Retest Measurements Research Articles

Metrology of Supraspinatus Tendon Thickness in Swimmers with Tendinopathy Using Ultrasound Imaging: An Intra- and Inter-Rater Reliability Study.

Objective: This study aimed to assess the relative and absolute intra- and inter-rater reliability of supraspinatus tendon (SST) thickness. Materials: Thirty adolescent swimmers with supraspinatus (SS) tendinopathy (n = 15) and a control-matched group (n = 15) were evaluated. Tendon thickness was measured according to four different measure procedures, i.e., (1) at 15 mm, (2) at 10, 20, and 30 mm, (3) at 10, 15, and 20 mm, and (4) 5 and 10 mm lateral to the most hyperechogenic reference point of the biceps tendon. Each examiner took two US images for the test measurements with a 10 min rest period. After 30 min, the subjects underwent retest measurements that were also repeated 1 week later. Results: SST thickness was greater in swimmers with SS tendinopathy compared with the matched control group for each procedure and rater (p < 0.001). Intra- and inter-rater reliability was good to excellent (ICC2.3: 0.78-0.98 and 0.83-0.97, respectively) in both groups. The lowest intra- and inter-rater reliability was found in procedures no. 2 and 4 (ICC2.3: 0.78 and 0.83). However, procedure no. 3 was the most reliable with the lowest error rate (ICC2.3: 0.92-0.97; SEM: 0.05-0.10 mm; MDC: 0.14-0.28 mm). Conclusions: The study confirmed the diagnostic value of ultrasound in SS tendinopathy. A multiple-reference-point procedure including a simple methodology (10, 15, and 20 mm from biceps tendon), was defined as the most reliable, expressed by the highest intra- and inter-rater ICCs.

Reliability and validity of the Turkish version of the Physical Activity Barrier Scale for people who are blind or visually impaired

Purpose: The aim of this study was to investigate the validity and reliability of the Turkish version of the Physical Activity Barrier Scale (PABS) for visually impaired individuals. Methods: People with visually impaired, low vision (n=53) and blind people (n=84), a total of 137, were participated in the present study. The physical activity barriers of the participants were evaluated with the PABS. The International Physical Activity Questionnaire (IPAQ-Long Form) was used to determine the physical activity level of the participants. Internal consistency was determined by using Cronbach’s alpha and test-retest reliability was determined by using the intra-class correlation coefficient (ICC). Results: The mean age of the participants was 43.03±13.75 years and the mean body mass index was 26.11±4.77 kg/m 2 . Cronbach’s alpha for the PABS was 0.933 for the test and 0.894 for the re-test measurements. The test-retest ICC values of the PABS varied between 0.563 and 0.950. The mean physical activity level of the participants was found as 4049.43±4956.59 METXminutes/week. There was no statistically significant correlation between the total scores of the PABS and the IPAQ (p&amp;gt;0.05). Conclusion: There is currently no specific questionnaire regarding physical activity and its barriers for visually impaired individuals in Turkey. The study showed the reliability of the Turkish version of the PABS for individuals with visual impairment.

Reliability and clinical utility of a novel telehealth-based goniometry approach to measure range of motion of the digits of the hand

BackgroundRange of motion (ROM) is an outcome measure commonly used when treating acute and chronic hand injuries and conditions. Increased adoption of telehealth service provision in hand therapy practice, influenced by the advent of COVID-19, has led to the need for a valid and reliable approach to measure the range of motion of the digits of the hand when providing hand therapy services using telehealth. PurposeTo determine if performing manual goniometry during a livestream teleconsultation is reliable and clinically useful to measure the range of motion of the fifth digit when providing hand therapy services using telehealth. Study DesignClinical measurement, repeated-measures study. MethodsAccording to a measurement protocol, 12 independent raters (who currently provide hand therapy services) each obtained several screen-based goniometric range of motion measurements of the fifth digit at 2-time points. Raters were surveyed on the clinical utility of the telehealth-based goniometry approach. Measures of relative and absolute reliability were calculated to evaluate test-retest and inter-rater reliability. Free-text responses were analyzed using content analysis. ResultsInter-rater reliability was excellent for all flexion and extension measures (intraclass correlation coefficient [ICC] ≥ 0.89) but poor for the arc of motion (ICC ≤ 0.67). Test-retest reliability was poor (ICC ≤ 0.43). No statistically significant differences between test and retest measurements were observed (P ≥ 0.24). The overall coefficient of variation indicated good precision (14.69%). Measurement error (≤6.07º) and limits of agreement (≤6.33) had acceptable levels to support clinical use. Content analysis revealed several practical considerations. ConclusionsThis study suggests that performing manual goniometry during a livestream teleconsultation is unreliable for measuring the range of motion of the fifth digit. However, when combined with patient-reported and functional outcomes, this approach may be suitable to facilitate a range of motion assessment for certain functions of telehealth service provision in hand therapy practice.

Test-Retest Reliability of the Acoustic Voice Quality Index and the Acoustic Breathiness Index

The acoustic voice quality index (AVQI) and the acoustic breathiness index (ABI) are two validated measurements for the objective-acoustic assessment of voice quality. The aim of this study was to evaluate the relative and absolute reliability of AVQI and ABI as well as detect the natural variability of vocally-healthy voices. Totally, 39 vocally-healthy participants received weekly an AVQI- and ABI measurement using the freeware VOXplot over a period of 3 weeks. This study is a within-subject design to assess significant differences between the test and retest measurements (test and mean of two retests) of AVQI and ABI with the paired sample t test and to investigate the reliability of these two acoustic parameters with the intraclass correlation coefficient (ICC), Bland-Altman plot, and the minimal detectable change (MDC). No significant differences between the test-retest measurements of AVQI and ABI were revealed (all P-values>0.05). The relative reliability of AVQI and ABI showed good results (eg, ICC=0.81, and ICC=0.92, respectively). Absolute reliability measured with the MDC yielded a test-retest value of 0.78 and 0.66 for the AVQI and ABI, respectively. Deviations within this range may be due to natural variations of the voice (random bias). AVQI and ABI revealed high-reliability results in a test-retest measurement of vocally-healthy participants.

Cross-cultural adaptation, reliability, validity, and psychometric evaluation of the Tamil version STarT back screening tool among low back pain subjects

BackgroundThe STarT back screening tool helps primary care workers make the initial clinical decision and classify low back pain subjects into subgroups. Currently, the tool is required for stratification/triaging of low back pain and is commonly used in clinical practice, and requires linguistic validation in Tamil. The study aimed to determine the validity and reliability of the Tamil version of the STarT back screening tool. MethodsThe baseline measurements include the Tamil version of the STarT back screening tool-, pain severity using the Numeric pain rating Scale (NPRS), disability status using the Tamil version of the Roland Morris Disability Questionnaire (RMDQ), and fear avoidance beliefs using the fear-avoidance beliefs questionnaire (FABQ) - Tamil were obtained. After five days, the retest measures are done to investigate the test-retest reliability. ResultsThe current study showed excellent test-retest reliability of total score (ICC – 0.80) and psychosocial subscore (ICC-0.82) with excellent internal consistency and moderate to high validity with clinical outcomes. ConclusionThe study concludes that the Tamil version of the STarT Back Screening Questionnaire is a reliable and valid tool that reported good understanding and easy completion by the subject.

Standard Heart Rate Variability Parameters-Their Within-Session Stability, Reliability, and Sample Size Required to Detect the Minimal Clinically Important Effect.

Many intervention studies assume the stability of heart rate variability (HRV) parameters, and their sample sizes are often small, which can significantly affect their conclusions. The aim of this study is to assess the stability and reliability of standard HRV parameters within a single resting session, and to estimate the sample size required to detect the minimal clinically important effect of an intervention. Heart rate was recorded in 50 adult healthy subjects for 50 min in a seated position. Eight standard HRV parameters were calculated from five evenly spaced 5 min intervals. Stability was assessed by comparing the mean values of HRV parameters between the consecutive five test-retest measurements. Absolute reliability was determined by standard error of measurement, and relative reliability by intraclass correlation coefficient. The sample size required to detect a mean difference of ≥30% of between-subject standard deviation was estimated. As expected, almost all HRV parameters had poor absolute reliability but most HRV parameters had substantial to excellent relative reliability. We found statistically significant differences in almost all HRV parameters between the first 20 min and the last 30 min of the session. The estimated sample size ranged from 19 to 300 subjects for the first 20 min and from 36 to 194 subjects for the last 30 min of the session, depending on the selected HRV parameter. We concluded that optimal HRV measurement protocols in a resting seated position should be performed within the first 20 min or between 20 and 50 min after assuming a resting seated position. Future interventional HRV studies should include a sufficient number of subjects and consider the Bonferroni correction according to the number of selected HRV parameters to achieve an appropriate level of study power and precision.

Precision estimates of Relative and Absolute Cerebral Blood Flow in Alzheimer’s disease and Cognitively Normal individuals

AbstractBackgroundAlzheimer’s disease is characterized by regional reductions in cerebral blood flow (CBF) and the gold standard for measuring CBF is [15O]H2O PET. Recently, proxies of relative CBF, derived from the early distribution phase of amyloid‐β and tau tracers, have gained attention. It has been hypothesized that relative CBF is likely to have higher precision (but not accuracy) than absolute CBF, as global variations in CBF are cancelled out. The present study assessed precision of [15O]H2O PET derived relative and absolute CBF measures, and compared them with relative CBF proxies estimated from [18F]florbetapir and [18F]flortaucipir scans.MethodDynamic [15O]H2O, [18F]florbetapir and [18F]flortaucipir test‐retest (TRT) PET datasets were included, consisting of eleven cognitively normal (CN) individuals for [15O]H2O, four CN and five AD participants for [18F]florbetapir, and six CN and eight AD participants for [18F]flortaucipir. [15O]H2O data were analysed using the standard single tissue compartment model and [18F]florbetapir and [18F]flortaucipir using the simplified reference tissue model (SRTM). Relative CBF (i.e. K1/K1’) was derived from absolute CBF (i.e. K1 of [15O]H2O) or estimated using SRTM (i.e. R1), in all cases using cerebellar cortex as reference tissue. CBF values were obtained for 22 cortical grey matter regions and TRT variability (eq.1) was calculated for all metrics. Differences (%) between test and retest measures were assessed using Bland‐Altman analysis and TRT variability for different tracers and between diagnostic groups were compared using Wilcoxon Signed‐Rank and Mann‐Whitney U‐tests.ResultAverage differences (M±SD) between test and retest measures were small for relative measures, [15O]H2O K1/K1’:‐2.0±7.8%, [18F]florbetapir R1:‐1.7±4.1%, [18F]flortaucipir R1:‐0.1±4.2%, but somewhat larger for [15O]H2O K1:‐5.7±14.6%,(Fig.1). In case of [15O]H2O, TRT variability was lower for K1/K1’ than for K1 (p&lt;0.001). Furthermore, [18F]florbetapir and [18F]flortaucipir derived R1 showed lower TRT variability than [15O]H2O K1/K1’ (p&lt;0.001). Only for [18F]flortaucipir, TRT variability was higher in the AD compared with the CN group.ConclusionRelative CBF has higher precision than absolute CBF derived from [15O]H2O PET scans. Furthermore, relative CBF proxies derived from commonly used amyloid‐β and tau tracers appear to have an even higher precision, possibly due to the compensatory effect of extraction fraction and/or the older scanner used for [15O]H2O scans.

Precision estimates of Relative and Absolute Cerebral Blood Flow in Alzheimer’s disease and Cognitively Normal individuals

AbstractBackgroundAlzheimer’s disease is characterized by regional reductions in cerebral blood flow (CBF) and the gold standard for measuring CBF is [15O]H2O PET. Recently, proxies of relative CBF, derived from the early distribution phase of amyloid‐β and tau tracers, have gained attention. It has been hypothesized that relative CBF is likely to have higher precision (but not accuracy) than absolute CBF, as global variations in CBF are cancelled out. The present study assessed precision of [15O]H2O PET derived relative and absolute CBF measures, and compared them with relative CBF proxies estimated from [18F]florbetapir and [18F]flortaucipir scans.MethodDynamic [15O]H2O, [18F]florbetapir and [18F]flortaucipir test‐retest (TRT) PET datasets were included, consisting of eleven cognitively normal (CN) individuals for [15O]H2O, four CN and five AD participants for [18F]florbetapir, and six CN and eight AD participants for [18F]flortaucipir. [15O]H2O data were analysed using the standard single tissue compartment model and [18F]florbetapir and [18F]flortaucipir using the simplified reference tissue model (SRTM). Relative CBF (i.e. K1/K1’) was derived from absolute CBF (i.e. K1 of [15O]H2O) or estimated using SRTM (i.e. R1), in all cases using cerebellar cortex as reference tissue. CBF values were obtained for 22 cortical grey matter regions and TRT variability (eq.1) was calculated for all metrics. Differences (%) between test and retest measures were assessed using Bland‐Altman analysis and TRT variability for different tracers and between diagnostic groups were compared using Wilcoxon Signed‐Rank and Mann‐Whitney U‐tests.ResultAverage differences (M±SD) between test and retest measures were small for relative measures, [15O]H2O K1/K1’:‐2.0±7.8%, [18F]florbetapir R1:‐1.7±4.1%, [18F]flortaucipir R1:‐0.1±4.2%, but somewhat larger for [15O]H2O K1:‐5.7±14.6%,(Fig.1). In case of [15O]H2O, TRT variability was lower for K1/K1’ than forK1 (p&lt;0.001). Furthermore, [18F]florbetapir and [18F]flortaucipir derived R1 showed lower TRT variability than [15O]H2O K1/K1’ (p&lt;0.001). Only for [18F]flortaucipir, TRT variability was higher in the AD compared with the CN group.ConclusionRelative CBF has higher precision than absolute CBF derived from [15O]H2O PET scans. Furthermore, relative CBF proxies derived from commonly used amyloid‐β and tau tracers appear to have an even higher precision, possibly due to the compensatory effect of extraction fraction and/or the older scanner used for [15O]H2O scans.

Evaluation of a telepsychological intervention guide during COVID-19 pandemic: evidence from a pilot study with mexican population

The Virtual Psychological Care Guide (VPCG_COVID-19) has been designed as a tool for orientation and urgent attention to psychological conditions and symptoms during the SARS-CoV-2 pandemic. Objective. To assess the psychological impact on the levels of depression, anxiety and stress associated with the implementation of a telepsychology intervention based on the VPCG_COVID-19. A single group repeated measures design was used to assess depression, anxiety and stress before (T0 = pretest), after (T1 = posttest) and 14 days after its implementation (T2 = retest). A sample of 117 adults participated (mean age = 37.69; SD = 12.07; 62.4 % male) and received telepsychology care and were channeled according to VPCG_COVID 19 criteria: Level 2 psychoeducation and orientation (n = 46), level 3 = psychological first aid (n = 24) and level 4 = brief cognitive behavioral therapy-brief (n = 47). Significant differences were found in depression, anxiety and stress, for the three levels of attention (pre, post and retest measurements).

Meta-Analysis of the Test-Retest Repeatability of [18F]-Fluorodeoxyglucose Standardized Uptake Values: Implications for Assessment of Tumor Response.

Currently, guidelines for PET with 18F-fluorodeoxyglucose (FDG-PET) interpretation for assessment of therapy response in oncology primarily involve visual evaluation of FDG-PET/CT scans. However, quantitative measurements of the metabolic activity in tumors may be even more useful in evaluating response to treatment. Guidelines based on such measurements, including the European Organization for Research and Treatment of Cancer Criteria and PET Response Criteria in Solid Tumors, have been proposed. However, more rigorous analysis of response criteria based on FDG-PET measurements is needed to adopt regular use in practice. Well-defined boundaries of repeatability and reproducibility of quantitative measurements to discriminate noise from true signal changes are a needed initial step. An extension of the meta-analysis from de Langen and colleagues (2012) of the test-retest repeatability of quantitative FDG-PET measurements, including mean, maximum, and peak standardized uptake values (SUVmax, SUVmean, and SUVpeak, respectively), was performed. Data from 11 studies in the literature were used to estimate the relationship between the variance in test-retest measurements with uptake level and various study-level, patient-level, and lesion-level characteristics. Test-retest repeatability of percentage fluctuations for all three types of SUV measurement (max, mean, and peak) improved with higher FDG uptake levels. Repeatability in all three SUV measurements varied for different lesion locations. Worse repeatability in SUVmean was also associated with higher tumor volumes. On the basis of these results, recommendations regarding SUV measurements for assessing minimal detectable changes based on repeatability and reproducibility are proposed. These should be applied to differentiate between response categories for a future set of FDG-PET-based criteria that assess clinically significant changes in tumor response.

Two fully automated data-driven 3D whole-breast segmentation strategies in MRI for MR-based breast density using image registration and U-Net with a focus on reproducibility

Presence of higher breast density (BD) and persistence over time are risk factors for breast cancer. A quantitatively accurate and highly reproducible BD measure that relies on precise and reproducible whole-breast segmentation is desirable. In this study, we aimed to develop a highly reproducible and accurate whole-breast segmentation algorithm for the generation of reproducible BD measures. Three datasets of volunteers from two clinical trials were included. Breast MR images were acquired on 3 T Siemens Biograph mMR, Prisma, and Skyra using 3D Cartesian six-echo GRE sequences with a fat-water separation technique. Two whole-breast segmentation strategies, utilizing image registration and 3D U-Net, were developed. Manual segmentation was performed. A task-based analysis was performed: a previously developed MR-based BD measure, MagDensity, was calculated and assessed using automated and manual segmentation. The mean squared error (MSE) and intraclass correlation coefficient (ICC) between MagDensity were evaluated using the manual segmentation as a reference. The test-retest reproducibility of MagDensity derived from different breast segmentation methods was assessed using the difference between the test and retest measures (Δ2-1), MSE, and ICC. The results showed that MagDensity derived by the registration and deep learning segmentation methods exhibited high concordance with manual segmentation, with ICCs of 0.986 (95%CI: 0.974-0.993) and 0.983 (95%CI: 0.961-0.992), respectively. For test-retest analysis, MagDensity derived using the registration algorithm achieved the smallest MSE of 0.370 and highest ICC of 0.993 (95%CI: 0.982-0.997) when compared to other segmentation methods. In conclusion, the proposed registration and deep learning whole-breast segmentation methods are accurate and reliable for estimating BD. Both methods outperformed a previously developed algorithm and manual segmentation in the test-retest assessment, with the registration exhibiting superior performance for highly reproducible BD measurements.

Reliability of velocity pulsatility in small vessels on 3Tesla MRI in the basal ganglia: a test–retest study

ObjectiveRecent work showed the feasibility of measuring velocity pulsatility in the perforating arteries at the level of the BG using 3T MRI. However, test–retest measurements have not been performed, yet. This study assessed the test–retest reliability of 3T MRI blood flow velocity measurements in perforating arteries in the BG.Materials and methodsTwo-dimensional phase-contrast cardiac gated (2D-PC) images were acquired for 35 healthy controls and repeated with and without repositioning. 2D-PC images were processed and analyzed, to assess the number of detected perforating arteries (Ndetected), mean blood flow velocity (Vmean), and velocity pulsatility index (vPI). Paired t-tests and Bland–Altman plots were used to compare variance in outcome parameters with and without repositioning, and limits of agreement (LoA) were calculated.ResultsThe LoA was smallest for Vmean (35%) and highest for vPI (79%). Test–retest reliability was similar with and without repositioning of the subject.DiscussionWe found similar LoA with and without repositioning indicating that the measurement uncertainty is dominated by scanner and physiological noise, rather than by planning. This enables to study hemodynamic parameters in perforating arteries at clinically available scanners, provided sufficiently large sample sizes are used to mitigate the contribution of scanner- and physiological noise.

Reliability of IMU-based balance assessment in clinical stroke rehabilitation

BackgroundBalance is often affected after stroke, severely impacting activities of daily life. Conventional testing methods to assess balance provide limited information, as they are subjected to floor and ceiling effects. Instrumented tests, for instance using inertial measurement units, offer a feasible and promising alternative. Research questionWe examined whether postural sway can reliably be measured in sitting and standing balance in people after stroke in clinical rehabilitation using a single inertial measurement unit. Additionally, we assessed to what extent averaging two measurements would improve test-retest reliability compared to a single measurement, and if sway features can potentially be used to monitor progression. MethodForty participants performed two assessments with a test-retest interval of 24 h. Each assessment consisted of one sitting and four standing balance conditions (eyes open, feet together, eyes closed and foam). The standing balance conditions were performed twice during both assessments. In total, 35 sway features were calculated for each condition. For the standing balance conditions, these were calculated for both single test-retest measurement and the average of the two test and retest measurements. We determined the reliability using the intraclass correlation coefficient for both single and averaged measurements. Additionally, the minimal detectable change and the relative minimal detectable change were computed. ResultsThe single and averaged measurements resulted in 22 sitting, 30 & 32 eyes open, 27 & 22 feet together, 28 & 33 eyes closed and 23 & 13 foam sway features with good-excellent reliability. Overall, the difference between intraclass correlation coefficient values of the single and averaged measurements was small and inconsistent. The relative minimal detectable change ranged between 0.5 and 1.5 standard deviation. SignificanceSitting and standing balance can reliably be assessed in people after stroke in clinical rehabilitation with a single measurement using one inertial measurement unit.

Repeatability and test-retest reproducibility of mean apparent diffusion coefficient measurements of focal and diffuse disease in relapsed multiple myeloma at 3T whole body diffusion-weighted MRI (WB-DW-MRI).

To assess the test-retest reproducibility and intra/interobserver agreement of apparent diffusion coefficient (ADC) measurements of myeloma lesions using whole body diffusion-weighted MRI (WB-DW-MRI) at 3T MRI. Following ethical approval, 11 consenting patients with relapsed multiple myeloma were prospectively recruited and underwent baseline WB-DW-MRI. For a single bed position, axial DWI was repeated after a short interval to permit test-retest measurements.Mean ADC measurement was performed by two experienced observers. Intra- and interobserver agreement and test-retest reproducibility were assessed, using coefficient of variation (CV) and interclass correlation coefficient (ICC) measures, for diffuse and focal lesions (small ≤10 mm and large >10 mm). 47 sites of disease were outlined (23 focal, 24 diffuse) in different bed positions (pelvis = 22, thorax = 20, head and neck = 5). For all lesions, there was excellent intraobserver agreement with ICC of 0.99 (0.98-0.99) and COV of 5%. For interobserver agreement, ICC was 0.89 (0.8-0.934) and COV was 17%. There was poor interobserver agreement for diffuse disease (ICC = 0.46) and small lesions (ICC = 0.54).For test-retest reproducibility, excellent ICC (0.916) and COV (14.5%) values for mean ADC measurements were observed. ICCs of test-retest were similar between focal lesions (0.83) and diffuse infiltration (0.80), while ICCs were higher in pelvic (0.95) compared to thoracic (0.81) region and in small (0.96) compared to large (0.8) lesions. ADC measurements of focal lesions in multiple myeloma are repeatable and reproducible, while there is more variation in ADC measurements of diffuse disease in patients with multiple myeloma. Mean ADC measurements are repeatable and reproducible in focal lesions in multiple myeloma, while the ADC measurements of diffuse disease in multiple myeloma are more subject to variation. The evidence supports the future potential role of ADC measurements as predictive quantitative biomarker in multiple myeloma.

Development of a Manual Measurement Device for Measuring Hallux Valgus Angle in Patients with Hallux Valgus.

Background: Hallux valgus (HV) is one of the most common forefoot deformities, and its prevalence increases with age. HV has been associated with poor foot function, difficulty in fitting footwear and poor health-related quality of life. The aims of this study were to design and develop an easy-to-use measurement device for measuring hallux valgus angle (HVA) in patients with HV and to assess the measurement reliability of the newly designed measurement device. Methods: A manual measurement device for measuring HVA was designed and developed to test on patients with HV. Two measuring methods, i.e., test–retest and intra-observer measurements, were used to evaluate the repeatability and reliability of the newly designed measurement device. In the test–retest measurements, a total of 42 feet from 26 patients with HV were repeatedly measured by the same researcher using the manual measurement device every 3 weeks over a period of 12 months. The measurement reliability of the newly designed measurement device was analysed based on the collected HVA data. In the intra-observer measurements, a total of 22 feet from the same group of HV patients were measured by the same researcher using the manual measurement device and by a consultant using X-ray measurement for comparison. The intraclass correlation coefficient (ICC) was used to determine the correlation of measurements between the manual measurement device and X-ray measurement. Results: The mean of the difference between the two repeat measurements of HVA using the newly designed manual device was 0.62°, and the average of ICC was 0.995, which indicates excellent reliability. The ICC between X-ray and the average of twice-repeated manual measurements was 0.868, with 95% CI (0.649, 0.947) (p = 0.000). When the relationship in HVA between X-ray measurement and manual measurement using the new device was regressed as a linear relationship, the regression equation was y = 1.13x − 4.76 (R2 = 0.70). Conclusions: The newly designed measurement device is easy to use, with low-cost and excellent reliability for HVA measurement, with the potential for use in clinical practice.

Validity and reliability of the Turkish version of the Parent Attitudes About Childhood Vaccines (PACV) scale

AimsThis study aimed to determine the validity and reliability of the Turkish version of the “Parental Attitudes toward Childhood Vaccines” (PACV) scale. Materials and methods: A two-stage observational validation study was conducted. A back-translation technique was used and then the scale was validated with a sample of 343 parents with children aged 0–72 months. The test–retest method, Cronbach's alpha coefficient, Split-half analysis, and item analysis methods were used to determine the reliability of the scale, factor analyses were run to determine construct validity. Explanatory Factor Analysis and Confirmatory Factor Analysis were applied to assess construct validity. ResultsCronbach's alpha coefficient was measured as .84. The Spearman–Brown coefficient was .82 and the Guttman Split-half coefficient was .81. According to the item-total correlation and Cronbach's alpha values when the item was deleted, no item was deleted from the scale. The intraclass correlation coefficient between the test–retest measurements was .79. The three-factor structure consisting of 15 items explained 51.6% of the total variance. As a result of the confirmatory factor analysis, a sufficient fit of the model to the model proposed in the original version of the scale was evident (χ2/sd=2.214, RMSEA=.06). ConclusionThe Turkish version of the PACV is a valid and reliable scale and can be used to identify parental attitudes toward childhood vaccines.

A multi-modality physical phantom for mimicking tumor heterogeneity patterns in PET/CT and PET/MRI.

BackgroundHybrid imaging (e.g., positron emission tomography [PET]/computed tomography [CT], PET/magnetic resonance imaging [MRI]) helps one to visualize and quantify morphological and physiological tumor characteristics in a single study. The noninvasive characterization of tumor heterogeneity is essential for grading, treatment planning, and following‐up oncological patients. However, conventional (CONV) image‐based parameters, such as tumor diameter, tumor volume, and radiotracer activity uptake, are insufficient to describe tumor heterogeneities. Here, radiomics shows promise for a better characterization of tumors. Nevertheless, the validation of such methods demands imaging objects capable of reflecting heterogeneities in multi‐modality imaging. We propose a phantom to simulate tumor heterogeneity repeatably in PET, CT, and MRI.MethodsThe phantom consists of three 50‐ml plastic tubes filled partially with acrylic spheres of S1: 1.6 mm, S2: 50%(1.6 mm)/50%(6.3 mm), or S3: 6.3‐mm diameter. The spheres were fixed to the bottom of each tube by a plastic grid, yielding one sphere free homogeneous region and one heterogeneous (S1, S2, or S3) region per tube. A 3‐tube phantom and its replica were filled with a fluorodeoxyglucose (18F) solution for test–retest measurements in a PET/CT Siemens TPTV and a PET/MR Siemens Biograph mMR system. A number of 42 radiomic features (10 first order and 32 texture features) were calculated for each phantom region and imaging modality. Radiomic features stability was evaluated through coefficients of variation (COV) across phantoms and scans for PET, CT, and MRI. Further, the Wilcoxon test was used to assess the capability of stable features to discriminate the simulated phantom regions.ResultsThe different patterns (S1–S3) did present visible heterogeneity in all imaging modalities. However, only for CT and MRI, a clear visual difference was present between the different patterns. Across all phantom regions in PET, CT, and MR images, 10, 16, and 21 features out of 42 evaluated features in total had a COV of 10% or less. In particular, CONV, histogram, and gray‐level run length matrix features showed high repeatability for all the phantom regions and imaging modalities. Several of repeatable texture features allowed the image‐based discrimination of the different phantom regions (p < 0.05). However, depending on the feature, different pattern discrimination capabilities were found for the different imaging modalities.ConclusionThe proposed phantom appears suitable for simulating heterogeneities in PET, CT, and MRI. We demonstrate that it is possible to select radiomic features for the readout of the phantom. Most of these features had been shown to be relevant in previous clinical studies.

Ultrasound imaging of patellar tendon thickness in elite sprint track cyclists and elite soccer players: An intra-rater and inter-rater reliability study.

The goal of our study was to investigate the relative and absolute intra-rater and inter-rater reliability of ultrasound assessment of patellar tendon (PT) thickness assessed over four locations, in track cyclists and soccer players. Fifteen male elite track cyclists and 15 male elite soccer players participated. Tendon thickness was measured over 4 locations placed at 5-10-15-20 mm inferior to the apex of the patella by two experienced examiners. Each examiner took two US images for the test measurements with a 10-min rest period. After a 30-min period, the subjects underwent a retest measurements that were also repeated 1-week after. A two-way analysis of variance revealed a significant group x location interaction on PT thickness for Examiner 1 (p = .001, η2 = .81) and Examiner 2 (p = 0.001, η2 = 0.78). Intra-rater reliability ranged from good to excellent (ICC2,k ≥ 0.75), whereas inter-rater reliability was good (ICC2,k ≥ 0.75) in both groups. Ultrasonographic assessment of PT was found to be a reliable method to assess tendon thickness. The middle location of the PT (corresponding to 15 and 20 mm) can be considered the most reliable spot to measure PT thickness. The PT thickness was larger among track cyclists than soccer players, with larger differences over the distal location (15 mm). Ultrasonographic assessment of PT was found to be a reliable method to assess tendon thickness. The middle location of the PT corresponding to 15 mm and 20 mm can be considered the most reliable area to measure PT thickness.

Using wireless inertial measurement units for measuring hip range of motion through commonly used clinical tests

Hamstring extensibility is a crucial component of athletic performance and spinal health. In this regard, hip range of motion analysis through standardized clinical tests has been used as a valid and reliable method for measuring hamstring extensibility. Consequently, new inertial devices have been designed for this purpose. The aims of this study were to: (i) analyze the concurrent validity of inertial sensors for measuring hamstring extensibility through the Active Straight Leg Raise (ASLR) and Passive Straight Leg Raise (PSLR) tests; and (ii) analyze the test-retest reliability of inertial sensors for measuring hamstring extensibility through the ASLR and PSLR tests. A total of 18 healthy participants took part in this cross-sectional study. The hamstring extensibility was measured through the range of motion of the left and right hip in the Active Straight Leg Raise (ASLR) and Passive Straight Leg Raise (PSLR) tests. Data were collected by inertial sensors (WIMU Pro) and an ISOMED bi-level inclinometer, which was used as the reference instrument. The inertial sensors reported a standard error of the measurement (SEM) below 0.6° in all measurements. The R2 correlation and the intraclass correlation coefficient (ICC) were very close to 1 in all measurements. Regarding the reliability analysis, there were no significant differences ( p &gt; 0.05) between test and retest measures, and the SEM were below 0.8° in both instruments. The ICC were close to 1 in all cases as well. The coefficients of variation (CV) were below 2.7% in the inertial device and 2.2% in the inclinometer. This study showed that using microtechnology through WIMU Pro may be a valid and reliable method for measuring hip range of motion during the ASLR and PSLR tests.

Remote Monitoring of Adult Cochlear Implant Recipients Using Digits-in-Noise Self-Testing.

The COVID-19 pandemic has accelerated the uptake and scope of telehealth. This study determined the accuracy and reliability of a smartphone digits-in-noise (DIN) test when conducted by adult cochlear implant (CI) recipients in a simulated home environment compared with a clinic setup. Perceptions of remote monitoring using speech-in-noise (SIN) testing were also explored. Thirty-three adult CI recipients between 18 and 78 years of age (M = 46.7, SD = ±20.4) conducted the DIN test in a simulated home environment and a clinic setup. Test-retest reliability across the two environments and comparisons between test settings were evaluated. A survey explored the perceptions of adult CI recipients regarding remote monitoring and use of the DIN self-test. Mean-aided speech reception thresholds (SRTs) in the clinic and simulated home environment test conditions and clinic and simulated home environment retest conditions did not differ significantly. Mean test-retest SRTs in the clinic and simulated home environment were significantly different (p < .05). High intraclass correlation coefficient and low standard error of measurement scores reflected good and excellent reliability between test-retest measures and between clinic and simulated home environment measures. Most participants were positive about the possibility of using the DIN test at home to self-assess speech perception, although some test adjustments such as including training items and a less adverse starting signal-to-noise ratio may be required. Adult CI recipients can use the smartphone DIN test to self-assess aided SIN performance in a home environment with accuracy and reliability relatively similar to clinic testing. https://doi.org/10.23641/asha.20044418.