Good Test-retest Reproducibility Research Articles

Validation of the Polish Version of Voice Handicap Index-10

The aim of this study was to adapt and evaluate the psychometric properties of the Polish version of the VHI-10. We enrolled 183 subjects-118 patients with voice disorders and 65 without voice disorders. All items were correlated with each other and were strongly correlated with the total score (rho ≥ 0.70), the only exception being itemfive (rho=0.56). Internal consistency was very high, with Cronbach's alpha=0.92. There was a statistically significant difference between patients with voice disorders and healthy controls in terms of VHI-10 global score (U=251.0; P < 0.001). There was a statistically significant negative correlation between mean phonation time (MPT) and VHI-10 (rho=-0.30; P < 0.01). Only the amplitude perturbation quotient (APQ) was correlated positively with the global score (rho=0.22; P=0.020). There were statistically significant and positive correlations between VHI-10 scores and GRBAS evaluation. Correlations between global scores of VHI-30 and VHI-10, and between VHI-30 subscales and the corresponding items from VHI-10, were very strong (respectively 0.97 and 0.89-0.94). In the patient group, there was high test-retest reproducibility (intraclass correlation=0.91). A cut-off value of 8.5 points was estimated. The Polish version of VHI-10 showed excellent internal consistency, good test-retest reproducibility, and had clinical validity. It is a useful brief tool for self-reported evaluation and reliable assessment of patients with voice disorders.

Cardiopulmonary Exercise Testing with Elastic Resistance: A New Reproducible Proposal for Determination of Ventilatory Thresholds and Maximum Oxygen Consumption.

To propose a new Cardiopulmonary Exercise Test with Elastic Resistance (CPxEL) and compare the physiological responses to conventional cardiopulmonary exercise test (CPx) performed on a treadmill. In addition, we tested the reproducibility of the CPxEL. Twenty-four physically active participants completed the CPx (first session) and CPxEL twice (second and third sessions) interspersed by seven days. A treadmill protocol with increments of 1km·h^-1 every minute until exhaustion was used in CPx. The CPxEL consisted of performing alternating steps back-and-forth against an elastic resistance attached to a belt and an incremental protocol with 1 stage (S) per minute following a cadence of 200 bpm controlled by a metronome in an 8-stage rubber mat. First analysis: first ventilatory threshold (VT1) occurred at 69.7% and 75.3% of maximal heart rate (HR_max) and 53.5% and 65.7% of maximal oxygen consumption (V̇O_2max). Second VT (VT2) occurred at 93.3% and 96.8% of the HR_max and 87.0% and 96.9% of V̇O_2max for CPx and CPxEL, respectively. At exhaustion, V̇O_2max, perceived exertion (BORG-CR10 and OMNI-RES EB), and test duration presented lower values for CPxEL (P &lt; 0.05). Second analysis: VT1 occurred at warm-up (S0) (P = 0.731), VT2 occurred at S5 (P = 0.912), and the exhaustion occurred at S6 and S7 (P = 0.271) for CPxEL and retest, respectively. The intraclass correlation coefficient (ICC) for V̇O_2max was 0.921 and for HR_max was 0.930. The CPxEL has good test-retest reproducibility and represents a possible and interesting add-on to determine maximal oxygen consumption, maximal heart rate, and second ventilatory threshold without using traditional ergometers.

Polish Translation and Validation of the Voice Handicap Index (VHI-30).

Traditional voice evaluations, including imaging techniques, auditory-perceptual ratings, and acoustic and aerodynamic analyses, fail to assess the global handicap that a patient experiences as a result of a voice disorder. The Voice Handicap Index (VHI) is currently one of the most widely used and psychometrically robust instruments for measuring voice disability. The aim of the study is to translate and validate a Polish version of the VHI. The original English-language version of VHI-30 was translated into Polish. We enrolled 188 subjects—123 patients (91 women and 32 men) with voice disorders and 65 controls (53 women and 12 men) without voice disorders. Results obtained by the patients were significantly higher than those obtained by the controls on the Emotional subscale (U = 519.0; p < 0.001), Functional (U = 829.0; p < 0.001), Physical (U = 331.0; p < 0.001), and the global score (U = 390.0; p < 0.001). There were statistically significant negative correlations between maximum phonation time and global score (rho = −0.31; p < 0.01) as well as all three subscales. Shimmer and Smoothed Amplitude Perturbation Quotient were correlated positively with the global score (rho = 0.22; p < 0.05; rho = 0.25; p < 0.01, respectively) and with all three subscales. There were also statistically significant correlations between VHI scores and auditory perceptual evaluation. In the patient group, there was excellent internal consistency (α = 0.97) and strong test–retest reliability (intraclass correlation = 0.94). The cut-off value equal to 17 points was estimated. The Polish VHI showed excellent internal consistency, good test–retest reproducibility, and clinical validity. It is a useful tool for evaluating the voice disability perceived by a patient.

Applied Assessment Method for Varus Thrust during Walking in Patients with Knee Osteoarthritis Using Acceleration Data Measured by an Inertial Measurement Unit.

We developed a novel quantitative method to assess varus thrust during walking using acceleration data obtained from an inertial measurement unit (IMU). This study aimed to examine the reliability of the developed index and to evaluate its ability to distinguish patients with knee osteoarthritis (OA) with varus thrust from healthy adults. Overall, 16 patients with knee OA and 16 healthy adults walked on a treadmill with IMUs attached to the tibial tuberosity and lateral femoral condyle. As an index of varus thrust, we used the root mean square (RMS) of acceleration in the mediolateral direction. This value was adjusted by dividing it by swing speed while walking (adjusted RMS, A-RMS) because the RMS of the acceleration was strongly coupled with the speed of motion. The intraclass correlation coefficients of A-RMS of the tibia and femur were 0.85 and 0.73, respectively. Significant differences were observed in the A-RMSs of the tibia and femur, with large effect sizes between the patients with knee OA and healthy adults (Cohen’s d: 1.23 and 0.97, respectively). Our results indicate that A-RMS has good test–retest reproducibility and can differentiate patients with varus thrust from healthy adults.

A Custom-Made Electronic Dynamometer for Evaluation of Peak Ankle Torque after COVID-19.

The negative effects of SARS-CoV-2 infection on the musculoskeletal system include symptoms of fatigue and sarcopenia. The aim of this study is to assess the impact of COVID-19 on foot muscle strength and evaluate the reproducibility of peak ankle torque measurements in time by using a custom-made electronic dynamometer. In this observational cohort study, we compare two groups of four participants, one exposed to COVID-19 throughout measurements and one unexposed. Peak ankle torque was measured using a portable custom-made electronic dynamometer. Ankle plantar flexor and dorsiflexor muscle strength was captured for both feet at different ankle angles prior and post COVID-19. Average peak torque demonstrated no significant statistical differences between initial and final moment for both groups (p = 0.945). An increase of 4.8%, p = 0.746 was obtained in the group with COVID-19 and a decrease of 1.3%, p = 0.953 was obtained in the group without COVID-19. Multivariate analysis demonstrated no significant differences between the two groups (p = 0.797). There was a very good test–retest reproducibility between the measurements in initial and final moments (ICC = 0.78, p < 0.001). In conclusion, peak torque variability is similar in both COVID-19 and non-COVID-19 groups and the custom-made electronic dynamometer is a reproducible method for repetitive ankle peak torque measurements.

Assessment of the Precision in Measuring Glutathione at 3 T With a MEGA-PRESS Sequence in Primary Motor Cortex and Occipital Cortex.

Glutathione (GSH) is an important brain antioxidant and a number of studies have reported its measurement by edited and nonedited localized 1 H spectroscopy techniques within a range of applications in healthy volunteers and disease states. Good test-retest reproducibility is key when assessing the efficacy of treatments aimed at modulating GSH levels within the central nervous system or when noninvasively assessing changes in GSH content over time. To evaluate the intraday (in vitro and in vivo) and 1-month apart (in vivo) test-retest reproducibility of GSH measurements from GSH-edited MEGA-PRESS acquisitions at 3 T in a phantom and in the brain of a cohort of middle-aged and older healthy volunteers. Prospective. A phantom containing physiological concentrations of GSH and metabolites with overlapping spectral signatures and 10 healthy volunteers (4 F, 6 M, 55 ± 14 years old). GSH-edited spectra were acquired at 3 T using the MEGA-PRESS sequence. The phantom was scanned twice and the healthy subjects were scanned three times (on two separate days, 1 month apart). GSH was quantified from each acquisition, with the in vivo voxels placed at the primary motor cortex (PMC) and the occipital cortex (OCC). Mean coefficients of variation (CV) were used to assess short-term (in vitro and in vivo) and longer-term (in vivo) test-retest reproducibility. In vitro, the CV was 2.3%. In vivo, the mean intraday CV was 3.3% in the PMC and 2.4% in the OCC, while the CVs at 1 month apart were 4.6% in the PMC and 7.8% in the OCC. GSH-edited MEGA-PRESS spectroscopy allows measurement of GSH with excellent precision. 1 TECHNICAL EFFICACY: Stage 2.

B1 -Corrected T1 Mapping in Lung Cancer: Repeatability, Reproducibility, and Identification of Histological Types.

T1 mapping can potentially quantitatively assess the intrinsic properties of tumors. B1 correction can reduce the magnetic field inhomogeneity. To assess the repeatability and reproducibility of B1 -corrected T1 mapping for lung cancer and the ability to identify pathological types. Prospective reproducibility study. Sixty lung cancer patients (22 with emphysema) with a total of 60 lesions (adenocarcinoma [n=23], squamous cell carcinoma [n=19], and small-cell lung cancer [SCLC] [n=18]). A 3 T/B1 -corrected 3D variable flip angle T1 mapping and free-breathing diffusion-weighted imaging. Intraobserver, interobserver, and test-retest reproducibility of minimum, maximum, mean, and SD of lung tumor T1 values were assessed. The correlation between mean T1 and apparent diffusion coefficient (ADC) and differences between different histological types of lung cancer were evaluated. Intraclass correlation coefficients (ICCs), within-subject coefficients of variation (WCVs), Bland-Altman plots, Pearson's correlation coefficient (r), and analysis of variance (ANOVA). A P value <0.05 was considered to be statistically significant. No significant differences were found in minimum, maximum, mean, and SD T1 values for repeated measurements (intraobserver and interobserver) and repeated examinations (P=0.103-0.979). All parameters showed good intraobserver, interobserver and test-retest reproducibility (ICC, 0.780-0.978), except the maximum T1 value (ICC, 0.645-0.922). The mean T1 exhibited the best reproducibility and repeatability, with an average difference <6% for repeated measurements, <8% for repeated scans in lung cancer patients, and<10% for repeated scans in those with emphysema. The mean T1 correlated moderately with ADC (r=-0.580, -0.516, and -0.511 for observers A, B, and C). Both mean T1 and mean ADC were significantly different in SCLC patients compared with those in adenocarcinoma and squamous cell carcinoma patients. The mean T1 from B1 -corrected T1 mapping is a repeatable parameter with the potential to identify histological types of lung cancer and thus may be a promising imaging biomarker for characterizing lung cancer. 1 TECHNICAL EFFICACY: Stage 2.

Quantification of lung water density with UTE Yarnball MRI.

An efficient Yarnball ultrashort-TE k-space trajectory, in combination with an optimized pulse sequence design and automated image-processing approach, is proposed for fast and quantitative imaging of water density in the lung parenchyma. Three-dimensional Yarnball k-space trajectories (TE = 0.07 ms) were designed at 3 T for breath-hold and free-breathing navigator acquisitions targeting the lung parenchyma (full torso spatial coverage) with minimal T1 and weighting. A composite of all solid tissues surrounding the lungs (muscle, liver, heart, blood pool) was used for user-independent lung water density signal referencing and B1 -inhomogeneity correction needed for the calculation of relative lung water density images. Sponge phantom experiments were used to validate absolute water density quantification, and relative lung water density was evaluated in 10 healthy volunteers. Phantom experiments showed excellent agreement between sponge wet weight and imaging-derived water density. Breath-hold (13 seconds) and free-breathing (~2 minutes) Yarnball acquisitions in volunteers (2.5-mm isotropic resolution) had negligible artifacts and good lung parenchyma SNR (>10). Whole-lung average relative lung water density values with fully automated analysis were 28.2 ± 1.9% and 28.6 ± 1.8% for breath-hold and free-breathing acquisitions, respectively, with good test-retest reproducibility (intraclass correlation coefficient = 0.86 and 0.95, respectively). Quantitative lung water density imaging with an optimized Yarnball k-space acquisition approach is possible in a breath-hold or short free-breathing study with automated signal referencing and segmentation.

Comparison Between Blood-Brain Barrier Water Exchange Rate and Permeability to Gadolinium-Based Contrast Agent in an Elderly Cohort.

Background: Dynamic contrast-enhanced (DCE) MRI using intravenous injection of gadolinium-based contrast agents (GBCAs) is commonly used for imaging blood-brain barrier (BBB) permeability. Water is an alternative endogenous tracer with limited exchange rate across the BBB. A direct comparison between BBB water exchange rate and BBB permeability to GBCA is missing. The purpose of this study was to directly compare BBB permeability to GBCA (Ktrans and kGad = Ktrans/Vp) and water exchange rate (kw) in a cohort of elderly subjects at risk of cerebral small vessel disease (cSVD).Methods: Ktrans/kGad and kw were measured by DCE-MRI and diffusion prepared pseudo-continuous arterial spin labeling (DP-pCASL), respectively, at 3 Tesla in 16 elderly subjects (3 male, age = 67.9 ± 3.0 yrs) at risk of cSVD. The test-retest reproducibility of kw measurements was evaluated with repeated scans ~6 weeks apart. Mixed effects linear regression was performed in the whole brain, gray matter (GM), white matter (WM), and 6 subcortical brain regions to investigate associations between Ktrans/kGad and test-retest kw. In addition, kw and Ktrans/kGad were compared in normal appearing white matter (NAWM), white matter hyperintensity (WMH) lesions and penumbra.Results: Significant correlation was found between kw and Ktrans only in WM (β = 6.7 × 104, P = 0.036), caudate (β = 8.6 × 104, P = 0.029), and middle cerebral artery (MCA) perforator territory (β = 6.9 × 104, P = 0.009), but not in the whole brain, GM or rest 5 brain regions. Significant correlation was found between kw and kGad in MCA perforator territory (β = 1.5 × 103, P = 0.049), medial-temporal lobe (β = 3.5 × 103, P = 0.032), and hippocampus (β = 3.4 × 103, P = 0.038), but not in the rest brain regions. Good reproducibility of kw measurements (ICC=0.75) was achieved. Ktrans was significantly lower inside WMH than WMH penumbra (16.2%, P = 0.026), and kGad was significantly lower in NAWM than in the WMH penumbra (20.8%, P < 0.001).Conclusion: kw provides a measure of water exchange rate across the BBB with good test-retest reproducibility. The BBB mechanism underlying kw and Ktrans/kGad is likely to be different, as manifested by correlations in only three brain regions for each pair of comparison between kw and Ktrans or kGad.

Reproducibility of left atrial assessment in cardiac magnetic resonance imaging

Abstract Background Left atrial (LA) volume and strain are recognised as predictors of adverse outcomes in cardiovascular disease. We aimed to determine the test-retest reproducibility of LA assessment derived from cardiac MRI in subjects with and without cardiovascular disease. Methods 38 participants had two MRI scans a week apart: aortic stenosis (n=16); type 2 diabetes (n=16) and healthy volunteers (n=6). Images were analysed by a single trained observer using Medis v3.1, medical imaging system, Leiden, Netherlands. LA strain and strain rate were assessed with Feature Tracking (QStrain v2.0), corresponding to LA reservoir, conduit, and contractile function. LA ejection fraction (LAEF) was calculated using biplane area-length method (QMass v8.1). Both were assessed on 4- and 2-chamber long-axis standard steady-state free precession cine images, and average values calculated. Results As shown in the table, the test-retest reproducibility for strain and strain rate was moderate for reservoir phase (CoV 25–28%, ICC ∼0.70) and poor for conduit and contraction phases (CoV&amp;gt;40%). The test-retest repeatability for LA volumes and LAEF was good (CoV 16–29%, ICC≥0.70). Conclusion LA strain assessment using feature tracking is a poorly reproducible technique on CMR. However, good test-retest reproducibility for LA volumes and EF. Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.

Functional parcellation of the hippocampus by semi-supervised clustering of resting state fMRI data

Many unsupervised methods are widely used for parcellating the brain. However, unsupervised methods aren’t able to integrate prior information, obtained from such as exiting functional neuroanatomy studies, to parcellate the brain, whereas the prior information guided semi-supervised method can generate more reliable brain parcellation. In this study, we propose a novel semi-supervised clustering method for parcellating the brain into spatially and functionally consistent parcels based on resting state functional magnetic resonance imaging (fMRI) data. Particularly, the prior supervised and spatial information is integrated into spectral clustering to achieve reliable brain parcellation. The proposed method has been validated in the hippocampus parcellation based on resting state fMRI data of 20 healthy adult subjects. The experimental results have demonstrated that the proposed method could successfully parcellate the hippocampus into head, body and tail parcels. The distinctive functional connectivity patterns of these parcels have further demonstrated the validity of the parcellation results. The effects of aging on the three hippocampus parcels’ functional connectivity were also explored across the healthy adult subjects. Compared with state-of-the-art methods, the proposed method had better performance on functional homogeneity. Furthermore, the proposed method had good test–retest reproducibility validated by parcellating the hippocampus based on three repeated resting state fMRI scans from 24 healthy adult subjects.

Reproducibility, reliability and variability of FA and MD in the older healthy population: A test-retest multiparametric analysis.

• In older healthy subjects, FA and MD show overall good test-retest reliability & reproducibility. • MD is sistematically more reproducible than FA across the entire brain anatomy. • FA is more reliable than MD in subcortical white matter regions. • In high reliability & low reproducibility regions, variability between subjects is high and statistical power is low. • In low reliability & high reproducibility regions, variability between subjects is low and statistical power is high.

TRANSLATION AND VALIDATION OF THE DUTCH INJURY PSYCHOLOGICAL READINESS TO RETURN TO SPORT SCALE (I-PRRS)

In facilitating and predicting successful return to sport (RTS), not only are physical factors important, but also the athlete's psychological status. No questionnaire in the Dutch language exists for measuring psychological readiness for RTS after injuries in general. To translate and validate the Injury-Psychological Readiness to Return to Sport scale into the Dutch language. Cross-sectional, validation study. One hundred and sixty-eight athletes, returning to high impact sports after lower extremity injuries, completed the Dutch I-PRRS twice. Another 162 athletes who visited their physical therapist for initial intake also completed the questionnaire. Floor and ceiling effects, internal consistency, reproducibility, construct validity, and divergent validity were analyzed. The I-PRRS was successfully translated into Dutch and showed no floor or ceiling effects. It had good internal consistency (0.85) and good test-retest reproducibility (ICC 0.74, 95% CI 0.43-0.86) where the lower bound of 95% CI indicates at least fair reproducibility. The SEM was 2.02 and the MDC 5.58 points. There was a significant fair correlation between total scores on the I-PRRS and TSK (rs = 0.41, p<0.001). Athletes who RTS and those who initially visited their physical therapist differed significantly on all items and on total scores (p<0.001). The I-PRRS was successfully translated into Dutch and can be administered to athletes with lower extremity injuries who have clearance to RTS. The MDC of 5.58 on the total score indicated that with a score below six, there is no noticeable change outside the measurement error. For measuring and monitoring psychological readiness for RTS, the use of the Dutch I-PRRS is recommended for Dutch physical therapists. 3b.

Validity of the factorial structure of the Brazilian version scale of the Food Choice Questionnaire.

This study examines the dimensional structure and reliability of the 36-item Food Choice Questionnaire (FCQ) in a Brazilian Portuguese version, an instrument used to measure the importance of motives behind food choices. The sample includes 502 adults. Confirmatory factorial analysis (CFA) were used to evaluate the configural (dimensionality) and metric (magnitude of factorial loadings, residual correlations and factorial discriminatory validity) structures of the instrument. Internal consistency evaluation used the Omega coefficient (Ω); temporal reproducibility used the Kappa coefficient with quadratic weighting (κ) in a separate sample of 41 subjects. The final CFA corroborates the 9-factor original structure and shows high factorial loadings (λi > 0.80 in 34 items); two residual correlations (r(i2-i3) = 0.773 and r(i16 i17) = 0.853); and factorial correlations indicating factor discriminant validity (φ < 0.80). Regarding reliability, there is adequate internal consistency (Ω = 0.877 to 0.968), and good test-retest reproducibility indicating temporal stability (κ = 0.768 to 0.917). It can be concluded that the FCQ version has good configural and metric properties, and may be recommended for use in Brazil in its present form.

Test-Retest Reproducibility of Response Duration in Tinnitus Patients With Positive Residual Inhibition.

Purpose Functional imaging is often used to try to elucidate the pathophysiological mechanism of tinnitus. Residual inhibition, the temporary suppression of tinnitus after application of a masking noise, could be an interesting technique to modulate tinnitus perception in functional imaging paradigms. The purposes of this study were to primarily assess reproducibility of the (partial) positive residual inhibition response duration in patients with tinnitus and to explore its utility in experimental designs. Method Patients with tinnitus exhibiting a (partial) positive residual inhibition response or tinnitus reduction after a 1-min white noise presentation were selected from a broad consulting tinnitus population. In 27 patients, this response was tested 4 times: twice during initial testing and twice during a retest of the psychoacoustic tinnitus measures, 4-8 weeks after initial consultation. In 17 patients with stable residual inhibition responses, reproducibility of response duration, the duration of tinnitus reduction up to pretesting state, was analyzed. Results Initial testing showed a residual inhibition duration of 29.5 s on average. Test-retest reproducibility of response duration was shown to be reliable with an ICC(3, 4) of .871 (95% CI [0.733, 0.948]) and a standard error of measurement of 6.64 s. Conclusions This study indicates the good test-retest reproducibility of residual inhibition duration in our subset of 17 patients with stable (partial) positive residual inhibition. Residual inhibition is, therefore, a technique that can potentially be used for temporary tinnitus manipulation in experimental paradigms to unravel tinnitus pathophysiology.

In vivo evaluation of human patellar tendon microstructure and microcirculation with diffusion MRI.

Patellar tendon (PT) microstructure integrity and microcirculation status play a crucial role in the progression of tendinopathy and tendon repair. To assess the feasibility and robustness of stimulated-echo based diffusion-weighted MRI with readout-segmented echo-planar imaging (ste-RS-EPI) for noninvasive assessment of microstructure and microcirculation of human PT. Prospective. Fifteen healthy volunteers. PT diffusion tensor imaging (DTI) and intravoxel incoherent motion (IVIM) were acquired with an ste-RS-EPI protocol on a 3T MRI scanner. Subjects were positioned with their PT at the magic angle. DTI-derived parameters including axial diffusivity (AD), radial diffusivity (RD), mean diffusivity (MD), and fractional anisotropy (FA) were estimated with b-values of 0 and 800 s/mm2 and 12 diffusion directions. IVIM-derived parameters, f p , D* × f p , V b , and D* × V b were assessed in the central-third and the outer-two thirds of the PT with b-values of 0, 20, 30, 60, 80, 120, 200, 400, and 600 s/mm2 in three orthogonal directions. Paired t-tests were used to evaluate differences in IVIM parameters between the central-third and outer-two thirds regions of the patellar tendon. Paired t-tests and within-subject coefficient of variation were used to assess the intra- and intersession reproducibility of PT DTI and IVIM parameters. DTI parameters for healthy PT were 1.54 ± 0.09 × 10-3 mm2 /s, 1.01 ± 0.05 × 10-3 mm2 /s, 1.18 ± 0.06 × 10-3 mm2 /s, and 0.30 ± 0.04 for AD, RD, MD, and FA, respectively. Significantly higher (P < 0.05) IVIM parameters f p and D* × f p were observed in the outer-two thirds (6.1% ± 2.4% and 95.2 ± 49.6, respectively) compared with the central-third (3.8% ± 2.3% and 48.6 ± 35.2, respectively) of the PT. Diffusion MRI of PT with an ste-RS-EPI protocol is clinically feasible. Both DTI- and IVIM-derived parameters of the PT demonstrated good test-retest reproducibility and interrater reliability. 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2020;51:780-790.

French translation and cultural adaptation of a questionnaire for patients with hip or knee prosthesis

IntroductionThe Kingsbury questionnaire offers the possibility of follow-up by means of an X-ray and a simple questionnaire sent to the home address of the patient, who will not need to come in consultation if there are no problems. The questionnaire detects any anomaly in follow-up. In case of anomaly in the questionnaire or radiograph, the patient is contacted and/or seen again, as appropriate. The Kingsbury questionnaire has had no transcultural validation, and we therefore conducted a prospective study in order to 1) translate into French the questionnaire, previously validated in English; 2) adapt it for good understanding according to cultural habits; and 3) assess the translated version on a test-retest procedure. HypothesisThe study hypothesis was that the translated questionnaire would show good test-retest reproducibility. Material and methodsThe exact English version of the questionnaire was obtained directly from the authors of the index publication. A methodology of translation, back-translation and test-retest enabled assessment of the translation and of the reproducibility of the French version. The reference method of cultural adaptation of self-administered questionnaires and patient information documents was used. The questionnaire was tested prospectively. ResultsOne hundred patients were contacted, providing 73 clinical tests with radiographic validation and 48 complete test-retests in a representative population of total hip and total knee arthroplasty (THA, TKA). Internal coherence showed a KR-20 coefficient of 0.71 and Cronbach alpha of 0.76: e.g., good internal coherence. Item difficulty, requiring renewed contact, was low for all questions. Mean variance was low on the first 7 questions: 0.08 (range, 0.02–0.16). Correlation was close to 0.5 for each question. Analysis of reproducibility found excellent agreement (>90%) for the first 7 questions, which were binary; for question 8, agreement was good (83.3%) considering that there were 5 possible responses. For 19 of the 73 respondents, the questionnaire results indicated a need for further contact. After analysis of their radiographs, 4 needed to be seen in consultation again. The other 15 had unfavorable responses but without deterioration since the last classical consultation or any radiologic abnormality consultation, and were not called back for consultation. ConclusionThe French version of the Kingsbury questionnaire provided reproducible assessment, avoiding the need to call the patient back for consultation unnecessarily. The questionnaire needs validating in a larger sample before being widely used: the present study was just a first step. Level of evidenceIV, Prospective without control group.

Adaptation of the Scoliosis Research Society–22 Questionnaire for the Hebrew Language: Transcultural Adaptation and Reliability Analysis

Study DesignA cross-cultural adaptation and reliability study. ObjectiveTo perform cross-cultural adaptation and evaluate the reliability and validity of the Hebrew version of the Scoliosis Research Society–22 (SRS-22) questionnaire. Summary of Background DataThe SRS-22 validated in different languages is used in assessing health-related quality of life of patients with scoliosis. MethodsThe English SRS-22 was translated/retranslated and a cross-cultural adaptation was performed. The Hebrew SRS-22 was administered twice, a week apart, to 45 patients with idiopathic scoliosis and 15 with Scheuermann kyphosis. The Cobb angle of the thoracic curvature, the numeric rating scale (NRS) of pain and of the self-perceived cosmetic defect, were evaluated. Internal consistency was determined by the Cronbach α coefficient. Intraclass correlation was used for test-retest reliability. Concurrent validity of the SRS-22 domains with the Cobb angle, NRS pain, and NRS cosmetic defect was evaluated by Pearson correlation. ResultsThe mean age of the subjects was 17.3 ± 7.42 years. The Cobb angle was 39.43 ± 17.52, NRS pain during the last 24 hours was 4.35 ± 3.42, and the NRS cosmetic defect was 3.80 ± 3.57. The mean overall Cronbach α of the Hebrew SRS-22 was 0.75. Two domains, function/activity (α = 0.63) and satisfaction (α = 0.66), showed a questionable internal consistency, self-image (α = 0.72) showed acceptable, pain (α = 0.80) good, and mental health (α = 0.92) excellent internal consistency. The intraclass correlation for five domains ranged from 0.71 to 0.95, demonstrating good test-retest reproducibility. The concurrent validity of the SRS-22 in scoliosis subjects with the Cobb angle was moderate (r = 0.37), and with NRS pain (r = 0.62) and NRS cosmetic defect (r = 0.54) good. In kyphosis subjects, the only significant high correlation was found between the self-image domain of SRS-22 and the NRS cosmetic defect (r = 0.84). ConclusionThe Hebrew version of the SRS-22 can be used to assess the outcome of treatment among Hebrew-speaking patients with idiopathic scoliosis and Scheuermann disease. Level of EvidenceLevel 2.

Reliability of a laboratory-based long sprint cycling test: applications of the smallest worthwhile changes in performance for repeated measures designs

The aims of the present study were to assess the reliability of long sprint cycling performance in a group of recreationally trained cyclists and to provide thresholds for changes in performance for this particular group of subjects in repeated measures designs through a scale of magnitudes. Repeatability of mean power output during a 1-min cycling time trial was assessed in a group of 15 recreationally trained cyclists (26 ± 5, years, 176 ± 5 cm, 78 ± 8 kg). They were tested on separate days, approximately one week apart. The test and retest values for the whole group of cyclists were 7.0 ± 0.5 W/kg and 6.9 ± 0.6 W/kg (systematic change and 90% confidence limits of -1.0% ± 1.1%). Our results indicated good test-retest reproducibility (typical error of 1.8%, 90% confidence limits of 1.4% to 2.6%; intraclass correlation coefficient of 0.96, confidence limits of 0.91 to 0.99), but suggested a reduction of mean power for the “slower” subjects on retest (-2.0%, 90% confidence limits of ±1.8%). If not monitored, this systematic decrease could interfere in results of studies utilizing groups with similar performance levels, particularly investigating strategies to improve performance in sprint cycling exercises around 1 min. The thresholds for moderate, large, very large and extremely large effects for mean power output on long sprint cycling performance are about 0.4%, 1.3%, 2.3%, 3.6%, and 5.8%, respectively.

Equivalence and test–retest reproducibility of conventional and extended-high-frequency audiometric thresholds obtained using pure-tone and narrow-band-noise stimuli

Objectives: Extended high-frequency (EHF) audiometry is useful for evaluating ototoxic exposures and may relate to speech recognition, localisation and hearing aid benefit. There is a need to determine whether common clinical practice for EHF audiometry using tone and noise stimuli is reliable. We evaluated equivalence and compared test-retest (TRT) reproducibility for audiometric thresholds obtained using pure tones and narrowband noise (NBN) from 0.25 to 16 kHz. Design: Thresholds and test-retest reproducibility for stimuli in the conventional (0.25–6 kHz) and EHF (8–16 kHz) frequency ranges were compared in a repeated-measures design. Study sample: A total of 70 ears of adults with normal hearing. Results: Thresholds obtained using NBN were significantly lower than thresholds obtained using pure tones from 0.5 to 16 kHz, but not 0.25 kHz. Good TRT reproducibility (within 2 dB) was observed for both stimuli at all frequencies. Responses at the lower limit of the presentation range for NBN centred at 14 and 16 kHz suggest unreliability for NBN as a threshold stimulus at these frequencies. Conclusion: Thresholds in the conventional and EHF ranges showed good test-retest reproducibility, but differed between stimulus types. Care should be taken when comparing pure-tone thresholds with NBN thresholds especially at these frequencies.