Percent Agreement Research Articles

Performance of a 52-gene NGS panel combined with shallow WGS for accurate HRD analysis.

e17570 Background: Homologous recombination deficiency (HRD) is a pivotal biomarker for predicting response to PARP inhibitors in multiple cancers. This study evaluates the analytical performance of a 53-gene somatic NGS panel combined with low-pass whole genome sequencing (shallow WGS, sWGS) for HRD assessment. Methods: In the present study, 36 FFPE tissues from ovarian cancer patients were analyzed for 52 genes implicated in DNA repair pathways, along with sWGS for the evaluation of tumor genomic instability (GI). Libraries were generated with the KAPA HyperPlus Kit (Roche) and sequenced in duplicate using the Avity sequencing instrument (Element Bioscience) and the DNBSEQ-G400 NGS platform, subsequent to conversion for compatibility with MGI chemistry. HRD positivity was defined as either the presence of pathogenic BRCA1/2 mutations or high GI. Data analysis was performed using the SeqOne platform. The performance of the sWGS assay in detecting GI was initially assessed using the OncoScan CNV assay for 15 samples, as well as 4 reference materials with known HRD status. The efficacy of sWGS was also evaluated by comparing its agreement with the GI scores obtained from the validated HRD test (Myriad MyChoice) in 21 samples. Results: A 93% agreement was observed between the sWGS assay and OncoScan, demonstrating strong concordance. Additionally, the assay accurately evaluated the HRD status in all 4 reference samples with known values. The results obtained were highly similar between the two sequencing platforms. In addition, shallow NGS achieved >95% overall percentage agreement (OPA) with the validated HRD test for genomic instability score (Table 1). 5 of the 6 samples with discordant GI findings between Myriad and OncoScan aligned with the Myriad results when analyzed with sWGS. This implies that sWGS has the potential to resolve the discrepancies that were observed with OncoScan, thereby indicating its reliability as a robust alternative for HRD analysis. Conclusions: The assay demonstrated robust performance in detecting HRD-associated genomic signatures, supporting its applicability in clinical use. The reliability of the NGS assay for clinical use is guaranteed by its high concordance (95%) with the validated test, which entails the incorporation of shallow WGS for HRD analysis. Concordance between Myriad MyChoice and shallow WGS. Validated HRD Test HRD + HRD - PPV NPV OPA r Shallow WGS HRD HRD + 13 0 100% 88% 95.24% 0.9014 HRD - 1 7 p< .00001

Comparison of quantitative Krenning Scores with visual assessment in 99m Tc-EDDA/HYNIC-TOC SPECT-CT.

The aim of this study is to assess inter-observer variability of the Krenning Score for 99m Tc-EDDA/HYNIC-TOC single photon emission computed tomography (SPECT)-computed tomography (CT) images and compare against quantitative metrics obtained from tumour and physiological uptake measurements. Thirty-two patients with 117 lesions visible on 99m Tc-EDDA/HYNIC-TOC SPECT-CT were scored by two expert observers using the Krenning Score. Five observers with less extensive experience also scored the lesions on visual assessment. Inter-observer agreement and comparison to the expert consensus was tested. Three observers made quantitative measurements of the lesions and physiological uptake, with intra-observer and inter-observer variation investigated. Assessment of agreement between quantitative metrics and the expert visual consensus was also made. Inter-observer agreement for visual assessment was 44.3% for proportions of agreement and 0.576 for Fleiss' Kappa, whilst for the best-performing quantitative metric the inter-observer Fleiss' Kappa was equal to 1. The agreement with expert consensus for the best-performing visual observer was 89.8% for percentage of agreement and 0.914 for Cohen's Kappa, similar to the best-performing quantitative metric (a derived quantitative Krenning Score) at 86.4% and κ = 0.877. Standardised uptake value maximum (SUV max ) also showed similar levels of agreement at 85.1% and κ = 0.871. A derived quantitative Krenning Score, or alternatively SUV max , can provide similar levels of agreement with an expert consensus Krenning Score as visual assessment, with reduced inter-observer variability. Quantification can deliver greater consistency in scoring of 99m Tc-EDDA/HYNIC-TOC images over visual assessment, an important factor when imaging is used to determine patient eligibility for peptide receptor radiotherapy.

Large Language Model and Traditional Machine Learning Scoring of Evolutionary Explanations: Benefits and Drawbacks

Few studies have compared Large Language Models (LLMs) to traditional Machine Learning (ML)-based automated scoring methods in terms of accuracy, ethics, and economics. Using a corpus of 1000 expert-scored and interview-validated scientific explanations derived from the ACORNS instrument, this study employed three LLMs and the ML-based scoring engine, EvoGrader. We measured scoring reliability (percentage agreement, kappa, precision, recall, F1), processing time, and explored contextual factors like ethics and cost. Results showed that with very basic prompt engineering, ChatGPT-4o achieved the highest performance across LLMs. Proprietary LLMs outperformed open-weight LLMs for most concepts. GPT-4o achieved robust but less accurate scoring than EvoGrader (~500 additional scoring errors). Ethical concerns over data ownership, reliability, and replicability over time were LLM limitations. EvoGrader offered superior accuracy, reliability, and replicability, but required, in its development a large, high-quality, human-scored corpus, domain expertise, and restricted assessment items. These findings highlight the diversity of considerations that should be used when considering LLM and ML scoring in science education. Despite impressive LLM advances, ML approaches may remain valuable in some contexts, particularly those prioritizing precision, reliability, replicability, privacy, and controlled implementation.

Accuracy of self-screening tools for contraindicated use of oral contraceptives: A systematic review

Introduction: Progesterone-only pills have been approved for over-the-counter sale in the United States. The American College of Obstetrics and Gynecology has long supported access to and advises the use of a self-screening tool to identify contraindications if combined oral contraceptives are to be sold without prescription. Objective: To evaluate whether self-screening tools used by women seeking oral contraceptives are sufficiently accurate to replace in-person screening performed by healthcare professionals to detect relevant contraindications. Methods: A systematic literature search was conducted using PubMed, Embase, Web of Science, and Scopus on April 16, 2024. Eligible studies were original studies that compared a self-screening tool with in-person screening performed by a healthcare professional. The target condition was defined as the presence of one or more category 3 or 4 contraindications to combined oral contraceptive use according to the World Health Organization's Medical Eligibility Criteria for contraceptive use. The risk of bias was assessed using a modified version of the Newcastle-Ottawa Scale adapted for cross-sectional studies. Due to the heterogeneity in the study populations and tool format, a narrative synthesis was conducted. Results: Of the 1353 unique records screened, five cross-sectional studies were included, comprising a total of 4,043 participants. The highest sensitivity of a self-screening tool was 83.2% (95% CI, 79.5-85.3) and lowest was 58.8% (95% CI, 51.0-66.3). Two studies presented agreement percentages between self-screening and healthcare professionals for individual contraindications, with all items above 83.6%. A meta-analysis could not be conducted because of the heterogeneity. The overall quality of the included studies was moderate. Conclusion: Limited but consistent evidence suggests that self-screening tools indicate contraindications to combined oral contraceptive use with moderate to high sensitivity and negative predictive value. These tools may be suitable for triage in situ considering over-the-counter access to combined oral contraceptives, and further validation is warranted.

Observational Study of Corticosteroid Phobia Using the TOPICOP Score among Adults and Caregivers of Children with Atopic Dermatitis in Japan.

Topical corticosteroid (TCS) phobia, which tends to interfere with the continuation of TCS treatment for atopic dermatitis (AD), has not been elucidated in Japan using the topical corticosteroid phobia (TOPICOP) scale. We aimed to clarify TCS phobia among patients with AD in Japan and evaluate its relationship with AD conditions. This observational study, using the database of health receipt (between October 2021 and October 2022) and online questionnaire (conducted in October 2022) data, included adult respondents with and without AD and caregivers who responded to the questionnaire about their children aged ≤ 18years, with and without AD. The TOPICOP scores measuring TCS phobia were summarized and compared according to AD severity, consultation with a doctor, and presence of AD using an analysis of covariance (ANCOVA) model (covariates: sex and age). In this study, 1507 adults with AD and 525 caregivers of children with AD were included. Among adults with AD, the mean TOPICOP score (± standard deviation) was 42.5 ± 18.9, while it was 41.7 ± 18.6 among caregivers of children with AD. Of the three TOPICOP domains (knowledge and beliefs, fears, and behaviors), the fear domain questions showed the highest percentage of agreement in both adults and caregivers of children with AD. In the ANCOVA models, the scores did not differ significantly according to AD severity, consultation with a doctor, or the presence of AD in adults and caregivers but significantly differed by sex and age (both p < 0.001) in adults. We obtained the latest TOPICOP scores that were independent of AD conditions in Japan. Most adults and caregivers of children with AD had TCS phobia, regardless of the AD conditions. Periodic education may be required for a wide range of patients and caregivers to ease TCS phobia and enable them to continue appropriate AD treatment.

Evaluation of Reporting Methods for Assessment and Surgical Planning of Perianal Fistulas.

Perianal fistula is a complex condition where surgeons conduct surgeries based on the mentally mapped images they created from the information found in the radiology report. If not properly treated, a fistula could reoccur. To reduce the chances of reoccurrence, a patient-specific, visual, and accurate depiction of the internal tracts in relation to the pelvic floor is required. A three-dimensional (3D) parametric model generation software was previously developed and evaluated successfully with radiologists. In this paper, the software output is evaluated with two colorectal surgeons for 10 fistula cases. The paper compares three reportingdifferent modes: (1) 3D models only, (2) conventional radiology report and picture archiving and communication system (PACS) magnetic resonance (MR) images, and (3) 3D models + standardized radiology report. The percentage of agreement between surgeons across cases and cognitive load are the primary metrics used for evaluation. Mode 3 superseded both modes 1 and 2, meaning that surgeons prefer to see a 3D model along with a standardized report to plan a case's surgical intervention. Mode 1 superseded mode 2, which also shows surgeons preference to inspect a 3D model rather than inspecting cases the conventional way. Surgeons' agreement in opinions across cases in mode 3 was 85%, whereas it was 18% and 5% in mode 1 and mode 2, respectively. This shows that information was conveyed moreconsistently across surgeonsin mode 3. NASA TLX tests show that surgeons had the least cognitive load while working with mode 3, followed by mode 1 and then mode 2. Overall, the findings indicate that 3D models, even without radiologists' written input, outperform the current standard practice of delivering unstructured radiology reports alongside raw PACS images.

Reproducibility of the Greulich &amp; Pyle method for determining the bone age of a Brazilian population sample

Introduction: this study aimed to evaluate the reproducibility of the widely known Greulich &amp; Pyle (G&amp;P) method to determine the bone age of a Brazilian population sample. Methodologies: two trained evaluators evaluated 302 radiographs (153 males and 149 females) on a 17-inch liquid crystal display with 1,280x1,024 pixels resolution and determined the bone age of the participants based on the G&amp;P atlas parameters. Data was analyzed at a level of significance of 5% (Cronbach’s alpha, Fleiss’ Kappa index, Student’s t-test, and Kruskal-Wallis). Results: the overall percentage of agreements between the chronological age of the participants and the bone age determined by evaluators 1 and 2 based on G&amp;P atlas parameters were 12.91% and 12.25%, respectively. The agreements for males were 18.30% and 15.69%, and for females were 7.38% and 8.72% for evaluators 1 and 2, respectively. The determined mean bone age was significantly higher than the mean chronological age (p&lt;.001). Comparisons between overall bone age and chronological age at all 6-month intervals were found significantly different (p&lt;.05). The comparison between genders revealed that the bone age mean of males was significantly higher than females only at the 9.6-year chronological age interval (p&lt;.05). Conclusion: although the bone age of both genders can be determined by using the G&amp;P method, which is based on the chronological age of an American population sample, it seems not an appropriate parameter to be used in a Brazilian population since a significantly higher bone development was observed.

Assessing ChatGPT’s Reliability in Endodontics: Implications for AI-Enhanced Clinical Learning

The integration of large language models (LLMs) like ChatGPT is transforming education the health sciences. This study evaluated the applicability of ChatGPT-4 and ChatGPT-4o in endodontics, focusing on their reliability and repeatability in responding to practitioner-level questions. Thirty closed-clinical questions, based on international guidelines, were each submitted thirty times to both models, generating a total of 1800 responses. These responses were evaluated by endodontic experts using a 3-point Likert scale. ChatGPT-4 achieved a reliability score of 52.67%, while ChatGPT-4o slightly outperformed it with 55.22%. Notably, ChatGPT-4o demonstrated greater response consistency, showing superior repeatability metrics such as Gwet’s AC1 and percentage agreement. While both models show promise in supporting learning, ChatGPT-4o may provide more consistent and pedagogically coherent feedback, particularly in contexts where response dependability is essential. From an educational standpoint, the findings support ChatGPT’s potential as a complementary tool for guided study or formative assessment in dentistry. However, due to moderate reliability, unsupervised use in specialized or clinically relevant contexts is not recommended. These insights are valuable for educators and instructional designers seeking to integrate AI into digital pedagogy. Further research should examine the performance of LLMs across diverse disciplines and formats to better define their role in AI-enhanced education.

The Czech Fugl-Meyer assessment for post-stroke sensorimotor function: translation and cross-cultural adaptation and validation.

To ensure wider use of the internationally recommended Fugl-Meyer Assessment (FMA) of sensorimotor function for people with stroke, official translations of the scale are needed. This study aimed to perform a translation and cross-cultural adaptation/validation of the FMA into the Czech language. Translation and cross-cultural adaptation/validation. Five clinical experts and 1 external expert participated as reviewers; 11 individuals with stroke in the early subacute phase were included in the pilot testing. A standardized process using forward-backward translations, expert panel reviews, and pilot testing between and within the raters (inter- and intra-rater reliability) were employed to ensure conceptual, semantic, and operational validity of the new Czech FMA. Agreement between raters was assessed in 11 individuals with stroke on 2 consecutive days at University Hospital Olomouc by using Svensson's rank-based statistics. Percentage of agreement between and within raters ranged between 70-100% and 55-100%, respectively. Systematic disagreements, found in 7 out of 96 FMA items, were discussed and revised in the final version. The Czech FMA offers a more unified and standardized assessment of sensorimotor impairment in clinical and research settings. This will improve stroke rehabilitation care and allow for wider international collaboration.

GPT models for text annotation: An empirical exploration in public policy research

AbstractText annotation, the practice of labeling text following a predetermined scheme, is essential to qualitative public policy research. Despite its importance, annotating large qualitative data faces challenges of high labor and time costs. Recent developments in large language models (LLMs), specifically models with generative pretrained transformers (GPTs), show a potential approach that may alleviate the burden of manual text annotation. In this report, we first introduce a small sample pretest strategy for researchers to decide whether to use Open AI's GPT models for text annotation. In addition, we test if GPT models can substitute human coders by comparing the results of two GPT models with different prompting strategies against human annotation. Using email messages collected from a national corresponding experiment in the US nursing home market as an example, on average, we demonstrate 86.25% percentage agreement between GPT and human annotations. We also show that GPT models possess context‐based limitations. Our report ends with reflections and suggestions for readers who are interested in using GPT models for text annotation.

Analysis of Higher Order Thinking Skills of Intended Mathematics Learning Outcomes in India

This study explores the integration of Higher Order Thinking Skills (HOTS) within the cognitive processes and knowledge dimensions of Bloom’s Revised Taxonomy (BRT) regarding the intended learning outcomes of the secondary-level mathematics curriculum in India, analysing data obtained from the National Council of Educational Research and Training (NCERT) website. The researchers employed a content analysis method to achieve the study’s objectives. The reliability of the analy- sis is ensured through Cohen’s kappa inter-rater reliability and percentage agreement, while method validity is established through expert opinion. The findings reveal a limited diversity in cognitive demands. The distribution of intended learning outcomes indicates a nearly equal emphasis on higher and lower-order thinking skills, with a notable focus (42.86%) on the ‘apply’ cognitive level. Procedural knowledge dominates at 80.85%, whereas conceptual and factual knowledge account for 16.67% and 2.38%, respectively. Our findings also indicate no significant difference in the distribution of expected learning outcomes concerning cognitive processes and knowledge dimensions between the grades. These findings provide insights for educators and stakeholders in the field of mathematics education in India, offering a foundation for enhancing instructional design and assessment strategies in secondary-level classes.

Variation in Arthroscopic Treatment of Discoid Lateral Meniscus and Postoperative Restrictions in Children: Results of a Multicenter Meniscus Study Group Survey.

Because of congenital abnormal collagenous structures and peripheral attachments, discoid lateral meniscus (DLM) is often associated with tears and instability and a risk of premature compartmental articular degeneration. Typically, surgery is indicated for symptomatic patients. Several surgical techniques have been described in the literature, but no studies have examined surgeon variation. To determine the intersurgeon agreement for DLM surgical planning and postoperative restriction after arthroscopic assessment. Cross-sectional study. Sixteen orthopaedic surgeons from an international pediatric meniscus study group were shown 4 different videos of a DLM arthroscopic procedure. Each surgeon completed a survey for each arthroscopic video. The survey included questions about operative planning, such as peripheral rim preservation, repair and stabilization technique, and postoperative restrictions. Descriptive statistics were used to characterize the variables collected. One of the 4 arthroscopic videos showed a complete discoid meniscus with no instability or tearing. For this specific meniscus, consensus was generally good, with 87.5% to 93.8% agreement for all the categories, except peripheral rim preservation, with 31.3% agreement. However, for the other 3 videos with tears and/or instability, consensus was generally low. Depending on the categories, the highest percentage of intersurgeon agreement varied between 25.0% and 62.5%, while being >50% only 2 of 27 times. Agreement regarding the surgical technique and postoperative rehabilitation among surgeons with experience in the treatment of DLM is poor in the event of tears and instability, which represent the greatest technical challenges with the most significant functional effect. Given the relative rarity of the condition and the implications on a child's long-term joint health, prospective, comparative multicenter studies regarding treatment algorithms and outcomes are warranted.

Subjective assessment of bone health from wrist radiographs.

Subjective assessment of bone health from wrist radiographs.

Effectiveness of machine learning algorithms for estimating montane vegetation from high-resolution satellites: a case study between Al-Baha and Baljurashi area, Saudi Arabia

ABSTRACT Machine learning (ML) algorithms are used to estimate vegetation cover in humid environments. However, their effectiveness in arid and semiarid environments remains limited, particularly in rugged mountainous areas. This study aimed to evaluate the effectiveness of ML algorithms in estimating and classifying montane vegetation cover and monitoring spatiotemporal changes in vegetation cover from 2005 to 2020 using high-resolution satellite images (SPOT-5/6/7). All data were processed and analysed using the maximum likelihood classifier (MLC), random forest (RF), and support vector machine (SVM) algorithms, and accuracy assessment. The results of the ML algorithms did not significantly differ because the highest agreement percentage between the RF and SVM algorithms was 90.27%. The vegetation coverage of the study area was 37.93% according to the SVM algorithm. Approximately 21.13% of the region’s total area was covered with scattered low green plants and the vegetation cover was highest in 2005 and lowest in 2010. The SVM algorithm classified the vegetation cover types with high efficiency and divided them into forests, agricultural lands with limited spread, shrubs, and grasses, covering 27%. This research highlights the necessity of remote sensing and ML techniques in monitoring montane vegetation cover and evaluating their effectiveness in improving accuracy.

Operating Department Practitioner's research priorities: A Delphi study.

With the 2022 Allied Health Professions' Research and Innovation Strategy and the College of Operating Department Practitioners joining the Council for Allied Health Professions Research, understanding the Operating Department Practitioner profession's vision for research and innovation and identifying its research priorities has become important. This Delphi study aimed to establish research priorities for the Operating Department Practitioner profession. Questionnaires were distributed to Operating Department Practitioners using College of Operating Department Practitioners and social media networks. Round 1 saw 49 eligible responses; this reduced to 21 in Round 2 and 17 in Round 3. Thirty-one research priorities were identified by consensus. Priority rank was determined by mean score, percentage agreement, and coefficient of variance. By reaching a consensus, Operating Department Practitioners co-created research priorities and identified several themes that will contribute to professional development and patient care and support funding opportunities. The five key themes were Workforce Transformation, Education, Patient Safety and Experience, Innovation and Technology, and Theatre Culture.

Abstract 742: Development and evaluation of a non-invasive qPCR assay for sensitive detection of FGFR2/3 alterations in urine samples as a companion diagnostic for erdafitinib

Abstract Introduction: Fibroblast growth factor receptor (FGFR) alterations, including point mutations and gene fusions, play a pivotal role in various cancers, particularly urothelial carcinoma. Erdafitinib, an FDA-approved therapy for locally advanced or metastatic urothelial carcinoma with FGFR2/3 alterations, currently relies on tissue-based diagnostics, which are invasive and may not always be feasible. Non-invasive liquid biopsy approaches, such as qPCR assays using urine cell pellets (UCP), offer significant advantages in terms of patient convenience and safety while providing accurate detection of clinically relevant alterations. Methods: We developed and evaluated the Predicine FGFR2/3 qPCR Kit, a real-time multiplex PCR assay designed to detect four FGFR3 mutations (R248C, S249C, G370C, Y373C) and five FGFR2/3 fusions (FGFR3-TACC3 V1/V3, FGFR3-BAIAP2L1, FGFR2-BICC1, FGFR2-CASP7) from urine DNA and RNA. The assay integrates proprietary buffers to preserve nucleic acids, allowing simultaneous detection of DNA mutations and RNA fusions. Analytical performance, including sensitivity, specificity, and accuracy, was assessed using gradient dilutions, known positive controls, and clinical urine samples. Detection thresholds were benchmarked against NGS and ddPCR. Results: The assay demonstrated high sensitivity, detecting DNA variants at allele frequencies as low as 0.25% and RNA fusions at 6-7 copies. Specificity exceeded 98% across all tested alterations in healthy donor samples, and positive percentage agreement (PPA) exceeded 95% for FGFR3 mutations and FGFR2/3 fusions compared to NGS results. In a retrospective cohort of 60 clinical urine samples, mutation detection sensitivity reached 100% for most variants, except for FGFR3-S249C, while specificity ranged from 92% to 100%. UCP-derived nucleic acids enabled streamlined workflows with a single vial of urine. Mutation detection achieved a limit of 0.1% for DNA and 6.25 copies for RNA fusions. Conclusion: The Predicine FGFR2/3 qPCR Kit offers a rapid, robust, and non-invasive solution for detecting FGFR alterations in urine samples. By providing high sensitivity, specificity, and efficiency, it represents a promising alternative to invasive tissue-based diagnostics for identifying patients eligible for FGFR-targeted therapies such as erdafitinib. These findings highlight its potential utility as a companion diagnostic, with further clinical validation planned to support its integration into routine molecular diagnostics. Citation Format: Meirong Zhang, Mingzhu Li, Yue Zhang, Hang Dong, Haoran Tang, Feng Xie, Qing Xu. Development and evaluation of a non-invasive qPCR assay for sensitive detection of FGFR2/3 alterations in urine samples as a companion diagnostic for erdafitinib [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 742.

Training and Experience in Study Selection (TESS): study protocol for a pilot randomised trial within a systematic review

Background Systematic reviews can be resource-intensive and require timely completion, yet limited availability of experienced reviewers often necessitates incorporating novice members into review teams. The purpose of this Study Within A Review (SWAR) will be to determine whether training and level of experience within the screening pair affects the reliability of decisions made by novice screeners during study selection for a systematic review Methods A 2(training: task-specific, minimal guidance) x 2(experience level of screening partner, ‘Reviewer 1’: moderate experience, minimal experience) pilot randomised trial will be conducted within a host systematic review in the topic area of depression and psychosocial functioning. Participants (N = 12), consisting of higher education students with no prior experience in evidence synthesis, will be randomised to one of the four conditions to complete a standardised study selection task at title/abstract level (k = 219 records) on Covidence systematic review screening software, blindly and independently. Total participation time is estimated at 5 hours. Screening decisions made by participants will be assessed for reliability against the consensus-based decisions by two reviewers with content and methodological expertise (expert standard), through calculation of chance-corrected Cohen’s kappa and percentage of agreement, then compared across the conditions. Secondary outcomes will include reliability within the screening pair (participant and allocated screening partner), validity of screening decisions (false positives, false negatives, sensitivity, specificity), feasibility measures, including time taken to complete the study selection task and success of blinding, as well as acceptability. Conclusions Findings will be used to inform the design of subsequent trial work to determine the efficacy of training and screener pairing for study selection. Ultimately, these insights will help to build capacity among novice screeners to engage with evidence synthesis and work alongside experienced review teams. Registration Northern Ireland Hub for Trials Methodology Research SWAR Registry: SWAR 38.

Bolstering agreement with scarce resource allocation policy using education: a post hoc analysis of a randomized controlled trial

BackgroundThe COVID- 19 pandemic prompted rapid development of scarce resource allocation policies (SRAP) in case demand for critical health services eclipsed capacity. We sought to test whether a brief, educational video could improve alignment of participant values and preferences with the tenets of the University of California Health’s SRAP in a post hoc analysis of a randomized controlled trial (RCT) conducted during the pandemic.MethodsAn RCT of an educational video intervention embedded in a longitudinal web-based survey conducted from May to December 2020, analyzed in August 2024. The “explainer” video intervention was approximately 6 min long and provided an overview of the mechanics and ethical principles underpinning the UC Health SRAP, subtitled in six languages. California residents were randomized to view the intervention or not, stratified by age, sex, education, racial identity, and self-reported health care worker status. Non-California residents were assigned to the control group. 1,971 adult participants were enrolled at baseline, and 939 completed follow-up. 770 participants with matched baseline and follow-up responses were analyzed. Self-reported survey assessments of values regarding components of SRAP were scored as the percentage of agreement with the UC Health SRAP as written. Participants responded to items at baseline and follow-up (approximately 10 weeks after baseline), with randomization occurring between administrations.ResultsAfter the intervention, overall agreement improved by a substantial margin of 5.2% (from 3.8% to 6.6%, P <.001) for the intervention group compared to the control group. Significant changes in agreement with SRAP logistics and health factors were also observed in the intervention group relative to the control, while no significant changes were noted for social factors. Differential intervention effects were observed for certain demographic subgroups.ConclusionsA brief educational video effectively explains the complex ethical principles and mechanisms of the SRAP, as well as how to improve the alignment of participant values with the foundational principles of UC Health SRAP. This directly informs practice by providing a framework for educating individuals about the use of these policies during future situations that require crisis standards of care, which can, in turn, enhance agreement and buy-in from affected parties.Trial registrationClinicalTrials.gov registration NCT04373135 (registered 4 May 2020).

Evaluating the Value of Certification Among Noncertified Neuroscience Nurses.

BACKGROUND : Nurses who obtain voluntary specialty certification have higher levels of perceived value for certification compared with noncertified nurses. By identifying and fostering the lesser held perceived values, peers and organizations may increase the overall perceived value of certification among noncertified neuroscience nurses, which, in turn, could lead to higher certification attainment. METHODS : This was a cross-sectional descriptive exploratory design after a survey completed by noncertified neuroscience nurses. Certified neuroscience (CNRN) and stroke certified registered nurses (SCRN) were used as a comparison group. The nurses reported the benefits of certification using the Perceived Value of Certification Tool 12. Logistic regression was used to determine the presence of significant differences in value statement responses among the 2 groups. Percentage of agreement with the value statements among noncertified nurses was also reported. RESULTS : A total of 338 noncertified neuroscience nurses completed the survey. Participants reported a mean age of 44.7 years, and 88% were female. About 68% of participants were White/Non-Hispanic. Among the 12 value statements, noncertified neuroscience nurses reported the highest levels of agreement with statements related to validation of knowledge, personal accomplishment, and commitment to neuroscience nursing. The lowest levels of agreement were associated with being listened to, professional autonomy, and higher pay. Logistic regression demonstrated that certified neuroscience nurses (n = 640) had significant higher levels of agreement with 8 of the 12 value statements compared with noncertified neuroscience nurses . CONCLUSION : Support for certification among neuroscience nurses cannot rely upon 1 source. Although hospitals and professional organizations play a significant role, peer support from certified neuroscience nurses is needed for fostering the value of certification. Further research using open-ended questions to provide detail regarding noncertificant responses to the 8 value statements may provide additional insight needed to strategize certification achievement.

Proficiency and associated factors of laboratory professionals in sputum smear microscopy at selected peripheral public and private diagnostic laboratories in Ethiopia: cross-sectional study

BackgroundIn countries with a high prevalence of TB, such as Ethiopia, direct sputum smear microscopy remains the most cost-effective tool for diagnosing patients with infectious tuberculosis and monitoring their progress on treatment. However, poor-quality sputum microscopy services may lead to the failure to detect persons with active tuberculosis and may cause unnecessary anti-TB treatment for non-TB cases. Proficiency level is the percentage agreement between participants'readings and the reference panel results. The aim of this study was to assess proficiency and associated factors of laboratory professionals in sputum smear microscopy for acid-fast bacilli at selected peripheral public and private diagnostic laboratories in East Gojjam Zone, Northwest Ethiopia, in 2023.MethodAn institutional-based cross-sectional study design was conducted from March 2023 to June 2023 at selected peripheral public diagnostic laboratories in East Gojjam Zone. 65 laboratory professionals were selected randomly from 41 peripheral public diagnostic laboratories in the study area. A validated questionnaire and 10 panel slides were used as data collection tools. The panel consisted of 5 pre-stained and 5 unstained slides. Data were entered and analyzed using the Statistical Package for Social Sciences software (SPSS version 20). P values less than 0.05 were considered statistically significant when looking for associations between dependent and independent variables.ResultThe overall proficiency level of laboratory professionals in tuberculosis smear microscopy was 81.92% with 95% CI [78.46–85.38]. Previous TB smear microscopy training, work experience, and institution of education had a significant association with the overall performance of laboratory professionals in TB smear microscopy.ConclusionThe overall TB smear microscopy performance level of laboratory professionals at peripheral diagnostic laboratories in Ethiopia, was satisfactory, indicating a good level of competence. However, notable technical errors related to smear reading and reporting were observed. Thus, higher education institutions, especially private institutions, and the Zonal Health Department, should implement educational and training interventions to address the identified gaps and ultimately contribute to the national TB control program.