of the 30-s STS test (mean differences = 0.20 ± 0.88, limits of agreement = 1.93 to - 1.53). Excellent interrater reliability was found for scores of the 30-s STS test [ICC = 0.93 (95% CI: 0.88; 0.96)]. In addition, all before and after test parameters show that there was a very good interrater reliability (ρ ≥ 0.75). This study shows a good level of agreement between tele-assessment and face-to-face assessment of the 30-s STS test. Our study's findings indicate that tele-assessment is a potential application to determine the level of physical capacity remotely in patients with T2DM.