Inexperienced Assessors Research Articles

Test-retest and interrater reliability of experimental within-subject variability of pain reports as assessed by the focused analgesia selection test.

Within-subject variability (WSV) of pain intensity reports has been shown to predict the placebo response. The focused analgesia selection test (FAST), which allows to experimentally assess WSV of pain reports, has been used as a screening tool to identify participants who are likely to have a strong placebo response in drug-development clinical trials. Yet, the reliability of FAST has not been reported. To assess test-retest and interrater reliability of the FAST outcomes. To mimic pharma-sponsored clinical trials, we enlisted inexperienced assessors who underwent limited training. Healthy volunteers performed the FAST twice within a week and were randomly assigned to either the test-retest group or the interrater group. T-tests, partial Pearson correlations, intraclass correlations (ICC), and Bland-Altman plots were generated to assess FAST outcomes' reliability. Sixty-three participants completed the study and were assigned to the test-retest (N = 33) or interrater (N = 30) arms. No statistically significant differences in the FAST outcomes were detected between the 2 sessions, except for the FAST covariance (FAST CoV) in the interrater assessment (P = 0.009). Test-retest reliabilities of the FAST-main outcomes were r = 0.461, ICC = 0.385 for the FAST R 2 and r = 0.605, ICC = 0.539 for the FAST ICC and in the interrater cohort, they were FAST R 2: r = 0.321, ICC = 0.337 and FAST ICC: r = 0.355, ICC = 0.330. Using inexperienced assessors, the FAST outcomes test-retest ranged from moderate to strong, whereas the interrater reliability ranged from weak to poor. These results highlight the importance of adequately training study staff members before using this tool in multicentre clinical trials.

Reliability and concurrent validity of 30-s and 5-time sit-to-stand tests in older adults with knee osteoarthritis.

Sit-to-stand (STS) movement is fundamental in daily life. STS tasks have been used to assess lower limb muscle strength, balance control, and functional abilities in various populations, but limited information is available on their use in older individuals with knee osteoarthritis. We here examined the intra-rater, inter-rater, and test-retest reliability of the 30-s and 5-time STS tests, and calculated the standard error of measurement (SEM) and minimal detectable change (MDC). Moreover, we explored the concurrent validity of these tests by analysing their correlation with knee muscle strength, pain, stiffness, and physical function in older adults with knee osteoarthritis. This cross-sectional study included 60 older participants diagnosed with knee osteoarthritis. Baseline demographic information and data on pain, stiffness, and physical function using the modified Western Ontario and McMaster Universities Osteoarthritis (WOMAC) were obtained. Participants performed the 30-s and 5-time STS tests as well as knee muscle strength assessment using a hand-held dynamometer. After 1week, 30 participants were reassessed to evaluate test-retest reliability. The 30-s and 5-time STS tests had excellent intra-, inter-, and test-retest reliability (intraclass correlation coefficients: 0.990-1.000, 0.996-0.999, and 0.841-0.853, respectively) with a large SEM and MDC. Both STS tests significantly correlated with knee extensor and flexor strength and all modified WOMAC domains (Pearson's correlation coefficients: 0.28-0.61, p < 0.05). The 30-s and 5-time STS tests are reliable assessment tools and correlate with knee muscle strength, pain, stiffness, and physical function in older adults with knee osteoarthritis. Key Points • The 30-s and 5-time STS test can serve as surrogate measures in various aspects of knee health, including muscle strength, pain levels, stiffness, and overall physical function, in older adults with knee osteoarthritis. • Both these STS tests are dependable tools, accessible for both experienced and inexperienced assessors to administer effectively.

Development of a body condition index to estimate adiposity in ponies and horses from morphometric measurements.

There is a high prevalence of obesity in ponies and pleasure horses. This may be associated with equine metabolic syndrome and an increased risk of laminitis. Body condition scoring (BCS) systems are widely used but are subjective and not very sensitive. To derive a body condition index (BCI), based on objective morphometric measurements, that correlates with % body fat. Retrospective cohort study. Morphometric measurements were obtained from 21 ponies and horses in obese and moderate body condition. Percentage body fat was determined using the deuterium dilution method and the BCI was derived to give the optimal correlation with body fat, applying appropriate weightings. The index was then validated by assessing inter-observer variation and correlation with % body fat in a separate population of Welsh ponies; and finally, the correlation between BCI and BCS was evaluated in larger populations from studies undertaken in Australia, the United Kingdom and the United States. The BCI correlated well with adiposity in the ponies and horses, giving a Pearson r value of 0.74 (P < 0.001); however, it was found to slightly overestimate the % body fat in leaner animals and underestimate in more obese animals. In field studies, the correlation between BCI and BCS varied particularly in Shetlands and miniature ponies, presumably due to differences in body shape. Further work may be required to adapt the BCI to a method that is more applicable for Shetlands and miniature ponies. This BCI was able to provide an index of adiposity which compared favourably with condition scoring in terms of accuracy of estimating adiposity; and was more consistent and repeatable when used by inexperienced assessors. Therefore, this may be a useful tool for assessing adiposity; and may be more sensitive than condition scoring for tracking weight gain or weight loss in individual animals.

A user-friendly decision support tool to assist one-health risk assessors

One-Health risk assessments are integral to developing efficient responses to disease threats, including global pandemics. However, short timeframes, inadequate disease-specific information and an insufficient skill-base make it hard for inexperienced assessors to distinguish between a large portfolio of approaches. The wrong choice can detract from the disease response. Here, we present an interactive decision support tool to help with this choice. A workshop with participants from diverse professional backgrounds provided six themes that should be considered when deciding on the best approach. Questions based on these themes were then developed to populate a decision tree which guides users to their most appropriate approach. One-Health risk assessment tools and literature were used as examples of the different approaches. The tool provides links to these examples and short descriptions of the approaches. Answers are easily changed, facilitating exploration though different approaches. The simple data structure of the tool means it is easy to update with more resources and approaches. It provides a valuable source of guidance and information for less experienced risk assessors.

RELIABILITY of a MOVEMENT QUALITY ASSESSMENT TOOL to GUIDE EXERCISE PRESCRIPTION (MOVEMENTSCREEN).

Movement quality is commonly assessed to identify movement limitations and guide exercise prescription. Rapid growth in the movement assessment landscape has led to the development and utilization of various movement quality assessments, many without reliability estimates. MovementSCREEN is a novel, tablet-based, video-recorded movement assessment tool, currently without published reliability information. Therefore, the purpose of this study was to determine the intra and inter-rater reliability of the MovementSCREEN, including the impact of rater experience, and provide estimates of measurement error and minimal detectable change. Cross-sectional design; reliability study. Thirty healthy young adults (14M:16F, mean age 28.4 yrs, SD 9.1) were video recorded completing the nine MovementSCREEN assessment items on two occasions, two weeks apart. Each individual movement was assessed against objective scoring criteria (component items: yes/no) and using a 100-point sliding scale. To create an overall score for each movement, the scale score is weighted against the objective items to provide a score out of 100. At the completion of all nine individual movements, a mean composite score of movement quality is also established (0-100). The first recording was scored twice by two expert and two novice assessors to investigate inter- and intra-rater reliability. The second recording was scored by one expert assessor to investigate within-subject error. Inter- and intra-rater reliability was calculated using intraclass correlation coefficients (ICCs) and Kappa statistics. The standard error of measurement (SEM), and minimal detectable change (MDC95) for the overall score for each movement, and the composite score of movement quality, were calculated. Intra-rater reliability for the component items ranged from κ = 0.619 - 1.000 (substantial to near perfect agreement) and 0.233 - 1.000 (slight to near perfect agreement) for expert and novice assessors, respectively. The ICCs for the overall movement quality scores for each individual movement ranged from 0.707 - 0.952 (fair to high) in expert and 0.502 - 0.958 (poor to high) in novice assessors. Inter-rater agreement for the component items between expert assessors ranged from κ = 0.242 - 1.000 (slight to almost perfect agreement), while for novice assessors ranged from 0.103 - 1.000 (less than chance to almost perfect agreement). ICCs for the overall scores for each individual movement from expert and novice assessors ranged from 0.294 - 0.851 (poor to good) and 0.249 - 0.775 (poor to fair), respectively. The SEM for the composite score was 2 points, while the MDC95 was 6 points, with an ICC 0.901. The MovementSCREEN can assess movement quality with fair to high reliability on a test-retest basis when used by experienced assessors, although reliability scores decrease in novice assessors. Comparisons between assessors involve greater error. Therefore, the training of inexperienced assessors is recommended to improve reliability. 2b.

Impact of Working Experience on Image Perception and Image Evaluation Approaches in Stroke Imaging: Results of an Eye-Tracking Study.

Higher rates of missed pathologies, caused by a lack of professional experience or systematic search, suggest that a methodical approach to radiological analysis can be learned. Thus, the aim of this study is to investigate the efficiency of different principles of screening stroke CTs for cerebrovascular diseases between radiologists and neuroradiologists with different levels of experience in relation to professional experience. A set of anonymous CT images of 20 patients, with a suspected stroke, was individually presented to 12 radiologists with different levels of professional experience. Meanwhile, their fixation position was recorded by an eye-tracking system. For statistical analysis, the interobserver variability and accuracy of lesion detection were evaluated, taking the individual level of professional experience into account. The sensitivity of the observer depends on the professional experience, also determined by a systematic observation sequence and knowledge of the course of the disease. The duration of eye fixation with inexperienced assessors was significantly longer for conspicuous findings, while experienced assessors were more likely to fix clinically relevant regions. The retention time of ocular fixation in important pathological findings did not differ significantly between those groups. Our results indicate that experienced radiologists are reducing the number of missed findings through a systematic approach and targeted inspection of important regions. Through raising the awareness of analyzing CT images in systematic patterns, physicians at all levels of experience seem to be able to improve their performance. · Experienced radiologists improve detection rates through targeted inspection of clinically important regions.. · Experienced radiologists reduce time spent on analysis through focused visual attention.. · All levels of experience improve their performance by analyzing CT images systematically.. · Kammerer S, Schülke C, Leclaire MD et al. Impact of Working Experience on Image Perception and Image Evaluation Approaches in Stroke Imaging: Results of an Eye-Tracking Study. Fortschr Röntgenstr 2019; 191: 836 - 844.

Assessing keel bone damage in laying hens by palpation: effects of assessor experience on accuracy, inter-rater agreement and intra-rater consistency.

ABSTRACTAccurate assessment is essential when evaluating keel bone damage. Palpation is commonly used to assess keel bone damage in living hens. However, there is little information on the accuracy of assessment of deviations and fractures on different parts of the keel, and on the consistency within, and agreement between, assessors. Crucially, although the importance of experience is commonly emphasized, knowledge on its effect is scarce. Ten assessors with or without prior experience palpated the same 50 75-wk-old hens for deviations, medial fractures, and caudal fractures (scored as present/absent). Accuracy, sensitivity, specificity, precision, and negative predictive value were determined by comparing palpation scores to post-dissection assessment, and then compared between experienced and inexperienced assessors. To determine the effect of the experience gained during the experiment, hens were subsequently re-assessed. Consistency within, and agreement between, assessors were also determined. Assessors with prior experience were more accurate (proportion of accurately assessed deviations: experienced 0.83 vs. inexperienced 0.79±0.01, P = 0.04; medial fractures: 0.82 vs. 0.68±0.03 in session 1 only, P = 0.04; caudal fractures: 0.41 vs. 0.29±0.03, P = 0.03), and inexperienced assessors classified medial fractures more accurately in session 2 (session 1: 0.68 vs. session 2: 0.77±0.04, P = 0.04). However, effect sizes were small for deviations and even experienced assessors lacked accuracy when assessing caudal fractures. Unexpectedly, deviations tended to be assessed more accurately in session 1 than in session 2, regardless of assessor status (1: 0.83 vs. 2: 0.79±0.01, P = 0.06), suggesting that prolonged assessment contributes to errors. Prior experience decreased specificity and precision of fracture assessment (more unfractured keels were classified as fractured) even though overall accuracy was greater. Intra-rater consistency was fair to good (0.55 to 0.67) for deviations and medial fractures, but poor to fair (0.36 to 0.44) for caudal fractures, and unaffected by prior experience (P = 0.49 to 0.89). In conclusion, experience improves accuracy to a limited extent but does not guarantee high accuracy for all types of damage. Future research should determine if other training methods (e.g., comparison to post-dissection scores or to radiographs) improve accuracy.

Analytic Confidence and Political Decision‐Making: Theoretical Principles and Experimental Evidence From National Security Professionals

When making decisions under uncertainty, it is important to distinguish between the probability that a judgment is true and the confidence analysts possess in drawing their conclusions. Yet analysts and decision‐makers often struggle to define “confidence” in this context, and many ways that scholars use this term do not necessarily facilitate decision‐making under uncertainty. To help resolve this confusion, we argue for disaggregating analytic confidence along three dimensions: reliability of available evidence, range of reasonable opinion, and responsiveness to new information. After explaining how these attributes hold different implications for decision‐making in principle, we present survey experiments examining how analysts and decision‐makers employ these ideas in practice. Our first experiment found that each conception of confidence distinctively influenced national security professionals' evaluations of high‐stakes decisions. Our second experiment showed that inexperienced assessors of uncertainty could consistently discriminate among our conceptions of confidence when making political forecasts. We focus on national security, where debates about defining “confidence levels” have clear practical implications. But our theoretical framework generalizes to nearly any area of political decision‐making, and our empirical results provide encouraging evidence that analysts and decision‐makers can grasp these abstract elements of uncertainty.

(The null) Importance of police experience on intuitive credibility of people with intellectual disabilities.

In the present study, the intuitive ability of police to discriminate between real and false statements of people with mild and moderate (IQ range=50-80, average=60.0) intellectual disabilities (ID) was analyzed. The assessments issued by groups with different levels of experience in police techniques (psychology students, and police officers) were compared. The results showed no differences between the two groups in their ability to discriminate (d'=0.785 and d'=0.644, respectively). When the experience of the police was taken into consideration, no differences were found between "experienced" and "novice" police officers (d'=0.721 and d'=0.582, respectively). No differences were found in response criteria, which were neutral in all cases. Moreover, 34.73% of cases evaluated by the inexperienced group were incorrectly discriminated, in comparison to the 37.75% of incorrect assessments made by police. The implications of the limited ability of intuition to discriminate between real and simulated victims with ID, which did not yield significant differences between experienced and inexperienced assessors in obtaining and assessing statements, are discussed. In light of the results of this study, it is concluded that adequate resources and standardized procedures to properly address people with ID who come into contact with the police and judicial institutions need to be provided.

Enhancements of pest risk analysis techniques

International, regional and national standards for plant health pest risk assessment and examples of their use from countries around the globe were examined together with similar documents from related fields such as animal health, nature conservation and genetically modified organism (GMO) assessment to determine how the consistency of assessing risk, or components of risk, within and between assessments is addressed. A range of approaches was identified that could be adopted and adapted for use in a revised decision support scheme for quarantine pests by the European and Mediterranean Plant Protection Organization (EPPO) to aid consistency. No single scheme contained a mechanism to ensure or guarantee consistency and no single scheme contained all of the approaches identified to maximize consistency. If the approach of using a five division scale to describe individual components that contribute to evaluating the overall pest risk is to be maintained in the EPPO scheme, then the primary needs required in the EPPO scheme to enhance consistency are (i) the provision of examples that describe divisions within the scales, or alternative but equivalent descriptors that allow assessors to distinguish between divisions, and (ii) a mechanism to combine risk elements in a consistent and transparent way. Features that would help inexperienced assessors include a clear structure, clear rating guidance, questions posed unambiguously, provision of standardized answers and an easily applicable method to interpret and summarize risk ratings. Beyond improvements to the EPPO scheme, assessors using the scheme will need training. Providing links to information and suggesting data sources that would help assessors answer questions would also be helpful (this is being addressed in Work Package 1 of PRATIQUE).

Reliability and validity of motion analysis in children treated for congenital clubfoot according to the Clubfoot Assessment Protocol (CAP) using inexperienced assessors.

BackgroundThe Clubfoot Assessment Protocol (CAP) was developed for follow-up of children treated for clubfoot. The objective of this study was to analyze reliability and validity of the six items used in the domain CAPMotion Quality using inexperienced assessors.FindingsFour raters (two paediatric orthopaedic surgeons, two senior physiotherapists) used the CAP scores to analyze, on two different occasions, 11 videotapes containing standardized recordings of motion activity according to the domain CAPMotion Quality These results were compared to a criterion (two raters, well experienced CAP assessors) for validity and for checking for learning effect.Weighted kappa statistics, exact percentage observer agreement (Po), percentage observer agreement including one level difference (Po-1) and amount of scoring scales defined how reliability was to be interpreted. Inter- and intra rater differences were calculated using median and inter quartile ranges (IQR) on item level and mean and limits of agreement on domain level.Inter-rater reliability varied between fair and moderate (kappa) and had a mean agreement of 48/88% (Po/Po-1). Intra -rater reliability varied between moderate to good with a mean agreement of 63/96%. The intra- and inter-rater differences in the present study were generally small both on item (0.00) and domain level (-1.10). There was exact agreement of 51% and Po-1 of 91% of the six items with the criterion. No learning effect was found.ConclusionThe CAPMotion quality can be used by inexperienced assessors with sufficient reliability in daily clinical practice and showed acceptable accuracy compared to the criterion.

Measuring the consequences of osteoarthritis and joint pain in population-based studies: can existing health measurement instruments capture levels of participation?

To identify health measurement instruments to investigate levels of participation associated with joint pain in a population survey questionnaire. A comprehensive electronic search of the published literature was performed to identify potential instruments that could measure participation. All items from identified instruments were assessed for the ability to measure participation by 2 experienced and 2 inexperienced assessors. Agreement was determined in terms of actual agreement (%) and agreement beyond chance (kappa). Twenty-seven instruments (912 items) were identified. Agreement between the experienced assessors occurred in 86% of items (kappa = 0.70, 95% confidence interval [95% CI] 0.65-0.75) and between the inexperienced assessors in 72% (kappa = 0.40, 95% CI 0.34-0.46). The greatest proportion of participation items in one instrument was 82%. None of the identified instruments consisted entirely of participation items. The concept of participation and its translation into measurement for use in the general population is likely to need further development.

Assessment Center Procedures: Cognitive Load During the Observation Phase

This study explores the traditional procedure of observing assessment center exercises while taking notes vs. an alternative procedure where assessors merely observe and postpone note‐taking until immediately after the exercise. The first procedure is considered to be cognitively demanding due to the requirement of simultaneous note‐taking and observing. Also, dual task processing (concurrent observing and note‐taking) is considered to be especially demanding for assessors without rating experience. The procedures are evaluated using a 2 × 2 design (with note‐taking/without note‐taking × experienced/inexperienced). Some 121 experienced and inexperienced assessors rated videotaped candidates, observing either with or without taking notes. Results showed that experienced assessors yield significantly higher differential accuracy than inexperienced assessors. We did not find an effect of observation procedure on accuracy, interrater reliability or halo. Implications for future research are described.

Subjective components of mildew assessment on spring barley

The severity of mildew on barley is usually assessed visually and this leads to variation between different scorers. Field assessments by four assessors were analysed to determine the nature and degree of subjective discrepancies between assessors. Two inexperienced assessors failed to detect a major effect of nitrogen due to differences in the interpretation of a scoring system. A computer-based training programme was evaluated for standardising assessments, and was found to improve assessors' accuracy. Linear regression analysis was used here to resolve the error variance into components representing the accuracy and precision of the assessors. Plots of the cumulative differences between the estimate of disease severity by each assessor and the best estimate were used to display how the discrepancies varied with the level of disease. Some modifications to the barley field scoring system are suggested to improve comparability between assessors.

Accuracy, repeatability and reproducibility of the anal fold measurement for predicting carcass backfat depth in cattle

Anal fold thickness as measured by inexperienced assessors was poorly related to carcass backfat depth ( r from 0.05 to 0.59) in studies on 296 cattle. Anal fold measurements were not highly repeatable within assessors nor reproducible between assessors. Residual standard deviations for backfat depth estimated from anal fold measurements ranged from 2.2 to 4.2 mm.