Standardized Assessment Tools Research Articles

Predicting stroke severity of patients using interpretable machine learning algorithms.

Stroke is a significant global health concern, ranking as the second leading cause of death and placing a substantial financial burden on healthcare systems, particularly in low- and middle-income countries. Timely evaluation of stroke severity is crucial for predicting clinical outcomes, with standard assessment tools being the Rapid Arterial Occlusion Evaluation (RACE) and the National Institutes of Health Stroke Scale (NIHSS). This study aims to utilize Machine Learning (ML) algorithms to predict stroke severity using these two distinct scales. We conducted this study using two datasets collected from hospitals in Urmia, Iran, corresponding to stroke severity assessments based on RACE and NIHSS. Seven ML algorithms were applied, including K-Nearest Neighbor (KNN), Decision Tree (DT), Random Forest (RF), Adaptive Boosting (AdaBoost), Extreme Gradient Boosting (XGBoost), Support Vector Machine (SVM), and Artificial Neural Network (ANN). Hyperparameter tuning was performed using grid search to optimize model performance, and SHapley Additive Explanations (SHAP) were used to interpret the contribution of individual features. Among the models, the RF achieved the highest performance, with accuracies of 92.68% for the RACE dataset and 91.19% for the NIHSS dataset. The Area Under the Curve (AUC) was 92.02% and 97.86% for the RACE and NIHSS datasets, respectively. The SHAP analysis identified triglyceride levels, length of hospital stay, and age as critical predictors of stroke severity. This study is the first to apply ML models to the RACE and NIHSS scales for predicting stroke severity. The use of SHAP enhances the interpretability of the models, increasing clinicians' trust in these ML algorithms. The best-performing ML model can be a valuable tool for assisting medical professionals in predicting stroke severity in clinical settings.

A single-blind, randomised control trial on the effectiveness of a structured multi component training module for family caregiver of persons with Parkinson's disease: A study protocol.

Parkinson disease (PD), a neurodegenerative disorder that progresses over time, is steadily growing in number and prevalence worldwide. PD in Malaysia is expected to increase five-fold by 2040 from the existing estimate of 20,000 patients in 2018. Treatment program of PD in Malaysia is rather unstructured, and there is no known comprehensive PD family caregiver training program available to date. To ensure the quality of a program, it must be tested for feasibility, effectiveness and sustainability. This paper describes the protocol of a study that evaluates the effectiveness of a structured, comprehensive training program of family caregiver to persons with PD in comparison to usual care. A total of 60 pairs of persons with PD of stage II and III, and their primary family caregiver will be recruited and allocated into either an experimental or a control group for 12 weeks of intervention. The experimental group will undergo initial training from multi-disciplinary healthcare providers and will be given a physical module containing weekly tasks that must be practised at home. While the control group will receive a usual care. Both groups will be assessed in terms of physical functions, functional mobility, quality of life (QoL), caregiver burden and knowledge using standardised assessment tools namely Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Timed Up and Go (TUG) test, Parkinson's Disease Questionnaire (PDQ-39), European Quality of Life five-dimensions (EQ-5D), Malay version of Zarit Burden Interview (MZBI) and Knowledge of Parkinson Disease Questionnaire (KPDQ). In addition, the feasibility and sustainability of the interventions will be evaluated, alongside its cost-effectiveness based on the average and incremental cost effectiveness ratio. All data will be analysed using descriptive and inferential statistics, particularly mixed model ANOVA. There is a significant gap in the literature pertaining family caregiver training programs for people with PD. Documented programs are lacking in term of comprehensiveness of content, application approach and the measurement of training outcomes including the program cost-effectiveness. The feasibility and effectiveness of such training program in a Malaysian setting also requires investigation due to differences in living environment, support system and population's perception. This study will assist to fulfil the existing literature gap and demonstrate the potential benefit of caregiver involvement in mediating the care and therapy for PD in the home setting. Optimum knowledge and skills gained through the training are expected to enhance the confidence and ability of the family caregivers and may possibly reduce their perceived caregiving burden. The protocol of this study is registered in the Australian-New Zealand Clinical Trial Registry (ANZCTR) with a registration number ACTRN12623000336684.

Competency-based medical education in interventional pulmonology: current state and future opportunities.

This chapter examines the evolution and current status of competency-based medical education (CBME) in interventional pulmonology, focusing on procedural skills assessment and training. Traditionally, interventional pulmonology training has used an apprenticeship model with case logs and director attestation, leading to inconsistent outcomes due to a lack of standardized curricula. CBME, established to address these issues, relies on outcome-based assessments to ensure trainees achieve necessary competencies. The chapter reviews various assessment tools, including global rating scales, checklists, and simulation-based methods, and their effectiveness in skill acquisition and clinical evaluation. It also covers specific procedures such as EBUS-TBNA, electromagnetic navigation bronchoscopy, and rigid bronchoscopy, discussing their assessment tools and learning curves. The chapter emphasizes the need for standardized assessment tools and suggests using entrustable professional activities (EPAs) to improve competency evaluation. Future directions include integrating real-time artificial intelligence feedback, addressing high-risk low-volume procedures, and enhancing workplace-based assessments to improve interventional pulmonology training and patient care quality. This chapter reviews the transition from traditional apprenticeship models to CBME in interventional pulmonology, highlighting advancements in procedural skills assessment, the effectiveness of various assessment tools, and future directions for improving training and patient care.

Impact of Fractional Ablative Laser Therapy on Function, Symptoms, and Quality of Life in the Management of Traumatic Scars: A Review.

A substantial and expanding body of literature addresses the safety and efficacy of fractional ablative laser therapy for traumatic scarring resulting from burns and other trauma. However, available scar research commonly employs standardized assessment scales that generally do not directly address the impact on function and overall quality of life. Unlike past reviews, this manuscript will explore available evidence with a focus explicitly on function and quality of life (QoL) outcomes and de-emphasize surrogate outcome measures that rely primarily on visual characteristics. Through literature review conducted up to January 2024, the authors examined relevant studies focusing on function and quality of life outcomes in traumatic and burn scar management with fractional ablative laser therapy. PubMed, EMBASE, MEDLINE, and Cochrane Library were utilized as primary databases. Reference lists were secondarily reviewed to supplement the literature review process. Studies that did not highlight functional or QoL endpoints or were not in the English language were excluded. The reviewed studies demonstrated that fractional ablative therapy led to consistent significant and meaningful improvements in functional outcomes, relief from pruritus and pain, and overall enhancements in quality of life for patients with traumatic scarring. Adverse events associated with fractional ablative therapy were infrequent and generally of mild severity, indicating a favorable safety profile. The findings from this literature review document ample existing evidence supporting the efficacy and safety of fractional ablative therapy to enhance function, mobility, reduce pruritus and pain, and improve overall QoL. Fractional ablative laser therapy should be integrated more widely into standard management protocols. Given the previous reliance on standardized scar assessment tools that heavily integrate visual characteristics, future studies should prioritize functional and QoL outcomes to further advance scar management protocols and optimize patient care.

Overcoming barriers and harnessing facilitators in the implementation of interprofessional education in pharmacy: insights and future directions

Abstract Introduction Interprofessional education (IPE) is increasingly recognized as vital for preparing pharmacy students for the collaborative demands of healthcare. Effective integration of IPE into pharmacy curricula not only aligns with educational standards but also equips students with essential skills for collaborative practice. However, the practical challenges and facilitators influencing the success of these initiatives remain underexplored. This systematic review aims to fill this gap by examining the real-world challenges and enablers encountered during the implementation of IPE within pharmacy education, drawing insights from existing literature and case studies. Aim This study seeks to identify key barriers and facilitators in the implementation of IPE among pharmacy educators and to propose strategies that can enhance the effectiveness and sustainability of IPE in pharmacy curricula. Methods This review was registered with PROSPERO (CRD42021244892) and included peer-reviewed articles published after September 2015 that discuss IPE implementation in pharmacy education. Relevant databases such as MEDLINE, CINAHL, PsycINFO, and Web of Science were meticulously searched in March 2021. The Kirkpatrick’s Evaluation Model (KEM) was utilized to assess the impact levels of IPE activities, focusing particularly on the qualitative aspects of implementation challenges and facilitators. Data extraction was performed, and the methodological quality of the studies was critically appraised using the Mixed Methods Appraisal Tool (MMAT). The research was approved by The University of Lincoln Ethics Approval System (LEAS), Research Ethics Committee on 15/02/2021 (Ref: 2021_5301). Results Fourteen studies met the inclusion criteria, showcasing a range of outcomes from successful to challenging implementations. The analysis identified several facilitators that contributed to successful IPE, including strong institutional support, active faculty engagement, and alignment of IPE activities with core curricular goals. Effective communication and ongoing professional development were also highlighted as critical. Conversely, significant barriers included logistical constraints, such as scheduling conflicts and resource limitations, resistance from faculty accustomed to traditional teaching methods, and a lack of standardized assessment tools to measure long-term outcomes of IPE initiatives. Discussion/Conclusion The findings underscore the complexity of implementing IPE in pharmacy education, pointing to the need for comprehensive strategies that address both pedagogical and logistical challenges. It is imperative that future IPE initiatives consider these factors to enhance the integration and sustainability of interprofessional collaboration in pharmacy training programs. Understanding the dynamics of implementing IPE within pharmacy curricula is crucial for fostering effective educational practices. This review not only sheds light on the current landscape of IPE implementation but also serves as a foundation for developing actionable strategies to overcome barriers and leverage facilitators. Future research should focus on longitudinal studies and innovative pedagogical models to bridge the gap between theoretical frameworks and practical execution, ensuring that pharmacy education remains responsive to the evolving needs of the healthcare sector. Reference 1. El Nsouli, Dayana, et al. “The application of Kirkpatrick’s evaluation model in the assessment of interprofessional simulation activities involving Pharmacy Students: A Systematic Review.” American Journal of Pharmaceutical Education, vol. 87, no. 8, Aug. 2023, https://doi.org/10.1016/j.ajpe.2023.02.003.

A Costly Cure: Understanding and Addressing Financial Toxicity in Cardiovascular Disease Health Care Within the Domain of Social Determinants of Health.

Cardiovascular disease (CVD) represents a significant financial burden on patients and families, compounded by both direct and indirect healthcare costs. The increasing prevalence of CVD, coupled with the rising costs of treatment, exacerbates financial toxicity-defined as the economic strain and associated physical, emotional, and behavioral consequences on patients. This review explores the scope of financial toxicity in CVD care, detailing its prevalence, associated risk factors, and the complex interplay with social determinants of health such as income, insurance status, and comorbidities. Drawing from models in oncology, we highlight key interventions aimed at mitigating financial toxicity, including patient counseling, financial navigation, and enhanced patient-physician cost discussions. By adopting these approaches, healthcare providers can better support patients with CVD in managing both their health and financial well-being, potentially improving clinical outcomes. Future research is needed to develop standardized assessment tools for financial toxicity in CVD and implement system-wide mitigation strategies.

Concordance between humans and GPT-4 in appraising the methodological quality of case reports and case series using the Murad tool

BackgroundAssessing the methodological quality of case reports and case series is challenging due to human judgment variability and time constraints. We evaluated the agreement in judgments between human reviewers and GPT-4 when applying a standard methodological quality assessment tool designed for case reports and series.MethodsWe searched Scopus for systematic reviews published in 2023–2024 that cited the appraisal tool by Murad et al. A GPT-4 based agent was developed to assess the methodological quality using the 8 signaling questions of the tool. Observed agreement and agreement coefficient were estimated comparing published judgments of human reviewers to GPT-4 assessment.ResultsWe included 797 case reports and series. The observed agreement ranged between 41.91% and 80.93% across the eight questions (agreement coefficient ranged from 25.39 to 79.72%). The lowest agreement was noted in the first signaling question about selection of cases. The agreement was similar in articles published in journals with impact factor < 5 vs. ≥ 5, and when excluding systematic reviews that did not use 3 causality questions. Repeating the analysis using the same prompts demonstrated high agreement between the two GPT-4 attempts except for the first question about selection of cases.ConclusionsThe study demonstrates a moderate agreement between GPT-4 and human reviewers in assessing the methodological quality of case series and reports using the Murad tool. The current performance of GPT-4 seems promising but unlikely to be sufficient for the rigor of a systematic review and pairing the model with a human reviewer is required.

Analysis of the quality of life in patients with multiple sclerosis within 3 years after high-dose immunosuppressive therapy with autologous hematopoietic stem cell transplantation

Introduction. To date, data have been accumulated indicating the high effectiveness of the HDIT-AHSCT and the possibility of preserving and improving the quality of life of patients after its application.The objective was to analyze the dynamics of quality of life using standardized assessment tools in patients with MS for 3 years after the use of HDIT-AHSCT, who participated in the program of clinical approbation of the method.Methods and materials. The single-center observational study included 21 patients (10 women, 11 men) with a reliable diagnosis of MS, who underwent HDIT-AHSCT at the Pavlov First Saint Petersburg State Medical Universityin accordance with the protocol of clinical approbation. Distribution by type of MS course: remitting (RMS) 16 (76.2 %), secondary progressive (SPMS) 4 (19 %), primary progressive (PPMS) 1 patient (4.8 %). The assessment of quality of life (SF-36, FAMS, CSP-MS42, HADS) and severity of disability (EDSS) in all patients was performed before, 12 and 36 months after HDIT-AHSCT.Results. Three years after the HDIT-AHSCT, a significant decrease in weakness, feelings of constant fatigue and rapid fatigue during exertion was recorded. The level of anxiety decreased in more than 50 % of patients. A direct relationship between the dynamics of clinical characteristics and the data of the scales of the SF-36 questionnaire was revealed; at the same time, after 36 months, an improvement in all parameters of the scale was noted.Conclusion. The assessment of the indicators of the quality of life questionnaires allows us to confirm the effectiveness and significance of therapy not only from the point of view of objective clinical and radiation parameters necessary for the evidence base of the treatment method, but also from the patient’s position, which in conditions of a chronic progressive process is an integral factor for the appointment of therapeutic intervention.

Exploring Korean Medicine professions' perspectives on the applicability of ChatGPT in facial palsy practice: A web-based survey

IntroductionSince November 2022, when Chat generative pre-trained transformer (ChatGPT) was released, studies have been conducted to explore its potential use in various text-based areas. In the field of Korean Medicine (KM), studies evaluating the feasibility of ChatGPT are mainly focused on the educational domain. This study aimed to 1) identify the current level of ChatGPT-generated responses in answering questions from patients and KM practitioners, specifically exemplified by facial palsy and 2) explore the potential applicability of ChatGPT in KM practice through a perception survey of experts. MethodsThis study evaluates the applicability of ChatGPT concerning facial palsy through a survey of board-certified acupuncturists. The survey comprises two parts: assessing response quality for patients and for KM doctors in clinical practice. Ethical approval was obtained, and a 36-item questionnaire was administered online to 33 participants. Responses were analyzed for quality, relevance, and applicability using a combination of Likert scales and a standardized assessment tool. ResultsAmong 33 eligible participants, 30 board-certified acupuncturists agreed to participate (response rate: 90.9%). Survey results showed that the applicability of ChatGPT was lower for specialized KM practitioner inquiries than for general patient inquiries. Although the responses were considered useful to the readers (part 1: 96.7%, part 2: 63.3%) and understandable (part 1: 66.7%, part 2: 60%), the proportion of positive evaluations was relatively low in the domains assessing reliability and sufficiency. ConclusionsThough ChatGPT is generally viewed positively for its potential utility, its direct application in KM clinical practice treating facial palsy at its current level seems challenging. To improve reliability, the information generated by ChatGPT should be critically reviewed by qualified expert medical personnel. To enhance sufficiency, further training of the artificial intelligence model with additional KM information is required.

Validation of the European French Version of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-Vf)

ObjectiveThis study aimed to validate the French adaptation of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-Vf) for assessing voice disorders in France. The CAPE-Vf addresses limitations of the GRBAS by providing a more sensitive, standardized approach to evaluating six vocal parameters (overall severity, roughness, breathiness, strain, pitch, and loudness) on three tasks (sustained vowels, sentence reading, and spontaneous speech). The study focused on investigating the intra- and inter-rater reliability, as well as the convergent and discriminant validity of the CAPE-Vf. MethodsThirty-four dysphonic and seven euphonic native French speakers participated in the study. Thirteen speech-language pathologists from France evaluated the voice samples using both the CAPE-Vf and GRBAS tools at a one-week interval. Intra- and inter-rater reliability were calculated using intraclass correlation coefficients (ICC), while convergent and discriminant validity were measured by correlating CAPE-Vf with GRBAS and Voice Handicap Index (VHI) scores, respectively. ResultsThe CAPE-Vf showed good intra-rater reliability for overall severity (mean ICC: 0.89), strain (ICC: 0.83), and pitch (ICC: 0.88), while roughness, breathiness, and loudness exhibited moderate reliability. Inter-rater reliability was low for most parameters, except overall severity, which demonstrated good reliability (mean ICC: 0.77). Strong correlations were observed between CAPE-Vf and GRBAS Grade (mean r: 0.84), supporting its convergent validity. Moderate correlations were found for roughness, breathiness, and strain. The CAPE-Vf’s correlation with the VHI was moderate (mean r: 0.53), reflecting its discriminant validity. ConclusionThe CAPE-Vf is a valid and reliable tool for perceptual assessment of voice disorders in French-speaking populations, with stronger psychometric properties than the GRBAS, particularly for intra-rater reliability and overall severity. While inter-rater reliability was lower, qualitative feedback suggested that improvements to the protocol, particularly for pitch and loudness ratings, could enhance its clinical applicability. The findings support the CAPE-Vf as a comprehensive tool for standardized clinical voice assessment.

The First Standardized Scoring System to Assess the Welfare of Free‐Ranging Indo‐Pacific Humpback Dolphins (Sousa chinensis)

ABSTRACTThe assessment of wild animal welfare has recently gained interest and represents a novel, complementary approach to monitoring free‐ranging populations for conservation purposes. However, few attempts have been made to develop standardized welfare assessment tools for free‐ranging animals. In the present study, a preliminary scoring system for the welfare assessment of Indo‐Pacific humpback dolphins (IPHDs) was created using the Five Domains Model. During a series of online meetings, the panel established the scoring unit, the contribution of each parameter to the four physical/functional domains, the inferred mental states and impact intensity associated with each of these parameters, and the method of aggregating parameter scores within and among domains. The resulting framework includes a total of 53 parameter scores. A total of 20 welfare‐status and 33 welfare‐alerting parameters were identified; these are aggregated into two overall welfare grades for enhancement (positive experiences) and compromise (negative experiences). The panel attributed confidence scores to the intensity impact reflected by each parameter and associated mental states. As expected, these scores reflect higher confidence in welfare‐status than welfare‐alerting parameters; welfare compromise was also attributed higher confidence than welfare enhancement and Domain 1 (Nutrition) globally received higher confidence scores than other domains. As with any expert elicitation study, subjective biases likely exist; these can be reduced through further research on the suggested parameters. The framework uses current knowledge and has been developed to enable continual improvement as further evidence becomes available on various parameters. This study represents an important step in the development of a welfare assessment tool (WAT) for IPHDs. Next steps include defining measurement methods and thresholds for scoring parameter intensities, followed by reliability testing. This WAT can then be used to systematically monitor populations of IPHDs in a way that will better inform conservation measures and ensure their effectiveness.

Factors Considered for the Assessment of Risk in Administrative Review Boards of Canada: A Scoping Review

Background: This scoping review examines the risk factors considered in assessing the dangerousness of individuals found Not Criminally Responsible on Account of Mental Disorder (NCRMD) in Canadian administrative courts. This review aims to identify the factors used by mental health review boards during annual case reviews to guide decisions on detention or release. Methods: Using a scoping review approach following PRISMA guidelines, this study analyzed research across multiple databases to identify relevant studies focusing on risk assessment for NCRMD cases. Results: The findings indicate that five primary categories of risk factors—historical, clinical, behavioral, legal, and miscellaneous—are influential in the decision-making process. Historical factors, such as past violence and early psychiatric contacts, are critical in predicting future risk. Clinical factors, including psychiatric diagnosis and treatment adherence, are key to evaluating current and potential future risks. This study reveals variability in the application of standardized risk assessment tools, highlighting a need for more consistent practices across Canadian jurisdictions. Conclusion: This review concludes that, while a multifaceted approach to risk assessment is essential for balancing public safety with individual rehabilitation, further research is needed to refine these processes and establish more uniform standards for managing NCRMD cases in forensic psychiatry.

Unveiling a hidden burden: exploring sarcopenia in hospitalized older patients through concordance and cluster analysis

BackgroundSarcopenia has been shown to be an important condition with the ability to predict negative health outcomes, especially in hospitalized older adults; hence, its accurate identification has an important role in the prognosis of older patients.AimThe prevalence of sarcopenia among hospitalized older adults was assessed by employing three distinct diagnostic methods.MethodsOlder adults who were hospitalized were recruited. Bioelectrical impedance analysis was used to assess muscle mass and body composition. Sarcopenia was diagnosed via the European and Asian criteria and via a modified approach in which the Colombian cutoff points for handgrip and gait speed were used. Finally, a cluster analysis was performed to classify the population.ResultsThe prevalence rates of sarcopenia and severe sarcopenia ranged from 7.3 to 31.6%. The agreement between approaches revealed substantial or almost perfect agreement in 30% of the sarcopenia comparisons and 46.6% of the severe sarcopenia comparisons. The cluster analysis defined three different clusters. The first cluster was associated with increased age, BMI and body fat and poorer functional status and muscle. The second cluster was the healthiest, with high functional status and muscle mass. The third cluster had intermediate characteristics.DiscussionThis study highlights the requirements for standardized diagnostic criteria and precise body composition assessment tools in acute geriatric units and highlights the heterogeneity of older adults. Accurate assessment and well-defined diagnostic criteria will facilitate the implementation of appropriate management and interventions.ConclusionSarcopenia is highly prevalent in hospitalized older adults, but the adjusted criteria and the inclusion of other parameters must be considered in the assessment.

Development and validation of a tool for assessing breast cancer health literacy among Chinese women

Abstract Background Breast cancer (BC) is a major malignancy that seriously threatens women’s health. No unified, evidence-based, standardized assessment tools for BC literacy are available in China yet. Objectives We sought to develop an assessment tool to measure BC health literacy among Chinese women and to test the tool’s reliability, validity, and feasibility. Methods Group discussion, expert consultation, and small-sample pilot investigation were conducted to develop an initial assessment tool. A multi-stage stratified random-sampling process was used to select women aged 18-64 years in Yichang City, Hubei Province, China, for an onsite survey. Project analysis and exploratory factor analysis were used to screen the questions to create a formal assessment tool, which was further evaluated by feasibility analysis and the measurement of reliability and validity. Results The official version of the assessment tool for Chinese female BC health literacy includes 32 items. Nine common factors (policy knowledge, uncorrectable risk factors, modifiable risk factors, identification of early warning signs #1 and #2, screening methods, breast self-awareness and examination behaviors, timely seeking of medical help and standardized treatment, and rehabilitation) were extracted through exploratory factor analysis with factor loadings of 0.511-0.873 and a cumulative explained variance of 65.989%. Confirmatory factor analysis revealed χ2/df = 1.61, CFI = 0.91, TLI = 0.90, RMSEA = 0.04, and SRMR = 0.06. The overall Cronbach’s α coefficient was 0.875, and the split-half reliability was 0.770 (both &amp;gt;0.700). Conclusions An assessment tool for Chinese female BC health literacy was developed with acceptable feasibility, reliability, and validity. The application of this tool can help to promote BC prevention and control in China and may also benefit other countries. Key messages • An assessment tool for Chinese female BC health literacy was developed with acceptable feasibility, reliability, and validity. • The application of this tool can help to promote BC prevention and control in China and may also benefit other countries.

Validation of a Photonumeric Scale for Evaluation of Telangiectasia in Rosacea.

Telangiectasia is a prominent feature of rosacea leading to a high demand for effective treatment. To ensure consistent clinical and scientific evaluations and assess treatment response accurately, standardized assessment tools are necessary for grading the severity of telangiectasia. However, no validated grading scales for this condition are currently available. To develop and validate a photonumeric scale for assessing the severity of telangiectasia in rosacea patients. The five-point photonumeric Telangiectasia in Rosacea Severity Assessment (TRoSA) scale was developed for the severity of telangiectasia in rosacea. Sixteen experts participated in the validation process, evaluating 50 images of rosacea patients in two rounds. Interrater and intrarater reliability were analyzed using the intraclass correlation coefficient (ICC) and weighted kappa, respectively. Interrater reliability was found to be "almost perfect" in both validation rounds (Round 1: ICC 0.847; Round 2: ICC 0.828). The mean weighted kappa indicated "substantial" intrarater reliability between the two rounds with a weighted kappa of 0.719. A bubble plot of the two rounds illustrated a diagonal order, confirming the consistency of the intrarater agreement. The TRoSA scale demonstrated high interrater and intrarater reliability indicating that it is a consistent and reproducible tool for grading the severity of telangiectasia in rosacea. This scale can standardize clinical assessments, assisting in diagnosis, treatment planning, and evaluation of therapeutic efficacy.

Psychometric and edumetric properties of the Turkish version of the assessment of physiotherapy practice

BackgroundClinical education is a crucial process in which students learn how to use theoretical knowledge in clinical settings. However, there is no standardized assessment tool routinely used to evaluate the clinical performance of physiotherapy students in Turkey. This study aimed to examine the psychometric (validity and reliability) and edumetric (acceptability, feasibility, and educational impact) properties of the Turkish version of the Assessment of Physiotherapy Practices (APP-T).MethodsThis methodological study included 7 clinical educators and 174 4th-grade physiotherapy students at three universities in Turkey. Students were assessed with the APP-T on completion of 4-week clinical placements. The construct validity was examined using the exploratory factor analysis. The internal consistency was determined using Cronbach’s α-coefficient. The test-retest and inter-rater reliability were evaluated with the intra-class correlation coefficient (ICC). For the measurement error of the APP-T, standard error of measurement (SEM) and minimum detectable change (MDC) values were calculated. After the administration of the APP-T was completed, clinical educators were requested to provide feedback on the acceptability, applicability, and educational impact of the APP-T.ResultsExploratory factor analysis demonstrated the 20 items of the APP-T represent a single dominant dimension explaining 76.28% of the variance. Excellent test-retest and inter-rater reliability was detected by ICC = 0.94 and ICC = 0.77, respectively, and good internal consistency was detected by Cronbach’s α = 0.935. The MDC90 values for test-retest and inter-rater reliability were 3.11 and 6.86, respectively. Clinical educators provided generally positive feedback on the acceptability, feasibility, and educational impact of the APP-T.ConclusionsThe current findings provided evidence for universities and clinical educators that the APP-T has sufficient psychometric and educational properties for evaluating the clinical performance of physiotherapy students in Turkey.

GeriNOT in the Surgical Inpatient Setting.

The guideline of the Federal Joint Committee (G-BA) on quality assessment measures for the care of patients with hip fracture makes it mandatory for hospitals to use an appropriate geriatric screening instrument in the context of acute inpatient care. After systematic application of GeriNOT and data collection in the admission process with integration into the Hospital Information System (HIS), it is possible to identify potential risks in geriatric patients with other diagnoses as well.With the integration of GeriNOT into the acute inpatient admission process, it was examined whether vulnerable geriatric patients with other diagnoses could benefit from the early initiation of risk identification.The data base for the present study was a retrospective bicentric collection of electronic case records (May 2014 to April 2015, n=3,443). From this primary data set, the subgroup of inpatient acute admissions (n=821) in the orthopaedic/trauma surgery of a study centre was analysed and evaluated with respect to the endpoints "utilisation of needs-based post-inpatient care services" and "new admission to inpatient permanent/short-term care". The predictive power and classification accuracy of GeriNOT of these patients who were 70 years and older to the endpoints were assessed for several groups: total acute admissions, total fractures, hip fracture, and spinal disorders including spinal fractures.A total of 821 patients were admitted as acute inpatients during the study period. The mean age of the patients was 81.4±6.8 years (n=821; 68.1% women, 31.9% men). The following subgroups were formed and analysed: total fractures (n=490), spinal disorders (n=265) including spinal fractures (n=174), and hip fracture (n=108). Both in the overall group (n=821; M=4.279; SD=2.180) and in the subgroups, the mean GeriNOT score was above the threshold ≥4. The highest score was found in the hip fracture group (M=4.852; SD=2.022), and the lowest in the spine fracture group (M=4.177; SD=2.171). At admission, if the terms of variables for requiring treatment were "polypharmacy" and "nursing services already used as needed", there were only slight differences in the diagnostic groups. Admissions from short-term and long-term care occurred in the total group in 16.44% of cases, most frequently with 31.48% in the group of hip fractures, compared to spinal diseases with 6.79%. For this group, GeriNOT detected an elevated risk with respect to the defined endpoints. However, only 4.26% of all patients with identified geriatric risk potential received further geriatric care.The results showed increased geriatric risk in all analysed groups, but most pronouncedly within the group of spinal diseases. The HIS-supported use of GeriNOT offers the possibility of systematic risk identification in acute inpatient admission management. The continuous visualisation of results at HIS workstations throughout the workflow could be used as a starting point for the subsequent application of standardized assessment tools and risk-adjusted treatment pathways. These findings could potentially improve outcomes.

Chronic pain in European adult populations: a systematic review of prevalence and associated clinical features

Abstract Chronic pain (CP) is a multifaceted and severely disabling persistent condition that affects individuals worldwide. A synthesis of epidemiological data is still lacking. The present systematic review aims at presenting point, period, and lifetime prevalence estimates of CP in the European adult population, as well as relevant features associated with it. Following PRISMA guidelines, a systematic search in PubMed, Web of Science, Embase, and Cochrane library was run from inception to May 2024, resulting in 39,832 hits. Among those, 132 full-text articles were assessed, and 23 studies comprising 862,013 participants with CP were included. The Joanna Biggs Institutes' Critical Appraisal Checklist for Studies Reporting Prevalence Data (JBI) was used for quality assessment. Findings showed a point prevalence ranging from 12% to 48%, a 6-month prevalence of 17.5% to 49.8%, a 12-month prevalence ranging from 8.1% to 44.6%, and a lifetime prevalence ranging from 12.7% to 33.7% independently from sex. Sociodemographic factors (eg, female sex, higher age, no partnership, lower education, unemployment) and clinical features (eg, medical diseases, mental disorders and burdens, healthcare utilization, functional impairment) were identified as being associated with CP. The variability in prevalence estimates can be reduced by applying consistent diagnostic criteria (eg, ICD-11) and by using standardized assessment tools (eg, scales, clinical interview). The high prevalence and the characteristics of the associated features support the need for adequate, multicomponent care paths to manage CP based on a comprehensive biopsychosocial model.

Comparison of Volleyball Skills of Rural and Urban Students in Bardiya

This study aims to compare the volleyball skills of rural and urban secondary school students in Bardiya district. A descriptive research method was employed, and respondents were selected using a random sampling technique. The AAHPER volleyball skill test, a standardized assessment tool, was utilized, comprising four specific skills: volleying, serving, passing, and setting. To analyze the data, various statistical techniques were applied as required. Each test item was compared separately between the rural and urban groups. The findings indicated that the mean scores of rural school students were higher for all four skills. A Z-test was conducted to determine the significance of the differences, revealing significant differences in each skill item. The study concluded that rural secondary school students in Bardiya district possess better volleyball skills compared to their urban counterparts. This conclusion is based on the higher mean scores and significant differences observed in the AAHPER volleyball skill test items. These findings suggest that rural students may have more opportunities or better conditions for developing their volleyball skills compared to urban students in this region. The findings of this study may be helpful to the coaches and selectors of players of volleyball game to find new players who possess potentiality to be good player of the game.

Initial Development of the Nurse Perception of Infant Condition (NPIC) Scale.

More than 350,000U.S. infants are admitted to the neonatal intensive care unit (NICU) annually and likely experience discomfort. Although nurse perceptions of infant symptoms, suffering, and quality of life (QOL) are valuable, the availability of standardized assessment tools to measure these concepts are limited. To provide preliminary evidence of the internal structure, reliability, and validity of the Nurse Perception of Infant Condition (NPIC) scale. Infants were enrolled from a Level IV NICU in the U.S. Midwest. Nurses reported on their perceptions of the infant symptom experience and their expectations for infant survival. Weekly behavioral observations of infants were obtained before and after standard delivery of care to obtain a comfort score. 237 nurses who cared for 73 infants completed 569 surveys over 28months. All NPIC items were significantly correlated with each other (P <.001). Factor analysis revealed strong evidence of a 2-factor structure (survival and suffering subscales). Both subscales demonstrated good to excellent internal consistency. Together the 2 factors explained 82% of the variability in the scale responses. Limited validity evidence was found. Evidence was found to support the internal structure and reliability of the NPIC scale. However, further item development and refinement is needed to increase the utility NPIC scale in clinical and research settings. The development of improved assessments of the infant NICU experience is warranted. Nurse perceptions of infant suffering or poor QOL may have implications for their expectations for infant survival and possibly care delivery.