Test-retest Reliability In Patients Research Articles

Use of the Peak Heart Rate Reached During Six-Minute Walk Test to Predict Individualized Training Intensity in Patients With Cystic Fibrosis: Validity and Reliability

Gruet M, Brisswalter J, Mely L, Vallier J-M. Use of the peak heart rate reached during six-minute walk test to predict individualized training intensity in patients with cystic fibrosis: validity and reliability. Objective To determine whether the peak heart rate reached during a six-minute walk test (HR 6peak) can be used to predict the heart rate determined at the gas exchange threshold (HR GET) during a maximal cardiopulmonary exercise test (CPET) in patients with cystic fibrosis (CF). To assess the test-retest reliability of HR 6peak. Design Case-control and reliability study. Setting CF unit. Participants Adults with CF (n=23) and age-matched sedentary subjects (control group, n=17). Interventions Not applicable. Main Outcome Measures Six-minute walk test, HR 6peak, CPET, and HR GET. Results HR GET and HR 6peak were not significantly different and were highly correlated in both groups (CF, r=.91, P<.01; controls, r=.81, P<.01). The mean differences (HR 6peak–HR GET) for patients with CF and control subjects were, respectively, −0.9 beats·min −1 (bpm) and –0.1bpm, with neither significantly different from 0. The limits of agreements were ±11bpm and ±18bpm, respectively. HR 6peak demonstrated excellent relative reliability (intraclass correlation coefficient=.93) and was associated with low variability (standard error of measurement=4.9bpm) in patients with CF. Conclusions HR 6peak is valid and demonstrates satisfactory test-retest reliability in patients with CF. These results might suggest the use of HR 6peak as a simple alternative method to individualize exercise prescriptions in this population. Further studies are needed in a larger cohort of patients to confirm these preliminary findings.

Translation and validation of the Persian version of the Arthritis Impact Measurement Scales 2-Short Form (AIMS2-SF) in patients with rheumatoid arthritis

Cultural adaptation and validation of the Persian version of the Arthritis Measurement Scales 2-Short Form (AIMS2-SF). The translation and cultural adaptation of the original questionnaire was carried out in accordance with published guidelines. Three hundred and fifty consecutive Persian-speaking patients with rheumatoid arthritis (RA) were asked to complete the AIMS2-SF, the Short Form Health Survey (SF-36), and four visual analog scales (VAS) for pain, joint stiffness, and patient's and physician's global assessment to test convergent validity. In addition, 90 randomly selected patients were asked to complete the questionnaire 48 h later for the second time. Moderate to high correlation were found between the AIMS2-SF and subscales of the SF-36 and VAS for pain, morning stiffness, and patient's and physician's global assessment. Cronbach's alpha coefficient for the Persian AIMS2-SF scales ranged from 0.74 to 0.89. The Persian AIMS2-SF scales showed excellent test-retest reliability with Intraclass Correlation Coefficient ranging from 0.83-0.93 (p < 0.01). The results of the present study showed that the Persian AIMS2-SF has reasonably good convergent validity, internal consistency, and test-retest reliability in patients with RA. It can now be applied in clinical settings and future outcome studies in Iran.

Psychometric Properties of the Neck Disability Index and Numeric Pain Rating Scale in Patients With Mechanical Neck Pain

Cleland JA, Childs JD, Whitman JM. Psychometric properties of the Neck Disability Index and numeric pain rating scale in patients with mechanical neck pain. ObjectiveTo examine the psychometric properties including test-retest reliability, construct validity, and minimum levels of detectable and clinically important change for the Neck Disability Index (NDI) and the numeric rating scale (NRS) for pain in a cohort of patients with neck pain. DesignSingle-group repeated-measures design. SettingOutpatient physical therapy (PT) clinics. ParticipantsPatients (N=137) presenting to PT with a primary report of neck pain. InterventionsNot applicable. Main Outcome MeasuresAll patients completed the NDI and the NRS at the baseline examination and at a follow-up. At the time of the follow-up, all patients also completed the global rating of change, which was used to dichotomize patients as improved or stable. Baseline and follow-up scores were used to determine the test-retest reliability, construct validity, and minimal levels of detectable and clinically important change for both the NDI and NRS. ResultsTest-retest reliability was calculated using an intraclass correlation coefficient (ICC) (NDI ICC=.50; 95% confidence interval [CI], .25–.67; NRS ICC=.76; 95% CI, .51–.87). The area under the curve was .83 (95% CI, .75–.90) for the NDI score and .85 (95% CI, .78–.93) for the NRS score for determining between stable and improved patients. Thresholds for the minimum clinically important difference (MCID) for the NDI were 19-percentage points and 1.3 for the NRS. ConclusionsBoth the NDI and NRS exhibit fair to moderate test-retest reliability in patients with mechanical neck pain. Both instruments also showed adequate responsiveness in this patient population. However, the MCID required to be certain that the change in scores has surpassed a level that could be contributed to measurement error for the NDI was twice that which has previously been reported. Therefore the ongoing analyses of the properties of the NDI in a patient population with neck pain are warranted.

Validity and Reliability of the Modified Shuttle Walk Test in Patients With Chronic Obstructive Pulmonary Disease

Campo LA, Chilingaryan G, Berg K, Paradis, B, Mazer B. Validity and reliability of the modified shuttle walk test in patients with chronic obstructive pulmonary disease. Objectives (1) To examine the concurrent criterion validity of the modified shuttle walk test (MSWT) by using the 6- (6MWT) and 12-minute walk test (12MWT), (2) to examine the concurrent criterion validity of the estimated maximum oxygen uptake (V̇ o 2max) of the MSWT with actual V̇ o 2max, and (3) to determine test-retest reliability of the MSWT in patients with chronic obstructive pulmonary disease (COPD). Design Validation study. Setting Outpatient pulmonary rehabilitation program. Participants Thirty clinically stable adults with COPD. Interventions Not applicable. Main Outcome Measures Subjects were randomly assigned to receive either the 6MWT and 12MWT or the MSWT first. The MSWT was repeated 1 week later (N=30). Estimated V̇ o 2max was calculated, and actual V̇ o 2max was conducted by using the Jones test. Validity of the MSWT was assessed by comparing endurance scores and V̇ o 2max with results from the 6MWT and 12MWT and Jones test, respectively. Results There was a moderately high correlation between the MSWT and the 6MWT and 12MWT at initial testing (.82 and .74, respectively). Correlation between estimated and actual V̇ o 2max was r equal to .68. Test-retest reliability for the entire sample was high (intraclass correlation coefficient, .88). Results remained quite stable across severity, age, and sex subgroups. Conclusions The MSWT is a standardized externally paced submaximal endurance walking test. The results indicate that the MSWT has high concurrent validity and test-retest reliability for patients with COPD.

A comparison of functional, patient-based scores in subacromial impingement

The goal of this study was to compare the Oxford Shoulder Score (OSS), the Shoulder Pain and Disability Index (SPADI), and the Short Form 36 (SF-36) for their correlation, agreement, sensitivity to change, and test-retest reliability in patients with a clinical diagnosis of subacromial impingement. All patients attending a specialist subacromial impingement clinic over a 6-month period completed the OSS, SPADI, and SF-36 at each visit. A total of 323 sets of observations were recorded in 110 patients. The first 38 of these patients were also sent the questionnaires to complete before their visit. There was good correlation between the OSS and SPADI scores (correlation coefficient = 0.85) and good agreement between the scores on each scale (weighted kappa = 0.79). The correlation with total SF-36 was poor (0.37 for OSS and 0.26 for SPADI). The OSS and SPADI showed good effect sizes compared with the total SF-36 score and good test-retest reliability. These data support the use of the OSS or SPADI in patients with subacromial impingement.

Test-Retest Reliability of the Short-Form McGill Pain Questionnaire

No previous study has adequately demonstrated the test-retest reliability of the Short-Form McGill Pain Questionnaire, yet it is increasingly being used as a measure of pain. This study evaluates the test-retest reliability in patients with osteoarthritis. A prospective, observational cohort study was undertaken using serial evaluation of 57 patients at 2 time points. A sample of patients awaiting primary hip or knee joint replacement surgery were recruited in clinic or via mail (mean age 64.8 years). Short-Form McGill Pain Questionnaires were delivered by mail 5 days apart, and a supplementary questionnaire was completed on the second occasion to explore if the patients' pain report had remained stable. The intraclass correlation coefficient was used as an estimate of reliability. For the total, sensory, affective, and average pain scores, high intra-class correlations were demonstrated (0.96, 0.95, 0.88, and 0.89, respectively). The current pain component demonstrated a lower intraclass correlation of 0.75. The coefficient of repeatability was calculated as an estimation of the minimum metrically detectable change. The coefficients of repeatability for the total, sensory, affective, average, and current pain components were 5.2, 4.5, 2.8, 1.4 cm, and 1.4, respectively. Problems of adequate completion of the Short-Form McGill Pain Questionnaire were highlighted in this sample, and supervision via telephone contact was required. Patients recruited in clinic who had practiced completing the Short-Form McGill Pain Questionnaire demonstrated fewer errors than those recruited by mail. The Short-Form McGill Pain Questionnaire was demonstrated to be a highly reliable measure of pain. These results should not be generalized to a more elderly population, as increasing age was correlated with greater variability of the sensory component scores.

Reliability of a patient-rated forearm evaluation questionnaire for patients with lateral epicondylitis

Purpose: To determine the reliability of a questionnaire designed to assess forearm pain and function in patients with lateral epicondylitis. Methods: Forty-seven patients with unilateral lateral epicondylitis completed a patient-related forearm evaluation questionnaire (PRFEQ) on two occasions. Intraclass correlation coefficients (ICC 2,1), standard error of measurement (SEM), and 95% confidence intervals (CIs) were determined for the whole group and for three subgroup comparisons of male vs. female subjects, subacute vs. chronic lateral epicondylitis, and work-related vs. non-work-related lateral epicondylitis. Results: The test-retest reliability for the overall PRFEQ (ICC, 0.89), and its pain (ICC, 0.89) and function (ICC, 0.83) subscales was excellent. Test-retest reliability for patients with work related lateral epicondylitis (ICC, 0.80) was significantly (p = 0.018) less than for patients with non-work-related lateral epicondylitis (ICC, 0.94). Conclusions: The PRFEQ can provide a simple, quick, and reliable estimate of arm pain and function in patients with lateral epicondylitis. However, large SEM and 95% CIs limit its ability to accurately predict individual scores.

Performance of an Asthma Quality of Life Questionnaire in an Outpatient Setting

The objectives of this study were to assess the validity, reliability, and responsiveness of a disease-specific quality of life questionnaire (AQLQ) in asthma patients presenting for assessment and treatment in an emergency department (ED). Fifty-two patients 18 to 64 yrs of age were surveyed in three EDs. Admitted and discharged patients with stable and unstable asthma were included. Patients were interviewed prior to discharge from the ED. They completed a self-report asthma questionnaire, the self-administered Sickness Impact Profile (SIP) and AQLQ, a global assessment of asthma severity, a symptom questionnaire, and pulmonary function testing. Forty-three (83%) patients were available for follow-up at 7 to 10 days, and they completed a similar series of tests. Moderate correlations were found between total SIP and AQLQ measurements (r = 0.49; p < 0.001). Correlations were high between physical domain scores of the SIP and AQLQ symptoms (r = 0.58; p < 0.0001) and activity limitations (r = 0.50; p < 0.0001). Low correlations were found between pulmonary function results and AQLQ domains, except activity limitations (r = 0.44; p < 0.001). High correlations were found between symptoms or global assessments and AQLQ (r > 0.6; p < 0.0001). The instrument is highly responsive to small changes in patient status and outperforms pulmonary function tests and symptom scores in this setting. Test-retest reliability in patients who were stable was substantial (intraclass correlation coefficients > 0.9) on all aspects of the AQLQ.(ABSTRACT TRUNCATED AT 250 WORDS)

RBC and plasma choline in neuroleptic-treated schizophrenic patients

We measured red blood cell (RBC) choline and plasma choline concentrations in 27 chronic schizophrenic inpatients and 23 normal controls. Both blood choline measures had a significant test-retest reliability in patients whose neuroleptic status remained unchanged over 1 month. RBC choline concentration was significantly lower in patients medicated with neuroleptics and cogentin. Patients with a low RBC choline and a low RBC/plasma choline ration were on significantly higher doses of medication and had higher scores on the hostility/suspiciousness subscale of the Brief Psychiatric Rating Scale. RBC choline increased when neuroleptics were discontinued. Blood choline measures were also compared among medication-free schizophrenic patients, inpatients with other diagnoses, and normal controls. No significant differences were seen among these groups for any choline measure, although the schizophrenic patients showed greater variability. Medication-free schizophrenic patients with such clinical factors as tardive dyskinesia and abnormalities on computed tomography contributed to this variability. Age was positively correlated with plasma choline.

A structured diagnostic interview for identification of primary alcoholism: a preliminary evaluation.

Forty alcoholic inpatient men were used to evaluate the test-retest reliability and the validity of a new structured diagnostic interview. The Alcohol Research Center (ARC) Intake Interview was constructed from the Schedule of Affective Disorders and Schizophrenia (SADS) parts I and II and from the Diagnostic Interview Schedule family history section by extracting information on diagnoses most likely to be seen in alcoholic patients and by expanding the data set with questions relevant to alcohol and drug use. The test-retest reliability for patients' primary and secondary diagnoses included a kappa of 1.00 for the comparison of interviewers A and B (100% agreement) and of .76 for interviewers A and C. The validity of ARC Intake Interview patient diagnoses as compared to the SADS demonstrated an overall agreement between 91 and 100%. Reliabilities for labeling of families as positive or negative for specific illness in any first-degree relatives revealed a kappa of 1.00; validities on family diagnoses ranged from 77 to 100%, with the ARC Intake Interview identifying more illness in families than the SADS. Although further evaluation of the ARC Intake Interview is needed, this instrument is recommended to investigators attempting to evaluate the clinical course and treatment needs among alcoholics, especially those patients presenting with multiple diagnoses.

The Leyton Obsessional Inventory-Child Version

The Leyton Obsessional Inventory for adults was modified for children and administered to 26 adolescents ( age 14.3 ± 2.1 years) meeting DSM-III criteria for obsessive compulsive disorder, 14 adolescents ( age 13.7 ± 1.7 years) having severe obsessive symptoms but who had received other primary psychiatric diagnoses, and 28 normal adolescent controls ( age 13.7 ± 1.9 years). The Leyton Obsessional Inventory-Child Version (LOI-CV) significantly differentiated obsessive patients from normal controls on total scores for obsessional symptoms as well as total scores for degree of resistance to the symptoms and interference with everyday life. Patients and psychiatric controls differed significantly on scores for resistance and interference. Test-retest reliability for patients was demonstrated and scores differentiating placebo and active drug treatment indicated further clinical validity. However, LOI-CV scores did not correlate significantly with other clinical measures of obsessive behavior (Obsessive Compulsive Rating Scale, Comprehensive Psychopathological Rating Scale, NIMH Global and Obsessive Compulsive Scales) obtained at baseline.