High Inter-rater Reliability Research Articles

CIPAS Scale: Pilot Test for Evaluating Interaction Quality and Secure Attachment Potential

The adult's sensitivity to the child's communicative signals, their prompt and appropriate response to the child's needs for security, protection, and comfort, along with their ability to regulate emotions in the face of childhood stress, are parenting skills associated with attachment quality. Various instruments and observation scales code these constructs. Furthermore, developmental psychology has made significant contributions regarding the affective and communicative exchanges between parents and children during early stages of life and their implications for the formation of emotional bonds. The objective of this study is to describe the development and preliminary analysis of a new observation scale called: Quality of Interaction and Secure Attachment Potential (CIPAS), which aims to simply integrate the different parameters of the interactive relationship between attachment figures and children in early childhood. The construction process and initial psychometric analyses from a pilot sample are presented. The results showed very high inter-rater reliability, with an overall kappa value of κ=0.88. The relevance of CIPAS is discussed not only as a valuable tool for developmental psychology research but also as an effective instrument to guide educational practices in promoting secure attachment and quality interaction in young children.

Achieving Inter-Rater Agreement and Inter-Rater Reliability to Assess Fidelity of an Occupation-Based Coaching (OBC) Clinical Trial Intervention

Introduction: Establishing inter-rater agreement and reliability ascertains that multiple raters consistently evaluate observed interventions to ensure that clinical research protocols are delivered as intended by the trial protocol. Purpose: Using the Guidelines for Reporting Reliability and Agreement Studies, we (a) exemplified the steps to establish inter-rater reliability and inter-rater agreement on the occupation-based coaching Video Evaluation Tool and (b) evaluated best practices that promoted high inter-rater reliability and inter-rater agreement between blinded raters prior to starting a pilot randomized controlled trial. The randomized controlled trial examined the preliminary effectiveness of occupation-based coaching via telehealth for rural families with children living with type 1 diabetes to improve family quality of life, participation, self-efficacy, and child health outcomes. Method: We created a library of 13 occupation-based coaching videos portraying a range of evaluations, scores, and ratings. The inter-rater agreement and reliability on the occupation-based coaching Video Evaluation Tool were established through the iterations of (a) blinded rater training, (b) data collection using the tool, and (c) statistical analysis using Cohen’s kappa and Cronbach’s alpha. Findings: Occurrence and Non-Occurrence Checklist (κ = 0.881, p < 0.001); “Caregiver Talk” and “Interventionist Talk Analysis” (ICC = 0.991–0.999, p < 0.001); Evidence of Independent Capacity Rating (ICC = 0.867 p = 0.006). Conclusion: Strong inter-rater reliability and inter-rater agreement was established by engaging two blinded raters through multifaceted training, integrating real-life clients and contexts into the instrumentation and training, and precisely defined rubric criteria. By employing such practices, high inter-rater reliability and agreement can be achieved in clinical research involving interventions and instruments that are highly subjective and individualized. To ascertain greater scientific confidence in the intervention effect, developing a multidomain fidelity framework and establishing high inter-rater agreement and reliability in the instruments a priori to implementation of clinical trials are necessary.

Assessing and Improving Medical-Spanish Language Proficiency Among Nursing Students.

Introduction: Language discordance among health care providers and patients has been shown to result in poor patient outcomes. Health care providers who identify as being proficient in the native language of their patients may decline the use of professional interpreters due to their self assessment of language proficiency. More information is needed about whether providers who speak Spanish are proficient in medical Spanish. This study measured medical-Spanish language proficiency among nursing students. Methods: A quantitative pretest posttest evaluation (N = 30) at a large private university in the northeastern U.S. compared student and faculty assessment of student language proficiency after taking a medical-Spanish course using the Interagency Language Roundtable (ILR). T-tests compared student's final, self-assessed ILR scores with faculty's final ILR scores. Results: A significant difference was noted between students' self assessments and faculty assessments of student language proficiency (Rater 1: t(29) = -2.660, p = 0.013; Rater 2: t(29) = -2.693, p = 0.012) with high interrater reliability (kappa = 0.875). There was a significant difference between students' self-assessment of language abilities before and after the course (t(29) = -3.694; p < 0.001). Conclusion: Objective assessment of medical-Spanish language proficiency following a medical Spanish course may more accurately measure proficiency than self-assessment alone.

Examining refusal and acceptance sequences employing a data-driven binary rating approach

This paper presents the development and preliminary validation of a data-driven analytic binary rating rubric for assessing roleplay-elicited pragmatic performance of learners. The roleplay task consists of two items—one lunch invitation to elicit a refusal and one gift offer to elicit an acceptance in Chinese, both of which involve initiating proposals to return an earlier favor. Responses to return-to-favor invitations or offers in Chinese are challenging for L2 learners as they involve complicated discursive features. To create a practical, reliable tool for evaluating L2 performance, the researchers conducted a discourse analysis of L1 Chinese performance data (N = 22) to identify key discursive features in two domains— Intention (i.e., refusing the return-for-favor intention) and Decision (i.e., refusing/accepting the offer/invitation). A roleplay can receive up to 4 points in both domains, including one point each for orientation/directness, position, modification, and justification, for 8 total possible points. Scores assigned to both L1 and L2 performance according to the rubric reflected high inter-rater reliability. The effect of proficiency was significant on learner scores and interacted with rating domains and scenarios. Lower-level learners scored lower with addressing the interlocutor's return-for-favor intention than with the invitation or offer itself; they also scored lower with refusing than accepting an offer. By focusing on key discursive features rather than exhaustive interactional details, the rubric streamlines the evaluation process while maintaining accuracy and reliability. Future studies may extend the use of the rubric to other speech act sequences and languages and apply it to automated grading systems.

Reliability and validity study of the Turkish version of the Schizophrenia Cognition Rating Scale (SCoRS-TR)

BackgroundSchizophrenia is characterized by significant dysfunction in cognitive domains. Despite its crucial role in prognosis, evaluating neurocognitive impairments is challenging in outpatient settings because of the time-consuming nature of neurocognitive assessments. SCoRS “Schizophrenia Cognition Rating Scale” is a scale that provides brief cognitive evaluation. This study aimed to establish the validity and reliability of the Turkish version of the “Schizophrenia Cognition Rating Scale” (SCoRS-TR) in patients with schizophrenia and examine the correlation between SCoRS and cognitive tests. MethodsData were collected from 130 patients with schizophrenia who met the DSM-5 criteria and 40 healthy controls. SCoRS rating, Positive and Negative Syndrome Scale (PANSS), and a neurocognitive test battery were administered. ResultsFindings indicated that SCoRS-TR is a reliable and valid scale for the Turkish population. The scale demonstrated strong internal consistency, with Cronbach's alpha values ranging from 0.937 to 0.940. High interrater reliability (ranging from 0.90 to 0.98) and test-retest reliability (ranging from 0.976 to 0.990) were observed. SCoRS-TR significantly discriminated patients from healthy controls (p<0.001). SCoRS-TR exhibited significant correlations to neurocognitive tests. DiscussionResults indicated that SCoRS-TR had significant reliability and validity scores that may be useful for evaluating daily life functioning related to cognitive dysfunction in patients with schizophrenia. This approach may be useful for neurocognitive evaluation and monitoring in clinical follow-up and outpatient settings.

Validation of a Photonumeric Scale for Evaluation of Telangiectasia in Rosacea.

Telangiectasia is a prominent feature of rosacea leading to a high demand for effective treatment. To ensure consistent clinical and scientific evaluations and assess treatment response accurately, standardized assessment tools are necessary for grading the severity of telangiectasia. However, no validated grading scales for this condition are currently available. To develop and validate a photonumeric scale for assessing the severity of telangiectasia in rosacea patients. The five-point photonumeric Telangiectasia in Rosacea Severity Assessment (TRoSA) scale was developed for the severity of telangiectasia in rosacea. Sixteen experts participated in the validation process, evaluating 50 images of rosacea patients in two rounds. Interrater and intrarater reliability were analyzed using the intraclass correlation coefficient (ICC) and weighted kappa, respectively. Interrater reliability was found to be "almost perfect" in both validation rounds (Round 1: ICC 0.847; Round 2: ICC 0.828). The mean weighted kappa indicated "substantial" intrarater reliability between the two rounds with a weighted kappa of 0.719. A bubble plot of the two rounds illustrated a diagonal order, confirming the consistency of the intrarater agreement. The TRoSA scale demonstrated high interrater and intrarater reliability indicating that it is a consistent and reproducible tool for grading the severity of telangiectasia in rosacea. This scale can standardize clinical assessments, assisting in diagnosis, treatment planning, and evaluation of therapeutic efficacy.

Chinese Version of the Nonverbal Pain Assessment Tool: Critical Patient Reliability and Validity.

To translate and validate the Nonverbal Pain Assessment Tool. Timely assessment of the pain degree of nonverbal intensive care unit (ICU) patients can provide humanistic care. However, there is a lack of pain assessment tools that can meet the needs of patients who cannot use language in ICUs in China. A cross-sectional survey. We conducted forward-backward translation of the Nonverbal Pain Assessment Tool. A total of 300 critically ill patients in the intensive care unit who could not communicate verbally completed the Chinese version of the Nonverbal Pain Assessment Tool and the Critical Care Pain Observation Tool. Exploratory and confirmatory factor analyses were performed to verify structural validity, and content validity and reliability analyses were also conducted. The Nonverbal Pain Assessment Tool demonstrated high internal consistency (α = 0.901) and interrater reliability (intraclass correlation coefficient = 0.981), with good split-half reliability. Content validity was established through acceptable item-level content validity index and scale-level content validity index scores. Exploratory factor analysis showed a single factor explaining 71.79% of total variance, and confirmatory factor analysis confirmed good model fit. The Spearman rank correlation coefficient was 0.917 between the Nonverbal Pain Assessment Tool and the Critical Care Pain Observation Tool. The Chinese Nonverbal Pain Assessment Tool demonstrated significant differences in scores between different states of consciousness and illness severity, supporting its known-groups validity. The Chinese version of the Nonverbal Pain Assessment Tool is a reliable and valid tool for nonverbal pain assessment in ICU patients in China. The Chinese version of the Nonverbal Pain Assessment Tool can assess the pain of patients who cannot use language in ICU, which provides a new valuable assessment tool for Chinese clinicians and nurses in pain assessment and management. Our study followed the STROBE Checklists. Patients actively cooperated and participated in data collection during the implementation of the study.

Evaluating the Reliability of Name Writing Rubric Scoring

Early literacy screening tools are often a critical component of schools’ intervention frameworks. As the use of screening tools becomes more prevalent for identifying students who may be at risk for learning difficulties and in need of additional instruction, it is important to continuously evaluate teachers’ implementation of these screening tools and to improve efforts to support their implementation. Measures of name writing as a part of a screening tool can pose specific implementation challenges due to the subjectivity that rubric scoring allows. As such, this study aimed to evaluate the reliability of a rubric used by pre-kindergarten teachers to score a name writing task, as part of a larger screening tool, in the context of their own classrooms, and to examine scoring patterns between researchers and teachers on the name writing rubric. Results revealed that researchers had higher interrater reliability among themselves than the reliability between researchers and teachers. Although there was not a substantial difference between the two groups, it is worthwhile to examine the implementation of screening tool scoring systems in the field to ensure proper identification of and intervention for students who may be at risk for learning difficulties. Implications for researchers and teachers are discussed.

Histomorphological scoring of murine colitis models: A practical guide for the evaluation of colitis and colitis-associated cancer

Background and aimsHistomorphology is a powerful and cost-efficient tool for evaluating inflammatory and neoplastic conditions. Inflammatory bowel disease (IBD) is a widespread condition with globally rising incidences, and a lot of research is done to better understand the pathogenesis of IBD and to identify potential therapeutic approaches. However, standardized and reproducible scores for the histomorphological evaluation of murine IBD models are lacking. Therefore, we aimed to develop an easy-to-use and reproducible score for standardized assessment of colitis and associated cancer models. MethodsIn this study, samples from three different colitis models with and without associated cancer formation were analyzed to develop a universal, robust, and reproducible score for the grading of murine colitis models using the following three parameters: 1. Extent of leucocyte infiltration, 2. Tissue damage, 3. Architectural disruption of the mucosa. ResultsA scoring system was established for different kinds of colitis models (genetically induced enterocolitis, genetically induced metabolic injury, and chemically induced colitis-associated cancer) and all stages of the disease, from mild inflammatory changes to severe inflammation with neoplastic changes as the extreme extent of IBD. The scoring scheme is easy to use, can easily be learned, and proves to have a high interrater reliability. ConclusionsWe propose a robust histological scoring system for the assessment of murine colitis and colitis-associated cancer models, giving more researchers access to conclusive and reliable histological assessment.

Validity and Reliability of a New Wearable Chest Strap to Estimate Respiratory Frequency in Elite Soccer Athletes.

Assessing respiratory frequency (fR) is practical in monitoring training progress in competitive athletes, especially during exercise. This study aimed to validate a new wearable chest strap (wCS) to estimate fR against ergospirometry as a criterion device in soccer players. A total of 26 elite professional soccer players (mean [standard deviation]: 23.6 [4.8] years; 180.6 [5.7] cm; 77.2 [5.4] kg) from three Italian Serie A League teams participated in this cross-sectional study. The sample included attackers, midfielders, and defenders. fR was assessed during a maximal cardiopulmonary exercise test (CPET) on a treadmill using (i) a breath-by-breath gas exchange analyzer (Vyntus® CPX, Vyaire Medical) and (ii) a novel wCS with sensors designed to assess breath frequency following chest expansions. Pearson's correlation coefficient (r), adjusted coefficient of determination (aR2), Bland-Altman plot analysis, and Lin's concordance correlation coefficient (ρc) were used for comparative analysis (correlation and concordance) among the methods. The repeated measures correlation coefficient (rrm) was used to assess the strength of the linear association between the methods. The intraclass correlation coefficient (ICC) and the Finn coefficient (rF) were used for inter-rater reliability. All statistical analyses were performed within the R statistical computing environment, with 95% confidence intervals (95% CIs) reported and statistical significance set at p < 0.05. A total of 16529 comparisons were performed after collecting the CPET data. The robust time series analysis with Hodges-Lehmann estimation showed no significant differences between both methods (p > 0.05). Correlation among devices was statistically significant and very large (r [95% CI]: 0.970 [0.970, 0.971], p < 0.01; aR2 [95% CI]: 0.942 [0.942, 0.943], p < 0.01) with strong evidence supporting consistency of the new wCS (BF10 > 100). In addition, a high concordance was found (ρc [95% CI]: 0.970 [0.969, 0.971], bias correction factor: 0.999). VyntusTM CPX, as a standard criterion, showed moderate agreement with wCS after Bland-Altman analysis (bias [95% lower to the upper limit of agreement]; % agree: 0.170 [-4.582 to 4.923] breaths·min-1; 69.9%). A strong association between measurements (rrm [95% CI]: 0.960 [0.959, 0.961]), a high absolute agreement between methods (ICC [95% CI]: 0.970 [0.970, 0.971]), and high inter-rater reliability (rF: 0.947) were found. With an RMSE = 2.42 breaths·min-1, the new wCS seems to be an valid and reliable in-field method to evaluate fR compared to a breath-by-breath gas exchange analyzer. Notwithstanding, caution is advised if methods are used interchangeably while further external validation occurs.

Retrospective Review of the Image Quality of Monoplane Transesophageal Echocardiography in Prehospital Out-of-Hospital Cardiac Arrest: A Single Center Pilot Study

Objectives Out of Hospital Cardiac Arrest (OHCA) is a frequently encountered pathology with resultant poor outcomes in the majority of patients. Echocardiography has been utilized to help guide clinical decision making and monitor effectiveness of resuscitative efforts. Transthoracic echocardiography (TTE) the mainstay of point-of-care ultrasound (POCUS) real time resuscitative imaging has limitations, most notably is the disruption of closed chest compressions. Trans-esophageal echocardiography (TEE) is an emerging technology in emergency care and can potentially overcome these limitations but image quality and accuracy of use in the prehospital environment remains unknown. Our primary objective is to identify the accuracy of Emergency Medical Services (EMS) fellow physicians in performing TEE via the identification of key cardiac structures. Secondarily we assess image quality as well as accuracy on cardiac activity interpretation as compared to TEE-experienced cardiologists. Methods A pilot study using descriptive analysis of a retrospective case-series with specific focus on inter-rater reliability as well as pragmatic management alterations based on real-time image interpretation by EMS physicians. After focused education, 13 patients were eligible for prehospital TEE who suffering OHCA from July 2022 to June 2023. Ultrasound (US) images were interpreted by EMS fellow physicians and over-read by cardiologists with specific focus on inter-rater reliability. After collection of patients presenting data and US images, analysis was performed. Results Of 13 patients initially screened, 10 patients were included in a study with a median age of 50 years old (41–70). Three patients were excluded due to equipment malfunction or insufficient image capture. An interrater reliability identified a kappa of 0.96 with respect to identification of cardiac structures and a kappa of 0.65 for identification of cardiac activity. Conclusions In this small study of prehospital TEE, EMS fellow physicians had high inter-rater reliability in image interpretation pertaining to anatomy and cardiac activity when compared with cardiologists. Further research is needed to determine its efficacy, safety, and widespread application in the prehospital setting.

Unlocking Success: Malaysian PolyCC Lecturers’ Altruism, Enthusiasm and Harmonism in Sparking and Sustaining Student Startups Business

This study investigates the personalities of lecturers as mentors to startup entrepreneurs at higher education institutions (HEIs). The problem stems from the need to understand how specific personality traits contribute to effective mentorship. The objective is to explore how altruism, enthusiasm, and harmonism in lecturers influence their mentoring roles. A qualitative approach was employed, utilizing semi-structured interviews with Malaysian Polytechnic and Community College (PolyCC) lecturers who were finalists in the Best Entrepreneurship Mentor Award Category of the Ministry of Higher Education Entrepreneurship Award (MEA) 2021. These lecturers mentor student entrepreneurs who have successfully sustained their businesses. Thematic analysis was conducted using ATLAS.ti 9 to identify patterns and interactions. The resulting Entrepreneurial Mentor Personality Competency Model Framework, with a high inter-rater reliability (Cohen's Kappa value of 0.99), highlights key personality traits essential for effective mentorship. Additionally, the transferability of this model was validated by an entrepreneurship mentoring expert from Coventry University, United Kingdom (UK). This framework aims to guide HEI lecturers in fostering student entrepreneurship, providing a comprehensive guideline to help students achieve their entrepreneurial aspirations.

Checking the Validity and Reliability of the Delirium-O-Meter Questionnaire in the Persian Language

Objective: Compiling and designing short and practical psychometric tools are among the benefits and strengths of a good standard test. The Delirium-O-Meter questionnaire measures patients' delirium status. Accordingly, the main aim of this research was to check the reliability and validity of the Persian version of this questionnaire. Method: This exploratory psychometric study was conducted from 2021 to 2022 at the therapeutic research training centers of Tabriz University of Medical Sciences. The study population included patients diagnosed with delirium. Content and construct validity were assessed using exploratory factor analysis and confirmatory factor analysis. Exploratory factor analysis was performed using SPSS 18, which helped identify the underlying factor structure, while confirmatory factor analysis in Smart PLS was employed to confirm the structure's fit. Pearson correlation was used to evaluate the consistency between different raters, and Cronbach's alpha was calculated to assess internal consistency. These methods were selected for their robustness in evaluating the instrument's psychometric properties, ensuring the reliability and validity of the Persian version of the Delirium-O-Meter questionnaire. Results: The Persian version of the Delirium-O-Meter questionnaire, consisting of 11 items, demonstrated strong psychometric properties. The average impact factor was 3.24, indicating a high relevance of the items. The content validity ratio was 0.78, and the content validity index was 0.87, both above the acceptable thresholds, confirming the content validity of the questionnaire. Cronbach's alpha coefficient for the entire questionnaire was 0.77, reflecting good internal consistency. The Kaiser-Meyer-Olkin index was 0.88, and Bartlett's sphericity test was significant (χ² = 278.45, P &lt; 0.001), indicating the appropriateness of the data for factor analysis. Exploratory factor analysis revealed two factors that explained 76.09% of the total variance, supporting the questionnaire's construct validity. Additionally, Pearson’s correlation coefficient between the assessments of two nurses was 0.91, signifying inter-rater solid reliability. Conclusion: The Persian version of the Delirium-O-Meter questionnaire demonstrates acceptable reliability and validity, as confirmed by the comprehensive psychometric evaluation conducted in this study. The strong internal consistency, significant content and construct validity, and high inter-rater reliability underscore its effectiveness in assessing delirium in Persian-speaking patients. These findings highlight the questionnaire's suitability for clinical use, providing a reliable and valid instrument for accurately diagnosing and managing delirium in diverse healthcare settings.

Comparative Analysis of Impacted Mandibular Third Molar Root Proximity to the Mandibular Canal using Orthopantomography and Cone-beam Computed Tomography Imaging Modalities: A Pilot Study

Abstract Introduction: Fully detect risks of nerve damage, which can lead to temporary or permanent issues. Cone-beam computed tomography (CBCT) offers a three-dimensional (3D) view, providing more detailed visualisation of anatomical structures and their spatial relationships, which improves the accuracy of predicting nerve exposure. The study aims to evaluate and compare these imaging techniques’ effectiveness in categorising the relationship between third molars and the inferior alveolar canal, emphasising the importance of precise imaging for safer surgical outcomes. Materials and Methods: A pilot study involving 20 patients, representing 10% of the total sample size of 200, was conducted at Ahmedabad Dental College’s Department of Oral Medicine and Radiology. Investigators, trained to interpret radiological images from orthopantomography (OPG) and CBCT, compared their interpretations with those of two experts. A high inter-rater reliability was confirmed with a kappa statistic of 0.98. Following ethical approval, data were retrospectively collected from 20 cases, with digital OPG and CBCT images analysed and classified according to established criteria. Results: The results revealed a significant association between the results diagnosed through OPG and CBCT indicating similarity in their diagnosis. It was also seen that there was no bias towards the gender and the distribution was similar in case of diagnosis through OPG or CBCT. Conclusion: CBCT demands an in-depth understanding of anatomy and pathology, coupled with proficiency in operating imaging software and the ability to identify abnormalities in cross-sectional images. When executed and interpreted accurately, CBCT proves to be an exceptionally valuable tool in clinical dental practice. Its detailed 3D imaging capabilities enhance the assessment of complex cases, such as those involving intricate anatomical structures and pathologies. By providing comprehensive views that surpass traditional two-dimensional imaging, CBCT aids in precise diagnosis and treatment planning, making it an indispensable resource for addressing various dental conditions effectively.

Public Perception of the Tobacco 21 Amendment on Twitter in the United States: Observational Study.

Following the signing of the Tobacco 21 Amendment (T21) in December 2019 to raise the minimum legal age for the sale of tobacco products from 18 to 21 years in the United States, there is a need to monitor public responses and potential unintended consequences. Social media platforms, such as Twitter (subsequently rebranded as X), can provide rich data on public perceptions. This study contributes to the literature using Twitter data to assess the knowledge and beliefs of T21. Twitter data were collected from November 2019 to February 2021 using the Twitter streaming application programming interface with keywords related to vaping or e-cigarettes, such as "vape," "ecig," etc. The temporal trend of the T21 discussion on Twitter was examined using the mean number of daily T21-related tweets. Inductive methods were used to manually code the tweets into different sentiment groups (positive, neutral, and negative) based on the attitude expressed toward the policy by 3 coders with high interrater reliability. Topics discussed were examined within each sentiment group through theme analyses. Among the collected 3197 tweets, 2169 tweets were related to T21, of which 444 tweets (20.5%) showed a positive attitude, 736 (33.9%) showed a negative attitude, and 989 (45.6%) showed a neutral attitude. The temporal trend showed a clear peak in the number of tweets around January 2020, following the enactment of this legislation. For positive tweets, the most frequent topics were "avoidance of further regulation" (120/444, 27%), "Enforce T21" (110/444, 24.8%), and "health benefits" (81/444, 18.2%). For negative tweets, the most frequent topics were "general disagreement or frustration" (207/736, 28.1%) and "will still use tobacco" (188/736, 25.5%). Neutral tweets were primarily "public service announcements (PSA) or news posts" (782/989, 79.1%). Overall, we find that one-third of tweets displayed a negative attitude toward T21 during the study period. Many were frustrated with T21 and reported that underage consumers could still obtain products. Social media data provide a timely opportunity to monitor public perceptions and responses to regulatory actions. Continued monitoring can inform enforcement efforts and potential unintended consequences of T21.

Analyzing Alignment Error in Tibial Tuberosity–Trochlear Groove Distance in Clinical Scans Using 2D and 3D Methods

Background: Tibial tuberosity–trochlear groove distance (TT-TG) is often used as a primary metric for surgical decision-making in the treatment of patellofemoral instability (PFI), particularly when considering tibial tubercle transfer. Although TT-TG has high interrater reliability, it is prone to measurement differences caused by the alignment of the patient's leg in a scanner gantry, potentially influencing surgical decision-making. Quantification of this error within the clinical literature remains limited. Purpose: To quantify and specify the error in TT-TG caused by leg-scanner alignment by using detailed topographical landmarks and 3-dimensional (3D) analysis of computed tomography scans of patients with PFI. Study Design: Controlled laboratory study. Methods: Three-dimensional models of knees with PFI were created from computed tomography scans and used to identify TT-TG landmarks. TT-TG was measured using the established 2-dimensional (2D) and 3D methods. A model to estimate the differences between these 2 methods was created, and the orientation of the patients’ legs in relation to scanner longitudinal axis was measured to validate this model via linear regression. Interrater reliability was calculated via intraclass correlation coefficients (ICC). Results: A total of 44 knees of patients with PFI were analyzed. Differences between the 2D and 3D methods ranged from -4.0 to 14.7 mm (mean ± SD, 2.7 ± 4.1 mm) with a root mean square difference of 4.8 mm. The TT-TG distance of the 2D method (19.8 ± 7.2 mm) was significantly (P = .045) longer than that of the 3D method (17.1 ± 4.9 mm). The variance of the 2D method was significantly larger than that of the 3D method. In total, 13 (29.5%) of the knees had a difference of >5 mm between 2D and 3D TT-TG. The estimation model had an adjusted r2 value of 1.00 and a resulting root mean square difference of 0.21 mm. 3D TT-TGs interrater reliability was good to excellent (ICC, 0.94 [95 CI%, 0.81-0.98]). Conclusion: 3D TT-TG can be used to correct scanner-leg alignment errors, some of which are substantial when using only 2D TT-TG measurements. Clinical Relevance: The findings in this study suggest a need for caution and awareness of the potential effects of differences in alignment of the axes of the leg and scanner when using purely 2D TT-TG as a basis for surgical planning.

Risk for Violent and IPV Recidivism Among Incarcerated Men With a History of IPV Perpetration: An Examination of the Predictive Validity of the ODARA, DVRAG, and PCL-R

Using a hybrid prospective-retrospective study design, we examined the predictive validity of the Ontario Domestic Assault Risk Assessment (ODARA), Domestic Violence Risk Appraisal Guide (DVRAG), and the Psychopathy Checklist–Revised (PCL-R) in an incarcerated sample of 94 Canadian adult men with a history of intimate partner violence (IPV) referred for treatment. The sample was followed for an average of 3.6 years following release, yielding base rates of 23.4% and 12.8% for violent and IPV recidivism, respectively. Analyses revealed that the ODARA and DVRAG displayed high inter-rater reliability and that the two measures along with Factor 1 of the PCL-R generated the largest area under the curve (AUC) for IPV recidivism (AUC = .71, .71, and .69, respectively). Predictive validity of the three measures was maintained even after accounting for treatment exposure. Although promising, clinical implications of administering the ODARA and DVRAG to incarcerated men with a history of IPV are discussed.

Reliability testing of an IMU-based 2-segment foot model for clinical gait analysis

BackgroundThe one of the most commonly used reference system for clinical gait analysis is an optical motion capture system (OMC) using a multi-segment foot model. A time- and cost-efficient alternative could be an inertial measurement unit (IMU)-based systems. However, these are limited to a single segment approach for the foot and ankle. Therefore, the current setup was modified to be based on a 2-segment foot model, allowing for a separate analysis of the hind- and midfoot. The study aimed to evaluate the reliability (inter-rater, intra-rater, and test-retest reliability) of an IMU-based 2-segment foot model. Material and methodsTwelve healthy subjects were recruited to test the inter-rater, intra-rater, and test-retest reliability of the new IMU based 2-segment foot model. Gait analysis was performed on a treadmill at a constant speed of 4 km/h. Kinematic data of the tibia/hindfoot, tibia/forefoot and hindfoot/forefoot over 100 % gait cycle were analyzed. The reliability was tested by using statistical parametric mapping (SPM) and the intraclass correlation coefficient (ICC). ResultsThe SPM showed no significant difference for inter-, intra-rater, and test-retest reliability, but for a small segment of tibia/forefoot dorsiflexion test-retest reliability (2.1° difference). The single standard deviation measurement error for the sagittal and transverse plane was <5° and worse for the frontal plane. ConclusionThe new 2-segment foot model revealed a high inter-rater, intra-rater, and test-retest reliability. It is suitable for use in adult clinical practice. Still, comparative data to the OMC system using a multi-segment foot model are missing.

Public Perceptions of the Food and Drug Administration's Regulatory Authority Over Synthetic Nicotine on Twitter: Observational Study.

The Omnibus Budget Bill, known as H. R. 2471, passed through Congress on March 10, 2022, and was eventually signed by President Biden on March 15, 2022. This bill amended the Federal Food, Drug, and Cosmetic Act granting the Food and Drug Administration (FDA) regulatory authority over synthetic nicotine. This study aims to examine the public perceptions of the Omnibus Bill that regulates synthetic nicotine products as tobacco products on Twitter (rebranded as X). Through the X streaming application programming interface, we collected and identified 964 tweets related to the Omnibus Bill on synthetic nicotine between March 8, 2022, and April 13, 2022. The longitudinal trend was used to examine the discussions related to the bill over time. An inductive method was used for the content analysis of related tweets. By hand-coding 200 randomly selected tweets by 2 human coders respectively with high interrater reliability, the codebook was developed for relevance, major topics, and attitude to the bill, which was used to single-code the rest of the tweets. Between March 8, 2022, and April 13, 2022, we identified 964 tweets related to the Omnibus Bill regulating synthetic nicotine. Our longitudinal trend analysis showed a spike in the number of tweets related to the bill during the immediate period following the bill's introduction, with roughly half of the tweets identified being posted between March 8 and 11, 2022. A majority of the tweets (497/964, 51.56%) had a negative sentiment toward the bill, while a much smaller percentage of tweets (164/964, 17.01%) had a positive sentiment toward the bill. Around 31.43% (303/964) of all tweets were categorized as objective news or questions about the bill. The most popular topic for opposing the bill was users believing that this bill would lead users back to smoking (145/497, 29.18%), followed by negative implications for small vape businesses (122/497, 24.55%) and government or FDA mistrust (94/497, 18.91%). The most popular topic for supporting the bill was that this bill would take a dangerous tobacco product targeted at teens off the market (94/164, 57.32%). We observed a more negative sentiment toward the bill on X, largely due to users believing it would lead users back to smoking and negatively impact small vape businesses. This study provides insight into public perceptions and discussions of this bill on X and adds valuable information for future regulations on alternative nicotine products.

What types of objective measures have been used to assess core ADHD symptoms in children and young people in naturalistic settings? A scoping review

ObjectivesWe described the range and types of objective measures of attention-deficit/hyperactivity disorder (ADHD) in children and young people (CYP) reported in research that can be applied in naturalistic settings.DesignScoping review...