Reproducibility Of Typing Research Articles

Diagnosis of type 2 Brugada pattern: insights from a pilot survey.

Differentiation of Type 2 Brugada Pattern (BP) from incomplete right bundle branch block or normal rSr' pattern can be insidious. The aim of this study was to assess interobserver and intraobserver agreement in the diagnosis of type 2 BP in a cohort of cardiologists with different skills. We collected 14 ECGs with a positive terminal deflection of the QRS complex in lead V1 and V2 at the 4th intercostal space. We proposed these ECGs, specifying to use 2012 Consensus conference criteria for diagnosis of type 2 BP, to 42 participants: 14 arrhythmologists, 14 general cardiologists and 14 electrophysiology (EP) fellows. The same 14 ECGs, with a different order, were proposed fifteen days later to the same cohort to assess intraobserver variability. Authors analyzed all 14 ECGs in order to assess whether 2012 Consensus Conference criteria for BP were fulfilled. All patients underwent provocative test with IC antiarrhythmics drugs (flecainide) in order to exclude or confirm the diagnosis of Brugada Syndrome (BrS). Slight interobserver agreement (Fleiss K<0.20) in the diagnosis of type 2 BP was observed in all three categories of cardiologists. Considering five operators per class, intraobserver agreement is variable (k ranging from 0.000 to 0.857), with a slight superiority of arrhytmologists (k minimum value 0.276; k maximum value 0.857). This study demonstrated, for the first time, a low interobserver agreement in diagnosis of type 2 BP in categories of cardiologists with different abilities. Reproducibility of type 2 BP diagnosis (intraobserver agreement) is poor, even among experts. These findings highlight the difficulties in analysis of ECG with BrS suspicion and, therefore, underscore the key role of clinical and anamnestic data.

Diagnosis of type 2 Brugada pattern: insights from a pilot survey

Differentiation of Type 2 Brugada Pattern (BP) from incomplete right bundle branch block or normal rSr' pattern can be insidious. The aim of this study was to assess interobserver and intraobserver agreement in the diagnosis of type 2 BP in a cohort of cardiologists with different skills. We collected 14 ECGs with a positive terminal deflection of the QRS complex in lead V1 and V2 at the 4th intercostal space. We proposed these ECGs, specifying to use 2012 Consensus conference criteria for diagnosis of type 2 BP, to 42 participants: 14 arrhythmologists, 14 general cardiologists and 14 electrophysiology (EP) fellows. The same 14 ECGs, with a different order, were proposed fifteen days later to the same cohort to assess intraobserver variability. Authors analyzed all 14 ECGs in order to assess whether 2012 Consensus Conference criteria for BP were fulfilled. All patients underwent provocative test with IC antiarrhythmics drugs (flecainide) in order to exclude or confirm the diagnosis of Brugada Syndrome (BrS). Slight interobserver agreement (Fleiss K<0.20) in the diagnosis of type 2 BP was observed in all three categories of cardiologists. Considering five operators per class, intraobserver agreement is variable (k ranging from 0.000 to 0.857), with a slight superiority of arrhytmologists (k minimum value 0.276; k maximum value 0.857). This study demonstrated, for the first time, a low interobserver agreement in diagnosis of type 2 BP in categories of cardiologists with different abilities. Reproducibility of type 2 BP diagnosis (intraobserver agreement) is poor, even among experts. These findings highlight the difficulties in analysis of ECG with BrS suspicion and, therefore, underscore the key role of clinical and anamnestic data.

The Influence of Test Positions on Clinical Assessment for Scapular Dyskinesis

BackgroundAppropriate evaluation of scapular dyskinesis is essential for therapeutic strategies. Although the current visual-based assessment is rapid and practical, the reliability of this method is unsatisfactory. It is necessary to adequately understand the conditions of assessment to maximize the benefit of therapeutic interventions. ObjectiveTo explore the influence of different test positions on clinical assessment for scapular dyskinesis. DesignObservational study. SettingUniversity rehabilitation department. PatientsA total of 102 subjects diagnosed with unilateral shoulder disorder were recruited from among rehabilitation outpatients from November 2015 to February 2016. MethodsTwo experienced raters categorized the subjects’ scapular movement pattern according to Kibler et al classification by the vision-palpation method at 4 test positions (at rest, and the end range of elevation in the sagittal, scapular, and coronal planes). Main Outcome MeasurementsThe overall prevalence of scapular dyskinesis, the distribution of types, and the reproducibility of types at the 4 test positions were analyzed. ResultsThe overall prevalence of scapular dyskinesis was 90.08%, and the highest frequency was found at the resting position. Type III was the most common type in our sample. In reproducibility analysis, 21.57% of subjects presented with the same type at any position, and 75.49% of subjects presented with 2 types. ConclusionsScapular dyskinesis in individuals with shoulder disorder showed a high prevalence, especially at the resting position. More than 1 type of scapular pattern would be present if assessed at different positions. This study indicates that test positions can affect the results of scapular dyskinesis assessment, and that the resting position should primarily be applied. Level of EvidenceIII

Bacteremia due to Pseudomonas aeruginosa: use of a combined typing system in an eight-year study.

P aeruginosa bacteremia is a nosocomial disease with a high mortality occurring in colonized, debilitated, and leukopenic patients and in those receiving immunosuppressive and antimicrobial agents [2]. Outbreaks of P aeruginosa bacteremia have often been associated with environmental reservoirs [3]. The 190 strains of P aeruginosa described in this study represent single isolates from bacteremic patients during an eight-year period. Representing about 50% of total isolates, the most common pyocin types were 1b, 3, and 10, immunotypes 1, 2, and 3 + 7, and serotypes 11, 6, and 1. Of the 37 known pyocin types, only 10 were represented in this study. All seven immunotypes and 14 of 17 serotypes were found. The overall typability for each of the three techniques was 88%-90%; however, the largest numbers of typable patterns were found when all three typing methods or pyocin and either immunotyping or serotyping were used. The smallest number of typing patterns occurred when immunotyping and serotyping were performed together. Correlation among the following types was greater than 50%; pyo 3:immuno 1:sero 6; pyo 10:immuno 2:sero 11, and pyo NI:immuno 4:sero 1. Upon repeated testing the reproducibility of types for each technique was 98%-100%. For the most precise epidemiologic studies of P aeruginosa infections all three typing methods should be employed.

Reproducibility of staphylococcal bacteriophage types by use of different concentrations of bacteriophage.

A comparative investigation was carried out on the reproducibility of staphylococcal bacteriophage types at 100 routine test dilution (RTD) and at the conventional concentrations, RTD and 1,000 RTD. The comparison includes multiple typing of laboratory strains and duplicate isolates from hospital patients. No significant difference was found in the reproducibility of the types at the different concentrations. A single concentration corresponding to 100 RTD is recommended for routine use in phage typing as a possible substitute for typing with two different concentrations.

Reproducibility of Staphylococcal Bacteriophage Types by Use of Different Concentrations of Bacteriophage

A comparative investigation was carried out on the reproducibility of staphylococcal bacteriophage types at 100 routine test dilution (RTD) and at the conventional concentrations, RTD and 1,000 RTD. The comparison includes multiple typing of laboratory strains and duplicate isolates from hospital patients. No significant difference was found in the reproducibility of the types at the different concentrations. A single concentration corresponding to 100 RTD is recommended for routine use in phage typing as a possible substitute for typing with two different concentrations.