Intraclass Correlation Coefficient Range Research Articles

Test-Retest of a Novel Wii Board-Based Device to Assess Eccentric Knee Flexor Strength During the Nordic Hamstring Exercise.

This study aimed to assess the test-retest reliability of a Wii board-based device to assess the eccentric knee strength. Healthy participants (n = 20, 22.7 [3.4]y, 1.71 [0.09]m, 69 [13]kg) performed 2 assessments-days 1 and 2-of the Nordic hamstring exercise (3 trials per day, 3 min of rest between trials, and 48 h between trials) on a padded board with an attached Wii Balance Board (WBB). A ratchet inelastic strap made the contact between the participant's distal aspect of both legs and the inverted upper surface of the WBB. The means among 3 trials were used to extract the absolute strength and the left and the right limb strengths. No between-session differences were found (P range = .691-.981). The intraclass correlation coefficient range showed excellent results (.905-.926), as the Cronbach α test (above .94). The correlation was high (r > .91; .820 < r2 < .862). The Bland-Altman analysis returned high levels of agreement. The standard error of measurement ranged from 5.56 to 11.07N and the minimal detectable change from 15.42 to 30.68N. The percentage of standard error of measurement values were 2.95%, 3.74%, 2.88%, respectively, for absolute strength, right limb strength, and left limb strength. The adapted system showed an excellent cost-benefit relationship with optimal test-retest reliability. The findings suggest that the adapted system, using the WBB, is a reliable method for measuring the eccentric knee strength.

P-269 A validation study for artificial intelligence (AI) compared with manual annotation, using donor eggs reveals that AI accurately predicts blastulation

Abstract Study question Are the annotations produced by AI comparable to manual annotations? Does AI accurately assess fertilisation checks, and predict embryo usage and blastulation compared to embryologists? Summary answer Automatic annotations by AI was consistent with manual annotations. AI implantation algorithms had strong prediction of blastulation and embryo usage. What is known already Currently, embryos are manually annotated for specific morphokinetic features during embryo development. This is a labour-intensive process, and dependent on training and experience, leading to inter and intra clinic variation. The decision to transfer, freeze or discard embryos relies heavily on these annotations. It is paramount that we develop a tool that will provide consistency and accuracy in annotation and produce scores that can facilitate decisions around embryo usage. AI has demonstrated its potential to achieve this, but first must be validated before its integration into clinical practice. There have been no such studies demonstrating this so far. Study design, size, duration Retrospective cohort study, that took place between September to December 2021 at a private fertility clinic in Spain. To control for embryo variability, this study only included 179 time-lapse videos for embryos created from donor eggs. This was based on the understanding that donor eggs are more likely to produce better quality blastocysts and embryos and thus will give the most optimal conditions for annotation in a validation framework. Participants/materials, setting, methods The same time-lapse cultured embryos were annotated manually and automatically by CHLOE(Fairtility, an AI-based tool). Manual and CHLOE annotations were compared to assess the strength of agreement (i) using intra-class correlation (ICC), and (ii) the proportion of corrections required at the pronuclei (PN) stage. AI accuracy in predicting blastulation at 30hours, and blastulation before 116 hours, was also assessed using AUC as the efficacy metric. Embryo usage was compared with the AI-generated ranking of embryos. Main results and the role of chance The majority of morphokinetic variables showed a very-strong agreement, with an ICC range of (0.81-1.00), namely for; tPNf, t2, t3, t5, t7, tSB, tB and tEB. Only t4 (0.5) showed a moderate agreement. On average (Mean+-Standard deviation), AI annotated t4 later than embryologists (36+-5vs39+-10 (hours)). All other variables fell within a strong ICC of (0.61-0.8). There were no very weak (0-0.2) or weak (0.21-0.4) variables. PN agreement between AI and embryologists was 93%: PN’s had to be corrected by an embryologist only 7%(n = 179) of the time. AI predicted blastulation on day 3 with a high level of sensitivity 0.77 and specificity 0.82, (AUC: 0.84,p&amp;lt;0.0001). Furthermore, the blastulation score given on day 3 was a predictor of blastulation before 116 hours with a high sensitivity 0.77 and specificity 0.80, (AUC: 0.81,p&amp;lt;0.0001). Similarly, AI-generated ranking accurately correlated with embryologist decisions to freeze, transfer or discard embryos, with an overall high sensitivity 0.88 and specificity 0.67, (AUC: 0.84,p&amp;lt;0.0001). A rank of 1 was seen in 14%(n = 113) of embryos, all of which were frozen or transferred. Some embryos that scored a rank of 2 were discarded, but this was significantly lower than those that scored a rank of 3 or more (3%vs32%,p=0.0004). Limitations, reasons for caution This study only included embryos from donor eggs. Furthermore, this study occurred at a single site and is planned to be replicated at several clinics. Where there are discrepancies between human and AI, further studies are required to determine the ground truth. Wider implications of the findings This study demonstrates an AI framework to safely introduce AI in the fertility clinic. AI will accurately annotate embryos and give reliable scores to predict good quality blastulation, and inform decisions around embryo usage determination. AI provides a time-effective, objective tool in decision-making, with the potential to optimise success. Trial registration number not applicable

Accuracy Assessment of Percutaneous Pedicle Screw Placement Using Cone Beam Computed Tomography with Metal Artifact Reduction.

Metal artifact reduction (MAR) algorithms are used with cone beam computed tomography (CBCT) during augmented reality surgical navigation for minimally invasive pedicle screw instrumentation. The aim of this study was to assess intra- and inter-observer reliability of pedicle screw placement and to compare the perception of baseline image quality (NoMAR) with optimized image quality (MAR). CBCT images of 24 patients operated on for degenerative spondylolisthesis using minimally invasive lumbar fusion were analyzed retrospectively. Images were treated using NoMAR and MAR by an engineer, thus creating 48 randomized files, which were then independently analyzed by 3 spine surgeons and 3 radiologists. The Gertzbein and Robins classification was used for screw accuracy rating, and an image quality scale rated the clarity of pedicle screw and bony landmark depiction. Intra-class correlation coefficients (ICC) were calculated. NoMAR and MAR led to similarly good intra-observer (ICC > 0.6) and excellent inter-observer (ICC > 0.8) assessment reliability of pedicle screw placement accuracy. The image quality scale showed more variability in individual image perception between spine surgeons and radiologists (ICC range 0.51–0.91). This study indicates that intraoperative screw positioning can be reliably assessed on CBCT for augmented reality surgical navigation when using optimized image quality. Subjective image quality was rated slightly superior for MAR compared to NoMAR.

Validation of Artificial Intelligence Cardiac MRI Measurements: Relationship to Heart Catheterization and Mortality Prediction.

Background Cardiac MRI measurements have diagnostic and prognostic value in the evaluation of cardiopulmonary disease. Artificial intelligence approaches to automate cardiac MRI segmentation are emerging but require clinical testing. Purpose To develop and evaluate a deep learning tool for quantitative evaluation of cardiac MRI functional studies and assess its use for prognosis in patients suspected of having pulmonary hypertension. Materials and Methods A retrospective multicenter and multivendor data set was used to develop a deep learning-based cardiac MRI contouring model using a cohort of patients suspected of having cardiopulmonary disease from multiple pathologic causes. Correlation with same-day right heart catheterization (RHC) and scan-rescan repeatability was assessed in prospectively recruited participants. Prognostic impact was assessed using Cox proportional hazard regression analysis of 3487 patients from the ASPIRE (Assessing the Severity of Pulmonary Hypertension In a Pulmonary Hypertension Referral Centre) registry, including a subset of 920 patients with pulmonary arterial hypertension. The generalizability of the automatic assessment was evaluated in 40 multivendor studies from 32 centers. Results The training data set included 539 patients (mean age, 54 years ± 20 [SD]; 315 women). Automatic cardiac MRI measurements were better correlated with RHC parameters than were manual measurements, including left ventricular stroke volume (r = 0.72 vs 0.68; P = .03). Interstudy repeatability of cardiac MRI measurements was high for all automatic measurements (intraclass correlation coefficient range, 0.79-0.99) and similarly repeatable to manual measurements (all paired t test P > .05). Automated right ventricle and left ventricle cardiac MRI measurements were associated with mortality in patients suspected of having pulmonary hypertension. Conclusion An automatic cardiac MRI measurement approach was developed and tested in a large cohort of patients, including a broad spectrum of right ventricular and left ventricular conditions, with internal and external testing. Fully automatic cardiac MRI assessment correlated strongly with invasive hemodynamics, had prognostic value, were highly repeatable, and showed excellent generalizability. Clinical trial registration no. NCT03841344 Published under a CC BY 4.0 license. Online supplemental material is available for this article. See also the editorial by Ambale-Venkatesh and Lima in this issue. An earlier incorrect version appeared online. This article was corrected on June 27, 2022.

Test-retest reliability of a new assessment to detect detailed temporal patterns of polysubstance use.

ObjectiveWhile polysubstance use is highly prevalent among people who use drugs, the field lacks a reliable assessment that can detect detailed temporal patterns of polysubstance use. This study assessed the test‐retest reliability of the newly developed Polysubstance Use–Temporal Patterns Section (PSU‐TPS).MethodsParticipants who used cocaine plus alcohol and/or marijuana at least once in the past 30 days (n = 48) were interviewed at baseline and approximately 7 days later (retest) using the Substance Abuse Module and the PSU‐TPS. Reliability of PSU‐TPS measures of quantity, frequency, and duration of polysubstance use was examined using intra‐class correlation coefficients (ICCs) and kappa tests.ResultsExcellent reliability was observed for frequencies of concurrent polysubstance use patterns in the past 30 days (ICC range: 0.90–0.94) and quantity of alcohol use (ICC = 0.83), and fair to good reliability was observed for duration of substance use (ICC range: 0.52–0.73).ConclusionDetailed information regarding cocaine, alcohol, and marijuana polysubstance use in the past 30 days can be reliably measured with the PSU‐TPS. Data on the order and timing of polysubstance use at the hourly level will improve our understanding of the implications of sequential and simultaneous use patterns, which can help inform treatment and prevention efforts.

Development of the opioid self-management scale for advanced Cancer patients with pain and examination of its validity and reliability

BackgroundApproximately 60% of outpatients with advanced cancer experience pain; therefore, self-management of opioid use is important for appropriate pain relief. To date, no studies have clearly described the concept of opioid self-management or assessed the factors involved, including the improvement of self-management abilities. This study developed, and evaluated the validity and reliability of an opioid self-management scale for advanced cancer patients with pain (OSSA). Opioid self-management in advanced cancer patients with pain was defined as the management of opioid medication performed by patients with advanced cancer to relieve cancer pain on their own.MethodsThree phases were required for validation and reliability of the OSSA: 1) testing content validity, 2) testing face validity, and 3) testing construct validity, concurrent validity and reliability.ResultsAfter a three-phase process, the OSSA consisted of 33 items on six subscales. The structural equation modeling was such that the χ2 value was 709.8 (p < 0.001, df = 467), goodness-of-fit index was 0.78, adjusted goodness-of-fit index was 0.73, root mean squares of approximation was 0.063, and comparative fit index was 0.92. The Pearson correlation coefficients between the total OSSA score and the 24-hour average pain or pain relief over 24 hours were − 0.21 (p < 0.05) and 0.26 (p < 0.01), respectively. Cronbach’s α was 0.93. The intraclass correlation coefficient range was 0.59–0.90.ConclusionThe findings of this study show that the OSSA has acceptable validity and reliability, and that better self-management leads to greater pain relief. The OSSA can be considered effective for use in research, but shortened version should be prepared for realistic and practical clinical use.

MP10-17 DEVELOPMENT AND VALIDATION OF THE END-TO-END ASSESSMENT OF SUTURING EXPERTISE (EASE)

MP10-17 DEVELOPMENT AND VALIDATION OF THE END-TO-END ASSESSMENT OF SUTURING EXPERTISE (EASE)

Real-time imaging of respiratory effects on cerebrospinal fluid flow insmall diameter passageways.

PurposeRespiration‐related CSF flow through the cerebral aqueduct may be useful for elucidating physiology and pathophysiology of the glymphatic system, which has been proposed as a mechanism of brain waste clearance. Therefore, we aimed to (1) develop a real‐time (CSF) flow imaging method with high spatial and sufficient temporal resolution to capture respiratory effects, (2) validate the method in a phantom setup and numerical simulations, and (3) apply the method in vivo and quantify its repeatability and correlation with different respiratory conditions.MethodsA golden‐angle radial flow sequence (reconstructed temporal resolution 168 ms, spatial resolution 0.6 mm) was implemented on a 7T MRI scanner and reconstructed using compressed sensing. A phantom setup mimicked simultaneous cardiac and respiratory flow oscillations. The effect of temporal resolution and vessel diameter was investigated numerically. Healthy volunteers (n = 10) were scanned at four different respiratory conditions, including repeat scans.ResultsPhantom data show that the developed sequence accurately quantifies respiratory oscillations (ratio real‐time/reference Q R = 0.96 ± 0.02), but underestimates the rapid cardiac oscillations (ratio Q C = 0.46 ± 0.14). Simulations suggest that Q C can be improved by increasing temporal resolution. In vivo repeatability was moderate to very strong for cranial and caudal flow (intraclass correlation coefficient range: 0.55–0.99) and weak to strong for net flow (intraclass correlation coefficient range: 0.48–0.90). Net flow was influenced by respiratory condition (p < 0.01).ConclusionsThe presented real‐time flow MRI method can quantify respiratory‐related variations of CSF flow in the cerebral aqueduct, but it underestimates rapid cardiac oscillations. In vivo, the method showed good repeatability and a relationship between flow and respiration.

Validation of the French Clinical Assessment Interview for Negative Symptoms in a Sample of Stable French Individuals With Schizophrenia.

ObjectivesThe Clinical Assessment Interview for Negative Symptoms (CAINS) is an interview-based instrument evaluating the existence and severity of negative symptoms in people diagnosed with schizophrenia or schizoaffective disorder. The aim of this study is to translate and validate a French version of the CAINS in a French sample of outpatients diagnosed with schizophrenia or schizoaffective disorder.MethodsIn this study, we included 84 outpatients with a diagnosis of schizophrenia from the University Department of Adult Psychiatry in Montpellier, France. All participants were assessed for the severity of negative symptoms as well as level of depression. Psychometric properties of the French CAINS were investigated including its factor structure, internal consistency, and interrater and test–retest reliabilities. We also determined the discriminant and convergent validity.ResultsExploratory factor analysis and parallel analysis reproduced the two-factor model, and explained 43.55% of the total score variation with good internal consistency (Cronbach α of 0.87). Both interrater and test–retest reliabilities were high for the CAINS and its subscales (intraclass correlation coefficient range, 0.89–0.99). The standard errors of measurement and minimal detectable change were also investigated. Convergent validity of the CAINS was underpinned by correlations obtained with various measures of negative symptoms. Adequate discriminant validity was established by showing that the CAINS did not correlate with positive symptoms.ConclusionOverall, our results obtained were similar to those found in the original study of the CAINS. Structural analyses also replicated the two-factor model of the CAINS. Our results indicate that the French CAINS has robust psychometric properties and is a valid tool for evaluating negative symptoms in French-speaking individuals diagnosed with schizophrenia.

Time to achieve steady state for an accurate assessment of resting energy expenditure in adolescents with healthy weight and obesity: A cross-sectional study.

The present study investigated the time needed to achieve a steady state for an accurate assessment of resting energy expenditure (REE) in adolescents with healthy weight and obesity. Thirty adolescents aged 12-17 years were assigned to a group with healthy weight (GHW; n = 12, body mass index [BMI] 22.5 ± 3.6 kg/m2) and another group with obesity (GO; n = 18, BMI 34.1 ± 5.2 kg/m2). Participants underwent test-retest reliability of REE assessment as follows: a) 24 h of abstention from physical exercise, soft drinks, or caffeine; b) fasting for ~12 h; c) acclimation period of 10 min; d) 30-min assessment in a supine position. A significant change occurred during the 30 min in REE. Significant differences existed between consecutive means until the 20th and 25th min for the GHW and GO, respectively. Although significant differences between trials 1 and 2 were detected during the first 5-10 min of assessment, the REE for each 5-min time point exhibited high test-retest reliability across trials in both groups (intraclass correlation coefficients range 0.79-0.99). The following recommendations are provided to promote accurate assessment of REE among adolescents: a) initiate the REE assessment with 10 min of acclimation to decrease restlessness; b) determine REE for a minimum of 20 min if healthy weight and 25 min if obesity; c) determine REE for a further 5 min, with the average of this last 5 min of REE data being regarded as the REE.

Paraspinal Muscle in Chronic Low Back Pain: Comparison Between Standard Parameters and Chemical Shift Encoding-Based Water-Fat MRI.

Paraspinal musculature (PSM) is increasingly recognized as a contributor to low back pain (LBP), but with conventional MRI sequences, assessment is limited. Chemical shift encoding-based water-fat MRI (CSE-MRI) enables the measurement of PSM fat fraction (FF), which may assist investigations of chronic LBP. To investigate associations between PSM parameters from conventional MRI and CSE-MRI and between PSM parameters and pain. Prospective, cross-sectional. Eighty-four adults with chronic LBP (44.6± 13.4 years; 48 males). 3-T, T1-weighted fast spin-echo and iterative decomposition of water and fat with echo asymmetry and least squares estimation sequences. T1-weighted images for Goutallier classification (GC), muscle volume, lumbar indentation value, and muscle-fat index, CSE-MRI for FF extraction (L1/2-L5/S1). Pain was self-reported using a visual analogue scale (VAS). Intra- and/or interreader agreement was assessed for MRI-derived parameters. Mixed-effects and linear regression models to 1) assess relationships between PSM parameters (entire cohort and subgroup with GC grades 0 and 1; statistical significance α= 0.0025) and 2) evaluate associations of PSM parameters with pain (α= 0.05). Intraclass correlation coefficients (ICCs) for intra- and/or interreader agreement. The FF showed excellent intra- and interreader agreement (ICC range: 0.97-0.99) and was significantly associated with GC at all spinal levels. Subgroup analysis suggested that early/subtle changes in PSM are detectable with FF but not with GC, given the absence of significant associations between FF and GC (P-value range: 0.036 at L5/S1 to 0.784 at L2/L3). Averaged over all spinal levels, FF and GC were significantly associated with VAS scores. In the absence of FF, GC may be the best surrogate for PSM quality. Given the ability of CSE-MRI to detect muscle alterations at early stages of PSM degeneration, this technique may have potential for further investigations of the role of PSM in chronic LBP. 2 TECHNICAL EFFICACY STAGE: 2.

Comparison of surface- and voxel-based registration on the mandibular ramus for long-term three-dimensional assessment of condylar remodelling following orthognathic surgery.

The purpose of the present study was to validate and compare the accuracy and reliability of surface- and voxel-based registration on the mandibular rami for long-term three-dimensional (3D) evaluation of condylar remodelling following Orthognathic Surgery. The mandible was 3D reconstructed from a pair of superimposed pre- and postoperative (two years) cone-beam computerized tomography scans and divided into the condyle, and 21 ramal regions. The accuracy of surface- and voxel-based registration was measured by the absolute mean surface distance of each region after alignment of the pre- and postoperative rami. To evaluate the reliability, mean absolute differences and intraclass correlation coefficients (ICC) were calculated at a 95% confidence interval on volumetric and surface distance measurements of two observers. Paired t-tests were applied to statistically evaluate whether the accuracy and reliability of surface- and voxel-based registration were significantly different (p < 0.05). A total of twenty subjects (sixteen female; four male; mean age 27.6 years) with class II malocclusion and maxillomandibular retrognathia, who underwent bimaxillary surgery, were included. Surface-based registration was more accurate and reliable than voxel-based registration on the mandibular ramus two years post-surgery (p < 0.05). The interobserver reliability of using surface-based registration was excellent, ICC range [0.82-1.00]. For voxel-based registration, the interobserver reliability ranged from poor to excellent [0.00-0.98]. The measurement error introduced by applying surface-based registration for assessment of condylar remodelling was considered clinical irrelevant (1.83% and 0.18 mm), while the measurement error introduced by voxel-based registration was considered clinical relevant (5.44% and 0.52 mm). Surface-based registration was proven more accurate and reliable compared to voxel-based registration on the mandibular ramus for long-term 3D assessment of condylar remodelling following Orthognathic Surgery. However, importantly, the performance difference may be caused by an inappropriate reference structure, proposed in the literature, and applied in this study.

Interrater and Intrarater Reliability of the EasyForce Dynamometer for Assessment of Maximal Shoulder, Knee and Hip Strength.

This study aimed to determine the interrater and intrarater reliability of EasyForce dynamometer for assessing shoulder, knee, and hip muscle strength in healthy young adults. Shoulder, knee, and hip maximal isometric strength were measured using the EasyForce in healthy adults (11 women and 12 men). Three repetitions of shoulder internal rotation, abduction, knee flexion, extension, and hip abduction and adduction were performed. The tests were performed by three raters on the same day. The results showed good to high inter- and intrarater reliability (intraclass correlation coefficient range: 0.63–0.91). Moreover, the absolute reliability of the EasyForce was slightly higher than acceptable for all tests (CV > 10%) except for hip abduction on the right leg (CV = 7.2%). The EasyForce dynamometer can be considered a reliable tool for assessing shoulder internal rotation and abduction, knee extension and flexion, as well as hip abduction and adduction strength. The EasyForce dynamometer showed no differences between the raters’ measurements, which could be of great importance for professionals who want to perform the tests regardless of their strength on the values.

Feasibility and reliability of the Functional Movement Screen battery in adults with intellectual disability.

BackgroundThe feasibility and reliability of the Functional Movement Screen (FMS) battery for predicting injury risk have been widely studied in athletic, military, public service and healthy populations. However, scant research has been carried out in people with disabilities. This study aimed at identifying the feasibility and reliability of the FMS battery when administered to adults with intellectual disability (ID).MethodsAdults from a residential and day care centre over 18 years of age, diagnosed with ID and able to follow simple instructions, were included in the study. All participants with behavioural or health problems that prevented the completion of the FMS battery were excluded. All exercises were video recorded to assure proper scoring. Three assessors (one trained and two novices) scored each of the FMS subtests performed separately from the videos. Feasibility was based on completion rates. Reliability of the composite test scores was analysed using intraclass correlation coefficients (ICCs).ResultsA total of 30 people with ID (mean age: 35.5 ± 7.12 years; 33.3% women) completed all assessments. The battery showed to be feasible, although difficulties when performing two of the subtests were observed among those with moderate and severe ID. Mean total scores from the three assessors ranged from 7.83 to 8.90. An inverse trend was observed indicating that the higher the ID level, the lower the total FMS score. Test–retest reliability was good for the trained assessor (ICC = 0.89) and mostly moderate for both novice assessors (ICC range: 0.60 to 0.76). Moderate to good inter‐rater reliability was observed (ICC range: 0.65 to 0.80).ConclusionThe FMS battery is a reliable tool that can be performed by people with ID, albeit with certain difficulties, especially in those with moderate to severe impairment. The battery does not seem to be useful for identifying people with ID at risk of suffering a sport injury. Adequately powered, well‐designed studies are required to determine if the FMS battery is appropriate for identifying changes in functional performance in this population.

Reliability of Center of Pressure measures of Postural Stability in Anterior Cruciate Ligament Reconstructed Athletes: Effect of Vibration and Cognitive Load.

To evaluate intra and intersession reliability of the Center of Pressure (COP) parameters in Anterior Cruciate Ligament Reconstructed (ACLR) athletes with and without ankle vibration using a dual-task paradigm. Postural sway of 14 ACLR individuals was assessed during a single-leg stance on a force platform. COP parameters were assessed with manipulating sensory inputs via vision and ankle vibration under single and dual-task conditions. The outcome variables included COP displacement in medial-lateral (ML) and anterior-posterior (AP) range, mean velocity (mV), and area. During dual-task conditions, the auditory Stroop Task was applied. Intraclass correlation coefficient (ICC) values and standard error of measurement (SEM) were assessed for relative and absolute reliability. The COP measures had moderate to very high intrasession reliability (ICC range: 0.51-0.93) for conditions with vibration and cognitive task, with the highest ICCs for mV and the lowest for area, regardless of eyes being open or closed. The intersession reliability was moderate to high for mV (ICC range: 0.60-0.82) and little to very high (ICC range: 0.21-0.97) for the range of ML and AP, as well as an area in conditions with vibration and cognitive task. The mV is the most reliable COP parameter for assessing postural control under ankle vibration and dual-task conditions for both operated and non-operated sides. During closed-eye conditions, the application of vibration affected the intersession reliability with decreased ICCs on the operated side and increased ICCs on the non-operated side.

Test-retest reliability of regression dynamic causal modeling.

Regression dynamic causal modeling (rDCM) is a novel and computationally highly efficient method for inferring effective connectivity at the whole-brain level. While face and construct validity of rDCM have already been demonstrated, here we assessed its test-retest reliability—a test-theoretical property of particular importance for clinical applications—together with group-level consistency of connection-specific estimates and consistency of whole-brain connectivity patterns over sessions. Using the Human Connectome Project dataset for eight different paradigms (tasks and rest) and two different parcellation schemes, we found that rDCM provided highly consistent connectivity estimates at the group level across sessions. Second, while test-retest reliability was limited when averaging over all connections (range of mean intraclass correlation coefficient 0.24–0.42 over tasks), reliability increased with connection strength, with stronger connections showing good to excellent test-retest reliability. Third, whole-brain connectivity patterns by rDCM allowed for identifying individual participants with high (and in some cases perfect) accuracy. Comparing the test-retest reliability of rDCM connectivity estimates with measures of functional connectivity, rDCM performed favorably—particularly when focusing on strong connections. Generally, for all methods and metrics, task-based connectivity estimates showed greater reliability than those from the resting state. Our results underscore the potential of rDCM for human connectomics and clinical applications.

Comprehensive evaluation of left ventricular deformation using speckle tracking echocardiography in normal children: comparison of three-dimensional and two-dimensional approaches

BackgroundThree-dimensional (3D) speckle tracking echocardiography (STE) can overcome some of the inherent limitations of two-dimensional (2D) STE; however, clinical experience is lacking. We aimed to assess and compare the feasibility, agreement, and reproducibility of left ventricular (LV) global longitudinal (GLS), and regional strain by 3D vs 2D STE in normal children.MethodsHealthy pediatric subjects (n = 105, age mean = 11.2 ± 5.5 years) were prospectively enrolled. Three-dimensional and 2D LV GLS, as well as regional strain in 16 myocardial segments were quantified. Bland Altman analysis, intra- class correlation coefficients (ICC), percent error and linear regression were used for agreement and correlation between the two techniques. Analysis and acquisition times were compared. Inter- and intra-observer reproducibility was assessed in 20 studies.ResultsThere was good to excellent agreement for 2D and 3D global longitudinal strain (ICC =0.82) and modest agreement for regional strain (ICC range 0.43–0.71). Both methods had high feasibility (88.6% for 2D vs 85.7% for 3D, p = 0.21), although 3D STE required significantly shorter acquisition and analysis time than 2D STE (acquisition time 1 ± 1.2 mins vs 2.4 ± 1 mins; p = 0.03, analysis time = 3.3 ± 1 mins vs 8.2 ± 2.5 mins; p = 0.001, respectively). Inter and intra-observer reproducibility was excellent for GLS by the two techniques (ICC = 0.78–0.93) but moderate to poor for regional strain (ICC = 0.21–0.64).ConclusionThree-dimensional global LV strain is as feasible and reproducible as 2D strain, with good agreement yet significantly more efficient acquisition and analysis. Regional strain is less concordant and 2D and 3D values should not be used interchangeably. 3D LV GLS may represent a viable alternative in evaluation of LV deformation in pediatric subjects.

Reliability of preoperative MRI findings in patients with lumbar spinal stenosis

BackgroundMagnetic Resonance Imaging (MRI) is an important tool in preoperative evaluation of patients with lumbar spinal stenosis (LSS). Reported reliability of various MRI findings in LSS varies from fair to excellent. There are inconsistencies in the evaluated parameters and the methodology of the studies. The purpose of this study was to evaluate the reliability of the preoperative MRI findings in patients with LSS between musculoskeletal radiologists and orthopaedic spine surgeons, using established evaluation methods and imaging data from a prospective trial.MethodsConsecutive lumbar MRI examinations of candidates for surgical treatment of LSS from the Norwegian Spinal Stenosis and Degenerative Spondylolisthesis (NORDSTEN) study were independently evaluated by two musculoskeletal radiologists and two orthopaedic spine surgeons. The observers had a range of experience between six and 13 years and rated five categorical parameters (foraminal and central canal stenosis, facet joint osteoarthritis, redundant nerve roots and intraspinal synovial cysts) and one continuous parameter (dural sac cross-sectional area). All parameters were re-rated after 6 weeks by all the observers. Inter- and intraobserver agreement was assessed by Gwet’s agreement coefficient (AC1) for categorical parameters and Intraclass Correlation Coefficient (ICC) for the dural sac cross-sectional area.ResultsMRI examinations of 102 patients (mean age 66 ± 8 years, 53 men) were evaluated. The overall interobserver agreement was substantial or almost perfect for all categorical parameters (AC1 range 0.67 to 0.98), except for facet joint osteoarthritis, where the agreement was moderate (AC1 0.39). For the dural sac cross-sectional area, the overall interobserver agreement was good or excellent (ICC range 0.86 to 0.96). The intraobserver agreement was substantial or almost perfect/ excellent for all parameters (AC1 range 0.63 to 1.0 and ICC range 0.93 to 1.0).ConclusionsThere is high inter- and intraobserver agreement between radiologists and spine surgeons for preoperative MRI findings of LSS. However, the interobserver agreement is not optimal for evaluation of facet joint osteoarthritis.Trial registrationwww.ClinicalTrials.gov identifier: NCT02007083, registered December 2013.

Translation and Validation of the Dental Impact Daily Living Oral Health-related Quality of Life Questionnaire in Indonesia.

ABSTRACTObjective:The need to assess oral health-related quality of life (OHRQoL) has grown increasingly in the healthcare sector over the past few decades. The Dental Impact on Daily Living (DIDL) assessment is a tool created to measure OHRQoL. The aim of this study was to complete a cross-cultural adaptation of the DIDL to yield a valid and reliable Indonesian version for use as an official instrument to assist in further OHRQoL research in Indonesia.Materials and Methods:The original English version of the DIDL was translated and validated. Content validity and face validity were considered. Psychometric testing for test–retest reliability was analyzed among 32 subjects, while internal consistency using Cronbach’s alpha and clinical oral health status using the DMF-T index to obtain convergent validity of the questionnaire were checked among 278 subjects.Results:The study subjects showed a good understanding of how to complete the Indonesian language version of the DIDL questionnaire, and conceptual and semantic equivalence (content and face validity) were noted. Further, test–retest reliability was noted (intraclass correlation coefficient range: 0.975–1 and Cronbach’s alpha: 0.942), whereas convergent validity suggested a correlation between DMF-T and DIDL questionnaire of −0.502 with significance at alpha of 5% (P = 0.00), which means that decreasing the DMF-T outcome will increase the satisfaction using the DIDL among research subjects.Conclusion:Cross-cultural adaptation of the DIDL yielded a valid and reliable Indonesian version. The DIDL questionnaire is a promising questionnaire that can be applied to measure OHRQoL in Indonesians.

The reliability of a smartphone application in measuring the foot structure of cyclists during sitting and standing

Previous studies have focussed on the relation between foot structure and function, revealing that 3D scanning is the measurement tool with higher precision and accuracy. However, to date only non-studies have investigated the test–retest reliability and potential of a smartphone 3D application for measuring foot morphology. The purpose of the present study was to assess the intra-rater reliability of the Avatar3D application in analysing the foot structure of cyclists. Thirty-five female road cyclists assessed her own foot through the Avatar3D application on two occasions separated by 10 minutes. Instep girth, foot length, ball girth, and ball width were registered in sitting and standing positions during the test and retest. The reliability of the measurements was evaluated using intraclass correlation coefficient (ICC), coefficient of variation (CV’s) and Bland–Altman plots. All dependent variables showed ICC range values from moderate to very high with low CV’s (<6%), evidencing no significant changes in any variable. This thesis was reinforced by Bland–Altman plots and one sample t-tests (p > 0.05). The Avatar3D application is a reliable and easy-to-use tool for assessing the foot structure in female cyclists in sitting and standing positions.