Errors Using Observational Methods for Ergonomics Assessment in Real Practice.

PubMed

Diego-Mas, Jose-Antonio; Alcaide-Marzal, Jorge; Poveda-Bautista, Rocio

2017-12-01

The degree in which practitioners use the observational methods for musculoskeletal disorder risks assessment correctly was evaluated. Ergonomics assessment is a key issue for the prevention and reduction of work-related musculoskeletal disorders in workplaces. Observational assessment methods appear to be better matched to the needs of practitioners than direct measurement methods, and for this reason, they are the most widely used techniques in real work situations. Despite the simplicity of observational methods, those responsible for assessing risks using these techniques should have some experience and know-how in order to be able to use them correctly. We analyzed 442 risk assessments of actual jobs carried out by 290 professionals from 20 countries to determine their reliability. The results show that approximately 30% of the assessments performed by practitioners had errors. In 13% of the assessments, the errors were severe and completely invalidated the results of the evaluation. Despite the simplicity of observational method, approximately 1 out of 3 assessments conducted by practitioners in actual work situations do not adequately evaluate the level of potential musculoskeletal disorder risks. This study reveals a problem that suggests greater effort is needed to ensure that practitioners possess better knowledge of the techniques used to assess work-related musculoskeletal disorder risks and that laws and regulations should be stricter as regards qualifications and skills required by professionals.

Assessment of iron deficiency and anemia in pregnant women: an observational French study.

PubMed

Harvey, Thierry; Zkik, Asmaa; Auges, Marie; Clavel, Thierry

2016-01-01

We explored the prevalence and management of iron deficiency and anemia among pregnant women in France. In this prospective, observational, multicenter registry study, randomly selected investigators (gynecologists/obstetricians/midwives registered in the CEGEDIM(®) database) assessed pregnant women presenting for a consultation. Participants completed a questionnaire at study inclusion. A total of 1506 patients were enrolled by 95 investigators. Overall, investigators estimated a moderate or significant risk of iron deficiency in almost 60% of women. The overall prevalence of anemia (15.8%) increased with longer pregnancy duration. Medication (mainly iron-based) was prescribed to 57.3% of patients. In French clinical practice, the estimated risk of iron deficiency and prevalence of anemia during pregnancy align with expectations and are managed according to national/international recommendations.

Intra- and inter-observer agreement in histological assessment of canine soft tissue sarcoma.

PubMed

Yap, F W; Rasotto, R; Priestnall, S L; Parsons, K J; Stewart, J

2017-12-01

The diagnosis of canine soft tissue sarcoma (STS) is based on histological assessment. Assessment of criteria such as, degree of differentiation, necrosis score and mitotic score, gives rise to a final tumour grade, which is important in the recommendation of treatment and prognosis of patients. Previously diagnosed cases of STS were independently assessed by three board-certified veterinary pathologists. Participating pathologists were blinded to the original results. For the intra-observer study, the cases were assessed by a single pathologist six months apart and slides were randomized between readings. For the inter-observer study, the whole case series was assessed by a single pathologist before being passed onto the next pathologist. Intraclass correlation coefficient (ICC) and Fleiss's Kappa (ƙ) for the intra- (single observer) and inter-observer agreement. Strong agreement was observed for the intra-observer assessment in necrosis score, mitotic score, total score and tumour grading (ICC between 0.78 to 0.91). The intra-observer agreement for differentiation score was rated perfect (ICC 1.00). The agreement between pathologists for the diagnosis and grading of canine STS was moderate (ƙ = 0.60 and 0.43 respectively). Histological assessment of canine STS had high reproducibility by an individual pathologist. The agreement of diagnosis and grading of canine STS was moderate between pathologists. Future studies are required to investigate further assessment criteria to improve the specificity of STS diagnosis and the accuracy of the STS grading in dogs. © 2017 John Wiley & Sons Ltd.

An Approach to Assess Observation Impact Based on Observation-Minus-Forecast Residuals

NASA Technical Reports Server (NTRS)

Todling, Ricardo

2009-01-01

Langland and Baker (2004) introduced an approach to assess the impact of observations on the forecasts. In that, a state-space aspect of the forecast is defined and a procedure is derived that relates changes in the aspect with changes in the initial conditions associated with the assimilation of observations) ultimately providing information about the impact of individual observations on the forecast. Some features of the approach are to be noted. The typical choice of forecast aspect employed in related works is rather arbitrary and leads to an incomplete assessment of the observing system. Furthermore, the state-space forecast aspect requires availability of a verification state that should ideally be uncorrelated with the forecast but in practice is not. Lastly, the approach involves the adjoint operator of the entire data assimilation system and as such it is constrained by the validity of this operator. In this presentation, an observation-space metric is used that, for a relatively time-homogeneous observing system, allows inferring observation impact on the forecast without some of the limitations above. Specifically, using observation-minus-forecast residuals leads to an approach with the following features: (i) it suggests a rather natural choice of forecast aspect, directly linked to the analysis system and providing full assessment of the observations; (ii) it naturally avoids introducing undesirable correlations in the forecast aspect by verifying against the observations; and (iii) it does not involve linearization and use of adjoints; therefore being applicable to any length of forecast. The state and observation-space approaches might be complementary to some degree, and involve different limitations and complexities. Illustrations are given using the NASA GEOS-5 data.

Development of a quality assessment tool for systematic reviews of observational studies (QATSO) of HIV prevalence in men having sex with men and associated risk behaviours

PubMed Central

Wong, William CW; Cheung, Catherine SK; Hart, Graham J

2008-01-01

Background Systematic reviews based on the critical appraisal of observational and analytic studies on HIV prevalence and risk factors for HIV transmission among men having sex with men are very useful for health care decisions and planning. Such appraisal is particularly difficult, however, as the quality assessment tools available for use with observational and analytic studies are poorly established. Methods We reviewed the existing quality assessment tools for systematic reviews of observational studies and developed a concise quality assessment checklist to help standardise decisions regarding the quality of studies, with careful consideration of issues such as external and internal validity. Results A pilot version of the checklist was developed based on epidemiological principles, reviews of study designs, and existing checklists for the assessment of observational studies. The Quality Assessment Tool for Systematic Reviews of Observational Studies (QATSO) Score consists of five items: External validity (1 item), reporting (2 items), bias (1 item) and confounding factors (1 item). Expert opinions were sought and it was tested on manuscripts that fulfil the inclusion criteria of a systematic review. Like all assessment scales, QATSO may oversimplify and generalise information yet it is inclusive, simple and practical to use, and allows comparability between papers. Conclusion A specific tool that allows researchers to appraise and guide study quality of observational studies is developed and can be modified for similar studies in the future. PMID:19014686

Evaluation of Quality of Lower Limb Arthroplasty Observational Studies Using the Assessment of Quality in Lower Limb Arthroplasty (AQUILA) Checklist.

PubMed

Cowan, James B; Mlynarek, Ryan A; Nelissen, Rob G H H; Pijls, Bart G C W; Gagnier, Joel J

2015-09-01

This study used the assessment of quality in lower limb arthroplasty (AQUILA) checklist to assess the quality of lower limb arthroplasty observational studies. Among 132 studies the mean reporting quality score was 5.4 (SD=1.2) out of 8 possible points. Most studies adequately reported reasons for revisions (98%) and prosthesis brand and fixation (95%) in sufficient detail. Only 3% of studies adequately reported the number of patients unwilling to participate, 15% stated a clear primary research question or hypothesis, 11% reported a worst-case analysis or competing risk analysis for endpoints, and 42% reported more than 5% of patients were lost to follow-up. There is significant room for improvement in the reporting and methodology of lower limb arthroplasty observational studies. Level III. Copyright © 2015 Elsevier Inc. All rights reserved.

Potential Pitfalls of Reporting and Bias in Observational Studies With Propensity Score Analysis Assessing a Surgical Procedure: A Methodological Systematic Review.

PubMed

Lonjon, Guillaume; Porcher, Raphael; Ergina, Patrick; Fouet, Mathilde; Boutron, Isabelle

2017-05-01

To describe the evolution of the use and reporting of propensity score (PS) analysis in observational studies assessing a surgical procedure. Assessing surgery in randomized controlled trials raises several challenges. Observational studies with PS analysis are a robust alternative for comparative effectiveness research. In this methodological systematic review, we identified all PubMed reports of observational studies with PS analysis that evaluated a surgical procedure and described the evolution of their use over time. Then, we selected a sample of articles published from August 2013 to July 2014 and systematically appraised the quality of reporting and potential bias of the PS analysis used. We selected 652 reports of observational studies with PS analysis. The publications increased over time, from 1 report in 1987 to 198 in 2013. Among the 129 reports assessed, 20% (n = 24) did not detail the covariates included in the PS and 77% (n = 100) did not report a justification for including these covariates in the PS. The rate of missing data for potential covariates was reported in 9% of articles. When a crossover by conversion was possible, only 14% of reports (n = 12) mentioned this issue. For matched analysis, 10% of articles reported all 4 key elements that allow for reproducibility of a PS-matched analysis (matching ratio, method to choose the nearest neighbors, replacement and method for statistical analysis). Observational studies with PS analysis in surgery are increasing in frequency, but specific methodological issues and weaknesses in reporting exist.

Observation and Teacher Quality: Critical Analysis of Observational Instruments in Preservice Teacher Performance Assessment

ERIC Educational Resources Information Center

Caughlan, Samantha; Jiang, Heng

2014-01-01

Teacher preparation programs commonly use observational instruments to assess the progress and the exit performances of teacher candidates. However, while these instruments have been described and several have been studied for effectiveness, the field lacks a close examination of how they position participants: teacher candidates, K-12 pupils, and…

Work organization in hospital wards and nurses' emotional exhaustion: A multi-method study of observation-based assessment and nurses' self-reports.

PubMed

Stab, Nicole; Hacker, Winfried; Weigl, Matthias

2016-09-01

Ward organization is a major determinant for nurses' well-being on the job. The majority of previous research on this relationship is based on single source methods, which have been criticized as skewed estimations mainly due to subjectivity of the ratings and due to common source bias. To investigate the association of ward organization characteristics and nurses' exhaustion by combining observation-based assessments with nurses' self-reports. Cross-sectional study on 25 wards of four hospitals and 245 nurses. Our multi-method approach to evaluate hospital ward organization consisted of on-site observations with a standardized assessment tool and of questionnaires to evaluate nurses' self-reports and exhaustion. After establishing the reliability of our measures, we applied multi-level regression analyses to determine associations between determinant and outcome variables. We found substantial convergence in ward organization between the observation-based assessments and nurses' self-reports, which supports the validity of our external assessments. Furthermore, two observation-based characteristics, namely participation and patient-focused care, were significantly associated with lower emotional exhaustion among the nurses. Our results suggest that observation-based assessments are a valid and feasible way to assess ward organization in hospitals. Nurses' self-reported as well as observation-based ratings on ward organization were associated with nurses' emotional exhaustion. This is of interest mainly for identifying alternative measures in evaluating nurses' work environments, to inform health promotion activities and to evaluate job redesign intervention. Copyright © 2016 Elsevier Ltd. All rights reserved.

Strengthening the reliability and credibility of observational epidemiology studies by creating an Observational Studies Register.

PubMed

Swaen, Gerard M H; Carmichael, Neil; Doe, John

2011-05-01

To evaluate the need for the creation of a system in which observational epidemiology studies are registered; an Observational Studies Register (OSR). The current scientific process for observational epidemiology studies is described. Next, a parallel is made with the clinical trials area, where the creation of clinical trial registers has greatly restored and improved their credibility and reliability. Next, the advantages and disadvantages of an OSR are compared. The advantages of an OSR outweigh its disadvantages. The creation of an OSR, similar to the existing Clinical Trials Registers, will improve the assessment of publication bias and will provide an opportunity to compare the original study protocol with the results reported in the publication. Reliability, credibility, and transparency of observational epidemiology studies are strengthened by the creation of an OSR. We propose a structured, collaborative, and coordinated approach for observational epidemiology studies that can provide solutions for existing weaknesses and will strengthen credibility and reliability, similar to the approach currently used in clinical trials, where Clinical Trials Registers have played a key role in strengthening their scientific value. Copyright © 2011 Elsevier Inc. All rights reserved.

The Alberta smoke plume observation study

NASA Astrophysics Data System (ADS)

Anderson, Kerry; Pankratz, Al; Mooney, Curtis; Fleetham, Kelly

2018-02-01

A field project was conducted to observe and measure smoke plumes from wildland fires in Alberta. This study used handheld inclinometer measurements and photos taken at lookout towers in the province. Observations of 222 plumes were collected from 21 lookout towers over a 6-year period from 2010 to 2015. Observers reported the equilibrium and maximum plume heights based on the plumes' final levelling heights and the maximum lofting heights, respectively. Observations were tabulated at the end of each year and matched to reported fires. Fire sizes at assessment times and forest fuel types were reported by the province. Fire weather conditions were obtained from the Canadian Wildland Fire Information System (CWFIS). Assessed fire sizes were adjusted to the appropriate size at plume observation time using elliptical fire-growth projections. Though a logical method to collect plume observations in principle, many unanticipated issues were uncovered as the project developed. Instrument limitations and environmental conditions presented challenges to the investigators, whereas human error and the subjectivity of observations affected data quality. Despite these problems, the data set showed that responses to fire behaviour conditions were consistent with the physical processes leading to plume rise. The Alberta smoke plume observation study data can be found on the Canadian Wildland Fire Information System datamart (Natural Resources Canada, 2018) at http://cwfis.cfs.nrcan.gc.ca/datamart.

Company observational post-marketing studies: drug risk assessment and drug research in special populations--a study-based analysis.

PubMed

Hasford, J; Lamprecht, T

1998-01-01

Company observational post-marketing studies (COPS) claim to provide essential data about drug risks and effectiveness in special populations not admitted to pre-approval clinical trials. Since COPS are often mainly regarded as a marketing activity, this study-based analysis tries to evaluate the scientific contributions of COPS. Thirty-five COPS were identified by hand-searching through medical journals, writing to pharmaceutical manufacturers and using MEDLINE. Fourteen COPS evaluated cardiovascular drugs, 9 evaluated NSAIDs and 12 evaluated various other indications. Thirty-five COPS listed effectiveness, 31 listed safety and 8 listed patient compliance as principal objectives. Not a single COPS included a control group. Seventeen of 21 evaluable COPS mentioned extensive exclusion criteria similar to those in clinical trials. Median observation time was 8 weeks, too short for chronic diseases and for adverse drug reactions with longer latency periods. One new adverse event was regarded. Global assessments of the outcomes by physicians dominated and were not based on objective clinical findings. None of the studies specified any details concerning the standardisation of observations or quality-control procedures. The current COPS scheme does not contribute significantly to our knowledge of drug safety and the effects in special populations. Despite serious criticism over the past 20 years, the poor quality of COPS compared with dramatic improvements of pre-approval trials - implies a need for detailed guidelines for non-experimental phase IV research, similar to the Good Clinical Practice-Guideline of the European Community.

Strategic Assessment for Arctic Observing, and the New Arctic Observing Viewer

NASA Astrophysics Data System (ADS)

Kassin, A.; Cody, R. P.; Manley, W. F.; Gaylord, A. G.; Dover, M.; Score, R.; Lin, D. H.; Villarreal, S.; Quezada, A.; Tweedie, C. E.

2013-12-01

Although a great deal of progress has been made with various Arctic Observing efforts, it can be difficult to assess that progress. What data collection efforts are established or under way? Where? By whom? To help meet the strategic needs of SEARCH-AON, SAON, and related initiatives, a new resource has been released: the Arctic Observing Viewer (AOV; http://ArcticObservingViewer.org). This web mapping application covers the 'who', 'what', 'where', and 'when' of data collection sites - wherever marine or terrestrial data are collected. Hundreds of sites are displayed, providing an overview as well as details. Users can visualize, navigate, select, search, draw, print, and more. This application currently showcases a subset of observational activities and will become more comprehensive with time. The AOV is founded on principles of interoperability, with an emerging metadata standard and compatible web service formats, such that participating agencies and organizations can use the AOV tools and services for their own purposes. In this way, the AOV will complement other cyber-resources, and will help science planners, funding agencies, PI's, and others to: assess status, identify overlap, fill gaps, assure sampling design, refine network performance, clarify directions, access data, coordinate logistics, collaborate, and more to meet Arctic Observing goals.

WhatsApp Messenger is useful and reproducible in the assessment of tibial plateau fractures: inter- and intra-observer agreement study.

PubMed

Giordano, Vincenzo; Koch, Hilton Augusto; Mendes, Carlos Henrique; Bergamin, André; de Souza, Felipe Serrão; do Amaral, Ney Pecegueiro

2015-02-01

The aim of this study was to evaluate the inter- and intra-observer agreement in the initial diagnosis and classification by means of plain radiographs and CT scans of tibial plateau fractures photographed and sent via WhatsApp Messenger. The increasing popularity of smartphones has driven the development of technology for data transmission and imaging and generated a growing interest in the use of these devices as diagnostic tools. The emergence of WhatsApp Messenger technology, which is available for various platforms used by smartphones, has led to an improvement in the quality and resolution of images sent and received. The images (plain radiographs and CT scans) were obtained from 13 cases of tibial plateau fractures using the iPhone 5 (Apple Inc., Cupertino, CA, USA) and were sent to six observers via the WhatsApp Messenger application. The observers were asked to determine the standard deviation and type of injury, the classification according to the Schatzker and the Luo classifications schemes, and whether the CT scan changed the classification. The six observers independently assessed the images on two separate occasions, 15 days apart. The inter- and intra-observer agreement for both periods of the study ranged from excellent to perfect (0.75<κ<1.0) across all survey questions. When asked if the inclusion of the CT images would change their final X-ray classification (Schatzker or Luo), the inter- and intra-observer agreement was perfect (k=1) on both assessment occasions. We found an excellent inter- and intra-observer agreement in the imaging assessment of tibial plateau fractures sent via WhatsApp Messenger. The authors now propose the systematic use of the application to facilitate faster documentation and obtaining the opinion of an experienced consultant when not on call. Finally, we think the use of the WhatsApp Messenger as an adjuvant tool could be broadened to other clinical centres to assess its viability in other skeletal and non

Observing Protein & Energy Nutrition (OPEN) Study

Cancer.gov

The Observing Protein and Energy Nutrition (OPEN) Study was designed to assess dietary measurement error by comparing results from self-reported dietary intake data with four dietary biomarkers: doubly labeled water and urinary nitrogen, sodium, and potassium.

Inter- and intra- observer reliability of risk assessment of repetitive work without an explicit method.

PubMed

Eliasson, Kristina; Palm, Peter; Nyman, Teresia; Forsman, Mikael

2017-07-01

A common way to conduct practical risk assessments is to observe a job and report the observed long term risks for musculoskeletal disorders. The aim of this study was to evaluate the inter- and intra-observer reliability of ergonomists' risk assessments without the support of an explicit risk assessment method. Twenty-one experienced ergonomists assessed the risk level (low, moderate, high risk) of eight upper body regions, as well as the global risk of 10 video recorded work tasks. Intra-observer reliability was assessed by having nine of the ergonomists repeat the procedure at least three weeks after the first assessment. The ergonomists made their risk assessment based on his/her experience and knowledge. The statistical parameters of reliability included agreement in %, kappa, linearly weighted kappa, intraclass correlation and Kendall's coefficient of concordance. The average inter-observer agreement of the global risk was 53% and the corresponding weighted kappa (K w ) was 0.32, indicating fair reliability. The intra-observer agreement was 61% and 0.41 (K w ). This study indicates that risk assessments of the upper body, without the use of an explicit observational method, have non-acceptable reliability. It is therefore recommended to use systematic risk assessment methods to a higher degree. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Assessing the observed impact of anthropogenic climate change

DOE PAGES

Hansen, Gerrit; Stone, Dáithí

2015-12-21

Impacts of recent regional changes in climate on natural and human systems are documented across the globe, yet studies explicitly linking these observations to anthropogenic forcing of the climate are scarce. Here in this work, we provide a systematic assessment of the role of anthropogenic climate change for the range of impacts of regional climate trends reported in the IPCC’s Fifth Assessment Report. We find that almost two-thirds of the impacts related to atmospheric and ocean temperature can be confidently attributed to anthropogenic forcing. In contrast, evidence connecting changes in precipitation and their respective impacts to human influence is stillmore » weak. Moreover, anthropogenic climate change has been a major influence for approximately three-quarters of the impacts observed on continental scales. Finally, hence the effects of anthropogenic emissions can now be discerned not only globally, but also at more regional and local scales for a variety of natural and human systems.« less

The GRACE Checklist: A Validated Assessment Tool for High Quality Observational Studies of Comparative Effectiveness.

PubMed

Dreyer, Nancy A; Bryant, Allison; Velentgas, Priscilla

2016-10-01

Recognizing the growing need for robust evidence about treatment effectiveness in real-world populations, the Good Research for Comparative Effectiveness (GRACE) guidelines have been developed for noninterventional studies of comparative effectiveness to determine which studies are sufficiently rigorous to be reliable enough for use in health technology assessments. To evaluate which aspects of the GRACE Checklist contribute most strongly to recognition of quality. We assembled 28 observational comparative effectiveness articles published from 2001 to 2010 that compared treatment effectiveness and/or safety of drugs, medical devices, and medical procedures. Twenty-two volunteers from academia, pharmaceutical companies, and government agencies applied the GRACE Checklist to those articles, providing 56 assessments. Ten senior academic and industry experts provided assessments of overall article quality for the purpose of decision support. We also rated each article based on the number of annual citations and impact factor of the journal in which the article was published. To identify checklist items that were most predictive of quality, classification and regression tree (CART) analysis, a binary, recursive, partitioning methodology, was used to create 3 decision trees, which compared the 56 article assessments with 3 external quality outcomes: (1) expert assessment of overall quality, (2) citation frequency, and (3) impact factor. A fourth tree looked at the composite outcome of all 3 quality indicators. The best predictors of quality included the following: use of concurrent comparators, limiting the study to new initiators of the study drug, equivalent measurement of outcomes in study groups, collecting data on most if not all known confounders or effect modifiers, accounting for immortal time bias in the analysis, and use of sensitivity analyses to test how much effect estimates depended on various assumptions. Only sensitivity analyses appeared consistently as

Meta-analyses including data from observational studies.

PubMed

O'Connor, Annette M; Sargeant, Jan M

2014-02-15

Observational studies represent a wide group of studies where the disease or condition of interest is naturally occurring and the investigator does not control allocation to interventions or exposures. Observational studies are used to test hypotheses about the efficacy of interventions or about exposure-disease relationships, to estimate incidence or prevalence of conditions, and to assess the sensitivity and specificity of diagnostic assays. Experimental-study designs and randomized controlled trials (RCTs) can also contribute to the body of evidence about such questions. Meta-analyses (either with or without systematic reviews) aim to combine information from primary research studies to better describe the entire body of work. The aim of meta-analyses may be to obtain a summary effect size, or to understand factors that affect effect sizes. In this paper, we discuss the role of observational studies in meta-analysis questions and some factors to consider when deciding whether a meta-analysis should include results from such studies. Our suggestion is that one should only include studies that are not at high risk of inherent bias when calculating a summary effect size. Study design however can be a meaningful variable in assessment of outcome heterogeneity. Copyright © 2013 Elsevier B.V. All rights reserved.

Comparing Two Approaches for Assessing Observation Impact

NASA Technical Reports Server (NTRS)

Todling, Ricardo

2013-01-01

Langland and Baker introduced an approach to assess the impact of observations on the forecasts. In that approach, a state-space aspect of the forecast is defined and a procedure is derived ultimately relating changes in the aspect with changes in the observing system. Some features of the state-space approach are to be noted: the typical choice of forecast aspect is rather subjective and leads to incomplete assessment of the observing system, it requires availability of a verification state that is in practice correlated with the forecast, and it involves the adjoint operator of the entire data assimilation system and is thus constrained by the validity of this operator. This article revisits the topic of observation impacts from the perspective of estimation theory. An observation-space metric is used to allow inferring observation impact on the forecasts without the limitations just mentioned. Using differences of observation-minus-forecast residuals obtained from consecutive forecasts leads to the following advantages: (i) it suggests a rather natural choice of forecast aspect that directly links to the data assimilation procedure, (ii) it avoids introducing undesirable correlations in the forecast aspect since verification is done against the observations, and (iii) it does not involve linearization and use of adjoints. The observation-space approach has the additional advantage of being nearly cost free and very simple to implement. In its simplest form it reduces to evaluating the statistics of observationminus- background and observation-minus-analysis residuals with traditional methods. Illustrations comparing the approaches are given using the NASA Goddard Earth Observing System.

Normativity and Desirability in Observational Assessments of Family Interaction.

PubMed

Deal, James E

2018-06-11

Issues of normativity (responding in a typical or average fashion) and desirability (the tendency for raters to endorse positive characteristics rather than neutral or more negative ones) are common in areas of the social sciences that frequently utilize profile correlations to measure dyadic similarity. They have implications for family scholars as well. In the present study, a pre-existing data set was used to make an initial, though limited, investigation into potential confounds of normativity and desirability for macrolevel observational assessments of family interaction. An empirical example is presented using q-sort ratings of family interaction, with variance in observational assessments decomposed into component parts. High levels of both normativity and desirability were found, indicating possible problems in terms of both reliability and validity of assessment. While the results provide an interesting beginning, they are limited due to the use of a q-sort methodology as well as an instrument with limited background and use. These limitations are discussed, as well as alternative interpretations for normativity and desirability and implications for future research. © 2018 Family Process Institute.

Assessing the surgical skills of trainees in the operating theatre: a prospective observational study of the methodology.

PubMed

Beard, J D; Marriott, J; Purdie, H; Crossley, J

2011-01-01

To compare user satisfaction and acceptability, reliability and validity of three different methods of assessing the surgical skills of trainees by direct observation in the operating theatre across a range of different surgical specialties and index procedures. A 2-year prospective, observational study in the operating theatres of three teaching hospitals in Sheffield. The assessment methods were procedure-based assessment (PBA), Objective Structured Assessment of Technical Skills (OSATS) and Non-technical Skills for Surgeons (NOTSS). The specialties were obstetrics and gynaecology (O&G) and upper gastrointestinal, colorectal, cardiac, vascular and orthopaedic surgery. Two to four typical index procedures were selected from each specialty. Surgical trainees were directly observed performing typical index procedures and assessed using a combination of two of the three methods (OSATS or PBA and NOTSS for O&G, PBA and NOTSS for the other specialties) by the consultant clinical supervisor for the case and the anaesthetist and/or scrub nurse, as well as one or more independent assessors from the research team. Information on user satisfaction and acceptability of each assessment method from both assessor and trainee perspectives was obtained from structured questionnaires. The reliability of each method was measured using generalisability theory. Aspects of validity included the internal structure of each tool and correlation between tools, construct validity, predictive validity, interprocedural differences, the effect of assessor designation and the effect of assessment on performance. Of the 558 patients who were consented, a total of 437 (78%) cases were included in the study: 51 consultant clinical supervisors, 56 anaesthetists, 39 nurses, 2 surgical care practitioners and 4 independent assessors provided 1635 assessments on 85 trainees undertaking the 437 cases. A total of 749 PBAs, 695 NOTSS and 191 OSATSs were performed. Non-O&G clinical supervisors and

"Lies, damned lies ..." and observational studies in comparative effectiveness research.

PubMed

Albert, Richard K

2013-06-01

A new federal initiative has allocated $1.1 billion to comparative effectiveness research, and many have emphasized the importance of including observational studies in this effort. The rationale for using observational studies to assess comparative effectiveness is based on concerns that randomized controlled trials (RCTs) are not "real world" because they enroll homogeneous patient populations, measure study outcomes that are not important to patients, use protocols that are overly complex, are conducted in specialized centers, and use study treatments that are not consistent with usual care, and that RCTs are not always feasible because of a lack of equipoise, the need to assess delayed endpoints, and concerns that they take years to complete and are expensive. This essay questions the validity of each of these proposed limitations, summarizes concerns raised about the accuracy of results generated by observational studies, provides some examples of discrepancies between results of observational studies and RCTs that pertain to pulmonary and critical care, and suggests that using observational studies for comparative effectiveness research may increase rather than decrease the cost of health care and may harm patients.

A new stratified risk assessment tool for whiplash injuries developed from a prospective observational study

PubMed Central

Kasch, Helge; Kongsted, Alice; Qerama, Erisela; Bach, Flemming W; Bendix, Tom; Jensen, Troels Staehelin

2013-01-01

Objectives An initial stratification of acute whiplash patients into seven risk-strata in relation to 1-year work disability as primary outcome is presented. Design The design was an observational prospective study of risk factors embedded in a randomised controlled study. Setting Acute whiplash patients from units, general practitioners in four Danish counties were referred to two research centres. Participants During a 2-year inclusion period, acute consecutive whiplash-injured (age 18–70 years, rear-end or frontal-end car accident and WAD (whiplash-associated disorders) grades I–III, symptoms within 72 h, examination prior to 10 days postinjury, capable of written/spoken Danish, without other injuries/fractures, pre-existing significant somatic/psychiatric disorder, drug/alcohol abuse and previous significant pain/headache). 688 (438 women and 250 men) participants were interviewed and examined by a study nurse after 5 days; 605 were completed after 1 year. A risk score which included items of initial neck pain/headache intensity, a number of non-painful complaints and active neck mobility was applied. The primary outcome parameter was 1-year work disability. Results The risk score and number of sick-listing days were related (Kruskal-Wallis, p<0.0001). In stratum 1, less than 4%, but in stratum 7, 68% were work-disabled after 1 year. Early work assessment (p<0.0001), impact of the event questionnaire (p<0.0006), psychophysical pain measures being McGill pain questionnaire parameters (p<0.0001), pressure pain algometry (p<0.0001) and palpation (p<0.0001) showed a significant relationship with risk stratification. Analysis Findings confirm previous studies reporting intense neck pain/headache and distress as predictors for work disability after whiplash. Neck-mobility was a strong predictor in this study; however, it was a more inconsistent predictor in other studies. Conclusions Application of the risk assessment score and use of the risk strata

Assessing the use of BreatheSmart® mobile technology in adult patients with asthma: a remote observational study.

PubMed

Melvin, Emilie; Cushing, Anna; Tam, Anne; Kitada, Ruri; Manice, Melissa

2017-01-01

Non-adherence to asthma daily controller medications is a common problem, reported to be responsible for 60% of asthma-related hospitalisations. The mean level of adherence for asthma medications is estimated to be as low as 22%. Therefore, objective measurements of adherence to medicine are necessary. This virtual observational study is designed to measure the usability of an electronic monitoring device platform that measures adherence. Understanding how patients use the BreatheSmart mobile technology at home is essential to assess its feasibility as a solution to improve medication adherence. We anticipate this approach can be applied to real-world environments as a cost-effective solution to improve medication adherence. This is a virtual 6-month observational study of 100 adults (≥18 years) with an asthma diagnosis, using inhaled corticosteroids for at least 3 months. Participants will be recruited in the USA through ad placements online. All participants receive wireless Bluetooth-enabled inhaler sensors that track medication usage and an mSpirometer TM capable of clinical-grade lung function measurements, and download the BreatheSmart mobile application that transmits data to a secure server. All analyses are based on an intention-to-treat. Usability is assessed by patient questionnaires and question sessions. Simple paired t-test is used to assess significant change in Asthma Control Test score, quality of life (EuroQol-5D questionnaire) and lung function. No ethical or safety concerns pertain to the collection of these data. Results of this research are planned to be published as soon as available. NCT03103880.

A prospective observational study assessing home parenteral nutrition in patients with gastrointestinal cancer: benefits for quality of life.

PubMed

Senesse, Pierre; Tadmouri, Abir; Culine, Stéphane; Dufour, Patrick R; Seys, Patrick; Radji, Abderraouf; Rotarski, Maciej; Balian, Axel; Chambrier, Cecile

2015-02-01

Patients with gastrointestinal cancer are at high risk for deterioration of nutrition. Home parenteral nutrition (HPN) could improve nutritional status and quality of life (QoL). The purpose of this study was 1) to evaluate the impact of HPN on QoL, 2) to assess changes in nutritional status, and 3) to assess proxy perception of patient well-being. We conducted a prospective, observational, and a multicenter study. Inclusion criteria were adult patients with gastrointestinal cancer, for whom HPN was indicated and prescribed for at least 14 days. The physician, the patient, and a family member completed questionnaires at inclusion and 28 days later. The QoL was assessed by the patients using the Functional Assessment of Cancer Therapy-General questionnaire, at inclusion and 28 days later. The study included 370 patients with gastrointestinal cancer. The HPN was indicated for cancer-related undernutrition in 89% of the patients and was used as a complement to oral intake in 84%. After 28 days of parenteral intake, global QoL was significantly increased (48.9 at inclusion vs. 50.3, P=0.007). The patients' weight improved significantly by 2.7% (P<0.001). The nutrition risk screening also decreased significantly (3.2±1.1 vs. 2.8±1.3, P=0.003). HPN could provide benefit for malnourished patients with gastrointestinal cancer. However, randomized controlled studies are required to confirm this benefit and the safety profile. Copyright © 2015. Published by Elsevier Inc.

The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies.

PubMed

von Elm, Erik; Altman, Douglas G; Egger, Matthias; Pocock, Stuart J; Gøtzsche, Peter C; Vandenbroucke, Jan P

2014-12-01

Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available on the Web sites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Emergency nurses' evaluation of observational pain assessment tools for older people with cognitive impairment.

PubMed

Fry, Margaret; Arendts, Glenn; Chenoweth, Lynn

2017-05-01

To explore emergency nurses' perceptions of the feasibility and utility of Pain Assessment in Advanced Dementia tool in people over 65 with cognitive impairment. The Pain Assessment in Advanced Dementia tool was then compared with The Abbey Pain Scale, Doloplus-2 and PACSLAC. The objective was to determine which observational pain assessment tool was the most appropriate for the emergency department context and the cognitively impaired older person. The number of older people with cognitive impairment conditions, such as dementia, presenting to the emergency department is increasing. Approximately 28% of people over 65 years who present will have cognitive impairment. Older people with cognitive impairment often receive suboptimal pain management in the ED. There is limited evidence of the use and/or appropriateness of dementia-specific pain observation assessment tools in the ED. This was a multicentre exploratory qualitative study, which was conducted within a constructivist paradigm. Focus group interviews were conducted with nurses across three hospital emergency departments. Data were subject to thematic analysis. Six focus groups were conducted with 36 nurses over a 12-week period. Four themes emerged from the analysis: 1) cognitive impairment is a barrier to pain management; 2) PAINAD gives structure to pain assessment; 3) PAINAD assists to convey pain intensity; and 4) selection of an appropriate observational pain assessment tool. This study identified that emergency nurses find it challenging to detect, assess and manage pain in cognitively impaired people. While the use of the PAINAD helped to address these challenges compared to other tools, nurses also identified the important role that family and carers can play in pain assessment and management for older people with cognitive impairment. This study has generated new knowledge that has broad application across clinical settings, which can assist to transform pain management practice and reduce human

Health Instruction Packages: Nursing--Patient Observation and Assessment.

ERIC Educational Resources Information Center

Cooper, Freda; And Others

Text, illustrations, and exercises are utilized in this set of three learning modules to instruct nurses and nursing students in patient observation and assessment skills. The first module, "The ABC's of Observation" by Freda Cooper, provides psychiatric nurses and technicians with guidelines for determining the mental status of incoming…

Initial Assessment of Cyclone Global Navigation Satellite System (CYGNSS) Observations

NASA Astrophysics Data System (ADS)

McKague, D. S.; Ruf, C. S.

2017-12-01

The NASA Cyclone Global Navigation Satellite System (CYNSS) mission provides high temporal resolution observations of cyclones from a constellation of eight low-Earth orbiting satellites. Using the relatively new technique of Global Navigation Satellite System reflectometry (GNSS-R), all-weather observations are possible, penetrating even deep convection within hurricane eye walls. The compact nature of the GNSS-R receivers permits the use of small satellites, which in turn enables the launch of a constellation of satellites from a single launch vehicle. Launched in December of 2016, the eight CYGNSS satellites provide 25 km resolution observations of mean square slope (surface roughness) and surface winds with a 2.8 hour median revisit time from 38 S to 38 N degrees latitude. In addition to the calibration and validation of CYGNSS sea state observations, the CYGNSS science team is assessing the ability of the mission to provide estimates of cyclone size, intensity, and integrated kinetic energy. With its all-weather ability and high temporal resolution, the CYGNSS mission will add significantly to our ability to monitor cyclone genesis and intensification and will significantly reduce uncertainties in our ability to estimate cyclone intensity, a key variable in predicting its destructive potential. Members of the CYGNSS Science Team are also assessing the assimilation of CYGNSS data into hurricane forecast models to determine the impact of the data on forecast skill, using the data to study extra-tropical cyclones, and looking at connections between tropical cyclones and global scale weather, including the global hydrologic cycle. This presentation will focus on the assessment of early on-orbit observations of cyclones with respect to these various applications.

Using Electronic Medical Records to Assess the Effectiveness of Pharmacotherapy in Pain: A Review of Recent Observational Studies.

PubMed

Biltaji, Eman; Tak, Casey; Ma, Junjie; Ruiz-Negron, Natalia; Bellows, Brandon K

2016-09-01

Pain disorders affect a large number of individuals throughout the world and are costly. Although randomized clinical trials assess the efficacy (i.e., how well treatments work in controlled settings) of pain pharmacotherapy, clinical trials do not assess effectiveness (i.e., how well treatments work in real-world settings). The number of observational studies that use real-world data to assess the effectiveness of medications is increasing rapidly in many disease areas. It is important for clinicians to understand how real-world data may be used to assess the effectiveness of medications. This paper aims to review the current body of literature assessing the effectiveness of pain pharmacotherapy using medical records. To do this, a literature search was conducted to identify papers published between January 2013 and September 2015 that examined the effectiveness of pain pharmacotherapy using electronic medical records. The search found only three papers meeting these criteria, which were described, reviewed, and critiqued in this paper. Electronic medical records are an underutilized source of data to assess pain outcomes in real-world settings. Although there are many methodological challenges in using these data, there is also great opportunity to impact clinical practice and explore the real-world effectiveness of pharmacotherapy used in pain management.

Evaluation of Two Observational Assessment Systems for Children's Development and Learning

ERIC Educational Resources Information Center

Kim, Do-Hong; Smith, JaneDiane

2010-01-01

This study provided preliminary evidence for the reliability and validity of "Teaching Strategies GOLD", a recently developed observational system for assessing young children's development and learning. The measurement properties of "Teaching Strategies GOLD" were compared with those of an older instrument, "The Creative…

Collaborative Assessment: Middle School Case Study

ERIC Educational Resources Information Center

Parkison, Paul T.

2014-01-01

Utilizing a participant observer research model, a case study of the efficacy of a collaborative assessment methodology within a middle school social studies class was conducted. A review of existing research revealed that students' perceptions of assessment, evaluation, and accountability influence their intrinsic motivation to learn. A…

Interrater reliability of videotaped observational gait-analysis assessments.

PubMed

Eastlack, M E; Arvidson, J; Snyder-Mackler, L; Danoff, J V; McGarvey, C L

1991-06-01

The purpose of this study was to determine the interrater reliability of videotaped observational gait-analysis (VOGA) assessments. Fifty-four licensed physical therapists with varying amounts of clinical experience served as raters. Three patients with rheumatoid arthritis who demonstrated an abnormal gait pattern served as subjects for the videotape. The raters analyzed each patient's most severely involved knee during the four subphases of stance for the kinematic variables of knee flexion and genu valgum. Raters were asked to determine whether these variables were inadequate, normal, or excessive. The temporospatial variables analyzed throughout the entire gait cycle were cadence, step length, stride length, stance time, and step width. Generalized kappa coefficients ranged from .11 to .52. Intraclass correlation coefficients (2,1) and (3,1) were slightly higher. Our results indicate that physical therapists' VOGA assessments are only slightly to moderately reliable and that improved interrater reliability of the assessments of physical therapists utilizing this technique is needed. Our data suggest that there is a need for greater standardization of gait-analysis training.

Effect of formative evaluation using direct observation of procedural skills in assessment of postgraduate students of obstetrics and gynecology: Prospective study.

PubMed

Kumar, Naina; Singh, Namit Kant; Rudra, Samar; Pathak, Swanand

2017-01-01

Direct Observation of Procedural Skills (DOPS) is a way of evaluating procedural skills through observation in the workplace. The purpose of this study was to assess the role of DOPS in teaching and assessment of postgraduate students and to know the effect of repeated DOPS on improvement of the skills and confidence of the students. In both phases, significant difference was observed between the two groups on first DOPS comparison (1st phase: p=0.000; 2nd phase: p=0.002), with simulation group performing better. Comparison of sixth DOPS in the two groups revealed no difference in both phases, but significant difference on first and sixth DOPS comparison in each group (p=0.000). Repeated DOPS results in improved skills and confidence of students in managing real life obstetric emergencies irrespective of the teaching modality. Repeated DOPS results in improved skills and confidence of students in managing real life obstetric emergencies irrespective of the teaching modality.

Issues of reporting in observational studies in veterinary medicine.

PubMed

Sargeant, Jan M; O'Connor, Annette M

2014-02-15

Observational studies are common in veterinary medicine; the results may be used to inform decision-making, future research, or as inputs to systematic reviews or risk assessment. To be of use, the results must be published, all of the outcomes that were assessed must be included in the publication, and the research (methods and results) must be reported in sufficient detail that the reader can evaluate the internal and external validity. In human healthcare, concerns about the completeness of reporting - and evidence that poor reporting is associated with study results - have led to the creation of reporting guidelines; these include the STROBE statement for observational studies. There is evidence from a limited body of research that there also are reporting inadequacies in veterinary observational studies. There are differences between human and veterinary observational studies that might be relevant to recommendations for reporting. Such differences include: the use of observational studies in animal populations for simultaneously estimating disease frequency and risk-factor identification; the distinction between the animal owners who consent to participate and the animals that are the study subjects; and the complexity of organizational levels inherent in animal research (in particular, for studies in livestock species). In veterinary medicine, it is common to have clustering within outcomes (due to animal grouping) and clustering of predictor variables. We argue that there is a compelling need for the scientific community involved in veterinary observational studies to use the STROBE statement, use an amended version of STROBE, or to develop and use reporting guidelines that are specific to veterinary medicine to improve reporting of these studies. Copyright © 2013 Elsevier B.V. All rights reserved.

Clinical assessment of cerebrospinal fluid dynamics in hydrocephalus. Guide to interpretation based on observational study.

PubMed

Weerakkody, R A; Czosnyka, M; Schuhmann, M U; Schmidt, E; Keong, N; Santarius, T; Pickard, J D; Czosnyka, Z

2011-08-01

The term hydrocephalus encompasses a range of disorders characterised by clinical symptoms, abnormal brain imaging and derangement of cerebrospinal fluid (CSF) dynamics. The ability to elucidate which patients would benefit from CSF diversion (a shunt or third ventriculostomy) is often unclear. Similar difficulties are often encountered in shunted patients to predict the scope for improvement by shunt re-adjustment or revision. In this study we aimed to update our knowledge of how key quantitative parameters describing CSF dynamics may be used in diagnosis of shunt-responsive hydrocephalus and in the assessment of shunt function. A number of quantitative parameters [including resistance to CSF outflow (Rcsf), pulse amplitude of intracranial pressure waveform (AMP), RAP index and slow vasogenic waves] were studies in 1423 patients with 2665 CSF infusion tests and 305 overnight intracranial pressure (ICP)-monitoring sessions over a 17 year period. We demonstrate our observations for typical values of Pb, Rcsf, AMP, slow vasogenic waves derived from infusion studies or overnight ICP monitoring in differentiating atrophy from shunt-responsive normal pressure hydrocephalus or acute hydrocephalus. From the same variables tested on shunted patients we demonstrate a standardised approach to help differentiate a properly-functioning shunt from underdrainage or overdrainage. Quantitative variables derived from CSF dynamics allow differentiation between clinically overlapping entities such as shunt-responsive normal pressure hydrocephalus and brain atrophy (not shunt responsive) as well as allowing the detection of shunt malfunction (partial or complete blockage) or overdrainage. This observational study is intended to serve as an update for our understanding of quantitative testing of CSF dynamics. © 2011 John Wiley & Sons A/S.

Assessment of activity limitations with the health assessment questionnaire predicts the need for support measures in patients with rheumatoid arthritis: a multicenter observational study.

PubMed

Janssens, Xavier; Decuman, Saskia; De Keyser, Filip

2014-01-01

This study investigated whether the Health Assessment Questionnaire (HAQ) can be used as an instrument to assess the need for social support measures that address activity limitations and participation issues in patients with rheumatoid arthritis (RA). This multicenter observational study included patients with RA and disease duration of at least one year, consulting their rheumatologist for routine evaluation of disease activity. In the single study visit data on demographics, disease history and current treatment were collected. DAS28 values were collected to evaluate current RA disease activity. Patients were asked to fill out the HAQ and SF-36 questionnaires. Receiver Operator Characteristics (ROC) curves were constructed to evaluate the performance of the HAQ, SF-36 and DAS28 in predicting the need for nine supporting measures available for chronically ill patients in the Belgian social security system. The expert opinion of the treating rheumatologist was used as a reference. The study included 316 patients with a mean age of 59.8 ± 12.6 years, disease duration of 11.4 ± 9.3 years, mean DAS28 values of 2.83 ± 1.17. Mean HAQ score was 0.95 ± 0.73, mean SF-36 score 56.5 ± 21.3. HAQ scores >1 were observed in 39.4% of patients. The area under the HAQ ROC curve was consistently >0.7 and higher for the HAQ than for SF-36 or DAS28 for all support measures. Rheumatologists on average recommended 3.67 support measures. The HAQ score was found to be a good predictor of the need for social support measures in patients with RA.

Incremental Validity of Test Session and Classroom Observations in a Multimethod Assessment of Attention Deficit/Hyperactivity Disorder

ERIC Educational Resources Information Center

McConaughy, Stephanie H.; Harder, Valerie S.; Antshel, Kevin M.; Gordon, Michael; Eiraldi, Ricardo; Dumenci, Levent

2010-01-01

This study tested the incremental validity of behavioral observations, over and above parent and teacher reports, for assessing symptoms of Attention Deficit/Hyperactivity Disorder (ADHD) in children ages 6 to 12, using the Test Observation Form (TOF) and Direct Observation Form (DOF) from the Achenbach System of Empirically Based Assessment. The…

The impact of extended longitudinal observation on the assessment of personality disorders.

PubMed

Pedersen, G; Karterud, S; Hummelen, B; Wilberg, T

2013-11-01

Multiple sources of information are necessary for a valid assessment of personality disorders (PDs). This study investigates the impact of longitudinal observation. The sample comprised 1217 patients from 15 different treatment units. PDs were assessed at admission to treatment using the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) and additional clinical information (best estimate diagnosis). After approximately 18 weeks of treatment, the SCID-II protocols were re-examined at clinical conferences and the diagnostic status reassessed on the basis of longitudinal observations in multiple group situations (longitudinal, expert, all data principle). Using this procedure, 78% of the patients' diagnostic criteria sets were changed, and 32% of patients' diagnostic statuses were changed. Many (32%) patients who were evaluated initially as not having a PD received a PD diagnosis after re-examination. The information provided by customary clinical assessment has important limitations, and longitudinal observation provides additional information that may change the diagnostic status in approximately one-third of PD cases. Copyright © 2013 John Wiley & Sons, Ltd.

Social worker assessment of bad news delivery by emergency medicine residents: a novel direct-observation milestone assessment.

PubMed

Min, Alice Ann; Spear-Ellinwood, Karen; Berman, Melissa; Nisson, Peyton; Rhodes, Suzanne Michelle

2016-09-01

The skill of delivering bad news is difficult to teach and evaluate. Residents may practice in simulated settings; however, this may not translate to confidence or competence during real experiences. We investigated the acceptability and feasibility of social workers as evaluators of residents' delivery of bad news during patient encounters, and assessed the attitudes of both groups regarding this process. From August 2013 to June 2014, emergency medicine residents completed self-assessments after delivering bad news. Social workers completed evaluations after observing these conversations. The Assessment tools were designed by modifying the global Breaking Bad News Assessment Scale. Residents and social workers completed post-study surveys. 37 evaluations were received, 20 completed by social workers and 17 resident self-evaluations. Social workers reported discussing plans with residents prior to conversations 90 % of the time (18/20, 95 % CI 64.5, 97.8). Social workers who had previously observed the resident delivering bad news reported that the resident was more skilled on subsequent encounters 90 % of the time (95 % CI 42.2, 99). Both social workers and residents felt that prior training or experience was important. First-year residents valued advice from social workers less than advice from attending physicians, whereas more experienced residents perceived advice from social workers to be equivalent with that of attending physicians (40 versus 2.9 %, p = 0.002). Social worker assessment of residents' abilities to deliver bad news is feasible and acceptable to both groups. This formalized self-assessment and evaluation process highlights the importance of social workers' involvement in delivery of bad news, and the teaching of this skill. This method may also be used as direct-observation for resident milestone assessment.

MERRA-2 Input Observations: Summary and Assessment

NASA Technical Reports Server (NTRS)

Koster, Randal D. (Editor); McCarty, Will; Coy, Lawrence; Gelaro, Ronald; Huang, Albert; Merkova, Dagmar; Smith, Edmond B.; Sienkiewicz, Meta; Wargan, Krzysztof

2016-01-01

The Modern-Era Retrospective Analysis for Research and Applications, Version 2 (MERRA-2) is an atmospheric reanalysis, spanning 1980 through near-realtime, that uses state-of-the-art processing of observations from the continually evolving global observing system. The effectiveness of any reanalysis is a function not only of the input observations themselves, but also of how the observations are handled in the assimilation procedure. Relevant issues to consider include, but are not limited to, data selection, data preprocessing, quality control, bias correction procedures, and blacklisting. As the assimilation algorithm and earth system models are fundamentally fixed in a reanalysis, it is often a change in the character of the observations, and their feedbacks on the system, that cause changes in the character of the reanalysis. It is therefore important to provide documentation of the observing system so that its discontinuities and transitions can be readily linked to discontinuities seen in the gridded atmospheric fields of the reanalysis. With this in mind, this document provides an exhaustive list of the input observations, the context under which they are assimilated, and an initial assessment of selected core observations fundamental to the reanalysis.

Six Case-Studies of Performance Assessment.

ERIC Educational Resources Information Center

Mitchell, Ruth; Stempel, Amy

Six cases are studied to give some idea of the range of performance assessments in use in the United States. Contrast and comparison are made possible through the study of the following: (1) the South Brunswick (New Jersey) Public Schools Observational Portfolio for kindergarten through grade 12; (2) the Arizona Student Assessment Program (not yet…

Linking Indigenous Knowledge and Observed Climate Change Studies

NASA Technical Reports Server (NTRS)

Alexander, Chief Clarence; Bynum, Nora; Johnson, Liz; King, Ursula; Mustonen, Tero; Neofotis, Peter; Oettle, Noel; Rosenzweig, Cynthia; Sakakibara, Chie; Shadrin, Chief Vyacheslav;

Assessing video games to improve driving skills: a literature review and observational study.

PubMed

Sue, Damian; Ray, Pradeep; Talaei-Khoei, Amir; Jonnagaddala, Jitendra; Vichitvanichphong, Suchada

2014-08-07

For individuals, especially older adults, playing video games is a promising tool for improving their driving skills. The ease of use, wide availability, and interactivity of gaming consoles make them an attractive simulation tool. The objective of this study was to look at the feasibility and effects of installing video game consoles in the homes of individuals looking to improve their driving skills. A systematic literature review was conducted to assess the effect of playing video games on improving driving skills. An observatory study was performed to evaluate the feasibility of using an Xbox 360 Kinect console for improving driving skills. Twenty-nine articles, which discuss the implementation of video games in improving driving skills were found in literature. On our study, it was found the Xbox 360 with Kinect is capable of improving physical and mental activities. Xbox Video games were introduced to engage players in physical, visual and cognitive activities including endurance, postural sway, reaction time, eyesight, eye movement, attention and concentration, difficulties with orientation, and semantic fluency. However, manual dexterity, visuo-spatial perception and binocular vision could not be addressed by these games. It was observed that Xbox Kinect (by incorporating Kinect sensor facilities) combines physical, visual and cognitive engagement of players. These results were consistent with those from the literature review. From the research that has been carried out, we can conclude that video game consoles are a viable solution for improving user's physical and mental state. In future we propose to carry a thorough evaluation of the effects of video games on driving skills in elderly people.

Accuracy of physician self-assessment compared with observed measures of competence: a systematic review.

PubMed

Davis, David A; Mazmanian, Paul E; Fordis, Michael; Van Harrison, R; Thorpe, Kevin E; Perrier, Laure

2006-09-06

Core physician activities of lifelong learning, continuing medical education credit, relicensure, specialty recertification, and clinical competence are linked to the abilities of physicians to assess their own learning needs and choose educational activities that meet these needs. To determine how accurately physicians self-assess compared with external observations of their competence. The electronic databases MEDLINE (1966-July 2006), EMBASE (1980-July 2006), CINAHL (1982-July 2006), PsycINFO (1967-July 2006), the Research and Development Resource Base in CME (1978-July 2006), and proprietary search engines were searched using terms related to self-directed learning, self-assessment, and self-reflection. Studies were included if they compared physicians' self-rated assessments with external observations, used quantifiable and replicable measures, included a study population of at least 50% practicing physicians, residents, or similar health professionals, and were conducted in the United Kingdom, Canada, United States, Australia, or New Zealand. Studies were excluded if they were comparisons of self-reports, studies of medical students, assessed physician beliefs about patient status, described the development of self-assessment measures, or were self-assessment programs of specialty societies. Studies conducted in the context of an educational or quality improvement intervention were included only if comparative data were obtained before the intervention. Study population, content area and self-assessment domain of the study, methods used to measure the self-assessment of study participants and those used to measure their competence or performance, existence and use of statistical tests, study outcomes, and explanatory comparative data were extracted. The search yielded 725 articles, of which 17 met all inclusion criteria. The studies included a wide range of domains, comparisons, measures, and methodological rigor. Of the 20 comparisons between self- and

Developing and Validating a New Classroom Climate Observation Assessment Tool

PubMed Central

Leff, Stephen S.; Thomas, Duane E.; Shapiro, Edward S.; Paskewich, Brooke; Wilson, Kim; Necowitz-Hoffman, Beth; Jawad, Abbas F.

2011-01-01

The climate of school classrooms, shaped by a combination of teacher practices and peer processes, is an important determinant for children’s psychosocial functioning and is a primary factor affecting bullying and victimization. Given that there are relatively few theoretically-grounded and validated assessment tools designed to measure the social climate of classrooms, our research team developed an observation tool through participatory action research (PAR). This article details how the assessment tool was designed and preliminarily validated in 18 third-, fourth-, and fifth-grade classrooms in a large urban public school district. The goals of this study are to illustrate the feasibility of a PAR paradigm in measurement development, ascertain the psychometric properties of the assessment tool, and determine associations with different indices of classroom levels of relational and physical aggression. PMID:21643447

Developing and Validating a New Classroom Climate Observation Assessment Tool.

PubMed

Leff, Stephen S; Thomas, Duane E; Shapiro, Edward S; Paskewich, Brooke; Wilson, Kim; Necowitz-Hoffman, Beth; Jawad, Abbas F

2011-01-01

The climate of school classrooms, shaped by a combination of teacher practices and peer processes, is an important determinant for children's psychosocial functioning and is a primary factor affecting bullying and victimization. Given that there are relatively few theoretically-grounded and validated assessment tools designed to measure the social climate of classrooms, our research team developed an observation tool through participatory action research (PAR). This article details how the assessment tool was designed and preliminarily validated in 18 third-, fourth-, and fifth-grade classrooms in a large urban public school district. The goals of this study are to illustrate the feasibility of a PAR paradigm in measurement development, ascertain the psychometric properties of the assessment tool, and determine associations with different indices of classroom levels of relational and physical aggression.

Video observation of procedural skills for assessment of trabeculectomy performed by residents.

PubMed

Hassanpour, Narges; Chen, Rebecca; Baikpour, Masoud; Moghimi, Sasan

2016-06-01

The efficacy and sufficiency of a healthcare system is directly related to the knowledge and skills of graduates working in the system. In this regard, many different assessment methods have been proposed to evaluate various skills of the learners. Video Observation of Procedural Skills (VOPS) is one newly-proposed method. In this study we aimed to compare the results of the VOPS method with the more commonly used Direct Observation of Procedural Skills (DOPS). In this prospective study conducted in 2012, all 10 ophthalmology residents of post graduate year 4 were selected for participation. Three months into training in the glaucoma ward, these residents performed trabeculectomy surgery on patients, and their procedural skills were assessed in real time by an expert via the DOPS method. All surgeries were also recorded and later evaluated via the VOPS method by an expert. Bland-Altman plot also was used to compare the two methods and calculating the mean and 95% limit of agreement. Residents have been done a mean of 14.9 ± 3.5 (range 10-20) independent trabeculectomy before the assessments. DOPS grade was positively associated with number of independent trabeculectomy during glaucoma rotation (β=0.227, p = 0.004). The intra-observer reproducibility of VOPS measurements was 0.847 (95% CI: 0.634, 0.961). The mean VOPS grade was significantly lower than the mean DOPS grade (8.4 vs. 8.9, p = 0.02). However, a good correlation was observed between the grades of VOPS and DOPS (r = 0.89, p = 0.001). Bland-Altman analysis demonstrated that all data points fell within the 95% limits of agreement (-1.46, 0.46). The present study showed that VOPS might be considered a feasible, valid, and reliable assessment method for procedural skills of medical students and residents that can be used as an alternative to the DOPS method. However, VOPS might underestimate DOPS in evaluating surgical skills of residents.

A model of scientific attitudes assessment by observation in physics learning based scientific approach: case study of dynamic fluid topic in high school

NASA Astrophysics Data System (ADS)

Yusliana Ekawati, Elvin

2017-01-01

This study aimed to produce a model of scientific attitude assessment in terms of the observations for physics learning based scientific approach (case study of dynamic fluid topic in high school). Development of instruments in this study adaptation of the Plomp model, the procedure includes the initial investigation, design, construction, testing, evaluation and revision. The test is done in Surakarta, so that the data obtained are analyzed using Aiken formula to determine the validity of the content of the instrument, Cronbach’s alpha to determine the reliability of the instrument, and construct validity using confirmatory factor analysis with LISREL 8.50 program. The results of this research were conceptual models, instruments and guidelines on scientific attitudes assessment by observation. The construct assessment instruments include components of curiosity, objectivity, suspended judgment, open-mindedness, honesty and perseverance. The construct validity of instruments has been qualified (rated load factor > 0.3). The reliability of the model is quite good with the Alpha value 0.899 (> 0.7). The test showed that the model fits the theoretical models are supported by empirical data, namely p-value 0.315 (≥ 0.05), RMSEA 0.027 (≤ 0.08)

Enhancing the Assessment of Verbal Aggression through Observational Methodology

ERIC Educational Resources Information Center

van Dulmen, Manfred H. M.; Mata, Andrea D.; Klipfel, Katherine M.

2012-01-01

The assessment of verbal aggression in adolescent and young adult dating relationships has largely relied on self-report methodology. We investigated whether information on verbal aggression derived from an observational assessment would enhance the prediction of romantic relationship satisfaction and dissolution in a sample of young adult dating…

From randomized controlled trials to observational studies.

PubMed

Silverman, Stuart L

2009-02-01

Randomized controlled trials are considered the gold standard in the hierarchy of research designs for evaluating the efficacy and safety of a treatment intervention. However, their results can have limited applicability to patients in clinical settings. Observational studies using large health care databases can complement findings from randomized controlled trials by assessing treatment effectiveness in patients encountered in day-to-day clinical practice. Results from these designs can expand upon outcomes of randomized controlled trials because of the use of larger and more diverse patient populations with common comorbidities and longer follow-up periods. Furthermore, well-designed observational studies can identify clinically important differences among therapeutic options and provide data on long-term drug effectiveness and safety.

The value of including observational studies in systematic reviews was unclear: a descriptive study.

PubMed

Seida, Jennifer; Dryden, Donna M; Hartling, Lisa

2014-12-01

To evaluate (1) how often observational studies are included in comparative effectiveness reviews (CERs); (2) the rationale for including observational studies; (3) how data from observational studies are appraised, analyzed, and graded; and (4) the impact of observational studies on strength of evidence (SOE) and conclusions. Descriptive study of 23 CERs published through the Effective Health Care Program of the U.S. Agency for Healthcare Research and Quality. Authors searched for observational studies in 20 CERs, of which 18 included a median of 11 (interquartile range, 2-31) studies. Sixteen CERs incorporated the observational studies in their SOE assessments. Seventy-eight comparisons from 12 CERs included evidence from both trials and observational studies; observational studies had an impact on SOE and conclusions for 19 (24%) comparisons. There was diversity across the CERs regarding decisions to include observational studies; study designs considered; and approaches used to appraise, synthesize, and grade SOE. Reporting and methods guidance are needed to ensure clarity and consistency in how observational studies are incorporated in CERs. It was not always clear that observational studies added value in light of the additional resources needed to search for, select, appraise, and analyze such studies. Copyright © 2014 Elsevier Inc. All rights reserved.

Assessment of forward head posture in females: observational and photogrammetry methods.

PubMed

Salahzadeh, Zahra; Maroufi, Nader; Ahmadi, Amir; Behtash, Hamid; Razmjoo, Arash; Gohari, Mahmoud; Parnianpour, Mohamad

2014-01-01

There are different methods to assess forward head posture (FHP) but the accuracy and discrimination ability of these methods are not clear. Here, we want to compare three postural angles for FHP assessment and also study the discrimination accuracy of three photogrammetric methods to differentiate groups categorized based on observational method. All Seventy-eight healthy female participants (23 ± 2.63 years), were classified into three groups: moderate-severe FHP, slight FHP and non FHP based on observational postural assessment rules. Applying three photogrammetric methods - craniovertebral angle, head title angle and head position angle - to measure FHP objectively. One - way ANOVA test showed a significant difference in three categorized group's craniovertebral angle (P< 0.05, F=83.07). There was no dramatic difference in head tilt angle and head position angle methods in three groups. According to Linear Discriminate Analysis (LDA) results, the canonical discriminant function (Wilks'Lambda) was 0.311 for craniovertebral angle with 79.5% of cross-validated grouped cases correctly classified. Our results showed that, craniovertebral angle method may discriminate the females with moderate-severe and non FHP more accurate than head position angle and head tilt angle. The photogrammetric method had excellent inter and intra rater reliability to assess the head and cervical posture.

Assessing Video Games to Improve Driving Skills: A Literature Review and Observational Study

PubMed Central

Sue, Damian; Vichitvanichphong, Suchada

2014-01-01

Background For individuals, especially older adults, playing video games is a promising tool for improving their driving skills. The ease of use, wide availability, and interactivity of gaming consoles make them an attractive simulation tool. Objective The objective of this study was to look at the feasibility and effects of installing video game consoles in the homes of individuals looking to improve their driving skills. Methods A systematic literature review was conducted to assess the effect of playing video games on improving driving skills. An observatory study was performed to evaluate the feasibility of using an Xbox 360 Kinect console for improving driving skills. Results Twenty–nine articles, which discuss the implementation of video games in improving driving skills were found in literature. On our study, it was found the Xbox 360 with Kinect is capable of improving physical and mental activities. Xbox Video games were introduced to engage players in physical, visual and cognitive activities including endurance, postural sway, reaction time, eyesight, eye movement, attention and concentration, difficulties with orientation, and semantic fluency. However, manual dexterity, visuo-spatial perception and binocular vision could not be addressed by these games. It was observed that Xbox Kinect (by incorporating Kinect sensor facilities) combines physical, visual and cognitive engagement of players. These results were consistent with those from the literature review. Conclusions From the research that has been carried out, we can conclude that video game consoles are a viable solution for improving user’s physical and mental state. In future we propose to carry a thorough evaluation of the effects of video games on driving skills in elderly people. PMID:25654355

Inter-observer variability within BI-RADS and RANZCR mammographic density assessment schemes

NASA Astrophysics Data System (ADS)

Damases, Christine N.; Mello-Thoms, Claudia; McEntee, Mark F.

2016-03-01

This study compares variability associated with two visual mammographic density (MD) assessment methods using two separate samples of radiologists. The image test-set comprised of images obtained from 20 women (age 42-89 years). The images were assessed for their MD by twenty American Board of Radiology (ABR) examiners and twenty-six radiologists registered with the Royal Australian and New Zealand College of Radiologists (RANZCR). Images were assessed using the same technology and conditions, however the ABR radiologists used the BI-RADS and the RANZCR radiologists used the RANZCR breast density synoptic. Both scales use a 4-point assessment. The images were then grouped as low- and high-density; low including BIRADS 1 and 2 or RANZCR 1 and 2 and high including BI-RADS 3 and 4 or RANZCR 3 and 4. Four-point BI-RADS and RANZCR showed no or negligible correlation (ρ=-0.029 p<0.859). The average inter-observer agreement on the BI-RADS scale had a Kappa of 0.565; [95% CI = 0.519 - 0.610], and ranged between 0.328-0.669 while the inter-observer agreement using the RANZCR scale had a Kappa of 0.360; [95% CI = 0.308 - 0.412] and a range of 0.078-0.499. Our findings show a wider range of inter-observer variability among RANZCR registered radiologists than the ABR examiners.

Psychometric properties of the Doloplus-2 observational pain assessment scale and comparison to self-assessment in hospitalized elderly.

PubMed

Pautex, Sophie; Herrmann, François R; Michon, Agnès; Giannakopoulos, Panteleimon; Gold, Gabriel

2007-01-01

Self-report is the "gold standard" for pain assessment, however, observational pain scales, such as Doloplus-2 must be used for patients who cannot communicate. In this follow-up study, we report the psychometric properties of the observational Doloplus-2 scale using the visual analog scale (VAS) pain score as a gold standard and evaluate its performance. Prospective clinical study of 180 hospitalized older patients who demonstrated good comprehension and reliable use of the VAS: 131 participants with dementia and 49 without. All participants assessed their chronic pain using the VAS. Doloplus-2 was independently completed by the nursing team. Mean age of patients (133 women, 47 men) was 83.7+/-6.5. Median mini-mental state examination of patients with diagnosis of dementia was 18.0+/-7.7. Nearly half of the patients (49%) reported that they experienced pain in response to a direct question. The administration of Doloplus-2 was possible in all 180 patients. Doloplus-2 correlated moderately with self-assessment (Spearman coefficient: 0.46). In a multiple regression model, Doloplus-2 predicted 41% of the variability in pain intensity measured by VAS. The somatic dimension alone explained 36% of the variance, the psychosocial bloc 5% with no better contribution of the psychomotor bloc. To shorten Doloplus-2, we constructed a version with only the 5 items that were significantly associated with the VAS score in the multiple regression models. The observational Doloplus-2 scale correlates moderately with self-assessment pain score and has adequate internal consistency. Our data also suggest that Doloplus-2 could be substantially shortened as the brief version performed similarly to the complete Doloplus-2.

Development of a Peer Teaching-Assessment Program and a Peer Observation and Evaluation Tool

PubMed Central

Trujillo, Jennifer M.; Barr, Judith; Gonyeau, Michael; Van Amburgh, Jenny A.; Matthews, S. James; Qualters, Donna

2008-01-01

Objectives To develop a formalized, comprehensive, peer-driven teaching assessment program and a valid and reliable assessment tool. Methods A volunteer taskforce was formed and a peer-assessment program was developed using a multistep, sequential approach and the Peer Observation and Evaluation Tool (POET). A pilot study was conducted to evaluate the efficiency and practicality of the process and to establish interrater reliability of the tool. Intra-class correlation coefficients (ICC) were calculated. Results ICCs for 8 separate lectures evaluated by 2-3 observers ranged from 0.66 to 0.97, indicating good interrater reliability of the tool. Conclusion Our peer assessment program for large classroom teaching, which includes a valid and reliable evaluation tool, is comprehensive, feasible, and can be adopted by other schools of pharmacy. PMID:19325963

Assessing the Accuracy of Classwide Direct Observation Methods: Two Analyses Using Simulated and Naturalistic Data

ERIC Educational Resources Information Center

Dart, Evan H.; Radley, Keith C.; Briesch, Amy M.; Furlow, Christopher M.; Cavell, Hannah J.; Briesch, Amy M.

2016-01-01

Two studies investigated the accuracy of eight different interval-based group observation methods that are commonly used to assess the effects of classwide interventions. In Study 1, a Microsoft Visual Basic program was created to simulate a large set of observational data. Binary data were randomly generated at the student level to represent…

A cross-sectional observational study to assess inhaler technique in Saudi hospitalized patients with asthma and chronic obstructive pulmonary disease

PubMed Central

Ammari, Maha Al; Sultana, Khizra; Yunus, Faisal; Ghobain, Mohammed Al; Halwan, Shatha M. Al

2016-01-01

Objectives: To assess the proportion of critical errors committed while demonstrating the inhaler technique in hospitalized patients diagnosed with asthma and chronic obstructive pulmonary disease (COPD). Methods: This cross-sectional observational study was conducted in 47 asthmatic and COPD patients using inhaler devices. The study took place at King Abdulaziz Medical City, Riyadh, Saudi Arabia between September and December 2013. Two pharmacists independently assessed inhaler technique with a validated checklist. Results: Seventy percent of patients made at least one critical error while demonstrating their inhaler technique, and the mean number of critical errors per patient was 1.6. Most patients used metered dose inhaler (MDI), and 73% of MDI users and 92% of dry powder inhaler users committed at least one critical error. Conclusion: Inhaler technique in hospitalized Saudi patients was inadequate. Health care professionals should understand the importance of reassessing and educating patients on a regular basis for inhaler technique, recommend the use of a spacer when needed, and regularly assess and update their own inhaler technique skills. PMID:27146622

ARCADO - Adding random case analysis to direct observation in workplace-based formative assessment of general practice registrars.

PubMed

Ingham, Gerard; Fry, Jennifer; Morgan, Simon; Ward, Bernadette

2015-12-10

Workplace-based formative assessments using consultation observation are currently conducted during the Australian general practice training program. Assessment reliability is improved by using multiple assessment methods. The aim of this study was to explore experiences of general practice medical educator assessors and registrars (trainees) when adding random case analysis to direct observation (ARCADO) during formative workplace-based assessments. A sample of general practice medical educators and matched registrars were recruited. Following the ARCADO workplace assessment, semi-structured qualitative interviews were conducted. The data was analysed thematically. Ten registrars and eight medical educators participated. Four major themes emerged - formative versus summative assessment; strengths (acceptability, flexibility, time efficiency, complementarity and authenticity); weaknesses (reduced observation and integrity risks); and contextual factors (variation in assessment content, assessment timing, registrar-medical educator relationship, medical educator's approach and registrar ability). ARCADO is a well-accepted workplace-based formative assessment perceived by registrars and assessors to be valid and flexible. The use of ARCADO enabled complementary insights that would not have been achieved with direct observation alone. Whilst there are some contextual factors to be considered in its implementation, ARCADO appears to have utility as formative assessment and, subject to further evaluation, high-stakes assessment.

Observable phenomena that reveal medical students' clinical reasoning ability during expert assessment of their history taking: a qualitative study.

PubMed

Haring, Catharina M; Cools, Bernadette M; van Gurp, Petra J M; van der Meer, Jos W M; Postma, Cornelis T

2017-08-29

During their clerkships, medical students are meant to expand their clinical reasoning skills during their patient encounters. Observation of these encounters could reveal important information on the students' clinical reasoning abilities, especially during history taking. A grounded theory approach was used to analyze what expert physicians apply as indicators in their assessment of medical students' diagnostic reasoning abilities during history taking. Twelve randomly selected clinical encounter recordings of students at the end of the internal medicine clerkships were observed by six expert assessors, who were prompted to formulate their assessment criteria in a think-aloud procedure. These formulations were then analyzed to identify the common denominators and leading principles. The main indicators of clinical reasoning ability were abstracted from students' observable acts during history taking in the encounter. These were: taking control, recognizing and responding to relevant information, specifying symptoms, asking specific questions that point to pathophysiological thinking, placing questions in a logical order, checking agreement with patients, summarizing and body language. In addition, patients' acts and the course, result and efficiency of the conversation were identified as indicators of clinical reasoning, whereas context, using self as a reference, and emotion/feelings were identified by the clinicians as variables in their assessment of clinical reasoning. In observing and assessing clinical reasoning during history taking by medical students, general and specific phenomena to be used as indicators for this process could be identified. These phenomena can be traced back to theories on the development and the process of clinical reasoning.

Becoming a Reflective Mathematics Teacher: A Guide for Observations and Self-Assessment. Studies in Mathematical Thinking and Learning Series.

ERIC Educational Resources Information Center

Artzt, Alice F.; Armour-Thomas, Eleanor

This activity-oriented book for preservice mathematics teachers who are taking methods courses or who have been student teaching offers a framework for teacher reflection and self- assessment. It supplies detailed observation instruments for observing other teachers, reflective activities, and guidelines and instruments for supervisors. There are…

The intra- and inter-observer reliability of the physical examination methods used to assess patients with patellofemoral joint instability.

PubMed

Smith, Toby O; Clark, Allan; Neda, Sophia; Arendt, Elizabeth A; Post, William R; Grelsamer, Ronald P; Dejour, David; Almqvist, Karl Fredrik; Donell, Simon T

2012-08-01

An accurate physical examination of patients with patellar instability is an important aspect of the diagnosis and treatment. While previous studies have assessed the diagnostic accuracy of such physical examination tests, little has been undertaken to assess the inter- and intra-tester reliability of such techniques. The purpose of this study was to determine the inter- and intra-tester reliability of the physical examination tests used for patients with patellar instability. Five patients (10 knees) with bilateral recurrent patellar instability were assessed by five members of the International Patellofemoral Study Group. Each surgeon assessed each patient twice using 18 reported physical examination tests. The inter- and intra-observer reliability was assessed using weighted Kappa statistics with 95% confidence intervals. The findings of the study suggested that there were very poor inter-observer reliability for the majority of the physical tests, with only the assessments of patellofemoral crepitus, foot arch position and the J-sign presenting with fair to moderate agreement respectively. The intra-observer reliability indicated largely moderate to substantial agreement between the first and second tests performed by each assessor, with the greatest agreement seen for the assessment of tibial torsion, popliteal angle and the Bassett's sign. For the common physical examination tests used in the management of patients with patellar instability inter-observer reliability is poor, while intra-observer reliability is moderate. Standardization of physical exam assessments and further study of these results among different clinicians and more divergent patient groups is indicated. Copyright © 2011 Elsevier B.V. All rights reserved.

The Network Structure Underlying the Earth Observation Assessment

NASA Astrophysics Data System (ADS)

Vitkin, S.; Doane, W. E. J.; Mary, J. C.

2017-12-01

The Earth Observations Assessment (EOA 2016) is a multiyear project designed to assess the effectiveness of civil earth observation data sources (instruments, sensors, models, etc.) on societal benefit areas (SBAs) for the United States. Subject matter experts (SMEs) provided input and scored how data sources inform products, product groups, key objectives, SBA sub-areas, and SBAs in an attempt to quantify the relationships between data sources and SBAs. The resulting data were processed by Integrated Applications Incorporated (IAI) using MITRE's PALMA software to create normalized relative impact scores for each of these relationships. However, PALMA processing obscures the natural network representation of the data. Any network analysis that might identify patterns of interaction among data sources, products, and SBAs is therefore impossible. Collaborating with IAI, we cleaned and recreated a network from the original dataset. Using R and Python we explore the underlying structure of the network and apply frequent itemset mining algorithms to identify groups of data sources and products that interact. We reveal interesting patterns and relationships in the EOA dataset that were not immediately observable from the EOA 2016 report and provide a basis for further exploration of the EOA network dataset.

Investigations of the reliability of observational gait analysis for the assessment of lameness in horses.

PubMed

Hewetson, M; Christley, R M; Hunt, I D; Voute, L C

2006-06-24

The objectives of this study were to assess the reliability of a numerical rating scale (NRS) and a verbal rating scale (VRS) for the assessment of lameness in horses and to determine whether they can be used interchangeably. Sixteen independent observers graded the severity of lameness in 20 videotaped horses, and the agreement between and within observers, correlation and bias were determined for each scale. The observers agreed with each other in 56 per cent of the observations with the NRS and in 60 per cent of the observations with the VRS, and the associated Kendall coefficient of concordance was high. Similar trends were evident in the agreement between two observations by each observer. The correlation between and within observers was high for both scales. There were no significant differences (bias) among the observers' mean scores when using either scale. There was a significant correlation between the lameness scores attributed when using the two scales, but the differences between the scores when plotted against their overall mean were unacceptable for clinical purposes. The results indicate that the NRS and VRS are only moderately reliable when used to assess lameness severity in the horse, and that they should not be used interchangeably.

Assessment of Developing Intensity Duration Frequency Curves using Satellite Observations (Case Study)

NASA Astrophysics Data System (ADS)

Ombadi, Mohammed; Nguyen, Phu; Sorooshian, Soroosh

2017-12-01

Intensity Duration Frequency (IDF) curves are essential for the resilient design of infrastructures. Since their earlier development, IDF relationships have been derived using precipitation records from rainfall gauge stations. However, with the recent advancement in satellite observation of precipitation which provides near global coverage and high spatiotemporal resolution, it is worthy of attention to investigate the validity of utilizing the relatively short record length of satellite rainfall to generate robust IDF relationships. These satellite-based IDF can address the paucity of such information in the developing countries. Few studies have used satellite precipitation data in IDF development but mainly focused on merging satellite and gauge precipitation. In this study, however, IDF have been derived solely from satellite observations using PERSIANN-CDR (Precipitation Estimation from Remotely Sensed Information Using Artificial Neural Networks-Climate Data Record). The unique PERSIANN-CDR attributes of high spatial resolution (0.25°×0.25°), daily temporal resolution and a record dating back to 1983 allow for the investigation at fine resolution. The results are compared over most of the contiguous United States against NOAA Atlas 14. The impact of using different methods of sampling, distribution estimators and regionalization in the resulting relationships is investigated. Main challenges to estimate robust and accurate IDF from satellite observations are also highlighted.

Generalizing from Observations of Mathematics Teachers' Instructional Practice Using the Instructional Quality Assessment

ERIC Educational Resources Information Center

Wilhelm, Anne Garrison; Kim, Sungyeun

2015-01-01

One crucial question for researchers who study teachers' classroom practice is how to maximize information about what is happening in classrooms while minimizing costs. This report extends prior studies of the reliability of the Instructional Quality Assessment (IQA), a widely used classroom observation toolkit, and offers insight into the often…

A Phenomenological Case Study: Teacher Bias Effects on Early Education Assessments

ERIC Educational Resources Information Center

Reynolds, Rebecca Jeannine

2012-01-01

This qualitative phenomenological case study explored the lived experiences of a purposive sample of 20 current and past early education teachers who have experience in assessing children through observational assessment. The purpose of this study was to determine if bias affects the documentation of observational assessment and the implementation…

An inter-observer Ki67 reproducibility study applying two different assessment methods: on behalf of the Danish Scientific Committee of Pathology, Danish breast cancer cooperative group (DBCG).

PubMed

Laenkholm, Anne-Vibeke; Grabau, Dorthe; Møller Talman, Maj-Lis; Balslev, Eva; Bak Jylling, Anne Marie; Tabor, Tomasz Piotr; Johansen, Morten; Brügmann, Anja; Lelkaitis, Giedrius; Di Caterino, Tina; Mygind, Henrik; Poulsen, Thomas; Mertz, Henrik; Søndergaard, Gorm; Bruun Rasmussen, Birgitte

2018-01-01

In 2011, the St. Gallen Consensus Conference introduced the use of pathology to define the intrinsic breast cancer subtypes by application of immunohistochemical (IHC) surrogate markers ER, PR, HER2 and Ki67 with a specified Ki67 cutoff (>14%) for luminal B-like definition. Reports concerning impaired reproducibility of Ki67 estimation and threshold inconsistency led to the initiation of this quality assurance study (2013-2015). The aim of the study was to investigate inter-observer variation for Ki67 estimation in malignant breast tumors by two different quantification methods (assessment method and count method) including measure of agreement between methods. Fourteen experienced breast pathologists from 12 pathology departments evaluated 118 slides from a consecutive series of malignant breast tumors. The staining interpretation was performed according to both the Danish and Swedish guidelines. Reproducibility was quantified by intra-class correlation coefficient (ICC) and Lights Kappa with dichotomization of observations at the larger than (>) 20% threshold. The agreement between observations by the two quantification methods was evaluated by Bland-Altman plot. For the fourteen raters the median ranged from 20% to 40% by the assessment method and from 22.5% to 36.5% by the count method. Light's Kappa was 0.664 for observation by the assessment method and 0.649 by the count method. The ICC was 0.82 (95% CI: 0.77-0.86) by the assessment method vs. 0.84 (95% CI: 0.80-0.87) by the count method. Although the study in general showed a moderate to good inter-observer agreement according to both ICC and Lights Kappa, still major discrepancies were identified in especially the mid-range of observations. Consequently, for now Ki67 estimation is not implemented in the DBCG treatment algorithm.

The Anaclitic-Introjective Depression Assessment: Development and preliminary validity of an observer-rated measure.

PubMed

Rost, Felicitas; Luyten, Patrick; Fonagy, Peter

2018-03-01

The two-configurations model developed by Blatt and colleagues offers a comprehensive conceptual and empirical framework for understanding depression. This model suggests that depressed patients struggle, at different developmental levels, with issues related to dependency (anaclitic issues) or self-definition (introjective issues), or a combination of both. This paper reports three studies on the development and preliminary validation of the Anaclitic-Introjective Depression Assessment, an observer-rated assessment tool of impairments in relatedness and self-definition in clinical depression based on the item pool of the Shedler-Westen Assessment Procedure. Study 1 describes the development of the measure using expert consensus rating and Q-methodology. Studies 2 and 3 report the assessment of its psychometric properties, preliminary reliability, and validity in a sample of 128 patients diagnosed with treatment-resistant depression. Four naturally occurring clusters of depressed patients were identified using Q-factor analysis, which, overall, showed meaningful and theoretically expected relationships with anaclitic/introjective prototypes as formulated by experts, as well as with clinical, social, occupational, global, and relational functioning. Taken together, findings reported in this paper provide preliminary evidence for the reliability and validity of the Anaclitic-Introjective Depression Assessment, an observer-rated measure that allows the detection of important nuanced differentiations between and within anaclitic and introjective depression. Copyright © 2017 John Wiley & Sons, Ltd.

Inter- and intra-observer reliability of measurement of pedicle screw breach assessed by postoperative CT scans.

PubMed

Lavelle, William F; Ranade, Ashish; Samdani, Amer F; Gaughan, John P; D'Andrea, Linda P; Betz, Randal R

2014-01-01

Pedicle screws are used increasingly in spine surgery. Concerns of complications associated with screw breach necessitates accurate pedicle screw placement. Postoperative CT imaging helps to detect screw malposition and assess its severity. However, accuracy is dependent on the reading of the CT scans. Inter- and intra-observer variability could affect the reliability of CT scans to assess multiple screw types and sites. The purpose of this study was to assess the reliability of multi-observer analysis of CT scans for determining pedicle screw breach for various screw types and sites in patients with spinal deformity or degenerative pathologies. Axial CT scan images of 23 patients (286 screws) were read by four experienced spine surgeons. Pedicle screw placement was considered 'In' when the screw was fully contained and/or the pedicle wall breach was ≤2 mm. 'Out' was defined as a breach in the medial or lateral pedicle wall >2 mm. Intra-class coefficients (ICC) were calculated to assess the inter- and intra-observer reliability. Marked inter- and intra-observer variability was noticed. The overall inter-observer ICC was 0.45 (95% confidence limits 0.25 to 0.65). The intra-observer ICC was 0.49 (95% confidence limits 0.29 to 0.69). Underlying spinal pathology, screw type, and patient age did not seem to impact the reliability of our CT assessments. Our results indicate the evaluation of pedicle screw breach on CT by a single surgeon is highly variable, and care should be taken when using individual CT evaluations of millimeters of breach as a basis for screw removal. This was a Level III study.

Observational studies in systematic [corrected] reviews of comparative effectiveness: AHRQ and the Effective Health Care Program.

PubMed

Norris, Susan L; Atkins, David; Bruening, Wendy; Fox, Steven; Johnson, Eric; Kane, Robert; Morton, Sally C; Oremus, Mark; Ospina, Maria; Randhawa, Gurvaneet; Schoelles, Karen; Shekelle, Paul; Viswanathan, Meera

2011-11-01

Systematic reviewers disagree about the ability of observational studies to answer questions about the benefits or intended effects of pharmacotherapeutic, device, or procedural interventions. This study provides a framework for decision making on the inclusion of observational studies to assess benefits and intended effects in comparative effectiveness reviews (CERs). The conceptual model and recommendations were developed using a consensus process by members of the methods workgroup of the Effective Health Care Program of the Agency for Healthcare Research and Quality. In considering whether to use observational studies in CERs for addressing beneficial effects, reviewers should answer two questions: (1) Are there gaps in the evidence from randomized controlled trials (RCTs)? (2) Will observational studies provide valid and useful information? The latter question involves the following: (a) refocusing the study questions on gaps in the evidence from RCTs, (b) assessing the risk of bias of the body of evidence of observational studies, and (c) assessing whether available observational studies address the gap review questions. Because it is unusual to find sufficient evidence from RCTs to answer all key questions concerning benefit or the balance of benefits and harms, comparative effectiveness reviewers should routinely assess the appropriateness of inclusion of observational studies for questions of benefit. Furthermore, reviewers should explicitly state the rationale for inclusion or exclusion of observational studies when conducting CERs. Copyright © 2011 Elsevier Inc. All rights reserved.

Live versus Video Observations: Comparing the Reliability and Validity of Two Methods of Assessing Classroom Quality

ERIC Educational Resources Information Center

Curby, Timothy W.; Johnson, Price; Mashburn, Andrew J.; Carlis, Lydia

2016-01-01

When conducting classroom observations, researchers are often confronted with the decision of whether to conduct observations live or by using pre-recorded video. The present study focuses on comparing and contrasting observations of live and video administrations of the Classroom Assessment Scoring System-PreK (CLASS-PreK). Associations between…

The clinical assessment study of the foot (CASF): study protocol for a prospective observational study of foot pain and foot osteoarthritis in the general population

PubMed Central

2011-01-01

Background Symptomatic osteoarthritis (OA) affects approximately 10% of adults aged over 60 years. The foot joint complex is commonly affected by OA, yet there is relatively little research into OA of the foot, compared with other frequently affected sites such as the knee and hand. Existing epidemiological studies of foot OA have focussed predominantly on the first metatarsophalangeal joint at the expense of other joints. This three-year prospective population-based observational cohort study will describe the prevalence of symptomatic radiographic foot OA, relate its occurrence to symptoms, examination findings and life-style-factors, describe the natural history of foot OA, and examine how it presents to, and is diagnosed and managed in primary care. Methods All adults aged 50 years and over registered with four general practices in North Staffordshire, UK, will be invited to participate in a postal Health Survey questionnaire. Respondents to the questionnaire who indicate that they have experienced foot pain in the preceding twelve months will be invited to attend a research clinic for a detailed clinical assessment. This assessment will consist of: clinical interview; physical examination; digital photography of both feet and ankles; plain x-rays of both feet, ankles and hands; ultrasound examination of the plantar fascia; anthropometric measurement; and a further self-complete questionnaire. Follow-up will be undertaken in consenting participants by postal questionnaire at 18 months (clinic attenders only) and three years (clinic attenders and survey participants), and also by review of medical records. Discussion This three-year prospective epidemiological study will combine survey data, comprehensive clinical, x-ray and ultrasound assessment, and review of primary care records to identify radiographic phenotypes of foot OA in a population of community-dwelling older adults, and describe their impact on symptoms, function and clinical examination findings

Using Non-Participant Observation in Curriculum Assessment: A Case Example.

ERIC Educational Resources Information Center

Troutman, Benjamin I., Jr.

In this paper a rationale for the use of non-participant observation in curriculum development is presented. An assessment of the University of Georgia Anthropology Curriculum Project's Race, Caste, and Prejudice (RCP) provides a case example of the use of this qualitative model in educational research. The researcher's assessment of RCP focuses…

Longitudinal assessment of brain-derived neurotrophic factor in Sardinian psychotic patients (LABSP): a protocol for a prospective observational study

PubMed Central

Primavera, Diego; Deriu, Luca; Collu, Roberto; Scherma, Maria; Fadda, Paola; Fratta, Walter; Carpiniello, Bernardo

2017-01-01

Introduction Brain-derived neurotrophic factor (BDNF) plays a crucial role in neurodevelopment, synaptic plasticity and neuronal function and survival. Serum and plasma BDNF levels are moderately, but consistently, decreased in patients with schizophrenia (SCZ) compared with healthy controls. There is a lack of knowledge, however, on the temporal manifestation of this decline. Clinical, illness course and treatment factors might influence the variation of BDNF serum levels in patients with psychosis. In this context, we propose a longitudinal study of a cohort of SCZ and schizophrenic and schizoaffective disorder (SAD) Sardinian patients with the aim of disentangling the relationship between peripheral BDNF serum levels and changes of psychopathology, cognition and drug treatments. Methods and analysis Longitudinal assessment of BDNF in Sardinian psychotic patients (LABSP) is a 24-month observational prospective cohort study. Patients with SAD will be recruited at the Psychiatry Research Unit of the Department of Medical Science and Public Health, University of Cagliari and University of Cagliari Health Agency, Cagliari, Italy. We will collect BDNF serum levels as well as sociodemographic, psychopathological and neurocognitive measures. Structured, semistructured and self-rating assessment tools, such as the Positive and Negative Syndrome Scale for psychopathological measures and the Brief Assessment of Cognition in Schizophrenia for cognitive function, will be used. Ethics and dissemination This study protocol was approved by the University of Cagliari Health Agency Ethics Committee (NP2016/5491). The study will be conducted in accordance with the principles of good clinical practice, in the Declaration of Helsinki in compliance with the regulations. Participation will be voluntary and written informed consent will be obtained for each participant upon entry into the study. We plan to disseminate the results of our study through conference presentations and

Observational Studies: Cohort and Case-Control Studies

PubMed Central

Song, Jae W.; Chung, Kevin C.

2010-01-01

Observational studies are an important category of study designs. To address some investigative questions in plastic surgery, randomized controlled trials are not always indicated or ethical to conduct. Instead, observational studies may be the next best method to address these types of questions. Well-designed observational studies have been shown to provide results similar to randomized controlled trials, challenging the belief that observational studies are second-rate. Cohort studies and case-control studies are two primary types of observational studies that aid in evaluating associations between diseases and exposures. In this review article, we describe these study designs, methodological issues, and provide examples from the plastic surgery literature. PMID:20697313

Visual assessment of breast density using Visual Analogue Scales: observer variability, reader attributes and reading time

NASA Astrophysics Data System (ADS)

Ang, Teri; Harkness, Elaine F.; Maxwell, Anthony J.; Lim, Yit Y.; Emsley, Richard; Howell, Anthony; Evans, D. Gareth; Astley, Susan; Gadde, Soujanya

2017-03-01

Breast density is a strong risk factor for breast cancer and has potential use in breast cancer risk prediction, with subjective methods of density assessment providing a strong relationship with the development of breast cancer. This study aims to assess intra- and inter-observer variability in visual density assessment recorded on Visual Analogue Scales (VAS) among trained readers, and examine whether reader age, gender and experience are associated with assessed density. Eleven readers estimated the breast density of 120 mammograms on two occasions 3 years apart using VAS. Intra- and inter-observer agreement was assessed with Intraclass Correlation Coefficient (ICC) and variation between readers visualised on Bland-Altman plots. The mean scores of all mammograms per reader were used to analyse the effect of reader attributes on assessed density. Excellent intra-observer agreement (ICC>0.80) was found in the majority of the readers. All but one reader had a mean difference of <10 percentage points from the first to the second reading. Inter-observer agreement was excellent for consistency (ICC 0.82) and substantial for absolute agreement (ICC 0.69). However, the 95% limits of agreement for pairwise differences were -6.8 to 15.7 at the narrowest and 0.8 to 62.3 at the widest. No significant association was found between assessed density and reader age, experience or gender, or with reading time. Overall, the readers were consistent in their scores, although some large variations were observed. Reader evaluation and targeted training may alleviate this problem.

Notes From the Field: Direct Observation Versus Rating by Videos for the Assessment of Central Venous Catheterization Skills.

PubMed

Ma, Irene W Y; Zalunardo, Nadia; Brindle, Mary E; Hatala, Rose; McLaughlin, Kevin

2015-09-01

Blinded assessments of technical skills using video-recordings may offer more objective assessments than direct observations. This study seeks to compare these two modalities. Two trained assessors independently assessed 18 central venous catheterization performances by direct observation and video-recorded assessments using two tools. Although sound quality was deemed adequate in all videos, portions of the video for wire handling and drape handling were frequently out of view (n = 13, 72% for wire-handling; n = 17, 94% for drape-handling). There were no differences in summary global rating scores, checklist scores, or pass/fail decisions for either modality (p > 0.05). Inter-rater reliability was acceptable for both modalities. Of the 26 discrepancies identified between direct observation and video-recorded assessments, three discrepancies (12%) were due to inattention during video review, while one (4%) discrepancy was due to inattention during direct observation. In conclusion, although scores did not differ between the two assessment modalities, techniques of video-recording may significantly impact individual items of assessments. © The Author(s) 2014.

Physical Therapy Observation and Assessment in the Neonatal Intensive Care Unit

ERIC Educational Resources Information Center

Byrne, Eilish; Campbell, Suzann K.

2013-01-01

This article presents the elements of the Observation and Assessment section of the Infant Care Path for Physical Therapy in the Neonatal Intensive Care Unit (NICU). The types of physical therapy assessments presented in this path are evidence-based and the suggested timing of these assessments is primarily based on practice knowledge from expert…

Initial Steps in Creating a Developmentally Valid Tool for Observing/Assessing Rope Jumping

ERIC Educational Resources Information Center

Roberton, Mary Ann; Thompson, Gregory; Langendorfer, Stephen J.

2017-01-01

Background: Valid motor development sequences show the various behaviors that children display as they progress toward competence in specific motor skills. Teachers can use these sequences to observe informally or formally assess their students. While longitudinal study is ultimately required to validate developmental sequences, there are earlier,…

The NOAA Satellite Observing System Architecture Study

NASA Technical Reports Server (NTRS)

Volz, Stephen; Maier, Mark; Di Pietro, David

2016-01-01

NOAA is beginning a study, the NOAA Satellite Observing System Architecture (NSOSA) study, to plan for the future operational environmental satellite system that will follow GOES and JPSS, beginning about 2030. This is an opportunity to design a modern architecture with no pre-conceived notions regarding instruments, platforms, orbits, etc. The NSOSA study will develop and evaluate architecture alternatives to include partner and commercial alternatives that are likely to become available. The objectives will include both functional needs and strategic characteristics (e.g., flexibility, responsiveness, sustainability). Part of this study is the Space Platform Requirements Working Group (SPRWG), which is being commissioned by NESDIS. The SPRWG is charged to assess new or existing user needs and to provide relative priorities for observational needs in the context of the future architecture. SPRWG results will serve as input to the process for new foundational (Level 0 and Level 1) requirements for the next generation of NOAA satellites that follow the GOES-R, JPSS, DSCOVR, Jason-3, and COSMIC-2 missions.

Automated Ecological Assessment of Physical Activity: Advancing Direct Observation

PubMed Central

Carlson, Jordan A.; Liu, Bo; Sallis, James F.; Kerr, Jacqueline; Papa, Amy; Dean, Kelsey; Vasconcelos, Nuno M.

2017-01-01

Technological advances provide opportunities for automating direct observations of physical activity, which allow for continuous monitoring and feedback. This pilot study evaluated the initial validity of computer vision algorithms for ecological assessment of physical activity. The sample comprised 6630 seconds per camera (three cameras in total) of video capturing up to nine participants engaged in sitting, standing, walking, and jogging in an open outdoor space while wearing accelerometers. Computer vision algorithms were developed to assess the number and proportion of people in sedentary, light, moderate, and vigorous activity, and group-based metabolic equivalents of tasks (MET)-minutes. Means and standard deviations (SD) of bias/difference values, and intraclass correlation coefficients (ICC) assessed the criterion validity compared to accelerometry separately for each camera. The number and proportion of participants sedentary and in moderate-to-vigorous physical activity (MVPA) had small biases (within 20% of the criterion mean) and the ICCs were excellent (0.82–0.98). Total MET-minutes were slightly underestimated by 9.3–17.1% and the ICCs were good (0.68–0.79). The standard deviations of the bias estimates were moderate-to-large relative to the means. The computer vision algorithms appeared to have acceptable sample-level validity (i.e., across a sample of time intervals) and are promising for automated ecological assessment of activity in open outdoor settings, but further development and testing is needed before such tools can be used in a diverse range of settings. PMID:29194358

Automated Ecological Assessment of Physical Activity: Advancing Direct Observation.

PubMed

Carlson, Jordan A; Liu, Bo; Sallis, James F; Kerr, Jacqueline; Hipp, J Aaron; Staggs, Vincent S; Papa, Amy; Dean, Kelsey; Vasconcelos, Nuno M

2017-12-01

Technological advances provide opportunities for automating direct observations of physical activity, which allow for continuous monitoring and feedback. This pilot study evaluated the initial validity of computer vision algorithms for ecological assessment of physical activity. The sample comprised 6630 seconds per camera (three cameras in total) of video capturing up to nine participants engaged in sitting, standing, walking, and jogging in an open outdoor space while wearing accelerometers. Computer vision algorithms were developed to assess the number and proportion of people in sedentary, light, moderate, and vigorous activity, and group-based metabolic equivalents of tasks (MET)-minutes. Means and standard deviations (SD) of bias/difference values, and intraclass correlation coefficients (ICC) assessed the criterion validity compared to accelerometry separately for each camera. The number and proportion of participants sedentary and in moderate-to-vigorous physical activity (MVPA) had small biases (within 20% of the criterion mean) and the ICCs were excellent (0.82-0.98). Total MET-minutes were slightly underestimated by 9.3-17.1% and the ICCs were good (0.68-0.79). The standard deviations of the bias estimates were moderate-to-large relative to the means. The computer vision algorithms appeared to have acceptable sample-level validity (i.e., across a sample of time intervals) and are promising for automated ecological assessment of activity in open outdoor settings, but further development and testing is needed before such tools can be used in a diverse range of settings.

Development of Creative Behavior Observation Form: A Study on Validity and Reliability

ERIC Educational Resources Information Center

Dere, Zeynep; Ömeroglu, Esra

2018-01-01

This study, Creative Behavior Observation Form was developed to assess creativity of the children. While the study group on the reliability and validity of Creative Behavior Observation Form was being developed, 257 children in total who were at the ages of 5-6 were used as samples with stratified sampling method. Content Validity Index (CVI) and…

Observational Assessment of Preschool Disruptive Behavior, Part II: validity of the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS).

PubMed

Wakschlag, Lauren S; Briggs-Gowan, Margaret J; Hill, Carri; Danis, Barbara; Leventhal, Bennett L; Keenan, Kate; Egger, Helen L; Cicchetti, Domenic; Burns, James; Carter, Alice S

2008-06-01

To examine the validity of the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS), a new observational method for assessing preschool disruptive behavior. A total of 327 behaviorally heterogeneous preschoolers from low-income environments comprised the validation sample. Parent and teacher reports were used to identify children with clinically significant disruptive behavior. The DB-DOS assessed observed disruptive behavior in two domains, problems in Behavioral Regulation and Anger Modulation, across three interactional contexts: Examiner Engaged, Examiner Busy, and Parent. Convergent and divergent validity of the DB-DOS were tested in relation to parent and teacher reports and independently observed behavior. Clinical validity was tested in terms of criterion and incremental validity of the DB-DOS for discriminating disruptive behavior status and impairment, concurrently and longitudinally. DB-DOS scores were significantly associated with reported and independently observed behavior in a theoretically meaningful fashion. Scores from both DB-DOS domains and each of the three DB-DOS contexts contributed uniquely to discrimination of disruptive behavior status, concurrently and predictively. Observed behavior on the DB-DOS also contributed incrementally to prediction of impairment over time, beyond variance explained by meeting DSM-IV disruptive behavior disorder symptom criteria based on parent/teacher report. The multidomain, multicontext approach of the DB-DOS is a valid method for direct assessment of preschool disruptive behavior. This approach shows promise for enhancing accurate identification of clinically significant disruptive behavior in young children and for characterizing subtypes in a manner that can directly inform etiological and intervention research.

Active-comparator design and new-user design in observational studies

PubMed Central

Yoshida, Kazuki; Solomon, Daniel H.; Kim, Seoyoung C.

2015-01-01

SUMMARY Over the past decade, an increasing number of observational studies have examined the effectiveness or safety of rheumatoid arthritis treatments. However, unlike randomized controlled trials (RCTs), observational studies of drug effects face methodological challenges including confounding by indication. Two design principles - active comparator design and new user design can help mitigate such challenges in observational studies. To improve validity of study findings, observational studies should be designed in such a way that makes them more closely approximate RCTs. The active comparator design compares the drug of interest to another commonly used agent for the same indication, rather than a ‘non-user’ group. This principle helps select treatment groups similar in treatment indications (both measured and unmeasured characteristics). The new user design includes a cohort of patients from the time of treatment initiation, so that it can assess patients’ pretreatment characteristics and capture all events occurring anytime during follow-up. PMID:25800216

Mental health self-assessment in patients with moderate to severe psoriasis: an observational, multicenter study of 1164 patients in Spain (the VACAP Study).

PubMed

Pujol, R M; Puig, L; Daudén, E; Sánchez-Carazo, J L; Toribio, J; Vanaclocha, F; Yébenes, M; Sabater, E; Casado, M A; Caloto, M T; Aragón, B

2013-12-01

Poor self-assessed mental health appears to be related to the severity of psoriasis. To evaluate the impact of psoriasis severity on mood and anxiety disorders. A prospective, observational, multicenter study was conducted by 123 dermatologists in Spain. Patients (n=164; mean [SD] age, 45.11 [13.92] years; 60.8% males) with moderate to severe psoriasis were evaluated at baseline and 4 months later. Psoriasis severity was measured using the Psoriasis Area and Severity Index (PASI), with a score range of 0 (mild) to 72 (severe); body surface area involvement (BSA); and physician global assessment (PGA) scores, with a range of 1 (mild) to 7 (severe). Mental health was assessed using the Hospital Anxiety and Depression Scale (HADS), with a total possible score of 0-42 (higher scores representing worse mental health). Mean first and second visit scores were compared. Mean (SD) scores improved between the first and second visit as follows: 13.24 (9.50) to 5.07 (6.03) for PASI, 12.52 (7.92) to 10.78 (7.32) for overall HADS, 7.83 (4.55) to 6.85 (4.21) for the HADS anxiety subscale, and 4.72 (4.12) to 3.95 (3.76) for the HADS depression subscale (P<.001 in all cases). Multivariate analyses showed that the main factors related to anxiety were psoriasis severity, sex, and completion of graduate studies. The independent variables included in the model for depression were psoriasis severity, sex, and psoriasis located on the head. Reductions in disease severity improve self-assessed mood and anxiety disorders in patients with moderate to severe psoriasis. Copyright © 2012 Elsevier España, S.L. and AEDV. All rights reserved.

Assessing pre-service science teachers' technological pedagogical content knowledge (TPACK) through observations and lesson plans

NASA Astrophysics Data System (ADS)

Canbazoglu Bilici, Sedef; Selcen Guzey, S.; Yamak, Havva

2016-05-01

Background: Technological pedagogical content knowledge (TPACK) is critical for effective teaching with technology. However, generally science teacher education programs do not help pre-service teachers develop TPACK. Purpose: The purpose of this study was to assess pre-service science teachers' TPACK over a semester-long Science Methods. Sample: Twenty-seven pre-service science teachers took the course toward the end of their four-year teacher education program. Design and method: The study employed the case study methodology. Lesson plans and microteaching observations were used as data collection tools. Technological Pedagogical Content Knowledge-based lesson plan assessment instrument (TPACK-LpAI) and Technological Pedagogical Content Knowledge Observation Protocol (TPACK-OP) were used to analyze data obtained from observations and lesson plans. Results: The results showed that the TPACK-focused Science Methods course had an impact on pre-service teachers' TPACK to varying degrees. Most importantly, the course helped teachers gain knowledge of effective usage of educational technology tools. Conclusion: Teacher education programs should provide opportunities to pre-service teachers to develop their TPACK so that they can effectively integrate technology into their teaching.

Process-oriented Observational Metrics for CMIP6 Climate Model Assessments

NASA Astrophysics Data System (ADS)

Jiang, J. H.; Su, H.

2016-12-01

Observational metrics based on satellite observations have been developed and effectively applied during post-CMIP5 model evaluation and improvement projects. As new physics and parameterizations continue to be included in models for the upcoming CMIP6, it is important to continue objective comparisons between observations and model results. This talk will summarize the process-oriented observational metrics and methodologies for constraining climate models with A-Train satellite observations and support CMIP6 model assessments. We target parameters and processes related to atmospheric clouds and water vapor, which are critically important for Earth's radiative budget, climate feedbacks, and water and energy cycles, and thus reduce uncertainties in climate models.

Randomized controlled trials vs. observational studies: why not just live together?

PubMed

Faraoni, David; Schaefer, Simon Thomas

2016-10-21

Randomized controlled trials (RCTs) are considered the gold standard for clinical research, thus having a high impact on clinical guidelines and our daily patients' care. However, various treatment strategies which we consider "evidence based" have never been subject to a prospective RCT, as we would rate it unethical to withheld an established treatment to individuals in an placebo controlled trial.In a recent BMC Anesthesiology publication, Trentino et al. analyzed the usefulness of observational studies in assessing benefit and risk of different transfusion strategies. The authors nicely reviewed and summarized similarities and differences, advantages and limitations, between different study types frequently used in transfusion medicine. In this interesting article, the authors conclude, that 'when comparing the results of observational studies with RCTs assessing transfusion outcomes, it is important that one consider not only the study method, but also the key elements of the study design'. Thus, in this commentary we now discuss the pro's and con's of different study types, even irrespective of transfusion medicine.

Inter-observer and intra-observer agreement between embryologists during selection of a single Day 5 embryo for transfer: a multicenter study.

PubMed

Storr, Ashleigh; Venetis, Christos A; Cooke, Simon; Kilani, Suha; Ledger, William

2017-02-01

What is the inter-observer and intra-observer agreement between embryologists when selecting a single Day 5 embryo for transfer? The inter-observer and intra-observer agreement between embryologists when selecting a single Day 5 embryo for transfer was generally good, although not optimal, even among experienced embryologists. Previous research on the morphological assessment of early stage (two pronuclei to Day 3) embryos has shown varying levels of inter-observer and intra-observer agreement. However, single blastocyst transfer is now becoming increasingly popular and there are no published data that assess inter-observer and intra-observer agreement when selecting a single embryo for Day 5 transfer. This was a prospective study involving 10 embryologists working at five different IVF clinics within a single organization between July 2013 and November 2015. The top 10 embryologists were selected based on their yearly Quality Assurance Program scores for blastocyst grading and were asked to morphologically grade all Day 5 embryos and choose a single embryo for transfer in a survey of 100 cases using 2D images. A total of 1000 decisions were therefore assessed. For each case, Day 5 images were shown, followed by a Day 3 and Day 5 image of the same embryo. Subgroup analyses were also performed based on the following characteristics of embryologists: the level of clinical embryology experience in the laboratory; amount of research experience; number of days per week spent grading embryos. The agreement between these embryologists and the one that scored the embryos on the actual day of transfer was also evaluated. Inter-observer and intra-observer variability was assessed using the kappa coefficient to evaluate the extent of agreement. This study showed that all 10 embryologists agreed on the embryo chosen for transfer in 50 out of 100 cases. In 93 out of 100 cases, at least 6 out of the 10 embryologists agreed. The inter-observer and intra-observer agreement among

The reporting of observational research studies in dermatology journals: a literature-based study.

PubMed

Langan, Sinéad; Schmitt, Jochen; Coenraads, Pieter-Jan; Svensson, Ake; von Elm, Erik; Williams, Hywel

2010-05-01

To assess the quality of reporting in observational studies in dermatology. Five dermatology journals-the Archives of Dermatology, the British Journal of Dermatology, the Journal of the American Academy of Dermatology, the Journal of Investigative Dermatology, and Acta Dermato-Venereologica. Cohort, case-control, and cross-sectional studies published as original articles during the period January 2005 through December 2007. Studies were identified with a literature search of PubMed combining the journal title and the term epidemiological studies (free text) and by hand searching all of the issues of each journal to identify relevant articles. All articles were extracted by 2 reviewers independently using standardized checklists based on the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations. The number and proportion of reported STROBE items were analyzed for each article. The proportion of studies with good reporting for each item was also assessed. A total of 138 articles were included and analyzed. Reporting quality was very mixed. Key areas that were infrequently reported included sample size calculations (n = 10 [7%]), missing data (n = 8 [6%]), losses to follow-up (n = 17 [12%]), and statistical methods (n = 19 [14%]). Only 13 studies (9%) explained the role of funders in the research. The quality of reporting was similar across study designs for "critical" questions with the exception of reporting of participant details, which was better reported in cohort studies (96%) compared with cross-sectional (80%) and case-control (70%) studies. It is difficult to judge the quality of dermatological research unless it is reported well. This study has identified a clear need to improve the quality of reporting of observational studies in dermatology. We recommend that dermatology journals adopt the STROBE criteria.

Observational study to characterise 24-hour COPD symptoms and their relationship with patient-reported outcomes: results from the ASSESS study.

PubMed

Miravitlles, Marc; Worth, Heinrich; Soler Cataluña, Juan José; Price, David; De Benedetto, Fernando; Roche, Nicolas; Godtfredsen, Nina Skavlan; van der Molen, Thys; Löfdahl, Claes-Göran; Padullés, Laura; Ribera, Anna

2014-10-21

Few studies have investigated the 24-hour symptom profile in patients with COPD or how symptoms during the 24-hour day are inter-related. This observational study assessed the prevalence, severity and relationship between night-time, early morning and daytime COPD symptoms and explored the relationship between 24-hour symptoms and other patient-reported outcomes. The study enrolled patients with stable COPD in clinical practice. Baseline night-time, early morning and daytime symptoms (symptom questionnaire), severity of airflow obstruction (FEV1), dyspnoea (modified Medical Research Council Dyspnoea Scale), health status (COPD Assessment Test), anxiety and depression levels (Hospital Anxiety and Depression Scale), sleep quality (COPD and Asthma Sleep Impact Scale) and physical activity level (sedentary, moderately active or active) were recorded. The full analysis set included 727 patients: 65.8% male, mean ± standard deviation age 67.2 ± 8.8 years, % predicted FEV1 52.8 ± 20.5%. In each part of the 24-hour day, >60% of patients reported experiencing ≥1 symptom in the week before baseline. Symptoms were more common in the early morning and daytime versus night-time (81.4%, 82.7% and 63.0%, respectively). Symptom severity was comparable for each period assessed. Overall, in the week before baseline, 56.7% of patients had symptoms throughout the whole 24-hour day (3 parts of the day); 79.9% had symptoms in ≥2 parts of the 24-hour day. Symptoms during each part of the day were inter-related, irrespective of disease severity (all p < 0.001). Early morning and daytime symptoms were associated with the severity of airflow obstruction (p < 0.05 for both). Night-time, early morning and daytime symptoms were all associated with worse dyspnoea, health status and sleep quality, and higher anxiety and depression levels (all p < 0.001 versus patients without symptoms in each corresponding period). In each part of the 24-hour day, there was also an association between

Development and reliability of an observation method to assess food intake of young children in child care.

PubMed

Ball, Sarah C; Benjamin, Sara E; Ward, Dianne S

2007-04-01

To our knowledge, a direct observation protocol for assessing dietary intake among young children in child care has not been published. This article reviews the development and testing of a diet observation system for child care facilities that occurred during a larger intervention trial. Development of this system was divided into five phases, done in conjunction with a larger intervention study; (a) protocol development, (b) training of field staff, (c) certification of field staff in a laboratory setting, (d) implementation in a child-care setting, and (e) certification of field staff in a child-care setting. During the certification phases, methods were used to assess the accuracy and reliability of all observers at estimating types and amounts of food and beverages commonly served in child care. Tests of agreement show strong agreement among five observers, as well as strong accuracy between the observers and 20 measured portions of foods and beverages with a mean intraclass correlation coefficient value of 0.99. This structured observation system shows promise as a valid and reliable approach for assessing dietary intake of children in child care and makes a valuable contribution to the growing body of literature on the dietary assessment of young children.

THE PICNIC GAME: PRESENTATION OF A SITUATION OF OBSERVATION TO ASSESS FAMILY INTERACTIONS.

PubMed

Favez, Nicolas; Frascarolo, France; Grimard, Nathalie

2016-05-01

The aim of this article is to present a situation of observation designed for the assessment of family interactions: The PicNic Game (PNG). In this situation, families are invited to play at having a picnic together. This can be done with any number of children, aged from a few weeks to adolescence. A companion assessment tool, the Revised-Picnic Assessment Scale (Re-PAS), allows evaluation of interactions in the family on several dimensions. This article presents the PNG and a preliminary study of the validation of the Re-PAS dimensions in a sample of families (N = 67) with 18-month-old infants and their siblings. The PNG was well-received by the families. Construct validity of the Re-PAS was tested, first against self-reported data by mothers and fathers regarding marital satisfaction, coparenting behavior, and division of household tasks, and then against observed maternal and paternal sensitivity and controlling behaviors assessed during free-play. Results show satisfactory preliminary reliability and validity. Two contrasting cases are presented to illustrate the different interactions highlighted in the PNG. This situation is useful for researchers and clinicians, particularly as a basis for video-feedback work with the family. © 2016 Michigan Association for Infant Mental Health.

Search by photo methodology for signature properties assessment by human observers

NASA Astrophysics Data System (ADS)

Selj, Gorm K.; Heinrich, Daniela H.

2015-05-01

Reliable, low-cost and simple methods for assessment of signature properties for military purposes are very important. In this paper we present such an approach that uses human observers in a search by photo assessment of signature properties of generic test targets. The method was carried out by logging a large number of detection times of targets recorded in relevant terrain backgrounds. The detection times were harvested by using human observers searching for targets in scene images shown by a high definition pc screen. All targets were identically located in each "search image", allowing relative comparisons (and not just rank by order) of targets. To avoid biased detections, each observer only searched for one target per scene. Statistical analyses were carried out for the detection times data. Analysis of variance was chosen if detection times distribution associated with all targets satisfied normality, and non-parametric tests, such as Wilcoxon's rank test, if otherwise. The new methodology allows assessment of signature properties in a reproducible, rapid and reliable setting. Such assessments are very complex as they must sort out what is of relevance in a signature test, but not loose information of value. We believe that choosing detection times as the primary variable for a comparison of signature properties, allows a careful and necessary inspection of observer data as the variable is continuous rather than discrete. Our method thus stands in opposition to approaches based on detections by subsequent, stepwise reductions in distance to target, or based on probability of detection.

Inter-observer reliability of animal-based welfare indicators included in the Animal Welfare Indicators welfare assessment protocol for dairy goats.

PubMed

Vieira, A; Battini, M; Can, E; Mattiello, S; Stilwell, G

2018-01-08

This study was conducted within the context of the Animal Welfare Indicators (AWIN) project and the underlying scientific motivation for the development of the study was the scarcity of data regarding inter-observer reliability (IOR) of welfare indicators, particularly given the importance of reliability as a further step for developing on-farm welfare assessment protocols. The objective of this study is therefore to evaluate IOR of animal-based indicators (at group and individual-level) of the AWIN welfare assessment protocol (prototype) for dairy goats. In the design of the study, two pairs of observers, one in Portugal and another in Italy, visited 10 farms each and applied the AWIN prototype protocol. Farms in both countries were visited between January and March 2014, and all the observers received the same training before the farm visits were initiated. Data collected during farm visits, and analysed in this study, include group-level and individual-level observations. The results of our study allow us to conclude that most of the group-level indicators presented the highest IOR level ('substantial', 0.85 to 0.99) in both field studies, pointing to a usable set of animal-based welfare indicators that were therefore included in the first level of the final AWIN welfare assessment protocol for dairy goats. Inter-observer reliability of individual-level indicators was lower, but the majority of them still reached 'fair to good' (0.41 to 0.75) and 'excellent' (0.76 to 1) levels. In the paper we explore reasons for the differences found in IOR between the group and individual-level indicators, including how the number of individual-level indicators to be assessed on each animal and the restraining method may have affected the results. Furthermore, we discuss the differences found in the IOR of individual-level indicators in both countries: the Portuguese pair of observers reached a higher level of IOR, when compared with the Italian observers. We argue how the

Reliability and criterion validity of an observation protocol for working technique assessments in cash register work.

PubMed

Palm, Peter; Josephson, Malin; Mathiassen, Svend Erik; Kjellberg, Katarina

2016-06-01

We evaluated the intra- and inter-observer reliability and criterion validity of an observation protocol, developed in an iterative process involving practicing ergonomists, for assessment of working technique during cash register work for the purpose of preventing upper extremity symptoms. Two ergonomists independently assessed 17 15-min videos of cash register work on two occasions each, as a basis for examining reliability. Criterion validity was assessed by comparing these assessments with meticulous video-based analyses by researchers. Intra-observer reliability was acceptable (i.e. proportional agreement >0.7 and kappa >0.4) for 10/10 questions. Inter-observer reliability was acceptable for only 3/10 questions. An acceptable inter-observer reliability combined with an acceptable criterion validity was obtained only for one working technique aspect, 'Quality of movements'. Thus, major elements of the cashiers' working technique could not be assessed with an acceptable accuracy from short periods of observations by one observer, such as often desired by practitioners. Practitioner Summary: We examined an observation protocol for assessing working technique in cash register work. It was feasible in use, but inter-observer reliability and criterion validity were generally not acceptable when working technique aspects were assessed from short periods of work. We recommend the protocol to be used for educational purposes only.

Milestone-compatible neurology resident assessments: A role for observable practice activities.

PubMed

Jones, Lyell K; Dimberg, Elliot L; Boes, Christopher J; Eggers, Scott D Z; Dodick, David W; Cutsforth-Gregory, Jeremy K; Leep Hunderfund, Andrea N; Capobianco, David J

2015-06-02

Beginning in 2014, US neurology residency programs were required to report each trainee's educational progression within 29 neurology Milestone competency domains. Trainee assessment systems will need to be adapted to inform these requirements. The primary aims of this study were to validate neurology resident assessment content using observable practice activities (OPAs) and to develop assessment formats easily translated to the Neurology Milestones. A modified Delphi technique was used to establish consensus perceptions of importance of 73 neurology OPAs among neurology educators and trainees at 3 neurology residency programs. A content validity score (CVS) was derived for each neurology OPA, with scores ≥4.0 determined in advance to indicate sufficient content validity. The mean CVS for all OPAs was 4.4 (range 3.5-5.0). Fifty-seven (78%) OPAs had a CVS ≥4.0, leaving 16 (22%) below the pre-established threshold for content validity. Trainees assigned a higher importance to individual OPAs (mean CVS 4.6) compared to faculty (mean 4.4, p = 0.016), but the effect size was small (η(2) = 0.10). There was no demonstrated effect of length of education experience on perceived importance of neurology OPAs (p = 0.23). Two sample resident assessment formats were developed, one using neurology OPAs alone and another using a combination of neurology OPAs and the Neurology Milestones. This study provides neurology training programs with content validity evidence for items to include in resident assessments, and sample assessment formats that directly translate to the Neurology Milestones. Length of education experience has little effect on perceptions of neurology OPA importance. © 2015 American Academy of Neurology.

An Observational Assessment of Physical Activity Levels and Social Behaviour during Elementary School Recess

ERIC Educational Resources Information Center

Roberts, Simon J.; Fairclough, Stuart J.; Ridgers, Nicola D.; Porteous, Conor

2013-01-01

Objective: The purpose of the present study was to assess children's physical activity, social play behaviour, activity type and social interactions during elementary school recess using a pre-validated systematic observation system. Design: Cross-sectional. Setting: Two elementary schools located in Merseyside, England. Method: Fifty-six…

Observable Social Cognition: A Rating Scale (OSCARS): An Interview-Based Assessment for Schizophrenia

PubMed Central

Healey, Kristin M.; Combs, Dennis R.; Gibson, Clare M.; Keefe, Richard S.E.; Roberts, David L.; Penn, David L.

2015-01-01

Introduction Individuals with schizophrenia consistently show impairments in social cognition (SC). SC has become a potential treatment target due to its association with functional outcomes. An alternative method of assessment is to administer an observer-based scale incorporating an informant’s “first hand” impressions in ratings. Methods The present study used the Observable Social Cognition: A Rating Scale (OSCARS) in 62 outpatients and 50 non-psychiatric controls (NPCs) to assess performance in domains of SC (e.g. emotion perception, theory of mind). Results The OSCARS demonstrated sufficient internal consistency and test-retest reliability. Construct validity was assessed through an exploratory factor analysis. Patient OSCARS indices were not significantly correlated with measures of SC with the exception of aggressive attributional style. Individuals with less impairment in SC reacted more aggressively to ambiguous situations. NPC OSCARS were significantly correlated with measures of theory of mind and attributional style. In a combined sample of patients and controls, six of eight items were significantly correlated with the SC task assessing the same domain, providing modest evidence of convergent validity. In patients, the OSCARS was significantly correlated with measures of functional outcome and neurocognition. Lastly, the OSCARS was found to be significantly associated with functional outcome after the influence of objective measures of SC was statistically removed. Conclusions The present study provides preliminary evidence that the OSCARS may be useful for clinicians in collecting data about patients’ potential real-world SC deficits, in turn increasing the degree to which these impairments may be targeted in treatment. PMID:25675960

Analyzing the uncertainty of ensemble-based gridded observations in land surface simulations and drought assessment

NASA Astrophysics Data System (ADS)

Ahmadalipour, Ali; Moradkhani, Hamid

2017-12-01

Hydrologic modeling is one of the primary tools utilized for drought monitoring and drought early warning systems. Several sources of uncertainty in hydrologic modeling have been addressed in the literature. However, few studies have assessed the uncertainty of gridded observation datasets from a drought monitoring perspective. This study provides a hydrologic modeling oriented analysis of the gridded observation data uncertainties over the Pacific Northwest (PNW) and its implications on drought assessment. We utilized a recently developed 100-member ensemble-based observed forcing data to simulate hydrologic fluxes at 1/8° spatial resolution using Variable Infiltration Capacity (VIC) model, and compared the results with a deterministic observation. Meteorological and hydrological droughts are studied at multiple timescales over the basin, and seasonal long-term trends and variations of drought extent is investigated for each case. Results reveal large uncertainty of observed datasets at monthly timescale, with systematic differences for temperature records, mainly due to different lapse rates. The uncertainty eventuates in large disparities of drought characteristics. In general, an increasing trend is found for winter drought extent across the PNW. Furthermore, a ∼3% decrease per decade is detected for snow water equivalent (SWE) over the PNW, with the region being more susceptible to SWE variations of the northern Rockies than the western Cascades. The agricultural areas of southern Idaho demonstrate decreasing trend of natural soil moisture as a result of precipitation decline, which implies higher appeal for anthropogenic water storage and irrigation systems.

Intra- and inter-observer agreement in MRI assessment of rotator cuff healing using the Sugaya classification 10years after surgery.

PubMed

Niglis, L; Collin, P; Dosch, J-C; Meyer, N; Kempf, J-F

2017-10-01

The long-term outcomes of rotator cuff repair are unclear. Recurrent tears are common, although their reported frequency varies depending on the type and interpretation challenges of the imaging method used. The primary objective of this study was to assess the intra- and inter-observer reproducibility of the MRI assessment of rotator cuff repair using the Sugaya classification 10years after surgery. The secondary objective was to determine whether poor reproducibility, if found, could be improved by using a simplified yet clinically relevant classification. Our hypothesis was that reproducibility was limited but could be improved by simplifying the classification. In a retrospective study, we assessed intra- and inter-observer agreement in interpreting 49 magnetic resonance imaging (MRI) scans performed 10years after rotator cuff repair. These 49 scans were taken at random among 609 cases that underwent re-evaluation, with imaging, for the 2015 SoFCOT symposium on 10-year and 20-year clinical and anatomical outcomes of rotator cuff repair for full-thickness tears. Each of three observers read each of the 49 scans on two separate occasions. At each reading, they assessed the supra-spinatus tendon according to the Sugaya classification in five types. Intra-observer agreement for the Sugaya type was substantial (κ=0.64) but inter-observer agreement was only fair (κ=0.39). Agreement improved when the five Sugaya types were collapsed into two categories (1-2-3 and 4-5) (intra-observer κ=0.74 and inter-observer κ=0.68). Using the Sugaya classification to assess post-operative rotator cuff healing was associated with substantial intra-observer and fair inter-observer agreement. A simpler classification into two categories improved agreement while remaining clinically relevant. II, prospective randomised low-power study. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Values of a Patient and Observer Scar Assessment Scale to Evaluate the Facial Skin Graft Scar.

PubMed

Chae, Jin Kyung; Kim, Jeong Hee; Kim, Eun Jung; Park, Kun

2016-10-01

The patient and observer scar assessment scale (POSAS) recently emerged as a promising method, reflecting both observer's and patient's opinions in evaluating scar. This tool was shown to be consistent and reliable in burn scar assessment, but it has not been tested in the setting of skin graft scar in skin cancer patients. To evaluate facial skin graft scar applied to POSAS and to compare with objective scar assessment tools. Twenty three patients, who diagnosed with facial cutaneous malignancy and transplanted skin after Mohs micrographic surgery, were recruited. Observer assessment was performed by three independent rates using the observer component of the POSAS and Vancouver scar scale (VSS). Patient self-assessment was performed using the patient component of the POSAS. To quantify scar color and scar thickness more objectively, spectrophotometer and ultrasonography was applied. Inter-observer reliability was substantial with both VSS and the observer component of the POSAS (average measure intraclass coefficient correlation, 0.76 and 0.80, respectively). The observer component consistently showed significant correlations with patients' ratings for the parameters of the POSAS (all p -values<0.05). The correlation between subjective assessment using POSAS and objective assessment using spectrophotometer and ultrasonography showed low relationship. In facial skin graft scar assessment in skin cancer patients, the POSAS showed acceptable inter-observer reliability. This tool was more comprehensive and had higher correlation with patient's opinion.

The main pillar: Assessment of space weather observational asset performance supporting nowcasting, forecasting, and research to operations.

PubMed

Posner, A; Hesse, M; St Cyr, O C

2014-04-01

Space weather forecasting critically depends upon availability of timely and reliable observational data. It is therefore particularly important to understand how existing and newly planned observational assets perform during periods of severe space weather. Extreme space weather creates challenging conditions under which instrumentation and spacecraft may be impeded or in which parameters reach values that are outside the nominal observational range. This paper analyzes existing and upcoming observational capabilities for forecasting, and discusses how the findings may impact space weather research and its transition to operations. A single limitation to the assessment is lack of information provided to us on radiation monitor performance, which caused us not to fully assess (i.e., not assess short term) radiation storm forecasting. The assessment finds that at least two widely spaced coronagraphs including L4 would provide reliability for Earth-bound CMEs. Furthermore, all magnetic field measurements assessed fully meet requirements. However, with current or even with near term new assets in place, in the worst-case scenario there could be a near-complete lack of key near-real-time solar wind plasma data of severe disturbances heading toward and impacting Earth's magnetosphere. Models that attempt to simulate the effects of these disturbances in near real time or with archival data require solar wind plasma observations as input. Moreover, the study finds that near-future observational assets will be less capable of advancing the understanding of extreme geomagnetic disturbances at Earth, which might make the resulting space weather models unsuitable for transition to operations. Manuscript assesses current and near-future space weather assetsCurrent assets unreliable for forecasting of severe geomagnetic stormsNear-future assets will not improve the situation.

Pain Intensity During Ultrasound Assessment of Uterine Cavity and Tubal Patency With and Without Painkillers: Prospective Observational Study.

PubMed

Ludwin, Inga; Martins, Wellington P; Nastri, Carolina O; Ludwin, Artur

To determine the pain intensity and incidence of mild to severe pain during the ultrasound assessment of the uterine cavity and tubal patency using saline, air and saline, and foam as contrasts with and without painkiller. Prospective observational study (Canadian Task Force classification II-1). Private clinic. Three hundred infertile women who were consecutively submitted to uterine cavity and tubal patency assessment by ultrasound using saline, air, and foam in single exam between October 2012 and November 2013. No painkillers were used until March 2013 when we started offering an effervescent codeine tablet containing paracetamol 500 mg and codeine phosphate 30 mg approximately 1 hour before the procedure. Pain intensity measured with an 11-point (0-10) numerical rating scale and incidence of moderate/severe levels of pain (numerical rating scale > 3) during the main components of the procedure (speculum insertion, catheter insertion, saline infusion, air and saline infusion, foam infusion, and after the procedure [0 minutes, 15 minutes, 30 minutes, and 24 hours]) were assessed. The incidence of moderatesevere pain was significantly lower in women using painkillers considering any moment of the procedure: 49 of 175 (28%) versus 65 of 125 (52%); relative risk, .54; 95% confidence interval, .40-.72; p < .001; number needed to treat, 4. Less women presented with moderate/severe pain during air and saline compared with foam infusion: 31 of 300 (10%) versus 75 of 300 (25%); p < .001; relative risk, .41, 95% confidence interval, .28-.61. The incidence of moderate/severe pain during the ultrasound assessment of the uterine cavity and tubal patency is common. Our results suggest that using paracetamol + codeine before the procedure reduces the pain level, but randomized controlled trials are required. Copyright © 2017 AAGL. Published by Elsevier Inc. All rights reserved.

A large observational study to concurrently assess persistence of measles specific B-cell and T-cell immunity in individuals following two doses of MMR vaccine

PubMed Central

Haralambieva, Iana H.; Ovsyannikova, Inna G.; O’Byrne, Megan; Pankratz, V. Shane; Jacobson, Robert M.; Poland, Gregory A.

2011-01-01

The measurement of measles-specific neutralizing antibodies, directed against the surface measles virus hemagglutinin and fusion proteins, is considered the gold standard in measles serology. We assessed functional measles-specific neutralizing antibody levels in a racially diverse cohort of 763 young healthy adolescents after receipt of two doses of measles-mumps-rubella vaccine, by the use of an automated plaque reduction microneutralization (PRMN) assay, and evaluated their relevance to protective antibody levels, as well as their associations with demographic and clinical variables. We also concurrently assessed measles-specific IFNγ Elispot responses and their relation to the observed antibody concentrations. The geometric mean titer for our cohort was 832 mIU/mL (95% CIs: 776; 891). Sixty-eight subjects (8.9%) had antibody concentrations of less than the protective threshold of 210 mIU/mL (corresponding to PRMN titer of 120; suggesting protection against symptomatic disease), and 177 subjects (23.2%) demonstrated persisting antibody concentrations above 1,841 mIU/mL (corresponding to PRMN titer of 1,052; suggesting total protection against viral infection), 7.4 years after vaccination, in the absence of wild-type virus boosting. The mean measles-specific IFNγ Elispot response for our cohort was 46 (95% CIs: 43; 49) IFNγ-positive spots per 200,000 cells with no relation of cellular immunity measures to the observed antibody concentrations. No significant associations between antibody titers and demographic and clinical variables, including gender and race, were observed in our study. In conclusion, in a large observational study of measles immunity, we used an automated high-throughput measles virus-specific neutralization assay to measure humoral immunity, and concurrently determined measles-specific cellular immunity to aid the assessment of potential susceptibility to measles in vaccinated populations. PMID:21539880

Incorporating patient partner scores into high stakes assessment: an observational study into opinions and attitudes.

PubMed

Thomson, Fiona C; MacKenzie, Rhoda K; Anderson, Marie; Denison, Alan R; Currie, Graeme P

2017-11-15

Volunteer patients (also known as patient partners (PPs)) play a vital role in undergraduate healthcare curricula. They frequently take part in objective structured clinical examinations (OSCE) and rate aspects of students' performance. However, the inclusion and weighting of PP marks varies, while attitudes and opinions regarding how (and if) they should contribute towards the pass/fail outcome are uncertain. A prospective observational study was conducted to explore beliefs of PPs regarding inclusion of their scores in a high stakes undergraduate OSCE in a single UK medical school. All PPs delivering components of the local MBChB curriculum were asked to participate in the questionnaire study. Quantitative and qualitative data were analysed using descriptive statistics and framework analysis respectively. Fifty out of 160 (31% response rate) PPs completed the questionnaire; 70% had participated in a final year OSCE. Thirty (60%) felt their marks should be incorporated into a student's overall score, while 28% were uncertain. The main reasons for inclusion were recognition of the patient perspective (31%) and their ability to assess attitudes and professionalism (27%), while reasons against inclusion included lack of PP qualification/training (18%) and concerns relating to consistency (14%). The majority of PPs were uncertain what proportion of the total mark they should contribute, although many felt that 5-10% of the total score was reasonable. Most respondents (70%) felt that globally low PP scores should not result in an automatic fail and many (62%) acknowledged that prior to mark inclusion, further training was required. These data show that most respondents considered it reasonable to "formalise their expertise" by contributing marks in the overall assessment of students in a high stakes OSCE, although what proportion they believe this should represent was variable. Some expressed concerns that using marks towards progress decisions may alter PP response

The Main Pillar: Assessment of Space Weather Observational Asset Performance Supporting Nowcasting, Forecasting and Research to Operations

NASA Technical Reports Server (NTRS)

Posner, Arik; Hesse, Michael; SaintCyr, Chris

2014-01-01

Space weather forecasting critically depends upon availability of timely and reliable observational data. It is therefore particularly important to understand how existing and newly planned observational assets perform during periods of severe space weather. Extreme space weather creates challenging conditions under which instrumentation and spacecraft may be impeded or in which parameters reach values that are outside the nominal observational range. This paper analyzes existing and upcoming observational capabilities for forecasting, and discusses how the findings may impact space weather research and its transition to operations. A single limitation to the assessment is lack of information provided to us on radiation monitor performance, which caused us not to fully assess (i.e., not assess short term) radiation storm forecasting. The assessment finds that at least two widely spaced coronagraphs including L4 would provide reliability for Earth-bound CMEs. Furthermore, all magnetic field measurements assessed fully meet requirements. However, with current or even with near term new assets in place, in the worst-case scenario there could be a near-complete lack of key near-real-time solar wind plasma data of severe disturbances heading toward and impacting Earth's magnetosphere. Models that attempt to simulate the effects of these disturbances in near real time or with archival data require solar wind plasma observations as input. Moreover, the study finds that near-future observational assets will be less capable of advancing the understanding of extreme geomagnetic disturbances at Earth, which might make the resulting space weather models unsuitable for transition to operations.

Values of a Patient and Observer Scar Assessment Scale to Evaluate the Facial Skin Graft Scar

PubMed Central

Chae, Jin Kyung; Kim, Eun Jung; Park, Kun

2016-01-01

Background The patient and observer scar assessment scale (POSAS) recently emerged as a promising method, reflecting both observer's and patient's opinions in evaluating scar. This tool was shown to be consistent and reliable in burn scar assessment, but it has not been tested in the setting of skin graft scar in skin cancer patients. Objective To evaluate facial skin graft scar applied to POSAS and to compare with objective scar assessment tools. Methods Twenty three patients, who diagnosed with facial cutaneous malignancy and transplanted skin after Mohs micrographic surgery, were recruited. Observer assessment was performed by three independent rates using the observer component of the POSAS and Vancouver scar scale (VSS). Patient self-assessment was performed using the patient component of the POSAS. To quantify scar color and scar thickness more objectively, spectrophotometer and ultrasonography was applied. Results Inter-observer reliability was substantial with both VSS and the observer component of the POSAS (average measure intraclass coefficient correlation, 0.76 and 0.80, respectively). The observer component consistently showed significant correlations with patients' ratings for the parameters of the POSAS (all p-values<0.05). The correlation between subjective assessment using POSAS and objective assessment using spectrophotometer and ultrasonography showed low relationship. Conclusion In facial skin graft scar assessment in skin cancer patients, the POSAS showed acceptable inter-observer reliability. This tool was more comprehensive and had higher correlation with patient's opinion. PMID:27746642

“Assessment of the two-way Coupled WRF-CMAQ Model with Observations from the CARES”

EPA Science Inventory

The main goal of this assessment is to evaluate the improved aerosol component of two-way coupled WRF-CMAQ model particularly in representing aerosol physical and optical properties by utilizing observations from the Carbonaceous Aerosol and Radiative Effects Study (CARES) in May...

Preliminary Checklist for Reporting Observational Studies in Sports Areas: Content Validity.

PubMed

Chacón-Moscoso, Salvador; Sanduvete-Chaves, Susana; Anguera, M Teresa; Losada, José L; Portell, Mariona; Lozano-Lozano, José A

2018-01-01

Observational studies are based on systematic observation, understood as an organized recording and quantification of behavior in its natural context. Applied to the specific area of sports, observational studies present advantages when comparing studies based on other designs, such as the flexibility for adapting to different contexts and the possibility of using non-standardized instruments as well as a high degree of development in specific software and data analysis. Although the importance and usefulness of sports-related observational studies have been widely shown, there is no checklist to report these studies. Consequently, authors do not have a guide to follow in order to include all of the important elements in an observational study in sports areas, and reviewers do not have a reference tool for assessing this type of work. To resolve these issues, this article aims to develop a checklist to measure the quality of sports-related observational studies based on a content validity study. The participants were 22 judges with at least 3 years of experience in observational studies, sports areas, and methodology. They evaluated a list of 60 items systematically selected and classified into 12 dimensions. They were asked to score four aspects of each item on 5-point Likert scales to measure the following dimensions: representativeness, relevance, utility, and feasibility. The judges also had an open-format section for comments. The Osterlind index was calculated for each item and for each of the four aspects. Items were considered appropriate when obtaining a score of at least 0.5 in the four assessed aspects. After considering these inclusion criteria and all of the open-format comments, the resultant checklist consisted of 54 items grouped into the same initial 12 dimensions. Finally, we highlight the strengths of this work. We also present its main limitation: the need to apply the resultant checklist to obtain data and, thus, increase quality indicators of

Preliminary Checklist for Reporting Observational Studies in Sports Areas: Content Validity

PubMed Central

Chacón-Moscoso, Salvador; Sanduvete-Chaves, Susana; Anguera, M. Teresa; Losada, José L.; Portell, Mariona; Lozano-Lozano, José A.

2018-01-01

Observational studies are based on systematic observation, understood as an organized recording and quantification of behavior in its natural context. Applied to the specific area of sports, observational studies present advantages when comparing studies based on other designs, such as the flexibility for adapting to different contexts and the possibility of using non-standardized instruments as well as a high degree of development in specific software and data analysis. Although the importance and usefulness of sports-related observational studies have been widely shown, there is no checklist to report these studies. Consequently, authors do not have a guide to follow in order to include all of the important elements in an observational study in sports areas, and reviewers do not have a reference tool for assessing this type of work. To resolve these issues, this article aims to develop a checklist to measure the quality of sports-related observational studies based on a content validity study. The participants were 22 judges with at least 3 years of experience in observational studies, sports areas, and methodology. They evaluated a list of 60 items systematically selected and classified into 12 dimensions. They were asked to score four aspects of each item on 5-point Likert scales to measure the following dimensions: representativeness, relevance, utility, and feasibility. The judges also had an open-format section for comments. The Osterlind index was calculated for each item and for each of the four aspects. Items were considered appropriate when obtaining a score of at least 0.5 in the four assessed aspects. After considering these inclusion criteria and all of the open-format comments, the resultant checklist consisted of 54 items grouped into the same initial 12 dimensions. Finally, we highlight the strengths of this work. We also present its main limitation: the need to apply the resultant checklist to obtain data and, thus, increase quality indicators of

The main pillar: Assessment of space weather observational asset performance supporting nowcasting, forecasting, and research to operations

PubMed Central

Posner, A; Hesse, M; St Cyr, O C

2014-01-01

Space weather forecasting critically depends upon availability of timely and reliable observational data. It is therefore particularly important to understand how existing and newly planned observational assets perform during periods of severe space weather. Extreme space weather creates challenging conditions under which instrumentation and spacecraft may be impeded or in which parameters reach values that are outside the nominal observational range. This paper analyzes existing and upcoming observational capabilities for forecasting, and discusses how the findings may impact space weather research and its transition to operations. A single limitation to the assessment is lack of information provided to us on radiation monitor performance, which caused us not to fully assess (i.e., not assess short term) radiation storm forecasting. The assessment finds that at least two widely spaced coronagraphs including L4 would provide reliability for Earth-bound CMEs. Furthermore, all magnetic field measurements assessed fully meet requirements. However, with current or even with near term new assets in place, in the worst-case scenario there could be a near-complete lack of key near-real-time solar wind plasma data of severe disturbances heading toward and impacting Earth's magnetosphere. Models that attempt to simulate the effects of these disturbances in near real time or with archival data require solar wind plasma observations as input. Moreover, the study finds that near-future observational assets will be less capable of advancing the understanding of extreme geomagnetic disturbances at Earth, which might make the resulting space weather models unsuitable for transition to operations. Key Points Manuscript assesses current and near-future space weather assets Current assets unreliable for forecasting of severe geomagnetic storms Near-future assets will not improve the situation PMID:26213516

Quality, management, and the interplay of self-assessment, process assessments, and performance-based observations

NASA Astrophysics Data System (ADS)

Willett, D. J.

1993-04-01

In this document, the author presents his observations on the topic of quality assurance (QA). Traditionally the focus of quality management has been on QA organizations, manuals, procedures, audits, and assessments; quality was measured by the degree of conformance to specifications or standards. Today quality is defined as satisfying user needs and is measured by user satisfaction. The author proposes that quality is the responsibility of line organizations and staff and not the responsibility of the QA group. This work outlines an effective Conduct of Operations program. The author concludes his observations with a discussion of how quality is analogous to leadership.

Do observational studies using propensity score methods agree with randomized trials? A systematic comparison of studies on acute coronary syndromes

PubMed Central

Dahabreh, Issa J.; Sheldrick, Radley C.; Paulus, Jessica K.; Chung, Mei; Varvarigou, Vasileia; Jafri, Haseeb; Rassen, Jeremy A.; Trikalinos, Thomas A.; Kitsios, Georgios D.

2012-01-01

Aims Randomized controlled trials (RCTs) are the gold standard for assessing the efficacy of therapeutic interventions because randomization protects from biases inherent in observational studies. Propensity score (PS) methods, proposed as a potential solution to confounding of the treatment–outcome association, are widely used in observational studies of therapeutic interventions for acute coronary syndromes (ACS). We aimed to systematically assess agreement between observational studies using PS methods and RCTs on therapeutic interventions for ACS. Methods and results We searched for observational studies of interventions for ACS that used PS methods to estimate treatment effects on short- or long-term mortality. Using a standardized algorithm, we matched observational studies to RCTs based on patients’ characteristics, interventions, and outcomes (‘topics’), and we compared estimates of treatment effect between the two designs. When multiple observational studies or RCTs were identified for the same topic, we performed a meta-analysis and used the summary relative risk for comparisons. We matched 21 observational studies investigating 17 distinct clinical topics to 63 RCTs (median = 3 RCTs per observational study) for short-term (7 topics) and long-term (10 topics) mortality. Estimates from PS analyses differed statistically significantly from randomized evidence in two instances; however, observational studies reported more extreme beneficial treatment effects compared with RCTs in 13 of 17 instances (P = 0.049). Sensitivity analyses limited to large RCTs, and using alternative meta-analysis models yielded similar results. Conclusion For the treatment of ACS, observational studies using PS methods produce treatment effect estimates that are of more extreme magnitude compared with those from RCTs, although the differences are rarely statistically significant. PMID:22711757

The Arctic Observing Viewer (AOV): Visualization, Data Discovery, Strategic Assessment, and Decision Support for Arctic Observing

NASA Astrophysics Data System (ADS)

Kassin, A.; Cody, R. P.; Barba, M.; Escarzaga, S. M.; Villarreal, S.; Manley, W. F.; Gaylord, A. G.; Habermann, T.; Kozimor, J.; Score, R.; Tweedie, C. E.

2017-12-01

To better assess progress in Arctic Observing made by U.S. SEARCH, NSF AON, SAON, and related initiatives, an updated version of the Arctic Observing Viewer (AOV; http://ArcticObservingViewer.org) has been released. This web mapping application and information system conveys the who, what, where, and when of "data collection sites" - the precise locations of monitoring assets, observing platforms, and wherever repeat marine or terrestrial measurements have been taken. Over 13,000 sites across the circumarctic are documented including a range of boreholes, ship tracks, buoys, towers, sampling stations, sensor networks, vegetation plots, stream gauges, ice cores, observatories, and more. Contributing partners are the U.S. NSF, NOAA, the NSF Arctic Data Center, ADIwg, AOOS, a2dc, CAFF, GINA, IASOA, INTERACT, NASA ABoVE, and USGS, among others. Users can visualize, navigate, select, search, draw, print, view details, and follow links to obtain a comprehensive perspective of environmental monitoring efforts. We continue to develop, populate, and enhance AOV. Recent updates include: a vastly improved Search tool with free text queries, autocomplete, and filters; faster performance; a new clustering visualization; heat maps to highlight concentrated research; and 3-D represented data to more easily identify trends. AOV is founded on principles of interoperability, such that agencies and organizations can use the AOV Viewer and web services for their own purposes. In this way, AOV complements other distributed yet interoperable cyber resources and helps science planners, funding agencies, investigators, data specialists, and others to: assess status, identify overlap, fill gaps, optimize sampling design, refine network performance, clarify directions, access data, coordinate logistics, and collaborate to meet Arctic Observing goals. AOV is a companion application to the Arctic Research Mapping Application (armap.org), which is focused on general project information at a

A QUESTIONNAIRE TO ASSESS THE RELEVANCE AND CREDIBILITY OF OBSERVATIONAL STUDIES TO INFORM HEALTH CARE DECISION MAKING: AN ISPOR-AMCP-NPC GOOD PRACTICE TASK FORCE REPORT

PubMed Central

Berger, Marc L; Martin, Bradley C; Husereau, Don; Worley, Karen; Allen, Dan; Yang, Winnie; Mullins, C. Daniel; Kahler, Kristijan; Quon, Nicole C.; Devine, Scott; Graham, John; Cannon, Eric; Crown, William

2014-01-01

Evidence-based healthcare decisions are best informed by comparisons of all relevant interventions used to treat conditions in specific patient populations. Observational studies are being performed to help fill evidence gaps. However, widespread adoption of evidence from observational studies has been limited due to a variety of factors, including the lack of consensus regarding accepted principles for their evaluation and interpretation. Two Task Forces were formed to develop questionnaires to assist decision makers in evaluating observational studies, with one Task Force addressing retrospective research and the other prospective research. The intent was to promote a structured approach to reduce the potential for subjective interpretation of evidence and drive consistency in decision-making. Separately developed questionnaires were combined into a single questionnaire consisting of 33 items. These were divided into two domains: relevance and credibility. Relevance addresses the extent to which findings, if accurate, apply to the setting of interest to the decision maker. Credibility addresses the extent to which the study findings accurately answer the study question. The questionnaire provides a guide for assessing the degree of confidence that should be placed from observational studies and promotes awareness of the subtleties involved in evaluating those. PMID:24636373

Observer performance assessment of JPEG-compressed high-resolution chest images

NASA Astrophysics Data System (ADS)

Good, Walter F.; Maitz, Glenn S.; King, Jill L.; Gennari, Rose C.; Gur, David

1999-05-01

The JPEG compression algorithm was tested on a set of 529 chest radiographs that had been digitized at a spatial resolution of 100 micrometer and contrast sensitivity of 12 bits. Images were compressed using five fixed 'psychovisual' quantization tables which produced average compression ratios in the range 15:1 to 61:1, and were then printed onto film. Six experienced radiologists read all cases from the laser printed film, in each of the five compressed modes as well as in the non-compressed mode. For comparison purposes, observers also read the same cases with reduced pixel resolutions of 200 micrometer and 400 micrometer. The specific task involved detecting masses, pneumothoraces, interstitial disease, alveolar infiltrates and rib fractures. Over the range of compression ratios tested, for images digitized at 100 micrometer, we were unable to demonstrate any statistically significant decrease (p greater than 0.05) in observer performance as measured by ROC techniques. However, the observers' subjective assessments of image quality did decrease significantly as image resolution was reduced and suggested a decreasing, but nonsignificant, trend as the compression ratio was increased. The seeming discrepancy between our failure to detect a reduction in observer performance, and other published studies, is likely due to: (1) the higher resolution at which we digitized our images; (2) the higher signal-to-noise ratio of our digitized films versus typical CR images; and (3) our particular choice of an optimized quantization scheme.

Physical Activity Assessment Using an Activity Tracker in Patients with Rheumatoid Arthritis and Axial Spondyloarthritis: Prospective Observational Study

PubMed Central

Servy, Hervé; Molto, Anna; Sellam, Jérémie; Foltz, Violaine; Gandjbakhch, Frédérique; Hudry, Christophe; Mitrovic, Stéphane; Fautrel, Bruno; Gossec, Laure

2018-01-01

Background Physical activity can be tracked using mobile devices and is recommended in rheumatoid arthritis (RA) and axial spondyloarthritis (axSpA) management. The World Health Organization (WHO) recommends at least 150 min per week of moderate to vigorous physical activity (MVPA). Objective The objectives of this study were to assess and compare physical activity and its patterns in patients with RA and axSpA using an activity tracker and to assess the feasibility of mobile devices in this population. Methods This multicentric prospective observational study (ActConnect) included patients who had definite RA or axSpA, and a smartphone. Physical activity was assessed over 3 months using a mobile activity tracker, recording the number of steps per minute. The number of patients reaching the WHO recommendations was calculated. RA and axSpA were compared, using linear mixed models, for number of steps, proportion of morning steps, duration of total activity, and MVPA. Physical activity trajectories were identified using the K-means method, and factors related to the low activity trajectory were explored by logistic regression. Acceptability was assessed by the mean number of days the tracker was worn over the 3 months (ie, adherence), the percentage of wearing time, and by an acceptability questionnaire. Results A total of 157 patients (83 RA and 74 axSpA) were analyzed; 36.3% (57/157) patients were males, and their mean age was 46 (standard deviation [SD] 12) years and mean disease duration was 11 (SD 9) years. RA and axSpA patients had similar physical activity levels of 16 (SD 11) and 15 (SD 12) min per day of MVPA (P=.80), respectively. Only 27.4% (43/157) patients reached the recommendations with a mean MVPA of 106 (SD 77) min per week. The following three trajectories were identified with constant activity: low (54.1% [85/157] of patients), moderate (42.7% [67/157] of patients), and high (3.2% [5/157] of patients) levels of MVPA. A higher body mass index was

Observer assessment of multi-pinhole SPECT geometries for prostate cancer imaging: a simulation study

NASA Astrophysics Data System (ADS)

Kalantari, Faraz; Sen, Anando; Gifford, Howard C.

2014-03-01

SPECT imaging using In-111 ProstaScint is an FDA-approved method for diagnosing prostate cancer metastases within the pelvis. However, conventional medium-energy parallel-hole (MEPAR) collimators produce poor image quality and we are investigating the use of multipinhole (MPH) imaging as an alternative. This paper presents a method for evaluating MPH designs that makes use of sampling-sensitive (SS) mathematical model observers for tumor detectionlocalization tasks. Key to our approach is the redefinition of a normal (or background) reference image that is used with scanning model observers. We used this approach to compare different MPH configurations for the task of small-tumor detection in the prostate and surrounding lymph nodes. Four configurations used 10, 20, 30, and 60 pinholes evenly spaced over a complete circular orbit. A fixed-count acquisition protocol was assumed. Spherical tumors were placed within a digital anthropomorphic phantom having a realistic Prostascint biodistribution. Imaging data sets were generated with an analytical projector and reconstructed volumes were obtained with the OSEM algorithm. The MPH configurations were compared in a localization ROC (LROC) study with 2D pelvic images and both human and model observers. Regular and SS versions of the scanning channelized nonprewhitening (CNPW) and visual-search (VS) model observers were applied. The SS models demonstrated the highest correlations with the average human-observer results

Cautionary tales in the interpretation of observational studies of effects of clinical interventions.

PubMed

Scott, I A; Attia, J

2017-02-01

Observational studies of the effectiveness of clinical interventions are proliferating as more 'real-world' clinical data (so called 'big data') are gathered from clinical registries, administrative datasets and electronic health records. While well-conducted randomised controlled trials (RCT) remain the scientific standard in assessing the efficacy of clinical interventions, well-designed observational studies may add to the evidence base of effectiveness in situations where RCT are of limited value or very difficult to perform. Rather than dismissing observational studies, we need to determine what circumstances may justify doing an observational study and when the study is sufficiently rigorous to be considered reasonably trustworthy. This article proposes criteria by which users of the literature might make such determinations. © 2016 Royal Australasian College of Physicians.

Benchmarking Controlled Trial--a novel concept covering all observational effectiveness studies.

PubMed

Malmivaara, Antti

2015-06-01

The Benchmarking Controlled Trial (BCT) is a novel concept which covers all observational studies aiming to assess effectiveness. BCTs provide evidence of the comparative effectiveness between health service providers, and of effectiveness due to particular features of the health and social care systems. BCTs complement randomized controlled trials (RCTs) as the sources of evidence on effectiveness. This paper presents a definition of the BCT; compares the position of BCTs in assessing effectiveness with that of RCTs; presents a checklist for assessing methodological validity of a BCT; and pilot-tests the checklist with BCTs published recently in the leading medical journals.

Benchmarking Controlled Trial—a novel concept covering all observational effectiveness studies

PubMed Central

Malmivaara, Antti

2015-01-01

Abstract The Benchmarking Controlled Trial (BCT) is a novel concept which covers all observational studies aiming to assess effectiveness. BCTs provide evidence of the comparative effectiveness between health service providers, and of effectiveness due to particular features of the health and social care systems. BCTs complement randomized controlled trials (RCTs) as the sources of evidence on effectiveness. This paper presents a definition of the BCT; compares the position of BCTs in assessing effectiveness with that of RCTs; presents a checklist for assessing methodological validity of a BCT; and pilot-tests the checklist with BCTs published recently in the leading medical journals. PMID:25965700

Assessing treatment effects in older breast cancer patients: systematic review of observational research methods.

PubMed

de Glas, N A; Kiderlen, M; de Craen, A J M; Hamaker, M E; Portielje, J E A; van de Velde, C J H; Liefers, G J; Bastiaannet, E

2015-03-01

Solid evidence of treatment effects in older women with breast cancer is lacking, as they are generally underrepresented in randomized clinical trials on which guideline recommendations are based. An alternative way to study treatment effects in older patients could be to use data from observational studies. However, using appropriate methods in analyzing observational data is a key condition in order to draw valid conclusions, as directly comparing treatments generally results in biased estimates due to confounding by indication. The aim of this systematic review was to investigate the methods that have been used in observational studies that assessed the effects of breast cancer treatment on survival, breast cancer survival and recurrence in older patients (aged 65 years and older). Studies were identified through systematic review of the literature published between January 1st 2009 and December 13th 2013 in the PubMed database and EMBASe. Finally, 31 studies fulfilled the inclusion criteria. Of these, 22 studies directly compared two treatments. Fifteen out of these 22 studies addressed the problem of confounding by indication, while seven studies did not. Nine studies used some form of instrumental variable analysis. In conclusion, the vast majority of observational studies that investigate treatment effects in older breast cancer patients compared treatments directly. These studies are therefore likely to be biased. Observational research will be essential to improve treatment and outcome of older breast cancer patients, but the use of accurate methods is essential to draw valid conclusions from this type of data. Copyright © 2015 Elsevier Ltd. All rights reserved.

Using data mining techniques to characterize participation in observational studies.

PubMed

Linden, Ariel; Yarnold, Paul R

2016-12-01

Data mining techniques are gaining in popularity among health researchers for an array of purposes, such as improving diagnostic accuracy, identifying high-risk patients and extracting concepts from unstructured data. In this paper, we describe how these techniques can be applied to another area in the health research domain: identifying characteristics of individuals who do and do not choose to participate in observational studies. In contrast to randomized studies where individuals have no control over their treatment assignment, participants in observational studies self-select into the treatment arm and therefore have the potential to differ in their characteristics from those who elect not to participate. These differences may explain part, or all, of the difference in the observed outcome, making it crucial to assess whether there is differential participation based on observed characteristics. As compared to traditional approaches to this assessment, data mining offers a more precise understanding of these differences. To describe and illustrate the application of data mining in this domain, we use data from a primary care-based medical home pilot programme and compare the performance of commonly used classification approaches - logistic regression, support vector machines, random forests and classification tree analysis (CTA) - in correctly classifying participants and non-participants. We find that CTA is substantially more accurate than the other models. Moreover, unlike the other models, CTA offers transparency in its computational approach, ease of interpretation via the decision rules produced and provides statistical results familiar to health researchers. Beyond their application to research, data mining techniques could help administrators to identify new candidates for participation who may most benefit from the intervention. © 2016 John Wiley & Sons, Ltd.

Assessing the inter-observer variability of Computer-Aided Nodule Assessment and Risk Yield (CANARY) to characterize lung adenocarcinomas.

PubMed

Nakajima, Erica C; Frankland, Michael P; Johnson, Tucker F; Antic, Sanja L; Chen, Heidi; Chen, Sheau-Chiann; Karwoski, Ronald A; Walker, Ronald; Landman, Bennett A; Clay, Ryan D; Bartholmai, Brian J; Rajagopalan, Srinivasan; Peikert, Tobias; Massion, Pierre P; Maldonado, Fabien

2018-01-01

Lung adenocarcinoma (ADC), the most common lung cancer type, is recognized increasingly as a disease spectrum. To guide individualized patient care, a non-invasive means of distinguishing indolent from aggressive ADC subtypes is needed urgently. Computer-Aided Nodule Assessment and Risk Yield (CANARY) is a novel computed tomography (CT) tool that characterizes early ADCs by detecting nine distinct CT voxel classes, representing a spectrum of lepidic to invasive growth, within an ADC. CANARY characterization has been shown to correlate with ADC histology and patient outcomes. This study evaluated the inter-observer variability of CANARY analysis. Three novice observers segmented and analyzed independently 95 biopsy-confirmed lung ADCs from Vanderbilt University Medical Center/Nashville Veterans Administration Tennessee Valley Healthcare system (VUMC/TVHS) and the Mayo Clinic (Mayo). Inter-observer variability was measured using intra-class correlation coefficient (ICC). The average ICC for all CANARY classes was 0.828 (95% CI 0.76, 0.895) for the VUMC/TVHS cohort, and 0.852 (95% CI 0.804, 0.901) for the Mayo cohort. The most invasive voxel classes had the highest ICC values. To determine whether nodule size influenced inter-observer variability, an additional cohort of 49 sub-centimeter nodules from Mayo were also segmented by three observers, with similar ICC results. Our study demonstrates that CANARY ADC classification between novice CANARY users has an acceptably low degree of variability, and supports the further development of CANARY for clinical application.

Assessment of Global Annual Atmospheric Energy Balance from Satellite Observations

NASA Technical Reports Server (NTRS)

Lin, Bing; Stackhouse, Paul; Minnis, Patrick; Wielicki, Bruce A.; Hu, Yongxiang; Sun, Wenbo; Fan, Tai-Fang (Alice); Hinkelman, Laura

2008-01-01

Global atmospheric energy balance is one of the fundamental processes for the earth's climate system. This study uses currently available satellite data sets of radiative energy at the top of atmosphere (TOA) and surface and latent and sensible heat over oceans for the year 2000 to assess the global annual energy budget. Over land, surface radiation data are used to constrain assimilated results and to force the radiation, turbulent heat, and heat storage into balance due to a lack of observation-based turbulent heat flux estimations. Global annual means of the TOA net radiation obtained from both direct measurements and calculations are close to zero. The net radiative energy fluxes into the surface and the surface latent heat transported into the atmosphere are about 113 and 86 Watts per square meter, respectively. The estimated atmospheric and surface heat imbalances are about -8 9 Watts per square meter, values that are within the uncertainties of surface radiation and sea surface turbulent flux estimates and likely systematic biases in the analyzed observations. The potential significant additional absorption of solar radiation within the atmosphere suggested by previous studies does not appear to be required to balance the energy budget the spurious heat imbalances in the current data are much smaller (about half) than those obtained previously and debated at about a decade ago. Progress in surface radiation and oceanic turbulent heat flux estimations from satellite measurements significantly reduces the bias errors in the observed global energy budgets of the climate system.

Anabolic Androgenic Steroids—Use and Correlates among Gym Users—An Assessment Study Using Questionnaires and Observations at Gyms in the Stockholm Region

PubMed Central

Leifman, Håkan; Rehnman, Charlotta; Sjöblom, Erika; Holgersson, Stefan

2011-01-01

The purpose of this study was to estimate the prevalence of anabolic androgenic steroid (AAS) use and offers to use among gym users in Stockholm County (Sweden), and to conduct a comparison of concordance in estimates of AAS and supplements at gyms between two data collection methods. A questionnaire was distributed to members at 36 training facilities and 1,752 gym users participated in the study. An observation study was conducted as covert participant observations at 64 gyms. According to the questionnaire, 3.9% of men reported life time use of AAS, 1.4% use during the past 12 months and 0.4% AAS use during past 30 days. Not only were there similar patterns found in the two methods, i.e., similar age and gender distributions for AAS use, but analyses of concordance showed that gyms with a higher prevalence of self-reported AAS-use and supplement use (questionnaire) showed a significantly higher proportion of observer-assessed AAS users. Analyses of individual predictors showed that AAS users were almost always young men, regular weight trainers and more often users of drugs and nutritional supplements. The higher prevalence of AAS use among gym users than in the general population makes the former an appropriate target group for AAS prevention. The connection between supplements, drugs and AAS use suggests that effective AAS prevention need to focus on several risk factors for AAS use. The clear resemblance in estimates between the observation and questionnaire data strengthen the credibility of the two methods. PMID:21845151

Anabolic androgenic steroids--use and correlates among gym users--an assessment study using questionnaires and observations at gyms in the Stockholm region.

PubMed

Leifman, Håkan; Rehnman, Charlotta; Sjöblom, Erika; Holgersson, Stefan

2011-07-01

The purpose of this study was to estimate the prevalence of anabolic androgenic steroid (AAS) use and offers to use among gym users in Stockholm County (Sweden), and to conduct a comparison of concordance in estimates of AAS and supplements at gyms between two data collection methods. A questionnaire was distributed to members at 36 training facilities and 1,752 gym users participated in the study. An observation study was conducted as covert participant observations at 64 gyms. According to the questionnaire, 3.9% of men reported life time use of AAS, 1.4% use during the past 12 months and 0.4% AAS use during past 30 days. Not only were there similar patterns found in the two methods, i.e., similar age and gender distributions for AAS use, but analyses of concordance showed that gyms with a higher prevalence of self-reported AAS-use and supplement use (questionnaire) showed a significantly higher proportion of observer-assessed AAS users. Analyses of individual predictors showed that AAS users were almost always young men, regular weight trainers and more often users of drugs and nutritional supplements. The higher prevalence of AAS use among gym users than in the general population makes the former an appropriate target group for AAS prevention. The connection between supplements, drugs and AAS use suggests that effective AAS prevention need to focus on several risk factors for AAS use. The clear resemblance in estimates between the observation and questionnaire data strengthen the credibility of the two methods.

Estimating sensitivity and specificity for technology assessment based on observer studies.

PubMed

Nishikawa, Robert M; Pesce, Lorenzo L

2013-07-01

The goal of this study was to determine the accuracy and precision of using scores from a receiver operating characteristic rating scale to estimate sensitivity and specificity. We used data collected in a previous study that measured the improvements in radiologists' ability to classify mammographic microcalcification clusters as benign or malignant with and without the use of a computer-aided diagnosis scheme. Sensitivity and specificity were estimated from the rating data from a question that directly asked the radiologists their biopsy recommendations, which was used as the "truth," because it is the actual recall decision, thus it is their subjective truth. By thresholding the rating data, sensitivity and specificity were estimated for different threshold values. Because of interreader and intrareader variability, estimated sensitivity and specificity values for individual readers could be as much as 100% in error when using rating data compared to using the biopsy recommendation data. When pooled together, the estimates using thresholding the rating data were in good agreement with sensitivity and specificity estimated from the recommendation data. However, the statistical power of the rating data estimates was lower. By simply asking the observer his or her explicit recommendation (eg, biopsy or no biopsy), sensitivity and specificity can be measured directly, giving a more accurate description of empirical variability and the power of the study can be maximized. Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.

Establishing the feasibility of direct observation in the assessment of tics in children with chronic tic disorders.

PubMed

Himle, Michael B; Chang, Susanna; Woods, Douglas W; Pearlman, Amanda; Buzzella, Brian; Bunaciu, Liviu; Piacentini, John C

2006-01-01

Behavior analysis has been at the forefront in establishing effective treatments for children and adults with chronic tic disorders. As is customary in behavior analysis, the efficacy of these treatments has been established using direct-observation assessment methods. Although behavior-analytic treatments have enjoyed acceptance and integration into mainstream health care practices for tic disorders (e.g., psychiatry and neurology), the use of direct observation as a primary assessment tool has been neglected in favor of less objective methods. Hesitation to use direct observation appears to stem largely from concerns about the generalizability of clinic observations to other settings (e.g., home) and a lack of consensus regarding the most appropriate and feasible techniques for conducting and scoring direct observation. The purpose of the current study was to evaluate and establish a reliable, valid, and feasible direct-observation protocol capable of being transported to research and clinical settings. A total of 43 children with tic disorders, collected from two outpatient specialty clinics, were assessed using direct (videotape samples) and indirect (Yale Global Tic Severity Scale; YGTSS) methods. Videotaped observation samples were collected across 3 consecutive weeks and two different settings (clinic and home), were scored using both exact frequency counts and partial-interval coding, and were compared to data from a common indirect measure of tic severity (the YGTSS). In addition, various lengths of videotaped segments were scored to determine the optimal observation length. Results show that (a) clinic-based observations correspond well to home-based observations, (b) brief direct-observation segments scored with time-sampling methods reliably quantified tics, and (c) indirect methods did not consistently correspond with the direct methods.

An Observational Study of Antibiotic Prescribing Behavior and the Hawthorne Effect

PubMed Central

Mangione-Smith, Rita; Elliott, Marc N; McDonald, Laurie; McGlynn, Elizabeth A

2002-01-01

Objectives To assess whether prospective, observational study procedures, including questionnaires and audio recording, are associated with different patterns of physician diagnostic decision making and antibiotic prescribing. Data Sources/Setting (1) Survey data from a prospective observational study of treatment patterns for children with acute upper respiratory illnesses (10/96–3/97) and (2) retrospective medical record abstraction data of nonobserved encounters for the same problems occurring during (10/96–3/97) and one year after (10/97–3/98) the observational study period. Ten pediatricians in two community practices were studied. Study Design Patterns of diagnoses recorded in the medical record and antibiotics ordered for visits occurring outside of the observational study (same time period and one year later) were compared with the pattern of diagnoses and antibiotics ordered during the observational study. Data Collection/Extraction Methods For the observational study (10/96–2/97), diagnosis and treatment choices were obtained from questionnaires completed by physicians immediately following the visit. For the nonstudy encounters (10/96–3/97 and 10/97–3/98), data were abstracted from medical records one year after the observational study was completed. Principal Findings The proportion of viral cases in which an antibiotic was prescribed was 29 percentage points lower for the observational study compared to the retrospective analysis (p <.05). In one of two study sites, the proportion of cases assigned a bacterial diagnosis was 29 percentage points lower in the observational study period compared to the retrospective study (p <.05). Conclusions Observational study procedures including questionnaires and audio recording can affect antibiotic prescribing behavior. Future observational studies aimed at examining the frequency of inappropriate antibiotic prescribing should measure and adjust for the Hawthorne effect; without such adjustments, the

Some Observational and Modeling Studies of the Atmospheric Boundary Layer at Mississippi Gulf Coast for Air Pollution Dispersion Assessment

PubMed Central

Yerramilli, Anjaneyulu; Challa, Venkata Srinivas; Indracanti, Jayakumar; Dasari, Hariprasad; Baham, Julius; Patrick, Chuck; Young, John; Hughes, Robert; White, Lorren D.; Hardy, Mark G.; Swanier, Shelton

2008-01-01

Coastal atmospheric conditions widely vary from those over inland due to the land-sea interface, temperature contrast and the consequent development of local circulations. In this study a field meteorological experiment was conducted to measure vertical structure of boundary layer during the period 25–29 June, 2007 at three locations Seabee base, Harrison and Wiggins sites in the Mississippi coast. A GPS Sonde along with slow ascent helium balloon and automated weather stations equipped with slow and fast response sensors were used in the experiment. GPS sonde were launched at three specific times (0700 LT, 1300 LT and 1800 LT) during the experiment days. The observations indicate shallow boundary layer near the coast which gradually develops inland. The weather research and forecasting (WRF) meso-scale atmospheric model and a Lagrangian particle dispersion model (HYSPLIT) are used to simulate the lower atmospheric flow and dispersion in a range of 100 km from the coast for 28–30 June, 2007. The simulated meteorological parameters were compared with the experimental observations. The meso-scale model results show significant temporal and spatial variations in the meteorological fields as a result of development of sea breeze flow, its coupling with the large scale flow field and the ensuing alteration in the mixing depth across the coast. Simulated ground-level concentrations of SO2 from four elevated point sources located along the coast indicate diurnal variation and impact of the local sea-land breeze on the direction of the plume. Model concentration levels were highest during the stable morning condition and during the sea-breeze time in the afternoon. The highest concentrations were found up to 40 km inland during sea breeze time. The study illustrates the application of field meteorological observations for the validation of WRF which is coupled to HYSPLIT for dispersion assessment in the coastal region. PMID:19151446

Attention-Deficit/Hyperactivity Disorder Drugs and Growth: An Italian Prospective Observational Study

PubMed Central

Germinario, Elena A.P.; Arcieri, Romano; Bonati, Maurizio; Zuddas, Alessandro; Masi, Gabriele; Vella, Stefano; Chiarotti, Flavia

2013-01-01

Abstract Objective This study was conducted to assess the long-term effect of methylphenidate (MPH) or atomoxetine (ATX) on growth in attention-deficit/hyperactivity disorder (ADHD) drug-naïve children. Design The study was an observational, post-marketing, fourth phase study. Methods Data on height and weight were collected at baseline and every 6 months up to 24 months. Results Both ATX and MPH lead to decreased height gain (assessed by means of z-scores); the effect was significantly higher for ATX than for MPH. At any time, height z-score decrease in the ATX group was higher than the corresponding decrease observed in the MPH group, but the difference was significantly relevant only during the first year of treatment. An increment of average weight was observed both in patients treated with MPH and in those treated with ATX. However, using Tanner's percentile, a subset of patients showed a degree of growth lower than expected. This negative effect was significantly higher for ATX than for MPH. Conclusions We conclude that ADHD drugs show a negative effect on linear growth in children in middle term. Such effect appears more evident for ATX than for MPH. PMID:24024538

Multidisciplinary assessment of post-Ebola sequelae in Guinea (Postebogui): an observational cohort study.

PubMed

Etard, Jean-François; Sow, Mamadou Saliou; Leroy, Sandrine; Touré, Abdoulaye; Taverne, Bernard; Keita, Alpha Kabinet; Msellati, Philippe; Magassouba, N'Fally; Baize, Sylvain; Raoul, Hervé; Izard, Suzanne; Kpamou, Cécé; March, Laura; Savane, Ibrahima; Barry, Moumié; Delaporte, Eric

2017-05-01

The high number of survivors from the 2013-16 west African outbreak of Ebola virus disease (EVD) has raised several new issues: long-term clinical complications, psychosocial consequences, risks of EVD reactivation, and secondary transmission due to viral persistence in body fluids. We aimed to assess long-term clinical, psychosocial, and viral outcomes in EVD survivors in Guinea. In this multidisciplinary observational cohort study, we recruited patients aged 1 year or more in four sites in Guinea (Donka National Hospital, Conakry; Macenta Prefectoral Hospital, Macenta; N'zérékoré Regional Hospital, N'zérékoré; and Forécariah Prefectoral Hospital, Forécariah) following discharge from any Ebola treatment centre in Guinea. Eligible patients had had laboratory-confirmed EVD and had then been declared clear of the virus in the blood. All consenting patients were included, with no exclusion criteria. Trained clinicians assessed patients at enrolment to the cohort, recording clinical symptoms and signs of depression. We did routine blood examinations and examined viral persistence in body fluids using RT-PCR. We did psychological evaluations using questionnaires developed for different age groups. Follow-up is planned to 2 years, and here we present findings at enrolment. Between March 23, 2015, and July 11, 2016, we recruited 802 patients, of whom 360 (45%) were male, 442 (55%) were female; 158 (20%) were younger than 18 years. The median age was 28·4 years (range 1·0-79·9, IQR 19·4-39·8). The median delay after discharge was 350 days (IQR 223-491). The most frequent symptoms were general symptoms (324 [40%] patients), musculoskeletal pain (303 [38%]), headache (278 [35%]), depression (124 [17%] of 713 responses), abdominal pain (178 [22%]), and ocular disorders (142 [18%]). More adults than children had at least one clinical symptom (505 [78%] vs 101 [64%], p<0·0003), ocular complications (124 [19%] vs 18 [11%], p=0·0200), or musculoskeletal symptoms

Self-Assessment of Word Knowledge with Graded Readers: A Preliminary Study

ERIC Educational Resources Information Center

Wan-a-rom, Udorn

2010-01-01

The study investigated how second language (L2) learners self-assessed word knowledge on a page of text taken from a graded reader. The case study subjects were five Thai high school learners of English. They were asked to assess their word knowledge using a page of continuous text. Data gained through observation, interviews, self-assessment and…

Observation of Couple Conflicts: Clinical Assessment Applications, Stubborn Truths, and Shaky Foundations

PubMed Central

Heyman, Richard E.

2006-01-01

The purpose of this review is to provide a balanced examination of the published research involving the observation of couples, with special attention toward the use of observation for clinical assessment. All published articles that (a) used an observational coding system and (b) relate to the validity of the coding system are summarized in a table. The psychometric properties of observational systems and the use of observation in clinical practice are discussed. Although advances have been made in understanding couple conflict through the use of observation, the review concludes with an appeal to the field to develop constructs in a psychometrically and theoretically sound manner. PMID:11281039

Development of a structured observational method for the systematic assessment of school food-choice architecture.

PubMed

Ozturk, Orgul D; McInnes, Melayne M; Blake, Christine E; Frongillo, Edward A; Jones, Sonya J

2016-01-01

The objective of this study is to develop a structured observational method for the systematic assessment of the food-choice architecture that can be used to identify key points for behavioral economic intervention intended to improve the health quality of children's diets. We use an ethnographic approach with observations at twelve elementary schools to construct our survey instrument. Elements of the structured observational method include decision environment, salience, accessibility/convenience, defaults/verbal prompts, number of choices, serving ware/method/packaging, and social/physical eating environment. Our survey reveals important "nudgeable" components of the elementary school food-choice architecture, including precommitment and default options on the lunch line.

Osteoporosis therapies: evidence from health-care databases and observational population studies.

PubMed

Silverman, Stuart L

2010-11-01

Osteoporosis is a well-recognized disease with severe consequences if left untreated. Randomized controlled trials are the most rigorous method for determining the efficacy and safety of therapies. Nevertheless, randomized controlled trials underrepresent the real-world patient population and are costly in both time and money. Modern technology has enabled researchers to use information gathered from large health-care or medical-claims databases to assess the practical utilization of available therapies in appropriate patients. Observational database studies lack randomization but, if carefully designed and successfully completed, can provide valuable information that complements results obtained from randomized controlled trials and extends our knowledge to real-world clinical patients. Randomized controlled trials comparing fracture outcomes among osteoporosis therapies are difficult to perform. In this regard, large observational database studies could be useful in identifying clinically important differences among therapeutic options. Database studies can also provide important information with regard to osteoporosis prevalence, health economics, and compliance and persistence with treatment. This article describes the strengths and limitations of both randomized controlled trials and observational database studies, discusses considerations for observational study design, and reviews a wealth of information generated by database studies in the field of osteoporosis.

A questionnaire to assess the relevance and credibility of observational studies to inform health care decision making: an ISPOR-AMCP-NPC Good Practice Task Force report.

PubMed

Berger, Marc L; Martin, Bradley C; Husereau, Don; Worley, Karen; Allen, J Daniel; Yang, Winnie; Quon, Nicole C; Mullins, C Daniel; Kahler, Kristijan H; Crown, William

2014-03-01

Evidence-based health care decisions are best informed by comparisons of all relevant interventions used to treat conditions in specific patient populations. Observational studies are being performed to help fill evidence gaps. Widespread adoption of evidence from observational studies, however, has been limited because of various factors, including the lack of consensus regarding accepted principles for their evaluation and interpretation. Two task forces were formed to develop questionnaires to assist decision makers in evaluating observational studies, with one Task Force addressing retrospective research and the other Task Force addressing prospective research. The intent was to promote a structured approach to reduce the potential for subjective interpretation of evidence and drive consistency in decision making. Separately developed questionnaires were combined into a single questionnaire consisting of 33 items. These were divided into two domains: relevance and credibility. Relevance addresses the extent to which findings, if accurate, apply to the setting of interest to the decision maker. Credibility addresses the extent to which the study findings accurately answer the study question. The questionnaire provides a guide for assessing the degree of confidence that should be placed from observational studies and promotes awareness of the subtleties involved in evaluating those. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Validation of a Brief Questionnaire Against Direct Observation to Assess Adolescents' School Lunchtime Beverage Consumption.

PubMed

Grummon, Anna H; Hampton, Karla E; Hecht, Amelie; Oliva, Ariana; McCulloch, Charles E; Brindis, Claire D; Patel, Anisha I

Beverage consumption is an important determinant of youth health outcomes. Beverage interventions often occur in schools, yet no brief validated questionnaires exist to assess whether these efforts improve in-school beverage consumption. This study validated a brief questionnaire to assess beverage consumption during school lunch. Researchers observed middle school students' (n = 25) beverage consumption during school lunchtime using a standardized tool. After lunch, students completed questionnaires regarding their lunchtime beverage consumption. Kappa statistics compared self-reported with observed beverage consumption across 15 beverage categories. Eight beverages showed at least fair agreement (kappa [κ] > 0.20) for both type and amount consumed, with most showing substantial agreement (κ > 0.60). One beverage had high raw agreement but κ < 0.20. Six beverages had too few ratings to compute κ's. This brief questionnaire was useful for assessing school lunchtime consumption of many beverages and provides a low-cost tool for evaluating school-based beverage interventions. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

The Test Matters: The Relationship between Classroom Observation Scores and Teacher Value Added on Multiple Types of Assessment

ERIC Educational Resources Information Center

Grossman, Pam; Cohen, Julie; Ronfeldt, Matthew; Brown, Lindsay

2014-01-01

In this study, we examined how the relationships between one observation protocol, the Protocol for Language Arts Teaching Observation (PLATO), and value-added measures shift when different tests are used to assess student achievement. Using data from the Measures of Effective Teaching Project, we found that PLATO was more strongly related to the…

The Arctic Observing Viewer (AOV): Visualization, Data Discovery, Strategic Assessment, and Decision Support for Arctic Observing

NASA Astrophysics Data System (ADS)

Cody, R. P.; Manley, W. F.; Gaylord, A. G.; Kassin, A.; Villarreal, S.; Barba, M.; Dover, M.; Escarzaga, S. M.; Habermann, T.; Kozimor, J.; Score, R.; Tweedie, C. E.

2016-12-01

To better assess progress in Arctic Observing made by U.S. SEARCH, NSF AON, SAON, and related initiatives, an updated version of the Arctic Observing Viewer (AOV; http://ArcticObservingViewer.org) has been released. This web mapping application and information system conveys the who, what, where, and when of "data collection sites" - the precise locations of monitoring assets, observing platforms, and wherever repeat marine or terrestrial measurements have been taken. Over 8000 sites across the circum-arctic are documented including a range of boreholes, ship tracks, buoys, towers, sampling stations, sensor networks, vegetation plots, stream gauges, ice cores, observatories, and more. Contributing partners are the U.S. NSF, ACADIS, ADIwg, AOOS, a2dc, AON, CAFF, GINA, IASOA, INTERACT, NASA ABoVE, and USGS, among others. Users can visualize, navigate, select, search, draw, print, view details, and follow links to obtain a comprehensive perspective of environmental monitoring efforts. We continue to develop, populate, and enhance AOV. Recent improvements include: a more intuitive and functional search tool, a modern cross-platform interface using javascript and HTML5, and hierarchical ISO metadata coupled with RESTful web services & metadata XLinks to span the data life cycle (from project planning to establishment of data collection sites to release of scientific datasets). Additionally, through collaborations with the Barrow Area Information Database (BAID, www.barrowmapped.org) we are exploring linkages with datacenters and have developed a prototype dashboard application that allows users to explore data services in the AOV application. AOV is founded on principles of interoperability, such that agencies and organizations can use the AOV Viewer and web services for their own purposes. In this way, AOV complements other distributed yet interoperable cyber resources and helps science planners, funding agencies, investigators, data specialists, and others to: assess

Task Equivalence for Model and Human-Observer Comparisons in SPECT Localization Studies

NASA Astrophysics Data System (ADS)

Sen, Anando; Kalantari, Faraz; Gifford, Howard C.

2016-06-01

While mathematical model observers are intended for efficient assessment of medical imaging systems, their findings should be relevant for human observers as the primary clinical end users. We have investigated whether pursuing equivalence between the model and human-observer tasks can help ensure this goal. A localization receiver operating characteristic (LROC) study tested prostate lesion detection in simulated In-111 SPECT imaging with anthropomorphic phantoms. The test images were 2D slices extracted from reconstructed volumes. The iterative ordered sets expectation-maximization (OSEM) reconstruction algorithm was used with Gaussian postsmoothing. Variations in the number of iterations and the level of postfiltering defined the test strategies in the study. Human-observer performance was compared with that of a visual-search (VS) observer, a scanning channelized Hotelling observer, and a scanning channelized nonprewhitening (CNPW) observer. These model observers were applied with precise information about the target regions of interest (ROIs). ROI knowledge was a study variable for the human observers. In one study format, the humans read the SPECT image alone. With a dual-modality format, the SPECT image was presented alongside an anatomical image slice extracted from the density map of the phantom. Performance was scored by area under the LROC curve. The human observers performed significantly better with the dual-modality format, and correlation with the model observers was also improved. Given the human-observer data from the SPECT study format, the Pearson correlation coefficients for the model observers were 0.58 (VS), -0.12 (CH), and -0.23 (CNPW). The respective coefficients based on the human-observer data from the dual-modality study were 0.72, 0.27, and -0.11. These results point towards the continued development of the VS observer for enhancing task equivalence in model-observer studies.

Review on pen-and-paper-based observational methods for assessing ergonomic risk factors of computer work.

PubMed

Rahman, Mohd Nasrull Abdol; Mohamad, Siti Shafika

2017-01-01

Computer works are associated with Musculoskeletal Disorders (MSDs). There are several methods have been developed to assess computer work risk factor related to MSDs. This review aims to give an overview of current techniques available for pen-and-paper-based observational methods in assessing ergonomic risk factors of computer work. We searched an electronic database for materials from 1992 until 2015. The selected methods were focused on computer work, pen-and-paper observational methods, office risk factors and musculoskeletal disorders. This review was developed to assess the risk factors, reliability and validity of pen-and-paper observational method associated with computer work. Two evaluators independently carried out this review. Seven observational methods used to assess exposure to office risk factor for work-related musculoskeletal disorders were identified. The risk factors involved in current techniques of pen and paper based observational tools were postures, office components, force and repetition. From the seven methods, only five methods had been tested for reliability. They were proven to be reliable and were rated as moderate to good. For the validity testing, from seven methods only four methods were tested and the results are moderate. Many observational tools already exist, but no single tool appears to cover all of the risk factors including working posture, office component, force, repetition and office environment at office workstations and computer work. Although the most important factor in developing tool is proper validation of exposure assessment techniques, the existing observational method did not test reliability and validity. Futhermore, this review could provide the researchers with ways on how to improve the pen-and-paper-based observational method for assessing ergonomic risk factors of computer work.

A Turkish Version of the Critical-Care Pain Observation Tool: Reliability and Validity Assessment.

PubMed

Aktaş, Yeşim Yaman; Karabulut, Neziha

2017-08-01

The study aim was to evaluate the validity and reliability of the Critical-Care Pain Observation Tool in critically ill patients. A repeated measures design was used for the study. A convenience sample of 66 patients who had undergone open-heart surgery in the cardiovascular surgery intensive care unit in Ordu, Turkey, was recruited for the study. The patients were evaluated by using the Critical-Care Pain Observation Tool at rest, during a nociceptive procedure (suctioning), and 20 minutes after the procedure while they were conscious and intubated after surgery. The Turkish version of the Critical-Care Pain Observation Tool has shown statistically acceptable levels of validity and reliability. Inter-rater reliability was supported by moderate-to-high-weighted κ coefficients (weighted κ coefficient = 0.55 to 1.00). For concurrent validity, significant associations were found between the scores on the Critical-Care Pain Observation Tool and the Behavioral Pain Scale scores. Discriminant validity was also supported by higher scores during suctioning (a nociceptive procedure) versus non-nociceptive procedures. The internal consistency of the Critical-Care Pain Observation Tool was 0.72 during a nociceptive procedure and 0.71 during a non-nociceptive procedure. The validity and reliability of the Turkish version of the Critical-Care Pain Observation Tool was determined to be acceptable for pain assessment in critical care, especially for patients who cannot communicate verbally. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

Mapping the Delivery of Societal Benefit through the International Arctic Observations Assessment Framework

NASA Astrophysics Data System (ADS)

Lev, S. M.; Gallo, J.

2017-12-01

The international Arctic scientific community has identified the need for a sustained and integrated portfolio of pan-Arctic Earth-observing systems. In 2017, an international effort was undertaken to develop the first ever Value Tree framework for identifying common research and operational objectives that rely on Earth observation data derived from Earth-observing systems, sensors, surveys, networks, models, and databases to deliver societal benefits in the Arctic. A Value Tree Analysis is a common tool used to support decision making processes and is useful for defining concepts, identifying objectives, and creating a hierarchical framework of objectives. A multi-level societal benefit area value tree establishes the connection from societal benefits to the set of observation inputs that contribute to delivering those benefits. A Value Tree that relies on expert domain knowledge from Arctic and non-Arctic nations, international researchers, Indigenous knowledge holders, and other experts to develop a framework to serve as a logical and interdependent decision support tool will be presented. Value tree examples that map the contribution of Earth observations in the Arctic to achieving societal benefits will be presented in the context of the 2017 International Arctic Observations Assessment Framework. These case studies will highlight specific observing products and capability groups where investment is needed to contribute to the development of a sustained portfolio of Arctic observing systems.

Comparison of balance assessment modalities in emergency department elders: a pilot cross-sectional observational study.

PubMed

Caterino, Jeffrey M; Karaman, Rowan; Arora, Vinay; Martin, Jacqueline L; Hiestand, Brian C

2009-09-28

More than one-third of US adults 65 and over fall every year. These falls may cause serious injury including substantial long-term morbidity (due declines in activities of daily living) and death. The emergency department (ED) visit represents an opportunity for identifying high risk elders and potentially instituting falls-related interventions. The unique characteristic of the ED environment and patient population necessitate that risk-assessment modalities be validated in this specific setting. In order to better identify elders at risk of falls, we examined the relationship between patient-provided history of falling and two testing modalities (a balance plate system and the timed up-and-go [TUG] test) in elder emergency department (ED) patients. We conducted a cross-sectional observational study of patients > or = 60 years old being discharged from the ED. Patient history of falls in the past week, month, 6 months, and year was obtained. Balance plate center of pressure excursion (COP) measurements and TUG testing times were recorded. COP was recorded under four conditions: normal stability eyes open (NSEO) and closed (NSEC), and perturbed stability eyes open and closed. Correlation between TUG and COP scores was measured. Univariate logistic regression was used to identify the relationship between patient-provided falls history and the two testing modalities. Proportions, likelihood ratios, and receiver-operating-characteristic (ROC) curves for prediction of previous falls were reported. Fifty-three subjects were enrolled, 11% had fallen in the previous week and 42% in the previous year. There was no correlation between TUG and any balance plate measurements. In logistic regression, neither testing modality was associated with prior history of falls (p > 0.05 for all time periods). Balance plate NSEO and NSEC testing cutoffs could be identified which were 83% sensitive and had a negative likelihood ratio (LR-) of 0.3 for falls in the past week. TUG testing

Intimate partner violence and breastfeeding practices: a systematic review of observational studies.

PubMed

Mezzavilla, Raquel de Souza; Ferreira, Marina de Figueiredo; Curioni, Cintia Chaves; Lindsay, Ana Cristina; Hasselmann, Maria Helena

To review the association between intimate partner violence and breastfeeding practices in the literature. The search was carried out in five databases, including MEDLINE, LILACS, SCOPUS, PsycoINFO, and Science Direct. The search strategy was carried out in February 2017. The authors included original studies with observational design, which investigated forms of intimate partner violence (including emotional, physical, and/or sexual) and breastfeeding practices. The quality of the studies was assessed based on the bias susceptibility through criteria specifically developed for this review. The study included 12 original articles (10 cross-sectional, one case-control, and one cohort study) carried out in different countries. The forms of intimate partner violence observed were emotional, physical, and/or sexual. Breastfeeding was investigated by different tools and only assessed children between 2 days and 6 months of life. Of the 12 studies included in this review, eight found a lower breastfeeding intention, breastfeeding initiation, and exclusive breastfeeding during the first six months of the child's life, and a higher likelihood of early termination of exclusive breastfeeding among women living at home where violence was present. The quality varied between the studies and six were classified as having low bias susceptibility based on the assessed items. Intimate partner violence is associated with inadequate breastfeeding practices of children aged 2 days to 6 months of life. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Prospective study of recovery from copperhead snake envenomation: an observational study.

PubMed

Lavonas, Eric J; Gerardo, Charles J

2015-05-15

Although much is known about signs, symptoms, and management in the acute phase of crotaline snake envenomation, little is known about signs, symptoms, function, and quality of life during the recovery phase. The purpose of this observational pilot investigation is to evaluate the utility of several clinical outcome instruments in the setting of copperhead snakebite, and to characterize the clinical course of recovery. This is a multi-center prospective, open-label, observational study of patients envenomated by copperhead snakes. We administered the Disabilities of the Arm, Shoulder, and Hand (DASH), Lower Extremity Functional Scale (LEFS), Patient-Specific Functional Scale (PSFS), Work Productivity and Ability Impairment: Special Health Problem (WPAI: SHP), Patients' Global Impression of Change (PGIC), Patient's Global Assessment of Recovery (PGAR), and SF-36 instruments, obtained numeric pain rating scales, and measured grip strength, walking speed, and swelling prior to hospital discharge and 3, 7, 14, 21, and 28 days after envenomation. 20 subjects were enrolled; none were lost to follow-up. Most (80%) had moderate severity swelling, and most (75%) received antivenom. Across the broad range of measures, abnormalities of pain, swelling, impairments of physical and role function, and quality of life persisted for 7-14 days in most subjects. Validated self-reported outcome measures, such as the DASH, LEFS, PSFS, PGIC, SF-36, and the daily activities impairment portion of the WPAI: SHP were more responsive than measurements of swelling or walking speed. Data quality issues limited the utility of the work impairment portion of the WPAI: SHP. Residual signs, symptoms, and impairment in some subjects lasted through the 28-day study period. The study design precluded any assessment of the effectiveness of antivenom. Signs, symptoms, impaired function, and decreased quality of life typically last 7 - 14 days after copperhead envenomation. Several tools appear

Assessing distractors and teamwork during surgery: developing an event-based method for direct observation.

PubMed

Seelandt, Julia C; Tschan, Franziska; Keller, Sandra; Beldi, Guido; Jenni, Nadja; Kurmann, Anita; Candinas, Daniel; Semmer, Norbert K

2014-11-01

To develop a behavioural observation method to simultaneously assess distractors and communication/teamwork during surgical procedures through direct, on-site observations; to establish the reliability of the method for long (>3 h) procedures. Observational categories for an event-based coding system were developed based on expert interviews, observations and a literature review. Using Cohen's κ and the intraclass correlation coefficient, interobserver agreement was assessed for 29 procedures. Agreement was calculated for the entire surgery, and for the 1st hour. In addition, interobserver agreement was assessed between two tired observers and between a tired and a non-tired observer after 3 h of surgery. The observational system has five codes for distractors (door openings, noise distractors, technical distractors, side conversations and interruptions), eight codes for communication/teamwork (case-relevant communication, teaching, leadership, problem solving, case-irrelevant communication, laughter, tension and communication with external visitors) and five contextual codes (incision, last stitch, personnel changes in the sterile team, location changes around the table and incidents). Based on 5-min intervals, Cohen's κ was good to excellent for distractors (0.74-0.98) and for communication/teamwork (0.70-1). Based on frequency counts, intraclass correlation coefficient was excellent for distractors (0.86-0.99) and good to excellent for communication/teamwork (0.45-0.99). After 3 h of surgery, Cohen's κ was 0.78-0.93 for distractors, and 0.79-1 for communication/teamwork. The observational method developed allows a single observer to simultaneously assess distractors and communication/teamwork. Even for long procedures, high interobserver agreement can be achieved. Data collected with this method allow for investigating separate or combined effects of distractions and communication/teamwork on surgical performance and patient outcomes. Published by the

[Registration of observational studies: it is time to comply with the Declaration of Helsinki requirement].

PubMed

Dal-Ré, Rafael; Delgado, Miguel; Bolumar, Francisco

2015-01-01

Publication bias is a serious deficiency in the current system of disseminating the results of human research studies. Clinical investigators know that, from an ethical standpoint, they should prospectively register clinical trials in a public registry before starting them. In addition, it is believed that this approach will help to reduce publication bias. However, most studies conducted in humans are observational rather than experimental. It is estimated that less than 2% out of 2 million concluded or ongoing observational studies have been registered. The 2013 revision of the Declaration of Helsinki requires registration of any type of research study involving humans or identifiable samples or data. It is proposed that funding agencies, such as the Fondo de Investigaciones Sanitarias, as well as private companies, require preregistration of observational studies before providing funding. It is also proposed that Research Ethics Committees which, following Spanish regulation, have been using the Declaration as the framework for assessing the ethics of clinical trials with medicines since 1990, should follow the same provisions for the assessment of health-related observational studies: therefore, they should require prospective registration of studies before granting their final approval. This would allow observational study investigators to be educated in complying with an ethical requirement recently introduced in the most important ethical code for research involving humans. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

Carbon Dioxide Observational Platform System (CO-OPS), feasibility study

NASA Technical Reports Server (NTRS)

Bouquet, D. L.; Hall, D. W.; Mcelveen, R. P.

1987-01-01

The Carbon Dioxide Observational Platform System (CO-OPS) is a near-space, geostationary, multi-user, unmanned microwave powered monitoring platform system. This systems engineering feasibility study addressed identified existing requirements such as: carbon dioxide observational data requirements, communications requirements, and eye-in-the-sky requirements of other groups like the Defense Department, the Forestry Service, and the Coast Guard. In addition, potential applications in: earth system science, space system sciences, and test and verification (satellite sensors and data management techniques) were considered. The eleven month effort is summarized. Past work and methods of gathering the required observational data were assessed and rough-order-of magnitude cost estimates have shown the CO-OPS system to be most cost effective (less than $30 million within a 10 year lifetime). It was also concluded that there are no technical, schedule, or obstacles that would prevent achieving the objectives of the total 5-year CO-OPS program.

Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration

PubMed Central

Vandenbroucke, Jan P; von Elm, Erik; Altman, Douglas G; Gøtzsche, Peter C; Mulrow, Cynthia D; Pocock, Stuart J; Poole, Charles; Schlesselman, James J; Egger, Matthias

2007-01-01

Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. Taking into account empirical evidence and theoretical considerations, a group of methodologists, researchers, and editors developed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations to improve the quality of reporting of observational studies. The STROBE Statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how to improve the reporting of observational studies and facilitates critical appraisal and interpretation of studies by reviewers, journal editors and readers. This explanatory and elaboration document is intended to enhance the use, understanding, and dissemination of the STROBE Statement. The meaning and rationale for each checklist item are presented. For each item, one or several published examples and, where possible, references to relevant empirical studies and methodological literature are provided. Examples of useful flow diagrams are also included. The STROBE Statement, this document, and the associated Web site (http://www.strobe-statement.org/) should be helpful resources to improve reporting of observational research. PMID:17941715

Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration.

PubMed

Vandenbroucke, Jan P; von Elm, Erik; Altman, Douglas G; Gøtzsche, Peter C; Mulrow, Cynthia D; Pocock, Stuart J; Poole, Charles; Schlesselman, James J; Egger, Matthias

2014-12-01

Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. Taking into account empirical evidence and theoretical considerations, a group of methodologists, researchers, and editors developed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations to improve the quality of reporting of observational studies. The STROBE Statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how to improve the reporting of observational studies and facilitates critical appraisal and interpretation of studies by reviewers, journal editors and readers. This explanatory and elaboration document is intended to enhance the use, understanding, and dissemination of the STROBE Statement. The meaning and rationale for each checklist item are presented. For each item, one or several published examples and, where possible, references to relevant empirical studies and methodological literature are provided. Examples of useful flow diagrams are also included. The STROBE Statement, this document, and the associated Web site (http://www.strobe-statement.org/) should be helpful resources to improve reporting of observational research. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Standardized assessment of tumor-infiltrating lymphocytes in breast cancer: an evaluation of inter-observer agreement between pathologists.

PubMed

Tramm, Trine; Di Caterino, Tina; Jylling, Anne-Marie B; Lelkaitis, Giedrius; Lænkholm, Anne-Vibeke; Ragó, Péter; Tabor, Tomasz P; Talman, Maj-Lis M; Vouza, Emmanouela

2018-01-01

In breast cancer, there is a growing body of evidence that tumor-infiltrating lymphocytes (TILs) may have clinical utility and may be able to direct clinical decisions for subgroups of patients. Clinical utility is, however, not sufficient for warranting the implementation of a new biomarker in the routine practice, and evaluation of the analytical validity is needed, including testing the reproducibility of decentralized assessment of TILs. The aim of this study was to evaluate the inter-observer agreement of TILs assessment using a standardized method, as proposed by the International TILs Working Group 2014, applied to a cohort of breast cancers reflecting an average breast cancer population. Stromal TILs were assessed using full slide sections from 124 breast cancers with varying histology, malignancy grade and ER- and HER2 status. TILs were estimated by nine dedicated breast pathologists using scanned hematoxylin-eosin stainings. TILs results were categorized using various cutoffs, and the inter-observer agreement was evaluated using the intraclass coefficient (ICC), Kappa statistics as well as individual overall agreements with the median value of TILs. Evaluation of TILs led to an ICC of 0.71 (95% CI: 0.65-0.77) corresponding to an acceptable agreement. Kappa values were in the range of 0.38-0.46 corresponding to a fair to moderate agreement. The individual agreements increased, when using only two categories ('high' vs. 'low' TILs) and a cutoff of 50-60%. The results of the present study are in accordance with previous studies, and shows that the proposed methodology for standardized evaluation of TILs renders an acceptable inter-observer agreement. The findings, however, indicate that assessment of TILs needs further refinement, and is in support of the latest St. Gallen Consensus, that routine reporting of TILs for early breast cancer is not ready for implementation in a clinical setting.

Shift work and diabetes mellitus: a meta-analysis of observational studies.

PubMed

Gan, Yong; Yang, Chen; Tong, Xinyue; Sun, Huilian; Cong, Yingjie; Yin, Xiaoxu; Li, Liqing; Cao, Shiyi; Dong, Xiaoxin; Gong, Yanhong; Shi, Oumin; Deng, Jian; Bi, Huashan; Lu, Zuxun

2015-01-01

Observational studies suggest that shift work may be associated with diabetes mellitus (DM). However, the results are inconsistent. No systematic reviews have applied quantitative techniques to compute summary risk estimates. To conduct a meta-analysis of observational studies assessing the association between shift work and the risk of DM. Relevant studies were identified by a search of PubMed, Embase, Web of Science and ProQuest Dissertation and Theses databases to April 2014. We also reviewed reference lists from retrieved articles. We included observational studies that reported OR with 95% CIs for the association between shift work and the risk of DM. Two authors independently extracted data and assessed the study quality. Twelve studies with 28 independent reports involving 226 652 participants and 14 595 patients with DM were included. A pooled adjusted OR for the association between ever exposure to shift work and DM risk was 1.09 (95% CI 1.05 to 1.12; p=0.014; I(2)=40.9%). Subgroup analyses suggested a stronger association between shift work and DM for men (OR=1.37, 95% CI 1.20 to 1.56) than for women (OR=1.09, 95% CI 1.04 to 1.14) (p for interaction=0.01). All shift work schedules with the exception of mixed shifts and evening shifts were associated with a statistically higher risk of DM than normal daytime schedules, and the difference among those shift work schedules was significant (p for interaction=0.04). Shift work is associated with an increased risk of DM. The increase was significantly higher among men and the rotating shift group, which warrants further studies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Using non-specialist observers in 4AFC human observer studies

NASA Astrophysics Data System (ADS)

Elangovan, Premkumar; Mackenzie, Alistair; Dance, David R.; Young, Kenneth C.; Wells, Kevin

2017-03-01

Virtual clinical trials (VCTs) are an emergent approach for rapid evaluation and comparison of various breast imaging technologies and techniques using computer-based modeling tools. Increasingly 4AFC (Four alternative forced choice) virtual clinical trials are used to compare detection performances of different breast imaging modalities. Most prior studies have used physicists and/or radiologists and physicists interchangeably. However, large scale use of statistically significant 4AFC observer studies is challenged by the individual time commitment and cost of such observers, often drawn from a limited local pool of specialists. This work aims to investigate whether non-specialist observers can be used to supplement such studies. A team of five specialist observers (medical physicists) and five non-specialists participated in a 4AFC study containing simulated 2D-mammography and DBT (digital breast tomosynthesis) images, produced using the OPTIMAM toolbox for VCTs. The images contained 4mm irregular solid masses and 4mm spherical targets at a range of contrast levels embedded in a realistic breast phantom background. There was no statistically significant difference between the detection performance of medical physicists and non-specialists (p>0.05). However, non-specialists took longer to complete the study than their physicist counterparts, which was statistically significant (p<0.05). Overall, the results from both observer groups indicate that DBT has a lower detectable threshold contrast than 2D-mammography for both masses and spheres, and both groups found spheres easier to detect than irregular solid masses.

Clinical research on postoperative trauma care: has the position of observational studies changed?

PubMed

Smeeing, D P J; Houwert, R M; Kruyt, M C; van der Meijden, O A J; Hietbrink, F

2017-02-01

The postoperative care regimes of ankle fractures are studied for over 30 years and recommendations have shifted only slightly in the last decades. However, study methodology might have evolved. The aim of this study was to evaluate the changes in time in the design, quality and outcome measures of studies investigating the postoperative care of ankle fractures. The MEDLINE and EMBASE database were searched for both RCTs and cohort studies. The original studies were divided into decades of publication over the last 30 years. The methodological quality of the studies was assessed using the 'traditional' risk of bias assessment tool provided by The Cochrane Collaboration and the 'newer' MINORS criteria. The percentage of RCTs on this subject declined from 67 to 38 % in the last decades. According to the Cochrane tool, the reported quality of RCTs has improved in the last three decades whereas the reported quality of observational studies has remained unchanged. However, when quality was evaluated with the MINORS criteria, equal improvement was observed for both RCTs and observational studies. In the 80s, 67 % of all studies used the range of motion as the primary outcome measure, which decreased to 45 % in the 90s. In the 00s, none of the studies used the range of motion as the primary outcome. For postoperative care of ankle fractures, results of this study showed a relative decrease in the published number of RCTs. The overall quality of the published articles did not decline. In addition, a gradual shift from physician measured to patient-reported outcome variables was observed. However, it should be borne in mind that the findings are based on a small sample (n = 25).

Vegetation-rainfall feedbacks across the Sahel: a combined observational and modeling study

NASA Astrophysics Data System (ADS)

Yu, Y.; Notaro, M.; Wang, F.; Mao, J.; Shi, X.; Wei, Y.

2016-12-01

The Sahel rainfall is characterized by large interannual variability. Past modeling studies have concluded that the Sahel rainfall variability is primarily driven by oceanic forcings and amplified by land-atmosphere interactions. However, the relative importance of oceanic versus terrestrial drivers has never been assessed from observations. The current understanding of vegetation's impacts on climate, i.e. positive vegetation-rainfall feedback through the albedo, moisture, and momentum mechanisms, comes from untested models. Neither the positive vegetation-rainfall feedback, nor the underlying mechanisms, has been fully resolved in observations. The current study fills the knowledge gap about the observed vegetation-rainfall feedbacks, through the application of the multivariate statistical method Generalized Equilibrium Feedback Assessment (GEFA) to observational data. According to GEFA, the observed oceanic impacts dominate over terrestrial impacts on Sahel rainfall, except in the post-monsoon period. Positive leaf area index (LAI) anomalies favor an extended, wetter monsoon across the Sahel, largely due to moisture recycling. The albedo mechanism is not responsible for this positive vegetation feedback on the seasonal-interannual time scale, which is too short for a grass-desert transition. A low-level stabilization and subsidence is observed in response to increased LAI - potentially responsible for a negative vegetation-rainfall feedback. However, the positive moisture feedback overwhelms the negative momentum feedback, resulting in an observed positive vegetation-rainfall feedback. We further applied GEFA to a fully-coupled Community Earth System Model (CESM) control run, as an example of evaluating climate models against the GEFA-based observational benchmark. In contrast to the observed positive vegetation-rainfall feedbacks, CESM simulates a negative vegetation-rainfall feedback across Sahel, peaking in the pre-monsoon season. The simulated negative

Assessment of cardiac single-photon emission computed tomography performance using a scanning linear observer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, Chih-Jie; Kupinski, Matthew A.; Volokh, Lana

2013-01-15

Purpose: Single-photon emission computed tomography (SPECT) is widely used to detect myocardial ischemia and myocardial infarction. It is important to assess and compare different SPECT system designs in order to achieve the highest detectability of cardiac defects. Methods: Whitaker et al.'s study ['Estimating random signal parameters from noisy images with nuisance parameters: linear and scanning-linear methods,' Opt. Express 16(11), 8150-8173 (2008)] on the scanning linear observer (SLO) shows that the SLO can be used to estimate the location and size of signals. One major advantage of the SLO is that it can be used with projection data rather than withmore » reconstruction data. Thus, this observer model assesses the overall hardware performance independent of any reconstruction algorithm. In addition, the computation time of image quality studies is significantly reduced. In this study, three systems based on the design of the GE cadmium zinc telluride-based dedicated cardiac SPECT camera Discovery 530c were assessed. This design, which is officially named the Alcyone Technology: Discovery NM 530c, was commercialized in August, 2009. The three systems, GE27, GE19, and GE13, contain 27, 19, and 13 detectors, respectively. Clinically, a human heart can be virtually segmented into three coronary artery territories: the left-anterior descending artery, left-circumflex artery, and right coronary artery. One of the most important functions of a cardiac SPECT system is to produce images from which a radiologist can accurately predict in which territory the defect exists [http://www.asnc.org/media/PDFs/PPReporting081511.pdf, Guideline from American Society of Nuclear Cardiology]. A good estimation of the extent of the defect from the projection images is also very helpful for determining the seriousness of the myocardial ischemia. In this study, both the location and extent of defects were estimated by the SLO, and the system performance was assessed by localization

Visual-search model observer for assessing mass detection in CT

NASA Astrophysics Data System (ADS)

Karbaschi, Zohreh; Gifford, Howard C.

2017-03-01

Our aim is to devise model observers (MOs) to evaluate acquisition protocols in medical imaging. To optimize protocols for human observers, an MO must reliably interpret images containing quantum and anatomical noise under aliasing conditions. In this study of sampling parameters for simulated lung CT, the lesion-detection performance of human observers was compared with that of visual-search (VS) observers, a channelized nonprewhitening (CNPW) observer, and a channelized Hoteling (CH) observer. Scans of a mathematical torso phantom modeled single-slice parallel-hole CT with varying numbers of detector pixels and angular projections. Circular lung lesions had a fixed radius. Twodimensional FBP reconstructions were performed. A localization ROC study was conducted with the VS, CNPW and human observers, while the CH observer was applied in a location-known ROC study. Changing the sampling parameters had negligible effect on the CNPW and CH observers, whereas several VS observers demonstrated a sensitivity to sampling artifacts that was in agreement with how the humans performed.

Prospective clinical observational study evaluating gender-associated differences of preoperative pain intensity.

PubMed

Tafelski, Sascha; Kerper, Léonie F; Salz, Anna-Lena; Spies, Claudia; Reuter, Eva; Nachtigall, Irit; Schäfer, Michael; Krannich, Alexander; Krampe, Henning

2016-07-01

Previous studies reported conflicting results concerning different pain perceptions of men and women. Recent research found higher pain levels in men after major surgery, contrasted by women after minor procedures. This trial investigates differences in self-reported preoperative pain intensity between genders before surgery.Patients were enrolled in 2011 and 2012 presenting for preoperative evaluation at the anesthesiological assessment clinic at Charité University hospital. Out of 5102 patients completing a computer-assisted self-assessment, 3042 surgical patients with any preoperative pain were included into this prospective observational clinical study. Preoperative pain intensity (0-100 VAS, visual analog scale) was evaluated integrating psychological cofactors into analysis.Women reported higher preoperative pain intensity than men with median VAS scores of 30 (25th-75th percentiles: 10-52) versus 21 (10-46) (P < 0.001). Adjusted multiple regression analysis showed that female gender remained statistically significantly associated with higher pain intensity (P < 0.001). Gender differences were consistent across several subgroups especially with varying patterns in elderly. Women scheduled for minor and moderate surgical procedures showed largest differences in overall pain compared to men.This large clinical study observed significantly higher preoperative pain intensity in female surgical patients. This gender difference was larger in the elderly potentially contradicting the current hypothesis of a primary sex-hormone derived effect. The observed variability in specific patient subgroups may help to explain heterogeneous findings of previous studies.

Assessment of cumulative exposure to UVA through the study of asymmetrical facial skin aging.

PubMed

Mac-Mary, Sophie; Sainthillier, Jean-Marie; Jeudy, Adeline; Sladen, Christelle; Williams, Cara; Bell, Mike; Humbert, Philippe

2010-09-23

Published studies assessing whether asymmetrical facial ultraviolet light exposure leads to underlying differences in skin physiology and morphology report only clinical observations. The aim of this study was to assess the visual impact on the skin of repeated ultraviolet-A (UVA) exposure through a window. Eight women and two men presenting with asymmetrical signs of photoaging due to overexposure of one side of their face to the sun through a window over a long period of time were enrolled in the study. Split-face biometrologic assessments were performed (clinical scoring, hydration with Corneometer, mechanical properties with Cutometer, transepidermal water loss with AquaFlux, skin relief with fringe projection, photography, stripping, and then lipid peroxidation analysis). Significant differences were observed in clinical scores for wrinkles, skin roughness assessed by fringe projection on the cheek, and skin heterogeneity assessed with spectrocolorimetry on the cheekbone. Other differences were observed for skin hydration, as well as skin laxity, which tended towards significance. This study suggests the potential benefit of daily UVA protection during nondeliberate exposure indoors as well as outside.

ASQ Program Observation Instrument: A Tool for Assessing School-Age Child Care Quality.

ERIC Educational Resources Information Center

O'Connor, Susan; And Others

ASQ (Assessing School-Aged Child Care Quality) is a system for determining the quality of school-age child care programs. The ASQ Program Observation Instrument is a ten-step, self assessment process to guide program improvement. This instrument does not work well in full-day programs that have a single focus, but works well in programs that offer…

Comparing Vignette Instruction and Assessment Tasks to Classroom Observations and Reflections

ERIC Educational Resources Information Center

Jeffries, Carolyn; Maeder, Dale W.

2011-01-01

The growing body of research on the use of vignettes in teacher education courses suggests that vignette-based instruction and assessment tasks may represent a viable alternative to traditional forms of scaffolded instruction and reflective essays following classroom observations, thereby creating a bridge between college and K-12 classrooms for…

Case Study Observational Research: A Framework for Conducting Case Study Research Where Observation Data Are the Focus.

PubMed

Morgan, Sonya J; Pullon, Susan R H; Macdonald, Lindsay M; McKinlay, Eileen M; Gray, Ben V

2017-06-01

Case study research is a comprehensive method that incorporates multiple sources of data to provide detailed accounts of complex research phenomena in real-life contexts. However, current models of case study research do not particularly distinguish the unique contribution observation data can make. Observation methods have the potential to reach beyond other methods that rely largely or solely on self-report. This article describes the distinctive characteristics of case study observational research, a modified form of Yin's 2014 model of case study research the authors used in a study exploring interprofessional collaboration in primary care. In this approach, observation data are positioned as the central component of the research design. Case study observational research offers a promising approach for researchers in a wide range of health care settings seeking more complete understandings of complex topics, where contextual influences are of primary concern. Future research is needed to refine and evaluate the approach.

Discriminating between camouflaged targets by their time of detection by a human-based observer assessment method

NASA Astrophysics Data System (ADS)

Selj, G. K.; Søderblom, M.

2015-10-01

Detection of a camouflaged object in natural sceneries requires the target to be distinguishable from its local background. The development of any new camouflage pattern therefore has to rely on a well-founded test methodology - which has to be correlated with the final purpose of the pattern - as well as an evaluation procedure, containing the optimal criteria for i) discriminating between the targets and then eventually ii) for a final rank of the targets. In this study we present results from a recent camouflage assessment trial where human observers were used in a search by photo methodology to assess generic test camouflage patterns. We conducted a study to investigate possible improvements in camouflage patterns for battle dress uniforms. The aim was to do a comparative study of potential, and generic patterns intended for use in arid areas (sparsely vegetated, semi desert). We developed a test methodology that was intended to be simple, reliable and realistic with respect to the operational benefit of camouflage. Therefore we chose to conduct a human based observer trial founded on imagery of realistic targets in natural backgrounds. Inspired by a recent and similar trial in the UK, we developed new and purpose-based software to be able to conduct the observer trial. Our preferred assessment methodology - the observer trial - was based on target recordings in 12 different, but operational relevant scenes, collected in a dry and sparsely vegetated area (Rhodes). The scenes were chosen with the intention to span as broadly as possible. The targets were human-shaped mannequins and were situated identically in each of the scenes to allow for a relative comparison of camouflage effectiveness in each scene. Test of significance, among the targets' performance, was carried out by non-parametric tests as the corresponding time of detection distributions in overall were found to be difficult to parameterize. From the trial, containing 12 different scenes from

Assessment of Forecast Sensitivity to Observation and Its Application to Satellite Radiances

NASA Astrophysics Data System (ADS)

Ide, K.

2017-12-01

The Forecast sensitivity to observation provides practical and useful metric for the assessment of observation impact without conducting computationally intensive data denial experiments. Quite often complex data assimilation systems use a simplified version of the forecast sensitivity formulation based on ensembles. In this talk, we first present the comparison of forecast sensitivity for 4DVar, Hybrid-4DEnVar, and 4DEnKF with or without such simplifications using a highly nonlinear model. We then present the results of ensemble forecast sensitivity to satellite radiance observations for Hybrid-4DEnVart using NOAA's Global Forecast System.

Methods to systematically review and meta-analyse observational studies: a systematic scoping review of recommendations.

PubMed

Mueller, Monika; D'Addario, Maddalena; Egger, Matthias; Cevallos, Myriam; Dekkers, Olaf; Mugglin, Catrina; Scott, Pippa

2018-05-21

Systematic reviews and meta-analyses of observational studies are frequently performed, but no widely accepted guidance is available at present. We performed a systematic scoping review of published methodological recommendations on how to systematically review and meta-analyse observational studies. We searched online databases and websites and contacted experts in the field to locate potentially eligible articles. We included articles that provided any type of recommendation on how to conduct systematic reviews and meta-analyses of observational studies. We extracted and summarised recommendations on pre-defined key items: protocol development, research question, search strategy, study eligibility, data extraction, dealing with different study designs, risk of bias assessment, publication bias, heterogeneity, statistical analysis. We summarised recommendations by key item, identifying areas of agreement and disagreement as well as areas where recommendations were missing or scarce. The searches identified 2461 articles of which 93 were eligible. Many recommendations for reviews and meta-analyses of observational studies were transferred from guidance developed for reviews and meta-analyses of RCTs. Although there was substantial agreement in some methodological areas there was also considerable disagreement on how evidence synthesis of observational studies should be conducted. Conflicting recommendations were seen on topics such as the inclusion of different study designs in systematic reviews and meta-analyses, the use of quality scales to assess the risk of bias, and the choice of model (e.g. fixed vs. random effects) for meta-analysis. There is a need for sound methodological guidance on how to conduct systematic reviews and meta-analyses of observational studies, which critically considers areas in which there are conflicting recommendations.

SU-F-J-178: A Computer Simulation Model Observer for Task-Based Image Quality Assessment in Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dolly, S; Mutic, S; Anastasio, M

Purpose: Traditionally, image quality in radiation therapy is assessed subjectively or by utilizing physically-based metrics. Some model observers exist for task-based medical image quality assessment, but almost exclusively for diagnostic imaging tasks. As opposed to disease diagnosis, the task for image observers in radiation therapy is to utilize the available images to design and deliver a radiation dose which maximizes patient disease control while minimizing normal tissue damage. The purpose of this study was to design and implement a new computer simulation model observer to enable task-based image quality assessment in radiation therapy. Methods: A modular computer simulation framework wasmore » developed to resemble the radiotherapy observer by simulating an end-to-end radiation therapy treatment. Given images and the ground-truth organ boundaries from a numerical phantom as inputs, the framework simulates an external beam radiation therapy treatment and quantifies patient treatment outcomes using the previously defined therapeutic operating characteristic (TOC) curve. As a preliminary demonstration, TOC curves were calculated for various CT acquisition and reconstruction parameters, with the goal of assessing and optimizing simulation CT image quality for radiation therapy. Sources of randomness and bias within the system were analyzed. Results: The relationship between CT imaging dose and patient treatment outcome was objectively quantified in terms of a singular value, the area under the TOC (AUTOC) curve. The AUTOC decreases more rapidly for low-dose imaging protocols. AUTOC variation introduced by the dose optimization algorithm was approximately 0.02%, at the 95% confidence interval. Conclusion: A model observer has been developed and implemented to assess image quality based on radiation therapy treatment efficacy. It enables objective determination of appropriate imaging parameter values (e.g. imaging dose). Framework flexibility allows for

Dietary assessment in elderly people: experiences gained from studies in the Netherlands.

PubMed

de Vries, J H M; de Groot, L C P G M; van Staveren, W A

2009-02-01

In selecting a dietary assessment method, several aspects such as the aim of the study and the characteristics of the target population should be taken into account. In elderly people, diminished functionality and cognitive decline may hamper dietary assessment and require tailored approaches to assess dietary intake. The objective of this paper is to summarize our experience in dietary assessment in a number of different studies in population groups over 65 years of age in the Netherlands, and to discuss this experience in the perspective of other nutrition surveys in the elderly. In longitudinal studies, we applied a modified dietary history; in clinical nursing home studies, trained staff observed and recorded food consumption; and in a controlled trial in healthy elderly men, we used a food frequency questionnaire (FFQ). For all methods applied in the community-dwelling elderly people, validation studies showed a similar underestimation of intake of 10-15% compared with the reference value. In the care-depending elderly, the underestimation was less: 5% according to an observational method. The methods varied widely in the resources required, including burden to the participants, field staff and finances. For effective dietary assessment in older adults, the major challenge will be to distinguish between those elderly who are able to respond correctly to the less intensive methods, such as 24-h recalls or FFQ, and those who are not able to respond to these methods and require adapted techniques, for example, observational records.

Rationale, objectives, and design of the EUTrigTreat clinical study: a prospective observational study for arrhythmia risk stratification and assessment of interrelationships among repolarization markers and genotype

PubMed Central

Seegers, Joachim; Vos, Marc A.; Flevari, Panagiota; Willems, Rik; Sohns, Christian; Vollmann, Dirk; Lüthje, Lars; Kremastinos, Dimitrios T.; Floré, Vincent; Meine, Mathias; Tuinenburg, Anton; Myles, Rachel C.; Simon, Dirk; Brockmöller, Jürgen; Friede, Tim; Hasenfuß, Gerd; Lehnart, Stephan E.; Zabel, Markus

2012-01-01

Aims The EUTrigTreat clinical study has been designed as a prospective multicentre observational study and aims to (i) risk stratify patients with an implantable cardioverter defibrillator (ICD) for mortality and shock risk using multiple novel and established risk markers, (ii) explore a link between repolarization biomarkers and genetics of ion (Ca2+, Na+, K+) metabolism, (iii) compare the results of invasive and non-invasive electrophysiological (EP) testing, (iv) assess changes of non-invasive risk stratification tests over time, and (v) associate arrythmogenomic risk through 19 candidate genes. Methods and results Patients with clinical ICD indication are eligible for the trial. Upon inclusion, patients will undergo non-invasive risk stratification, including beat-to-beat variability of repolarization (BVR), T-wave alternans, T-wave morphology variables, ambient arrhythmias from Holter, heart rate variability, and heart rate turbulence. Non-invasive or invasive programmed electrical stimulation will assess inducibility of ventricular arrhythmias, with the latter including recordings of monophasic action potentials and assessment of restitution properties. Established candidate genes are screened for variants. The primary endpoint is all-cause mortality, while one of the secondary endpoints is ICD shock risk. A mean follow-up of 3.3 years is anticipated. Non-invasive testing will be repeated annually during follow-up. It has been calculated that 700 patients are required to identify risk predictors of the primary endpoint, with a possible increase to 1000 patients based on interim risk analysis. Conclusion The EUTrigTreat clinical study aims to overcome current shortcomings in sudden cardiac death risk stratification and to answer several related research questions. The initial patient recruitment is expected to be completed in July 2012, and follow-up is expected to end in September 2014. Clinicaltrials.gov identifier: NCT01209494. PMID:22117037

Inter-rater reliability of an observation-based ergonomics assessment checklist for office workers.

PubMed

Pereira, Michelle Jessica; Straker, Leon Melville; Comans, Tracy Anne; Johnston, Venerina

2016-12-01

To establish the inter-rater reliability of an observation-based ergonomics assessment checklist for computer workers. A 37-item (38-item if a laptop was part of the workstation) comprehensive observational ergonomics assessment checklist comparable to government guidelines and up to date with empirical evidence was developed. Two trained practitioners assessed full-time office workers performing their usual computer-based work and evaluated the suitability of workstations used. Practitioners assessed each participant consecutively. The order of assessors was randomised, and the second assessor was blinded to the findings of the first. Unadjusted kappa coefficients between the raters were obtained for the overall checklist and subsections that were formed from question-items relevant to specific workstation equipment. Twenty-seven office workers were recruited. The inter-rater reliability between two trained practitioners achieved moderate to good reliability for all except one checklist component. This checklist has mostly moderate to good reliability between two trained practitioners. Practitioner Summary: This reliable ergonomics assessment checklist for computer workers was designed using accessible government guidelines and supplemented with up-to-date evidence. Employers in Queensland (Australia) can fulfil legislative requirements by using this reliable checklist to identify and subsequently address potential risk factors for work-related injury to provide a safe working environment.

Assessing anger regulation in middle childhood: development and validation of a behavioral observation measure.

PubMed

Rohlf, Helena L; Krahé, Barbara

2015-01-01

An observational measure of anger regulation in middle childhood was developed that facilitated the in situ assessment of five maladaptive regulation strategies in response to an anger-eliciting task. 599 children aged 6-10 years (M = 8.12, SD = 0.92) participated in the study. Construct validity of the measure was examined through correlations with parent- and self-reports of anger regulation and anger reactivity. Criterion validity was established through links with teacher-rated aggression and social rejection measured by parent-, teacher-, and self-reports. The observational measure correlated significantly with parent- and self-reports of anger reactivity, whereas it was unrelated to parent- and self-reports of anger regulation. It also made a unique contribution to predicting aggression and social rejection.

Assessing anger regulation in middle childhood: development and validation of a behavioral observation measure

PubMed Central

Rohlf, Helena L.; Krahé, Barbara

2015-01-01

An observational measure of anger regulation in middle childhood was developed that facilitated the in situ assessment of five maladaptive regulation strategies in response to an anger-eliciting task. 599 children aged 6–10 years (M = 8.12, SD = 0.92) participated in the study. Construct validity of the measure was examined through correlations with parent- and self-reports of anger regulation and anger reactivity. Criterion validity was established through links with teacher-rated aggression and social rejection measured by parent-, teacher-, and self-reports. The observational measure correlated significantly with parent- and self-reports of anger reactivity, whereas it was unrelated to parent- and self-reports of anger regulation. It also made a unique contribution to predicting aggression and social rejection. PMID:25964767

Standards and guidelines for observational studies: quality is in the eye of the beholder.

PubMed

Morton, Sally C; Costlow, Monica R; Graff, Jennifer S; Dubois, Robert W

2016-03-01

Patient care decisions demand high-quality research. To assist those decisions, numerous observational studies are being performed. Are the standards and guidelines to assess observational studies consistent and actionable? What policy considerations should be considered to ensure decision makers can determine if an observational study is of high-quality and valid to inform treatment decisions? Based on a literature review and input from six experts, we compared and contrasted nine standards/guidelines using 23 methodological elements involved in observational studies (e.g., study protocol, data analysis, and so forth). Fourteen elements (61%) were addressed by at least seven standards/guidelines; 12 of these elements disagreed in the approach. Nine elements (39%) were addressed by six or fewer standards/guidelines. Ten elements (43%) were not actionable in at least one standard/guideline that addressed the element. The lack of observational study standard/guideline agreement may contribute to variation in study conduct; disparities in what is considered credible research; and ultimately, what evidence is adopted. A common set of agreed on standards/guidelines for conducting observational studies will benefit funders, researchers, journal editors, and decision makers. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

An Observation-based Assessment of Instrument Requirements for a Future Precipitation Process Observing System

NASA Astrophysics Data System (ADS)

Nelson, E.; L'Ecuyer, T. S.; Wood, N.; Smalley, M.; Kulie, M.; Hahn, W.

2017-12-01

Global models exhibit substantial biases in the frequency, intensity, duration, and spatial scales of precipitation systems. Much of this uncertainty stems from an inadequate representation of the processes by which water is cycled between the surface and atmosphere and, in particular, those that govern the formation and maintenance of cloud systems and their propensity to form the precipitation. Progress toward improving precipitation process models requires observing systems capable of quantifying the coupling between the ice content, vertical mass fluxes, and precipitation yield of precipitating cloud systems. Spaceborne multi-frequency, Doppler radar offers a unique opportunity to address this need but the effectiveness of such a mission is heavily dependent on its ability to actually observe the processes of interest in the widest possible range of systems. Planning for a next generation precipitation process observing system should, therefore, start with a fundamental evaluation of the trade-offs between sensitivity, resolution, sampling, cost, and the overall potential scientific yield of the mission. Here we provide an initial assessment of the scientific and economic trade-space by evaluating hypothetical spaceborne multi-frequency radars using a combination of current real-world and model-derived synthetic observations. Specifically, we alter the field of view, vertical resolution, and sensitivity of a hypothetical Ka- and W-band radar system and propagate those changes through precipitation detection and intensity retrievals. The results suggest that sampling biases introduced by reducing sensitivity disproportionately affect the light rainfall and frozen precipitation regimes that are critical for warm cloud feedbacks and ice sheet mass balance, respectively. Coarser spatial resolution observations introduce regime-dependent biases in both precipitation occurrence and intensity that depend on cloud regime, with even the sign of the bias varying within a

A post-marketing observational study to assess the safety of mibefradil in the community in England.

PubMed

Riley, J; Wilton, L V; Shakir, S A W

2002-06-01

To conduct a post-marketing observational cohort study to assess the safety of mibefradil in the community, using Prescription-Event Monitoring (PEM). Data were collected and analyzed on patients prescribed mibefradil by 1,996 General Practitioners (GPs) throughout England. Incidence densities were calculated for all reported events and selected events were followed-up by means of further questionnaires. The study was terminated early due to the voluntary withdrawal of mibefradil from the market because of potential drug interactions. A cohort of 3,085 patients was recruited, with a mean age of 64.5 years. The major indication for use was hypertension (55% of the cohort), the indication was not specified in 33% of patients. 80% of GPs expressing an opinion rated mibefradil as effective. The major reason for stopping was withdrawal from the market (2,342 patients). The commonest reported adverse events and reasons for stopping were malaise/lassitude, dizziness, edema and headache. Seven clinically serious reports of bradycardia/collapse were considered to be possible adverse drug reactions (ADRs) to mibefradil. All were in the elderly (> 65 years), 6 were considered to be a result of possible drug interactions. In total, 11 possible drug interactions occurred. Nine (8 reports of bradycardia and 1 of syncope) involved beta-blockers. Another, a report of collapse and severe bradycardia, occurred in a patient who had started a dihydropyridine calcium channel blocker within 24 hours of stopping mibefradil and the other was a report of palpitations and dyspnea in a patient on concomitant digoxin and sotalol. None of the 53 deaths occurring during the study was attributed to mibefradil. Mibefradil was only available on the UK market for 6 months before it was withdrawn from the market because of potential drug interactions. With respect to the reasons leading to its withdrawal, in this cohort of 3,085 patients, 11 possible drug interactions were detected (6 clinically

A multilevel study on the association of observer-assessed working conditions with depressive symptoms among female eldercare workers from 56 work units in 10 care homes in Denmark

PubMed Central

Jakobsen, Louise M; Jorgensen, Anette F B; Thomsen, Birthe L; Greiner, Birgit A; Rugulies, Reiner

2015-01-01

Objectives Eldercare workers in Denmark have a higher prevalence of poor psychological health than other occupational groups. We examined the association between working conditions assessed by trained observers and depressive symptoms assessed by self-report in a study of female Danish eldercare workers. Methods Working conditions were observed based on action regulation theory and defined as (1) regulation requirements, a workplace resource providing opportunity for decision-making and skill development and (2) barriers for task completion. We examined the associations of individual and work unit averaged working conditions with depressive symptoms in a sample of 95 individually observed eldercare workers. Further, we examined the association of work unit averaged working conditions with depressive symptoms in a sample of 205 care workers, including both observed and non-observed individuals. We used regression models that allowed for correlations within work units and care homes and adjusted these models for demographics, job characteristics and stressful life events. Results Higher levels of regulation requirements were associated with lower depressive symptoms at the individual level (p=0.04), but not at the workplace level. Barriers were not associated with depressive symptoms at the individual level. At the workplace level, a higher number of qualitatively different barriers (p=0.04) and a higher number of barriers for equipment use (p=0.03) were associated with lower levels of depressive symptoms in the age and cohabitation adjusted model, however statistical significance was lost in the fully adjusted model. Conclusions Low level of regulation requirements was associated with a high level of depressive symptoms. The study highlights the importance of examining both individual and workplace levels of working conditions. PMID:26560058

A Regional Climate Model Evaluation System based on contemporary Satellite and other Observations for Assessing Regional Climate Model Fidelity

NASA Astrophysics Data System (ADS)

Waliser, D. E.; Kim, J.; Mattman, C.; Goodale, C.; Hart, A.; Zimdars, P.; Lean, P.

2011-12-01

Evaluation of climate models against observations is an essential part of assessing the impact of climate variations and change on regionally important sectors and improving climate models. Regional climate models (RCMs) are of a particular concern. RCMs provide fine-scale climate needed by the assessment community via downscaling global climate model projections such as those contributing to the Coupled Model Intercomparison Project (CMIP) that form one aspect of the quantitative basis of the IPCC Assessment Reports. The lack of reliable fine-resolution observational data and formal tools and metrics has represented a challenge in evaluating RCMs. Recent satellite observations are particularly useful as they provide a wealth of information and constraints on many different processes within the climate system. Due to their large volume and the difficulties associated with accessing and using contemporary observations, however, these datasets have been generally underutilized in model evaluation studies. Recognizing this problem, NASA JPL and UCLA have developed the Regional Climate Model Evaluation System (RCMES) to help make satellite observations, in conjunction with in-situ and reanalysis datasets, more readily accessible to the regional modeling community. The system includes a central database (Regional Climate Model Evaluation Database: RCMED) to store multiple datasets in a common format and codes for calculating and plotting statistical metrics to assess model performance (Regional Climate Model Evaluation Tool: RCMET). This allows the time taken to compare model data with satellite observations to be reduced from weeks to days. RCMES is a component of the recent ExArch project, an international effort for facilitating the archive and access of massive amounts data for users using cloud-based infrastructure, in this case as applied to the study of climate and climate change. This presentation will describe RCMES and demonstrate its utility using examples

An assessment of gravity model improvements using TOPEX/Poseidon TDRSS observations

NASA Technical Reports Server (NTRS)

Putney, B. H.; Teles, J.; Eddy, W. F.; Klosko, S. M.

1992-01-01

The contribution of TOPEX/Poseidon (T/P) TDRSS data to geopotential model recovery is assessed. Simulated TDRSS one-way and Bilateration Ranging Transponder System (BRTS) observations have been generated and orbitally reduced to form normal equations for geopotential parameters. These normals have been combined with those of the latest prelaunch T/P gravity model solution using data from over 30 satellites. A study of the resulting solution error covariance shows that TDRSS can make important contributions to geopotential recovery, especially for improving T/P specific effects like those arising from orbital resonance. It is argued that future effort is desirable both to establish TDRSS orbit determination limits in a reference frame compatible with that used for the precise laser/DORIS orbits, and the reduction of these TDRSS data for geopotential recovery.

Assessing Model Fitting of Megamaser Disks with Simulated Observations

NASA Astrophysics Data System (ADS)

Han, Jiwon; Braatz, James; Pesce, Dominic

2018-01-01

The Megamaser Cosmology Project (MCP) measures the Hubble Constant by determining distances to galaxies with observations of 22 GHz H20 megamasers. The megamasers arise in the circumnuclear accretion disks of active galaxies. In this research, we aim to improve the estimation of systematic errors in MCP measurements. Currently, the MCP fits a disk model to the observed maser data with a Markov Chain Monte Carlo (MCMC) code. The disk model is described by up to 14 global parameters, including up to 6 that describe the disk warping. We first assess the model by generating synthetic datasets in which the locations and dynamics of the maser spots are exactly known, and fitting the model to these data. By doing so, we can also test the effects of unmodeled substructure on the estimated uncertainties. Furthermore, in order to gain better understanding of the physics behind accretion disk warping, we develop a physics-driven model for the warp and test it with the MCMC approach.

Role of renal function in risk assessment of target non-attainment after standard dosing of meropenem in critically ill patients: a prospective observational study.

PubMed

Ehmann, Lisa; Zoller, Michael; Minichmayr, Iris K; Scharf, Christina; Maier, Barbara; Schmitt, Maximilian V; Hartung, Niklas; Huisinga, Wilhelm; Vogeser, Michael; Frey, Lorenz; Zander, Johannes; Kloft, Charlotte

2017-10-21

Severe bacterial infections remain a major challenge in intensive care units because of their high prevalence and mortality. Adequate antibiotic exposure has been associated with clinical success in critically ill patients. The objective of this study was to investigate the target attainment of standard meropenem dosing in a heterogeneous critically ill population, to quantify the impact of the full renal function spectrum on meropenem exposure and target attainment, and ultimately to translate the findings into a tool for practical application. A prospective observational single-centre study was performed with critically ill patients with severe infections receiving standard dosing of meropenem. Serial blood samples were drawn over 4 study days to determine meropenem serum concentrations. Renal function was assessed by creatinine clearance according to the Cockcroft and Gault equation (CLCR CG ). Variability in meropenem serum concentrations was quantified at the middle and end of each monitored dosing interval. The attainment of two pharmacokinetic/pharmacodynamic targets (100%T >MIC , 50%T >4×MIC ) was evaluated for minimum inhibitory concentration (MIC) values of 2 mg/L and 8 mg/L and standard meropenem dosing (1000 mg, 30-minute infusion, every 8 h). Furthermore, we assessed the impact of CLCR CG on meropenem concentrations and target attainment and developed a tool for risk assessment of target non-attainment. Large inter- and intra-patient variability in meropenem concentrations was observed in the critically ill population (n = 48). Attainment of the target 100%T >MIC was merely 48.4% and 20.6%, given MIC values of 2 mg/L and 8 mg/L, respectively, and similar for the target 50%T >4×MIC . A hyperbolic relationship between CLCR CG (25-255 ml/minute) and meropenem serum concentrations at the end of the dosing interval (C 8h ) was derived. For infections with pathogens of MIC 2 mg/L, mild renal impairment up to augmented renal function was

Epidemiology, quality and reporting characteristics of meta-analyses of observational studies published in Chinese journals.

PubMed

Zhang, Zhe-wen; Cheng, Juan; Liu, Zhuan; Ma, Ji-chun; Li, Jin-long; Wang, Jing; Yang, Ke-hu

2015-12-07

The aim of this study was to examine the epidemiological and reporting characteristics as well as the methodological quality of meta-analyses (MAs) of observational studies published in Chinese journals. 5 Chinese databases were searched for MAs of observational studies published from January 1978 to May 2014. Data were extracted into Excel spreadsheets, and Meta-analysis of Observational Studies in Epidemiology (MOOSE) and Assessment of Multiple Systematic Reviews (AMSTAR) checklists were used to assess reporting characteristics and methodological quality, respectively. A total of 607 MAs were included. Only 52.2% of the MAs assessed the quality of the included primary studies, and the retrieval information was not comprehensive in more than half (85.8%) of the MAs. In addition, 50 (8.2%) MAs did not search any Chinese databases, while 126 (20.8%) studies did not search any English databases. Approximately 41.2% of the MAs did not describe the statistical methods in sufficient details, and most (95.5%) MAs did not report on conflicts of interest. However, compared with the before publication of the MOOSE Checklist, the quality of reporting improved significantly for 20 subitems after publication of the MOOSE Checklist, and 7 items of the included MAs demonstrated significant improvement after publication of the AMSTAR Checklist (p<0.05). Although many MAs of observational studies have been published in Chinese journals, the reporting quality is questionable. Thus, there is an urgent need to increase the use of reporting guidelines and methodological tools in China; we recommend that Chinese journals adopt the MOOSE and AMSTAR criteria. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The Remote Observing Working Group for the Asteroid Impact and Deflection Assessment (AIDA)

NASA Astrophysics Data System (ADS)

Rivkin, A. S.; Pravec, P.; Thomas, C. A.; Thirouin, A.; Snodgrass, C.; Green, S.; Licandro, J.; Sickafoose, A. A.; Erasmus, N.; Howell, E. S.; Osip, D.; Thomas-Osip, J.; Moskovitz, N.; Scheirich, P.; Oszkiewicz, D.; Richardson, D. C.; Polishook, D.; Ryan, W. H.; Busch, M. W.

2017-09-01

The Asteroid Impact and Deflection Assessment (AIDA) is a joint US-European mission concept designed to demonstrate the effectiveness of an kinetic impactor for planetary defense. Ground-based observing is a key component to AIDA and critical for its success. We present the observing campaign we have been conducting of the asteroid Didymos, the AIDA target, and plans for future work.

The Reliability of Classification Decisions for the Furtado-Gallagher Computerized Observational Movement Pattern Assessment System--FG-COMPASS

ERIC Educational Resources Information Center

Furtado, Ovande, Jr.; Gallagher, Jere D.

2012-01-01

Mastery of fundamental movement skills (FMS) is an important factor in preventing weight gain and increasing physical activity. To master FMS, performance evaluation is necessary. In this study, we investigated the reliability of a new observational assessment tool. In Phase I, 110 video clips of children performing five locomotor, and six…

Clinical assessment of scapular positioning in musicians: an intertester reliability study.

PubMed

Struyf, Filip; Nijs, Jo; De Coninck, Kris; Giunta, Marco; Mottram, Sarah; Meeusen, Romain

2009-01-01

The reliability of the measurement of the distance between the posterior border of the acromion and the wall and the reliability of the modified lateral scapular slide test have not been studied. Overall, the reliability of the clinical tools used to assess scapular positioning has not been studied in musicians. To examine the intertester reliability of scapular observation and 2 clinical tests for the assessment of scapular positioning in musicians. Intertester reliability study. University research laboratory. Thirty healthy student musicians at a single university. Two assessors performed a standardized observation protocol, the measurement of the distance between the posterior border of the acromion and the wall, and the modified lateral scapular slide test. Each assessor was blinded to the other's findings. The intertester reliability coefficients (kappa) for the observation in relaxed position, during unloaded movement, and during loaded movement were 0.41, 0.63, and 0.36, respectively. The kappa values for the observation of tilting and winging at rest were 0.48 and 0.42, respectively; during unloaded movement, the kappa values were 0.52 and 0.78, respectively; and with a 1-kg load, the kappa values were 0.24 and 0.50, respectively. The intraclass correlation coefficient (ICC) of the measurement of the acromial distance was 0.72 in relaxed position and 0.75 with the participant actively retracting both shoulders. The ICCs for the modified lateral scapular slide test varied between 0.63 and 0.58. Our results demonstrated that the modified lateral scapular slide test was not a reliable tool to assess scapular positioning in these participants. Our data indicated that scapular observation in the relaxed position and during unloaded abduction in the frontal plane was a reliable assessment tool. The reliability of the measurement of the distance between the posterior border of the acromion and the wall in healthy musicians was moderate.

Standardised Observation Analogue Procedure (SOAP) for Assessing Parent and Child Behaviours in Clinical Trials

ERIC Educational Resources Information Center

Johnson, Cynthia R.; Butter, Eric M.; Handen, Benjamin L.; Sukhodolsky, Denis G.; Mulick, James; Lecavalier, Luc; Aman, Michael G.; Arnold, Eugene L.; Scahill, Lawrence; Swiezy, Naomi; Sacco, Kelley; Stigler, Kimberly A.; McDougle, Christopher J.

2009-01-01

Background: Observational measures of parent and child behaviours have a long history in child psychiatric and psychological intervention research, including the field of autism and developmental disability. We describe the development of the Standardised Observational Analogue Procedure (SOAP) for the assessment of parent-child behaviour before…

Cost-efficient observation of working postures from video recordings--more videos, more observers or more views per observer?

PubMed

Mathiassen, Svend Erik; Liv, Per; Wahlström, Jens

2012-01-01

In ergonomics, assessing the working postures of an individual by observation is a very common practice. The present study investigated whether monetary resources devoted to an observational study should preferably be invested in collecting many video recordings of the work, or in having several observers estimate postures from available videos multiple times. On the basis of a data set of observed working postures among hairdressers, necessary information in terms of posture variability, observer variability, and costs for recording and observing videos was entered into equations providing the total cost of data collection and the precision (informative value) of the resulting estimates of two variables: percentages time with the arm elevated <15 degrees and >90 degrees. In all 160 data collection strategies, differing with respect to the number of video recordings and the number of repeated observations of each recording, were simulated and compared for cost and precision. For both posture variables, the most cost-efficient strategy for a given budget was to engage 4 observers to look at available video recordings, rather than to have one observer look at more recordings. Since the latter strategy is the more common in ergonomics practice, we recommend reconsidering standard practice in observational posture assessment.

The implementation of nice guidance on venous thromboembolism risk assessment and prophylaxis: a before-after observational study to assess the impact on patient safety across four hospitals in England

PubMed Central

2013-01-01

Background Venous thromboembolism (VTE) is a major cause of morbidity and mortality in hospitalised patients. VTE prevention has been identified as a major health need internationally to improve patient safety. A National Institute for Health and Clinical Excellence (NICE) guideline was issued in February 2010. Its key priorities were to assess patients for risk of VTE on admission to hospital, assess patients for bleeding risk and evaluate the risks and benefits of prescribing VTE prophylaxis. The aim of this study was to evaluate the implementation of NICE guidance and its impact on patient safety. Methods A before-after observational design was used to investigate changes in VTE risk assessment documentation and inappropriate prescribing of prophylaxis between the year prior to (2009) and the year following (2010) the implementation of NICE guidance, using data from a 3-week period during each year. A total of 408 patients were sampled in each year across four hospitals in the NHS South region. Results Implementation strategies such as audit, education and training were used. The percentage of patients for whom a VTE risk assessment was documented increased from 51.5% (210/408) in 2009 to 79.2% (323/408) in 2010; difference 27.7% (95% CI: 21.4% to 33.9%; p < 0.001). There was little evidence of change in the percentage who were prescribed prophylaxis amongst patients without a risk assessment (71.7% (142/198) in 2009 and 68.2% (58/85) in 2010; difference −3.5% (95% CI: -15.2% to 8.2%; p =0.56) nor the percentage who were prescribed low molecular weight heparin amongst patients with a contraindication (14% (4/28) in 2009 and 15% (6/41) in 2010; RD = 0.3% (95% CI: -16.5% to 17.2%; p =0.97). Conclusions The documentation of risk assessment improved following the implementation of NICE guidance; it is questionable, however, whether this led to improved patient safety with respect to prescribing appropriate prophylaxis. PMID:23734903

Homeopathy in chronic sinusitis: a prospective multi-centric observational study.

PubMed

Nayak, Chaturbhuja; Singh, Vikram; Singh, V P; Oberai, Praveen; Roja, Varanasi; Shitanshu, Shashi Shekhar; Sinha, M N; Deewan, Deepti; Lakhera, B C; Ramteke, Sunil; Kaushik, Subhash; Sarkar, Sarabjit; Mandal, N R; Mohanan, P G; Singh, J R; Biswas, Sabyasachi; Mathew, Georgekutty

2012-04-01

The primary objective was to ascertain the therapeutic usefulness of homeopathic medicine in the management of chronic sinusitis (CS). Multicentre observational study at Institutes and Units of the Central Council for Research in Homoeopathy, India. Symptoms were assessed using the chronic sinusitis assessment score (CSAS). 17 pre-defined homeopathic medicines were shortlisted for prescription on the basis of repertorisation for the pathological symptoms of CS. Regimes and adjustment of regimes in the event of a change of symptoms were pre-defined. The follow-up period was for 6 months. Statistical analysis was done using SPSS version 16. 628 patients suffering from CS confirmed on X-ray were enrolled from eight Institutes and Units of the Central Council for Research in Homoeopathy. All 550 patients with at least one follow-up assessment were analyzed. There was a statistically significant reduction in CSAS (P = 0.0001, Friedman test) after 3 and 6 months of treatment. Radiological appearances also improved. A total of 13 out of 17 pre-defined medicines were prescribed in 550 patients, Sil. (55.2% of 210), Calc. (62.5% of 98), Lyc. (69% of 55), Phos. (66.7% of 45) and Kali iod. (65% of 40) were found to be most useful having marked improvement. 4/17 medicines were never prescribed. No complications were observed during treatment. Homeopathic treatment may be effective for CS patients. Controlled trials are required for further validation. Copyright © 2012 Elsevier Ltd. All rights reserved.

Development and Initial Testing of a Structured Clinical Observation Tool to Assess Pharmacotherapy Competence

ERIC Educational Resources Information Center

Young, John Q.; Lieu, Sandra; O'Sullivan, Patricia; Tong, Lowell

2011-01-01

Objective: The authors developed and tested the feasibility and utility of a new direct-observation instrument to assess trainee performance of a medication management session. Methods: The Psychopharmacotherapy-Structured Clinical Observation (P-SCO) instrument was developed based on multiple sources of expertise and then implemented in 4…

Assessing the Student-Instructional Setting Interface Using an Eco-Behavioral Observation System.

ERIC Educational Resources Information Center

Hendrickson, Jo M.

1992-01-01

An eco-behavioral observation system was developed for use with students with behavior disorders or emotional disturbances. Discussed are the ecosystem definition, the student-instructional setting interface, and the assessment procedure, including evaluation of the quality of academic responding, program evaluation, staff development, and…

Ways of learning: Observational studies versus experiments

USGS Publications Warehouse

Shaffer, T.L.; Johnson, D.H.

2008-01-01

Manipulative experimentation that features random assignment of treatments, replication, and controls is an effective way to determine causal relationships. Wildlife ecologists, however, often must take a more passive approach to investigating causality. Their observational studies lack one or more of the 3 cornerstones of experimentation: controls, randomization, and replication. Although an observational study can be analyzed similarly to an experiment, one is less certain that the presumed treatment actually caused the observed response. Because the investigator does not actively manipulate the system, the chance that something other than the treatment caused the observed results is increased. We reviewed observational studies and contrasted them with experiments and, to a lesser extent, sample surveys. We identified features that distinguish each method of learning and illustrate or discuss some complications that may arise when analyzing results of observational studies. Findings from observational studies are prone to bias. Investigators can reduce the chance of reaching erroneous conclusions by formulating a priori hypotheses that can be pursued multiple ways and by evaluating the sensitivity of study conclusions to biases of various magnitudes. In the end, however, professional judgment that considers all available evidence is necessary to render a decision regarding causality based on observational studies.

Assessing the hydrological impacts of Tropical Cyclones on the Carolinas: An observational and modeling based investigation

NASA Astrophysics Data System (ADS)

Leeper, R. D.; Prat, O. P.; Blanton, B. O.

2012-12-01

During the warm season, the Carolinas are particularly prone to tropical cyclone (TC) activity and can be impacted in many different ways depending on storm track. The coasts of the Carolinas are the most vulnerable areas, but particular situations (Frances and Ivan 2004) affected communities far from the coasts (Prat and Nelson 2012). Regardless of where landfall occurs, TCs are often associated with intense precipitation and strong winds triggering a variety of natural hazards (storm surge, flooding, landslides). The assessment of societal and environmental impacts of TCs requires a suite of observations. The scarcity of station coverage, sensor limitations, and rainfall retrieval uncertainties are issues limiting the ability to assess accurately the impact of extreme precipitation events. Therefore, numerical models, such as the Weather Research and Forecasting model (WRF), can be valuable tools to investigate those impacts at regional and local scales and bridge the gap between observations. The goal of this study is to investigate the impact of TCs across the Carolinas using both observational and modeling technologies, and explore the usefulness of numerical methods in data-scarce regions. To fully assess TC impacts on the Carolinas inhabitants, storms impacting both coastal and inner communities will be selected and high-resolution WRF ensemble simulations generated from a suite of physic schemes for each TC to investigate their impact at finer scales. The ensemble member performance will be evaluated with respect to ground-based and satellite observations. Furthermore, results from the high-resolution WRF simulations, including the average wind-speed and the sea level pressure, will be used with the ADCIRC storm-surge and wave-model (Westerink et al, 2008) to simulate storm surge and waves along the Carolinas coast for TCs travelling along the coast or making landfall. This work aims to provide an assessment of the various types of impacts TCs can have

Patients with prior vertebral or hip fractures treated with teriparatide in the Direct Assessment of Nonvertebral Fractures in Community Experience (DANCE) observational study.

PubMed

Beall, D P; Feldman, R G; Gordon, M L; Gruber, B L; Lane, J M; Valenzuela, G; Yim, D; Alam, J; Krege, J H; Krohn, K

2016-03-01

In patients in the Direct Assessment of Nonvertebral Fractures in Community Experience (DANCE) observational study with and without a prior vertebral or hip fracture, the incidence of nonvertebral fractures was lower with >6 months of teriparatide treatment than during the first 6 months. Clinical evidence on the effect of teriparatide in patients with prior fracture is limited. In the DANCE observational study, the incidence of nonvertebral fragility fractures (NVFX) decreased significantly in patients receiving teriparatide for >6 months (6-24 months) versus >0 to ≤6 months (reference period). We performed a post hoc analysis to assess the effect of teriparatide 20 μg/day in patients who entered DANCE with prior vertebral or hip fractures. The incidence of patients experiencing a NVFX for four 6-month intervals during and after treatment was compared with the reference period. Overall, 4085 patients received ≥1 dose of teriparatide. Of 3720 with sufficient data for efficacy analysis, 692 had prior vertebral fracture, including 179 with previous kyphoplasty/vertebroplasty; 290 had prior hip fracture. These patients were older, and those with prior vertebral fractures had more comorbid conditions at baseline than those without prior vertebral fractures. The incidence of patients experiencing NVFX declined over time in all patient groups. The fracture incidence rate declined 49 and 46%, respectively, in patients with and without prior vertebral fracture and was 63 and 46% lower in patients with previous kyphoplasty/vertebroplasty and without prior vertebral fracture. NVFX declined 43 and 48% in patients with and without prior hip fracture. The reduced incidence over time was consistent in the subgroups (all interaction p values >0.05). Patients with prior fracture were more likely to experience serious adverse events. The incidence of NVFX decreased over time in patients receiving teriparatide in DANCE regardless of prior fracture status.

A multilevel study on the association of observer-assessed working conditions with depressive symptoms among female eldercare workers from 56 work units in 10 care homes in Denmark.

PubMed

Jakobsen, Louise M; Jorgensen, Anette F B; Thomsen, Birthe L; Greiner, Birgit A; Rugulies, Reiner

2015-11-11

Eldercare workers in Denmark have a higher prevalence of poor psychological health than other occupational groups. We examined the association between working conditions assessed by trained observers and depressive symptoms assessed by self-report in a study of female Danish eldercare workers. Working conditions were observed based on action regulation theory and defined as (1) regulation requirements, a workplace resource providing opportunity for decision-making and skill development and (2) barriers for task completion. We examined the associations of individual and work unit averaged working conditions with depressive symptoms in a sample of 95 individually observed eldercare workers. Further, we examined the association of work unit averaged working conditions with depressive symptoms in a sample of 205 care workers, including both observed and non-observed individuals. We used regression models that allowed for correlations within work units and care homes and adjusted these models for demographics, job characteristics and stressful life events. Higher levels of regulation requirements were associated with lower depressive symptoms at the individual level (p=0.04), but not at the workplace level. Barriers were not associated with depressive symptoms at the individual level. At the workplace level, a higher number of qualitatively different barriers (p=0.04) and a higher number of barriers for equipment use (p=0.03) were associated with lower levels of depressive symptoms in the age and cohabitation adjusted model, however statistical significance was lost in the fully adjusted model. Low level of regulation requirements was associated with a high level of depressive symptoms. The study highlights the importance of examining both individual and workplace levels of working conditions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Earth Observations and the Role of UAVs: A Capabilities Assessment

NASA Technical Reports Server (NTRS)

Cox, Timothy H.

2006-01-01

This three-volume document, based on the draft document located on the website given on page 6, presents the findings of a NASA-led capabilities assessment of Uninhabited Aerial Vehicles (UAVs) for civil (defined as non-DoD) use in Earth observations. Volume 1 is the report that presents the overall assessment and summarizes the data. The second volume contains the appendices and references to address the technologies and capabilities required for viable UAV missions. The third volume is the living portion of this effort and contains the outputs from each of the Technology Working Groups (TWGs) along with the reviews conducted by the Universities Space Research Association (USRA). The focus of this report, intended to complement the Office of the Secretary of Defense UAV Roadmap, is four-fold: 1) To determine and document desired future Earth observation missions for all UAVs based on user-defined needs; 2) To determine and document the technologies necessary to support those missions; 3) To discuss the present state of the art platform capabilities and required technologies, including identifying those in progress, those planned, and those for which no current plans exist; 4) Provide the foundations for development of a comprehensive civil UAV roadmap. It is expected that the content of this report will be updated periodically and used to assess the feasibility of future missions. In addition, this report will provide the foundation to help influence funding decisions to develop those technologies that are considered enabling or necessary but are not contained within approved funding plans. This document is written such that each section will be supported by an Appendix that will give the reader a more detailed discussion of that section's topical materials.

Multiple Integrated Examinations: An Observational Study of Different Academic Curricula Based on a Business Administration Assessment

ERIC Educational Resources Information Center

Ardolino, Piermatteo; Noventa, Stefano; Formicuzzi, Maddalena; Cubico, Serena; Favretto, Giuseppe

2016-01-01

An observational study has been carried out to analyse differences in performance between students of different undergraduate curricula in the same written business administration examination, focusing particularly on possible effects of "integrated" or "multi-modular" examinations, a recently widespread format in Italian…

Strengthening the Reporting of Observational Studies in Epidemiology—Nutritional Epidemiology (STROBE-nut): An Extension of the STROBE Statement

PubMed Central

Hawwash, Dana; Ocké, Marga C.; Berg, Christina; Forsum, Elisabet; Sonestedt, Emily; Wirfält, Elisabet; Åkesson, Agneta; Kolsteren, Patrick; Byrnes, Graham; De Keyzer, Willem; Van Camp, John; Slimani, Nadia; Cevallos, Myriam; Egger, Matthias; Huybrechts, Inge

2016-01-01

Background Concerns have been raised about the quality of reporting in nutritional epidemiology. Research reporting guidelines such as the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement can improve quality of reporting in observational studies. Herein, we propose recommendations for reporting nutritional epidemiology and dietary assessment research by extending the STROBE statement into Strengthening the Reporting of Observational Studies in Epidemiology—Nutritional Epidemiology (STROBE-nut). Methods and Findings Recommendations for the reporting of nutritional epidemiology and dietary assessment research were developed following a systematic and consultative process, coordinated by a multidisciplinary group of 21 experts. Consensus on reporting guidelines was reached through a three-round Delphi consultation process with 53 external experts. In total, 24 recommendations for nutritional epidemiology were added to the STROBE checklist. Conclusion When used appropriately, reporting guidelines for nutritional epidemiology can contribute to improve reporting of observational studies with a focus on diet and health. PMID:27270749

Terminal illness and the increased mortality risk of conventional antipsychotics in observational studies: a systematic review.

PubMed

Luijendijk, Hendrika J; de Bruin, Niels C; Hulshof, Tessa A; Koolman, Xander

2016-02-01

Numerous large observational studies have shown an increased risk of mortality in elderly users of conventional antipsychotics. Health authorities have warned against use of these drugs. However, terminal illness is a potentially strong confounder of the observational findings. So, the objective of this study was to systematically assess whether terminal illness may have biased the observational association between conventional antipsychotics and risk of mortality in elderly patients. Studies were searched in PubMed, CINAHL, Embase, the references of selected studies and articles referring to selected studies (Web of Science). Inclusion criteria were (i) observational studies that estimated (ii) the risk of all-cause mortality in (iii) new elderly users of (iv) conventional antipsychotics compared with atypical antipsychotics or no use. Two investigators assessed the characteristics of the exposure and reference groups, main results, measured confounders and methods used to adjust for unmeasured confounders. We identified 21 studies. All studies were based on administrative medical and pharmaceutical databases. Sicker and older patients received conventional antipsychotics more often than new antipsychotics. The risk of dying was especially high in the first month of use, and when haloperidol was administered per injection or in high doses. Terminal illness was not measured in any study. Instrumental variables that were used were also confounded by terminal illness. We conclude that terminal illness has not been adjusted for in observational studies that reported an increased risk of mortality risk in elderly users of conventional antipsychotics. As the validity of the evidence is questionable, so is the warning based on it. Copyright © 2015 John Wiley & Sons, Ltd.

Observation and assessment of faculty development learning outcomes.

PubMed

Behar-Horenstein, Linda S; Childs, Gail Schneider; Graff, Randy A

2010-11-01

Prior research has found that participation in course offerings provides a means of professional development and results in changes to faculty beliefs and instructional practices. However, as with most professional development initiatives in education, little is known about the sustainability of these training efforts. The research question that guided this study was the following: Do professional development efforts in teaching result in observed learning outcomes among faculty members? In this study, teaching observations served as the primary data source. Twelve faculty members (six in the College of Dentistry and six in the College of Health and Human Performance) who completed two six-week teaching seminars in fall 2006 and spring 2007 or spring 2008 and summer 2008 were asked to participate in a classroom observation and an interview lasting no longer than forty-five minutes. Six dental faculty members and three faculty members from the College of Health and Human Performance agreed to participate in the study. Three standardized reviewers conducted these classroom observations during fall 2008, spring 2009, and summer 2009. An active teaching rubric was used to evaluate the class transcripts. The findings revealed that participants somewhat frequently to frequently used questions that were open-ended or checked for comprehension. Seven of nine instructors made extensive efforts to engage the students interactively throughout the teaching session. Six of the participants infused the description of actual or hypothetical cases to illustrate the connections between teaching and patient care, while six utilized reflective practices. Findings from the interviews corroborated the observations. Overall, the findings showed that participants demonstrated the integration of those strategies that were taught during the seminars, which were consistent with teaching critical thinking skills and showed that the learning acquired during professional development

Assessing physical activity during youth sport: the Observational System for Recording Activity in Children: Youth Sports.

PubMed

Cohen, Alysia; McDonald, Samantha; McIver, Kerry; Pate, Russell; Trost, Stewart

2014-05-01

The purpose of this study was to evaluate the validity and interrater reliability of the Observational System for Recording Activity in Children: Youth Sports (OSRAC:YS). Children (N = 29) participating in a parks and recreation soccer program were observed during regularly scheduled practices. Physical activity (PA) intensity and contextual factors were recorded by momentary time-sampling procedures (10-second observe, 20-second record). Two observers simultaneously observed and recorded children's PA intensity, practice context, social context, coach behavior, and coach proximity. Interrater reliability was based on agreement (Kappa) between the observer's coding for each category, and the Intraclass Correlation Coefficient (ICC) for percent of time spent in MVPA. Validity was assessed by calculating the correlation between OSRAC:YS estimated and objectively measured MVPA. Kappa statistics for each category demonstrated substantial to almost perfect interobserver agreement (Kappa = 0.67-0.93). The ICC for percent time in MVPA was 0.76 (95% C.I. = 0.49-0.90). A significant correlation (r = .73) was observed for MVPA recorded by observation and MVPA measured via accelerometry. The results indicate the OSRAC:YS is a reliable and valid tool for measuring children's PA and contextual factors during a youth soccer practice.

The potential of pigeons as surrogate observers in medical image perception studies

NASA Astrophysics Data System (ADS)

Krupinski, Elizabeth A.; Levenson, Richard M.; Navarro, Victor; Wasserman, Edward A.

2016-03-01

Assessment of medical image quality and how changes in image appearance impact performance are critical but assessment can be expensive and time-consuming. Could an animal (pigeon) observer with well-known visual skills and documented ability to distinguish complex visual stimuli serve as a surrogate for the human observer? Using sets of whole slide pathology (WSI) and mammographic images we trained pigeons (cohorts of 4) to detect and/or classify lesions in medical images. Standard training methods were used. A chamber equipped with a 15' display with a resistive touchscreen was used to display the images and record responses (pecks). Pigeon pellets were dispensed for correct responses. The pigeons readily learned to distinguish benign from malignant breast cancer histopathology in WSI (mean % correct responses rose 50% to 85% over 15 days) and generalized readily from 4X to 10X and 20X magnifications; to detect microcalcifications (mean % correct responses rose 50% to over 85% over 25 days); to distinguish benign from malignant breast masses (3 of 4 birds learned this task to around 80% and 60% over 10 days); and ignore compression artifacts in WSI (performance with uncompressed slides averaged 95% correct; 15:1 and 27:1 compression slides averaged 92% and 90% correct). Pigeons models may help us better understand medical image perception and may be useful in quality assessment by serving as surrogate observers for certain types of studies.

Observational studies: a valuable source for data on the true value of RA therapies.

PubMed

van Vollenhoven, Ronald F; Severens, Johan L

2011-03-01

The validity of observational studies is sometimes questioned because of the limitations of non-randomly assigned controls, various biases such as channeling bias, confounding by indication, and other pitfalls. Yet, (post-marketing) observational data can provide important information regarding not only drug safety but also the effectiveness and appropriate use of agents in the real world, outside of clinical trials. Observational studies also provide data regarding the wider value of these agents in terms of, for example, reducing the need for surgical procedures, reducing absenteeism and increasing productivity. Importantly, data from some observational registry studies have subsequently been confirmed by clinical trials, supporting the overall validity of the registry-based approach. Observational studies also allow measures such as health assessment questionnaire scores, disease activity scores, and glucocorticoid use over time to be monitored for longer periods. Furthermore, observational data in real, less strictly selected patients without the constraints of formal study populations may produce findings not observed in clinical trials but that warrant further investigation in a controlled trial environment. For example, recent data from the Stockholm tumor necrosis factor follow-up registry in Sweden showed increases in the time people worked after initiation of biologics that, surprisingly, continued into the fourth and fifth years of treatment--a finding not observed with standardized outcomes. Observational studies are truly an underappreciated and valuable source of data on the real value of anti-rheumatic therapies, and these data are essential for making sound decisions regarding coverage and reimbursement.

Do health economic evaluations using observational data provide reliable assessment of treatment effects?

PubMed Central

2013-01-01

Economic evaluation in modern health care systems is seen as a transparent scientific framework that can be used to advance progress towards improvements in population health at the best possible value. Despite the perceived superiority that trial-based studies have in terms of internal validity, economic evaluations often employ observational data. In this review, the interface between econometrics and economic evaluation is explored, with emphasis placed on highlighting methodological issues relating to the evaluation of cost-effectiveness within a bivariate framework. Studies that satisfied the eligibility criteria exemplified the use of matching, regression analysis, propensity scores, instrumental variables, as well as difference-in-differences approaches. All studies were reviewed and critically appraised using a structured template. The findings suggest that although state-of-the-art econometric methods have the potential to provide evidence on the causal effects of clinical and policy interventions, their application in economic evaluation is subject to a number of limitations. These range from no credible assessment of key assumptions and scarce evidence regarding the relative performance of different methods, to lack of reporting of important study elements, such as a summary outcome measure and its associated sampling uncertainty. Further research is required to better understand the ways in which observational data should be analysed in the context of the economic evaluation framework. PMID:24229445

Infants' social withdrawal symptoms assessed with a direct infant observation method in primary health care.

PubMed

Puura, Kaija; Mäntymaa, Mirjami; Luoma, Ilona; Kaukonen, Pälvi; Guedeney, Antoine; Salmelin, Raili; Tamminen, Tuula

2010-12-01

Distressed infants may withdraw from social interaction, but recognising infants' social withdrawal is difficult. The aims of the study were to see whether an infant observation method can be reliably used by front line workers, and to examine the prevalence of infants' social withdrawal symptoms. A random sample of 363 families with four, eight or 18-month-old infants participated in the study. The infants were examined by general practitioners (GPs) in well-baby clinics with the Alarm Distress BaBy Scale (ADBB), an observation method developed for clinical settings. A score of five or more on the ADBB Scale in two subsequent assessments at a two-week interval was regarded as a sign of clinically significant infant social withdrawal. Kappas were calculated for the GPs' correct rating of withdrawn/not withdrawn against a set of videotapes rated by developer of the method, Professor Guedeney and his research group. The kappas for their ratings ranged from 0.5 to 1. The frequency of infants scoring above the cut off in two subsequent assessments was 3%. The ADBB Scale is a promising method for detecting infant social withdrawal in front line services. Three percents of infants were showing sustained social withdrawal as a sign of distress in this normal population sample. Copyright © 2010 Elsevier Inc. All rights reserved.

Assessing the Use of Mobile Health Technology by Patients: An Observational Study in Primary Care Clinics.

PubMed

Ramirez, Veronica; Johnson, Emily; Gonzalez, Cesar; Ramirez, Vanessa; Rubino, Barbara; Rossetti, Gina

2016-04-19

There is significant potential for mobile health technology to improve health outcomes for patients with chronic diseases. However, there is a need for further development of mobile health technology that would help to improve the health of lower-income communities. The study objective was to assess mobile phone and app usage among a culturally diverse patient population, and to determine whether patients would be interested in using mobile health technology to help manage their chronic diseases. An observational study was conducted with patients of the Internal Medicine resident primary care clinics of Los Angeles County and University of Southern California (LAC+USC) Medical Center. Self-reported information regarding demographics, current mobile phone usage, current mobile health app and social media usage, barriers to using mobile phones or mobile health apps, and interest in using a mobile health app was collected. Ninety-one percent of patients owned a mobile phone, with 76% (169/223) of these reporting having a mobile phone with Internet capability. Fifty-seven percent of subjects used mobile apps on their mobile phones, and 32% (41/130) of these used mobile apps related to their health. Eighty-six percent (207/241) of respondents voiced interest in using a mobile app to improve their health, and 40% (88/221) stated they would use such an app daily. Patients stated they would find the mobile health app most useful for nutrition, exercise, and obtaining general information on medical conditions. Despite the fact that the majority of our primary care patients were of lower socioeconomic status, they utilized mobile phones with Internet and mobile app capabilities to a great extent. There was substantial interest among our patients in using mobile health technology to both manage chronic disease and improve overall health. Given that cultural, educational, and socioeconomic disparities strongly correlate with higher rates of chronic diseases such as obesity

Assessing the Use of Mobile Health Technology by Patients: An Observational Study in Primary Care Clinics

PubMed Central

Johnson, Emily; Gonzalez, Cesar; Ramirez, Vanessa; Rubino, Barbara; Rossetti, Gina

2016-01-01

Background There is significant potential for mobile health technology to improve health outcomes for patients with chronic diseases. However, there is a need for further development of mobile health technology that would help to improve the health of lower-income communities. Objective The study objective was to assess mobile phone and app usage among a culturally diverse patient population, and to determine whether patients would be interested in using mobile health technology to help manage their chronic diseases. Methods An observational study was conducted with patients of the Internal Medicine resident primary care clinics of Los Angeles County and University of Southern California (LAC+USC) Medical Center. Self-reported information regarding demographics, current mobile phone usage, current mobile health app and social media usage, barriers to using mobile phones or mobile health apps, and interest in using a mobile health app was collected. Results Ninety-one percent of patients owned a mobile phone, with 76% (169/223) of these reporting having a mobile phone with Internet capability. Fifty-seven percent of subjects used mobile apps on their mobile phones, and 32% (41/130) of these used mobile apps related to their health. Eighty-six percent (207/241) of respondents voiced interest in using a mobile app to improve their health, and 40% (88/221) stated they would use such an app daily. Patients stated they would find the mobile health app most useful for nutrition, exercise, and obtaining general information on medical conditions. Conclusions Despite the fact that the majority of our primary care patients were of lower socioeconomic status, they utilized mobile phones with Internet and mobile app capabilities to a great extent. There was substantial interest among our patients in using mobile health technology to both manage chronic disease and improve overall health. Given that cultural, educational, and socioeconomic disparities strongly correlate with

Using machine learning to assess covariate balance in matching studies.

PubMed

Linden, Ariel; Yarnold, Paul R

2016-12-01

In order to assess the effectiveness of matching approaches in observational studies, investigators typically present summary statistics for each observed pre-intervention covariate, with the objective of showing that matching reduces the difference in means (or proportions) between groups to as close to zero as possible. In this paper, we introduce a new approach to distinguish between study groups based on their distributions of the covariates using a machine-learning algorithm called optimal discriminant analysis (ODA). Assessing covariate balance using ODA as compared with the conventional method has several key advantages: the ability to ascertain how individuals self-select based on optimal (maximum-accuracy) cut-points on the covariates; the application to any variable metric and number of groups; its insensitivity to skewed data or outliers; and the use of accuracy measures that can be widely applied to all analyses. Moreover, ODA accepts analytic weights, thereby extending the assessment of covariate balance to any study design where weights are used for covariate adjustment. By comparing the two approaches using empirical data, we are able to demonstrate that using measures of classification accuracy as balance diagnostics produces highly consistent results to those obtained via the conventional approach (in our matched-pairs example, ODA revealed a weak statistically significant relationship not detected by the conventional approach). Thus, investigators should consider ODA as a robust complement, or perhaps alternative, to the conventional approach for assessing covariate balance in matching studies. © 2016 John Wiley & Sons, Ltd.

Biodex Fall Risk Assessment in the Elderly With Ataxia: A New Age-Dependent Derived Index in Rehabilitation: An Observational Study.

PubMed

Prometti, Paola; Olivares, Adriana; Gaia, Giuseppina; Bonometti, Giampietro; Comini, Laura; Scalvini, Simonetta

2016-03-01

The aim of this study was to evaluate if the Biodex Fall Risk Assessment could provide an age-adjusted index useful for classifying patients at "risk of fall."This was a cohort study conducted on 61 chronic patients, in stable conditions, having a history of ataxia, difficulty in walking or loss of balance, and aged >64 years. These patients were coming from home to our Institute undergoing a period of in-hospital standard rehabilitation. Assessment of clinical parameters was performed at entry. Functional scales (Functional Independence Measure [FIM] for motor and cognitive function, Barthel G, Tinetti POMA), and the Biodex Fall Risk Index (FRI) were performed at entry and discharge. The Normalized FRI, obtained adjusting FRI to the reported maximum predictive FRI for the relevant age, identified 2 types of patients: those with a greater risk of fall than expected for that age, labeled Case 1 (Normalized FRI>1); and those with an equal or even lesser risk of fall than expected for that age, labeled Case 0 (Normalized FRI≤1).FRI, Normalized FRI as well as independent variables as age, sex, pathology group, FIM, BarthelG, were considered in a multiple regression analysis to predict the functional improvement (i.e., delta Tinetti Total score) after rehabilitation.Normalized FRI is useful in assessing patients at risk of falls both before and after rehabilitation. At admission, the Normalized FRI evidenced high fall risk in 46% of patients (Case 1) which decreased to 12% after rehabilitation, being greater than age-predicted in 7 patients (Case 1-1) despite the functional improvement observed after the rehabilitation treatment. Normalized FRI evidenced Case 1-1 patients as neurological, "very old" (86% in age-group 75-84 years), and with serious events at 18 to 24 months' follow-up. Normalized FRI, but not FRI, at admission was a predictor of improvement in Tinetti Total scores.The normalized FRI effectively indicated patients at higher risk of fall, in whom health

Assessing the Relationship Between Observed Teaching Practice and Reading Growth in First Grade English Learners: A Validation Study

ERIC Educational Resources Information Center

Baker, Scott K.; Gersten, Russell; Haager, Diane; Dingle, Mary; Goldenberg, Claude

2005-01-01

Validation of a classroom observation measure for use with English Learners (ELs) in Grade 1 is the focus of this study. Fourteen teachers were observed during reading and language arts instruction with an instrument used to generate overall ratings of instructional quality on a number of dimensions. In these classrooms, the reading performance of…

Results of Observational Studies: Analysis of Findings from the Nurses’ Health Study

PubMed Central

Tai, Vicky; Grey, Andrew; Bolland, Mark J.

2014-01-01

Background The role of observational studies in informing clinical practice is debated, and high profile examples of discrepancies between the results of observational studies and randomised controlled trials (RCTs) have intensified that debate. We systematically reviewed findings from the Nurses’ Health Study (NHS), one of the longest and largest observational studies, to assess the number and strength of the associations reported and to determine if they have been confirmed in RCTs. Methods We reviewed NHS publication abstracts from 1978–2012, extracted information on associations tested, and graded the strength of the reported effect sizes. We searched PubMed for RCTs or systematic reviews for 3 health outcomes commonly reported in NHS publications: breast cancer, ischaemic heart disease (IHD) and osteoporosis. NHS results were compared with RCT results and deemed concordant when the difference in effect sizes between studies was ≤0.15. Findings 2007 associations between health outcomes and independent variables were reported in 1053 abstracts. 58.0% (1165/2007) were statistically significant, and 22.2% (445/2007) were neutral (no association). Among the statistically significant results that reported a numeric odds ratio (OR) or relative risk (RR), 70.5% (706/1002) reported a weak association (OR/RR 0.5–2.0), 24.5% (246/1002) a moderate association (OR/RR 0.25–0.5 or 2.0–4.0) and 5.0% (50/1002) a strong association (OR/RR ≤0.25 or ≥4.0). 19 associations reported in NHS publications for breast cancer, IHD and osteoporosis have been tested in RCTs, and the concordance between NHS and RCT results was low (≤25%). Conclusions NHS publications contain a large number of analyses, the majority of which reported statistically significant but weak associations. Few of these associations have been tested in RCTs, and where they have, the agreement between NHS results and RCTs is poor. PMID:25330007

Inter and intra-observer reliability in assessment of the position of the lateral sesamoid in determining the severity of hallux valgus.

PubMed

Panchani, Sunil; Reading, Jonathan; Mehta, Jaysheel

2016-06-01

The position of the lateral sesamoid on standard dorso-plantar weight bearing radiographs, with respect to the lateral cortex of the first metatarsal, has been shown to correlate well with the degree of the hallux valgus angle. This study aimed to assess the inter- and intra-observer error of this new classification system. Five orthopaedic consultants and five trainee orthopaedic surgeons were recruited to assess and document the degree of displacement of the lateral sesamoid on 144 weight-bearing dorso-plantar radiographs on two separate occasions. The severity of hallux valgus was defined as normal (0%), mild (≤50%), moderate (51-≤99%) or severe (≥100%) depending on the percentage displacement of the lateral sesamoid body from the lateral cortical border of the first metatarsal. Consultant intra-observer variability showed good agreement between repeated assessment of the radiographs (mean Kappa=0.75). Intra-observer variability for trainee orthopaedic surgeons also showed good agreement with a mean Kappa=0.73. Intraclass correlations for consultants and trainee surgeons was also high. The new classification system of assessing the severity of hallux valgus shows high inter- and intra-observer variability with good agreement and reproducibility between surgeons of consultant and trainee grades. Copyright © 2015 Elsevier Ltd. All rights reserved.

An observational clinical study of the efficacy and tolerability of donepezil in the treatment of Alzheimer's disease.

PubMed

Hager, Klaus; Calabrese, Pasquale; Frölich, Lutz; Göbel, Claus; Berger, Frank M

2003-01-01

An open-label, observational Post-Marketing Surveillance (PMS) study was undertaken in Germany to examine the efficacy and tolerability of donepezil in routine clinical practice. Alzheimer's disease (AD) patients were treated with donepezil (5 or 10 mg once daily) and observed for a period of approximately 3 months. Study assessments included the Mini-Mental State Examination (MMSE), the Nurses' Observation Scale for Geriatric Patients (NOSGER), and adverse events (AEs). A total of 2,092 patients (mean age 73.0 years; mean +/- SD MMSE score 17.8 +/- 5.8) were included in the efficacy assessments. MMSE and NOSGER scores showed statistically significant improvements in the total patient population and in the subpopulations with severe AD or AD with concomitant Parkinsonian symptoms (ADPS cohort). AEs were reported in a total of 12% of patients and were mostly due to peripheral cholinergic effects. In this observational PMS study, donepezil was shown to be an effective and well-tolerated therapy in the overall patient population, in patients with severe AD, and in the ADPS cohort. Copyright 2003 S. Karger AG, Basel

An Observing System Simulation Experiment Approach to Meteorological Network Assessment

NASA Astrophysics Data System (ADS)

Abbasnezhadi, K.; Rasmussen, P. F.; Stadnyk, T.; Boluwade, A.

2016-12-01

A proper knowledge of the spatiotemporal distribution of rainfall is important in order to conduct a mindful investigation of water movement and storage throughout a catchment. Currently, the most accurate precipitation information available for the remote Boreal ecozones of northern Manitoba is coming from the Canadian Precipitation Analysis (CaPA) data assimilation system. Throughout the Churchill River Basin (CRB), CaPA still does not have the proper skill due to the limited number of weather stations. A new approach to experimental network design was investigated based on the concept of Observing System Simulation Experiment (OSSE). The OSSE-based network assessment procedure which simulates the CaPA system provides a scientific and hydrologically significant tool to assess the sensitivity of CaPA precipitation analysis to observation network density throughout the CRB. To simulate CaPA system, synthetic background and station data were simulated, respectively, by adding spatially uncorrelated and correlated Gaussian noises to an assumingly true daily weather field synthesized by a gridded precipitation generator which simulates CaPA data. Given the true reference field on one hand, and a set of pseudo-CaPA analyses associated with different network realizations on the other hand, a WATFLOOD hydrological model was employed to compare the modeled runoff. The simulations showed that as network density increases, the accuracy of CaPA precipitation products improves up to a certain limit beyond which adding more stations to the network does not result in further accuracy.

Clinical Assessment of Scapular Positioning in Musicians: An Intertester Reliability Study

PubMed Central

Struyf, Filip; Nijs, Jo; De Coninck, Kris; Giunta, Marco; Mottram, Sarah; Meeusen, Romain

2009-01-01

Abstract Context: The reliability of the measurement of the distance between the posterior border of the acromion and the wall and the reliability of the modified lateral scapular slide test have not been studied. Overall, the reliability of the clinical tools used to assess scapular positioning has not been studied in musicians. Objective: To examine the intertester reliability of scapular observation and 2 clinical tests for the assessment of scapular positioning in musicians. Design: Intertester reliability study. Setting: University research laboratory. Patients or Other Participants: Thirty healthy student musicians at a single university. Main Outcome Measure(s): Two assessors performed a standardized observation protocol, the measurement of the distance between the posterior border of the acromion and the wall, and the modified lateral scapular slide test. Each assessor was blinded to the other's findings. Results: The intertester reliability coefficients (κ) for the observation in relaxed position, during unloaded movement, and during loaded movement were 0.41, 0.63, and 0.36, respectively. The κ values for the observation of tilting and winging at rest were 0.48 and 0.42, respectively; during unloaded movement, the κ values were 0.52 and 0.78, respectively; and with a 1-kg load, the κ values were 0.24 and 0.50, respectively. The intraclass correlation coefficient (ICC) of the measurement of the acromial distance was 0.72 in relaxed position and 0.75 with the participant actively retracting both shoulders. The ICCs for the modified lateral scapular slide test varied between 0.63 and 0.58. Conclusions: Our results demonstrated that the modified lateral scapular slide test was not a reliable tool to assess scapular positioning in these participants. Our data indicated that scapular observation in the relaxed position and during unloaded abduction in the frontal plane was a reliable assessment tool. The reliability of the measurement of the distance

Systematic Observation: Relevance of This Approach in Preschool Executive Function Assessment and Association with Later Academic Skills.

PubMed

Escolano-Pérez, Elena; Herrero-Nivela, Maria Luisa; Blanco-Villaseñor, Angel; Anguera, M Teresa

2017-01-01

Executive functions (EFs) are high-level cognitive processes that allow us to coordinate our actions, thoughts, and emotions, enabling us to perform complex tasks. An increasing number of studies have highlighted the role of EFs in building a solid foundation for subsequent development and learning and shown that EFs are associated with good adjustment and academic skills. The main objective of this study was to analyze whether EF levels in 44 Spanish children in the last year of preschool were associated with levels of literacy and math skills the following year, that is, in the first year of compulsory education. We used a multi-method design, which consisted of systematic observation to observe preschool children during play and selective methodology to assess their reading, writing, and math skills in the first year of compulsory primary education. General linear modeling was used to estimate the percentage of variability in academic skills in the first year of primary school that was explained by preschool EF abilities. The results showed that preschool EF level, together with participants and the instrument used to assess academic skills, explained 99% of the variance of subsequent academic performance. Another objective was to determine whether our findings were generalizable to the reference population. To make this determination, we estimated the optimal sample size for assessing preschool EFs. To do this, we performed a generalizability analysis. The resulting generalizability coefficient showed that our sample of 44 students was sufficient for assessing preschool EFs. Therefore, our results are generalizable to the reference population. Our results are consistent with previous reports that preschool EF abilities may be associated with subsequent literacy and math skills. Early assessment of EFs may therefore contribute to identifying children who are likely to experience later learning difficulties and guide the design of suitable interventions for the

Systematic Observation: Relevance of This Approach in Preschool Executive Function Assessment and Association with Later Academic Skills

PubMed Central

Escolano-Pérez, Elena; Herrero-Nivela, Maria Luisa; Blanco-Villaseñor, Angel; Anguera, M. Teresa

2017-01-01

Executive functions (EFs) are high-level cognitive processes that allow us to coordinate our actions, thoughts, and emotions, enabling us to perform complex tasks. An increasing number of studies have highlighted the role of EFs in building a solid foundation for subsequent development and learning and shown that EFs are associated with good adjustment and academic skills. The main objective of this study was to analyze whether EF levels in 44 Spanish children in the last year of preschool were associated with levels of literacy and math skills the following year, that is, in the first year of compulsory education. We used a multi-method design, which consisted of systematic observation to observe preschool children during play and selective methodology to assess their reading, writing, and math skills in the first year of compulsory primary education. General linear modeling was used to estimate the percentage of variability in academic skills in the first year of primary school that was explained by preschool EF abilities. The results showed that preschool EF level, together with participants and the instrument used to assess academic skills, explained 99% of the variance of subsequent academic performance. Another objective was to determine whether our findings were generalizable to the reference population. To make this determination, we estimated the optimal sample size for assessing preschool EFs. To do this, we performed a generalizability analysis. The resulting generalizability coefficient showed that our sample of 44 students was sufficient for assessing preschool EFs. Therefore, our results are generalizable to the reference population. Our results are consistent with previous reports that preschool EF abilities may be associated with subsequent literacy and math skills. Early assessment of EFs may therefore contribute to identifying children who are likely to experience later learning difficulties and guide the design of suitable interventions for the

A survey and assessment of the capabilities of Cubesats for Earth observation

NASA Astrophysics Data System (ADS)

Selva, Daniel; Krejci, David

2012-05-01

In less than a decade, Cubesats have evolved from purely educational tools to a standard platform for technology demonstration and scientific instrumentation. The use of COTS (Commercial-Off-The-Shelf) components and the ongoing miniaturization of several technologies have already led to scattered instances of missions with promising scientific value. Furthermore, advantages in terms of development cost and development time with respect to larger satellites, as well as the possibility of launching several dozens of Cubesats with a single rocket launch, have brought forth the potential for radically new mission architectures consisting of very large constellations or clusters of Cubesats. These architectures promise to combine the temporal resolution of GEO missions with the spatial resolution of LEO missions, thus breaking a traditional trade-off in Earth observation mission design. This paper assesses the current capabilities of Cubesats with respect to potential employment in Earth observation missions. A thorough review of Cubesat bus technology capabilities is performed, identifying potential limitations and their implications on 17 different Earth observation payload technologies. These results are matched to an exhaustive review of scientific requirements in the field of Earth observation, assessing the possibilities of Cubesats to cope with the requirements set for each one of 21 measurement categories. Based on this review, several Earth observation measurements are identified that can potentially be compatible with the current state-of-the-art of Cubesat technology although some of them have actually never been addressed by any Cubesat mission. Simultaneously, other measurements are identified which are unlikely to be performed by Cubesats in the next few years due to insuperable constraints. Ultimately, this paper is intended to supply a box of ideas for universities to design future Cubesat missions with high scientific payoff.

Seeing the same thing differently: mechanisms that contribute to assessor differences in directly-observed performance assessments.

PubMed

Yeates, Peter; O'Neill, Paul; Mann, Karen; Eva, Kevin

2013-08-01

Assessors' scores in performance assessments are known to be highly variable. Attempted improvements through training or rating format have achieved minimal gains. The mechanisms that contribute to variability in assessors' scoring remain unclear. This study investigated these mechanisms. We used a qualitative approach to study assessors' judgements whilst they observed common simulated videoed performances of junior doctors obtaining clinical histories. Assessors commented concurrently and retrospectively on performances, provided scores and follow-up interviews. Data were analysed using principles of grounded theory. We developed three themes that help to explain how variability arises: Differential Salience-assessors paid attention to (or valued) different aspects of the performances to different degrees; Criterion Uncertainty-assessors' criteria were differently constructed, uncertain, and were influenced by recent exemplars; Information Integration-assessors described the valence of their comments in their own unique narrative terms, usually forming global impressions. Our results (whilst not precluding the operation of established biases) describe mechanisms by which assessors' judgements become meaningfully-different or unique. Our results have theoretical relevance to understanding the formative educational messages that performance assessments provide. They give insight relevant to assessor training, assessors' ability to be observationally "objective" and to the educational value of narrative comments (in contrast to numerical ratings).

Hand assessment in older adults with musculoskeletal hand problems: a reliability study.

PubMed

Myers, Helen L; Thomas, Elaine; Hay, Elaine M; Dziedzic, Krysia S

2011-01-07

Musculoskeletal hand pain is common in the general population. This study aims to investigate the inter- and intra-observer reliability of two trained observers conducting a simple clinical interview and physical examination for hand problems in older adults. The reliability of applying the American College of Rheumatology (ACR) criteria for hand osteoarthritis to community-dwelling older adults will also be investigated. Fifty-five participants aged 50 years and over with a current self-reported hand problem and registered with one general practice were recruited from a previous health questionnaire study. Participants underwent a standardised, structured clinical interview and physical examination by two independent trained observers and again by one of these observers a month later. Agreement beyond chance was summarised using Kappa statistics and intra-class correlation coefficients. Median values for inter- and intra-observer reliability for clinical interview questions were found to be "substantial" and "moderate" respectively [median agreement beyond chance (Kappa) was 0.75 (range: -0.03, 0.93) for inter-observer ratings and 0.57 (range: -0.02, 1.00) for intra-observer ratings]. Inter- and intra-observer reliability for physical examination items was variable, with good reliability observed for some items, such as grip and pinch strength, and poor reliability observed for others, notably assessment of altered sensation, pain on resisted movement and judgements based on observation and palpation of individual features at single joints, such as bony enlargement, nodes and swelling. Moderate agreement was observed both between and within observers when applying the ACR criteria for hand osteoarthritis. Standardised, structured clinical interview is reliable for taking a history in community-dwelling older adults with self reported hand problems. Agreement between and within observers for physical examination items is variable. Low Kappa values may have resulted

Clinical Observed Performance Evaluation: A Prospective Study in Final Year Students of Surgery

ERIC Educational Resources Information Center

Markey, G. C.; Browne, K.; Hunter, K.; Hill, A. D.

2011-01-01

We report a prospective study of clinical observed performance evaluation (COPE) for 197 medical students in the pre-qualification year of clinical education. Psychometric quality was the main endpoint. Students were assessed in groups of 5 in 40-min patient encounters, with each student the focus of evaluation for 8 min. Each student had a series…

An observational study to assess back pain in patients with severe osteoporosis treated with teriparatide versus antiresorptives: An Indian subpopulation analysis

PubMed Central

Chhabra, Harvinder; Malhotra, Rajesh; Marwah, Sunil; Dave, Bharat; See, Kyoungah; Sohal, Simrat; Gurbuz, Sirel

2015-01-01

Background: One year, prospective, observational study in an Indian subpopulation to assess back pain in patients with severe osteoporosis treated with teriparatide or antiresorptives in a clinical setting. Materials and Methods: One hundred and nineteen teriparatide-naοve Indian men and postmenopausal women (mean age 68.0 years) with previous osteoporotic vertebral fracture participated. Patients were assessed at baseline, 6-and 12-months to evaluate relative risk (RR) of new/worsening back pain using the Back Pain Questionnaire. The incidence of back pain and changes in back pain severity were assessed using the visual analog scale (VAS); Health outcomes were assessed using the euroquol-5 dimensions (EQ-5D) questionnaire. All tests were conducted with a two-sided alpha of 0.05. Results: Of 562 overall patients, 57, 60, and 2 Indian patients received teriparatide, antiresorptive, or teriparatide and antiresorptive, respectively. Baseline disease characteristics were slightly worse for antiresorptive-treated patients, whereas teriparatide-treated patients were older with more comorbidities. At 6-months, the incidence of new/worsening back pain was 5.3% for teriparatide-treated patients versus 4.4% for antiresorptive-treated patients (RR: 1.00, 95% confidence interval: 0.68, 1.48); the incidence of severe back pain was 0% versus 12.5% (P = 0.017); in these treatment groups, respectively. Mean VAS change scores (mean ± standard deviation [SD]) were − 1.9 ± 1.73 versus − 1.4 ± 1.77, and mean EQ-5D change scores were 4.2 ± 27.20 versus 9.9 ± 26.23 at 6-months. At 6 months, more teriparatide-treated patients felt better (89% vs. 61%; P = 0.001) and were at least very satisfied with their treatment (30% vs. 9%; P = 0.011). Conclusion: Teriparatide-treated Indian patients had similar new/worsening back pain risk and minimal risk of severe back pain compared with antiresorptive-treated patients at 6-months. PMID:26180763

Night Shift Work and Risk of Depression: Meta-analysis of Observational Studies

PubMed Central

2017-01-01

This study aimed to assess whether night shift work is associated with the risk of depression by using a meta-analysis of observational studies. We searched PubMed and EMBASE in August, 2016 to locate eligible studies and investigated the association between night shift work and the risk of depression, reporting outcome measures with adjusted odds ratios (ORs) or relative risks (RRs) and 95% confidence intervals (CIs). In the meta-analysis of a total of 11 observational studies with 9 cross-sectional study, 1 longitudinal study, and 1 cohort study, night shift work was significantly associated with an increased risk of depression (OR/RR, 1.43; 95% CI, 1.24–1.64; I2 = 78.0%). Also, subgroup meta-analyses by gender, night shift work duration, type of occupation, continent, and type of publication showed that night shift work was consistently associated with the increased risk of depression. The current meta-analysis suggests that night shift work is associated with the increased risk of depression. However, further large prospective cohort studies are needed to confirm this association. PMID:28581264

Assessment of observed fog/low-cloud trends in central Taiwan

NASA Astrophysics Data System (ADS)

Lai, Yen-Jen; Lin, Po-Hsiung

2017-04-01

Xitou region, as the epitome of mid-elevation cloud forest ecosystems in Taiwan, it possesses a rich diversity of flora and fauna. It is also a popular forest recreation area. Due to rapid development of the local tourist industry, where tourist numbers increased from 0.3 million/year in 2000 to 2 million/year in 2015, the microclimate has changed continually. Global warming and landscape changes would be also the most likely factors. This study reports findings of monitoring systems including 4 visibility observed sites at different altitude, a self-developed atmospheric profile observation system carried by unmanned aerial vehicle (UAV) and a high temporal cloud base height observation system by a ceilometer. Besides this, the cloud top height of MODIS cloud product is evaluated as well. The results indicated the foggy day ratio in 2015 was 24% lower than that in 2005 around the district of the nursery. The foggy day ratio raised along with the increase of altitude and the sharpest increasing range happened in the summer time. The UAV-observed results showed the top heights of the nighttime atmospheric boundary layer (ABL) usually happened under 1300m a.s.l. (250m above ground) and the top heights of daytime ABL rose to 1500m - 2100m a.s.l. Unfortunately, it was difficult to observe the inversion layer/ABL in summer due to the fly height limitation of UAV. The ceilometer-observed results indicated the highest foggy ratio happened around 17:00 (local standard time). The daytime cloudy based height ratio was higher than nighttime and the cloud based height was usually located during 1150m - 1750m a.s.l. which was under the top heights of ABL. In addition, the higher cloud-based-heights-happened ratios were found at 1200m - 1250m a.s.l. and 1350m - 1400m a.s.l.. These results indicated the cloud based height uplifted from ground to at least 150m above ground-level causing the foggy ratio decrease. The MODIS cloud product showed the top height of low cloud uplifted

Tactile massage reduces rescue doses for pain and anxiety: an observational study.

PubMed

Pedersen, Karina; Björkhem-Bergman, Linda

2018-03-01

The aim of this study was to evaluate the effect of tactile massage (TM) on palliative care patients. An observational study at a hospice ward in Sweden was carried out. Forty-one palliative patients were offered TM, at an average of three treatments per patient. Before and after every treatment, self-assessed pain, well-being and anxiety according to the Edmonton Symptom Assessment Scale (0-10) were recorded. In addition, the number of rescue doses for pain and anxiety was monitored 24 hours before and after the treatment and in two consecutive days before the patients were offered TM (control data). TM resulted in improvement of self-assessed pain by 1.7 points (SD 1.6), anxiety by 2.3 points (SD 2.0) and well-being by 2.6 points (SD 1.4). The number of rescue doses for pain was reduced from 1.6 to 0.84 doses/patient (P<0.001) and for anxiety from 0.52 to 0.24 doses/patient (P<0.01). The number of rescue doses was not changed in the same patients in two consecutive days before the patients were offered TM. The effect was evident already after the first treatment and did not increase further with repeated treatments. No patients reported any harmful effects of the treatment. TM reduced the need for administration of rescue doses for pain and anxiety and improved well-being in palliative care patients. Larger randomised studies with parallel control groups are needed to confirm the findings from this observational pilot study. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Coronary artery disease reporting and data system (CAD-RADSTM): Inter-observer agreement for assessment categories and modifiers.

PubMed

Maroules, Christopher D; Hamilton-Craig, Christian; Branch, Kelley; Lee, James; Cury, Roberto C; Maurovich-Horvat, Pál; Rubinshtein, Ronen; Thomas, Dustin; Williams, Michelle; Guo, Yanshu; Cury, Ricardo C

The Coronary Artery Disease Reporting and Data System (CAD-RADS) provides a lexicon and standardized reporting system for coronary CT angiography. To evaluate inter-observer agreement of the CAD-RADS among an panel of early career and expert readers. Four early career and four expert cardiac imaging readers prospectively and independently evaluated 50 coronary CT angiography cases using the CAD-RADS lexicon. All readers assessed image quality using a five-point Likert scale, with mean Likert score ≥4 designating high image quality, and <4 designating moderate/low image quality. All readers were blinded to medical history and invasive coronary angiography findings. Inter-observer agreement for CAD-RADS assessment categories and modifiers were assessed using intra-class correlation (ICC) and Fleiss' Kappa (κ).The impact of reader experience and image quality on inter-observer agreement was also examined. Inter-observer agreement for CAD-RADS assessment categories was excellent (ICC 0.958, 95% CI 0.938-0.974, p < 0.0001). Agreement among expert readers (ICC 0.925, 95% CI 0.884-0.954) was marginally stronger than for early career readers (ICC 0.904, 95% CI 0.852-0.941), both p < 0.0001. High image quality was associated with stronger agreement than moderate image quality (ICC 0.944, 95% CI 0.886-0.974 vs. ICC 0.887, 95% CI 0.775-0.95, both p < 0.0001). While excellent inter-observer agreement was observed for modifiers S (stent) and G (bypass graft) (both κ = 1.0), only fair agreement (κ = 0.40) was observed for modifier V (high risk plaque). Inter-observer reproducibility of CAD-RADS assessment categories and modifiers is excellent, except for high-risk plaque (modifier V) which demonstrates fair agreement. These results suggest CAD-RADS is feasible for clinical implementation. Copyright © 2017. Published by Elsevier Inc.

Health visiting assessment--unpacking critical attributes in health visitor needs assessment practice: a case study.

PubMed

Appleton, Jane V; Cowley, Sarah

2008-02-01

Assessment of family health need is a central feature of health visiting practice in which a range of skills, knowledge and judgements are used. These assessments are pivotal in uncovering need, safeguarding children and in determining levels of health intervention to be offered to children and their families by the health visiting service in the UK. The central focus of this paper is to outline the critical attributes of the basic principles that underpin health visiting assessment practice that emerged as part of a case study enquiry. A case study design informed by a constructivist methodology was used to examine health visitors' professional judgements and use of formal guidelines in identifying health needs and prioritising families requiring extra health visiting support. The main study was conducted in three community Trust case sites in England, UK, with pilot work being undertaken in a fourth site. Fifteen health visitors participated in the main study and data were collected during 56 observed home visits to families receiving extra health visiting support. Separate in-depth interviews were conducted with the health visitors, pre- and post-home contacts, while 53 client interviews also took place. The analysis suggests that there are certain fundamental elements associated with the majority of health visitor assessments and these have been termed assessment principles. These characteristics are integral to, and provide the basis upon which health visitors' assessments are conducted and professional judgement is formed. They reflect the basic principles of health visiting assessment practice, which exist despite the constraints and realities of the practice context and can be differentiated from the activity centred methods of assessment processes.

In multiple situational light settings, visual observation for skin colour assessment is comparable with colorimeter measurement.

PubMed

Wright, C Y; Wilkes, M; du Plessis, J L; Reeder, A I; Albers, P N

2016-08-01

Finding inexpensive and reliable techniques for assessing skin colour is important, given that it is related to several adverse human health outcomes. Visual observation is considered a subjective approach assessment and, even when made by trained assessor, concern has been raised about the need for controlled lighting in the study venue. The aim of this study is to determine whether visual skin colour assessments correlate with objective skin colour measurements in study venues with different lighting types and configurations. Two trained investigators, with confirmed visual acuity, visually classified the inner, upper arm skin colour of 556 adults using Munsell(®) colour classifications converted to Individual Typology Angle (°ITA) values based on published data. Skin colour at the same anatomic site was also measured using a colorimeter. Each participant was assessed in one of 10 different buildings, each with a different study day. Munsell(®) -derived °ITA values were compared to colorimeter °ITA values for the full sample and by building/day. We found a strong positive, monotonic correlation between Munsell(®) derived °ITA values and colorimeter °ITA values for all participants (Spearman ρ = 0.8585, P < 0.001). Similar relationships were found when Munsell(®) and colorimeter °ITA values were compared for participants assessed in the same building for all 10 buildings (Spearman ρ values ranged from 0.797 to 0.934, all correlations were statistically significant at P < 0.001). It is possible to visually assess individual skin colour in multiple situational lighting settings and retrieve results that are comparable with objective measurements of skin colour. This was true for individuals of varying population groups and skin pigmentation. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The assessment of cognitive errors using an observer-rated method.

PubMed

Drapeau, Martin

2014-01-01

Cognitive Errors (CEs) are a key construct in cognitive behavioral therapy (CBT). Integral to CBT is that individuals with depression process information in an overly negative or biased way, and that this bias is reflected in specific depressotypic CEs which are distinct from normal information processing. Despite the importance of this construct in CBT theory, practice, and research, few methods are available to researchers and clinicians to reliably identify CEs as they occur. In this paper, the author presents a rating system, the Cognitive Error Rating Scale, which can be used by trained observers to identify and assess the cognitive errors of patients or research participants in vivo, i.e., as they are used or reported by the patients or participants. The method is described, including some of the more important rating conventions to be considered when using the method. This paper also describes the 15 cognitive errors assessed, and the different summary scores, including valence of the CEs, that can be derived from the method.

Inter-Observer Agreement of Whole-Body Computed Tomography in Staging and Response Assessment in Lymphoma: The Lugano Classification.

PubMed

Razek, Ahmed Abdel Khalek Abdel; Shamaa, Sameh; Lattif, Mahmoud Abdel; Yousef, Hanan Hamid

2017-01-01

To assess inter-observer agreement of whole-body computed tomography (WBCT) in staging and response assessment in lymphoma according to the Lugano classification. Retrospective analysis was conducted of 115 consecutive patients with lymphomas (45 females, 70 males; mean age of 46 years). Patients underwent WBCT with a 64 multi-detector CT device for staging and response assessment after a complete course of chemotherapy. Image analysis was performed by 2 reviewers according to the Lugano classification for staging and response assessment. The overall inter-observer agreement of WBCT in staging of lymphoma was excellent ( k =0.90, percent agreement=94.9%). There was an excellent inter-observer agreement for stage I ( k =0.93, percent agreement=96.4%), stage II ( k =0.90, percent agreement=94.8%), stage III ( k =0.89, percent agreement=94.6%) and stage IV ( k =0.88, percent agreement=94%). The overall inter-observer agreement in response assessment after a completer course of treatment was excellent ( k =0.91, percent agreement=95.8%). There was an excellent inter-observer agreement in progressive disease ( k =0.94, percent agreement=97.1%), stable disease ( k =0.90, percent agreement=95%), partial response ( k =0.96, percent agreement=98.1%) and complete response ( k =0.87, Percent agreement=93.3%). We concluded that WBCT is a reliable and reproducible imaging modality for staging and treatment assessment in lymphoma according to the Lugano classification.

Teaching and assessing procedural skills: a qualitative study

PubMed Central

2013-01-01

Background Graduating Internal Medicine residents must possess sufficient skills to perform a variety of medical procedures. Little is known about resident experiences of acquiring procedural skills proficiency, of practicing these techniques, or of being assessed on their proficiency. The purpose of this study was to qualitatively investigate resident 1) experiences of the acquisition of procedural skills and 2) perceptions of procedural skills assessment methods available to them. Methods Focus groups were conducted in the weeks following an assessment of procedural skills incorporated into an objective structured clinical examination (OSCE). Using fundamental qualitative description, emergent themes were identified and analyzed. Results Residents perceived procedural skills assessment on the OSCE as a useful formative tool for direct observation and immediate feedback. This positive reaction was regularly expressed in conjunction with a frustration with available assessment systems. Participants reported that proficiency was acquired through resident directed learning with no formal mechanism to ensure acquisition or maintenance of skills. Conclusions The acquisition and assessment of procedural skills in Internal Medicine programs should move toward a more structured system of teaching, deliberate practice and objective assessment. We propose that directed, self-guided learning might meet these needs. PMID:23672617

Teaching and assessing procedural skills: a qualitative study.

PubMed

Touchie, Claire; Humphrey-Murto, Susan; Varpio, Lara

2013-05-14

Graduating Internal Medicine residents must possess sufficient skills to perform a variety of medical procedures. Little is known about resident experiences of acquiring procedural skills proficiency, of practicing these techniques, or of being assessed on their proficiency. The purpose of this study was to qualitatively investigate resident 1) experiences of the acquisition of procedural skills and 2) perceptions of procedural skills assessment methods available to them. Focus groups were conducted in the weeks following an assessment of procedural skills incorporated into an objective structured clinical examination (OSCE). Using fundamental qualitative description, emergent themes were identified and analyzed. Residents perceived procedural skills assessment on the OSCE as a useful formative tool for direct observation and immediate feedback. This positive reaction was regularly expressed in conjunction with a frustration with available assessment systems. Participants reported that proficiency was acquired through resident directed learning with no formal mechanism to ensure acquisition or maintenance of skills. The acquisition and assessment of procedural skills in Internal Medicine programs should move toward a more structured system of teaching, deliberate practice and objective assessment. We propose that directed, self-guided learning might meet these needs.

Computed Tomography Assessment of Hepatic Metastases of Breast Cancer with Revised Response Evaluation Criteria in Solid Tumors (RECIST) Criteria (Version 1.1): Inter-Observer Agreement.

PubMed

Ghobrial, Fady Emil Ibrahim; Eldin, Manal Salah; Razek, Ahmed Abdel Khalek Abdel; Atwan, Nadia Ibrahim; Shamaa, Sameh Sayed Ahmed

2017-01-01

To assess inter-observer agreement of revised RECIST criteria (version 1.1) for computed tomography assessment of hepatic metastases of breast cancer. A prospective study was conducted in 28 female patients with breast cancer and with at least one measurable metastatic lesion in the liver that was treated with 3 cycles of anthracycline-based chemotherapy. All patients underwent computed tomography of the abdomen with 64-row multi- detector CT at baseline and after 3 cycles of chemotherapy for response assessment. Image analysis was performed by 2 observers, based on the RECIST criteria (version 1.1). Computed tomography revealed partial response of hepatic metastases in 7 patients (25%) by one observer and in 10 patients (35.7%) by the other observer, with good inter-observer agreement (k=0.75, percent agreement of 89.29%). Stable disease was detected in 19 patients (67.8%) by one observer and in 16 patients (57.1%) by the other observer, with good agreement (k=0.774, percent agreement of 89.29%). Progressive disease was detected in 2 patients (7.2%) by both observers, with perfect agreement (k=1, percent agreement of 100%). The overall inter-observer agreement in the CT-based response assessment of hepatic metastasis between the two observers was good ( k =0.793, percent agreement of 89.29%). We concluded that computed tomography is a reliable and reproducible imaging modality for response assessment of hepatic metastases of breast cancer according to the RECIST criteria (version 1.1).

Cultivating cohort studies for observational translational research.

PubMed

Ransohoff, David F

2013-04-01

"Discovery" research about molecular markers for diagnosis, prognosis, or prediction of response to therapy has frequently produced results that were not reproducible in subsequent studies. What are the reasons, and can observational cohorts be cultivated to provide strong and reliable answers to those questions? Experimental Selected examples are used to illustrate: (i) what features of research design provide strength and reliability in observational studies about markers of diagnosis, prognosis, and response to therapy? (ii) How can those design features be cultivated in existing observational cohorts, for example, within randomized controlled clinical trial (RCT), other existing observational research studies, or practice settings like health maintenance organization (HMOs)? Examples include a study of RNA expression profiles of tumor tissue to predict prognosis of breast cancer, a study of serum proteomics profiles to diagnose ovarian cancer, and a study of stool-based DNA assays to screen for colon cancer. Strengths and weaknesses of observational study design features are discussed, along with lessons about how features that help assure strength might be "cultivated" in the future. By considering these examples and others, it may be possible to develop a process of "cultivating cohorts" in ongoing RCTs, observational cohort studies, and practice settings like HMOs that have strong features of study design. Such an effort could produce sources of data and specimens to reliably answer questions about the use of molecular markers in diagnosis, prognosis, and response to therapy.

Data Quality Assessment of In Situ and Altimeter Observations Through Two-Way Intercomparison Methods

NASA Astrophysics Data System (ADS)

Guinehut, Stephanie; Valladeau, Guillaume; Legeais, Jean-Francois; Rio, Marie-Helene; Ablain, Michael; Larnicol, Gilles

2013-09-01

This proceeding presents an overview of the two-way inter-comparison activities performed at CLS for both space and in situ observation agencies and why this activity is a required step to obtain accurate and homogenous data sets that can then be used together for climate studies or in assimilation/validation tools. We first describe the work performed in the frame of the SALP program to assess the stability of altimeter missions through SSH comparisons with tide gauges (GLOSS/CLIVAR network). Then, we show how the SSH comparison between the Argo array and altimeter time series allows the detection of drifts or jumps in altimeter (SALP program) but also for some Argo floats (Ifremer/Coriolis center). Lastly, we describe how the combine use of altimeter and wind observations helps the detection of drogue loss of surface drifting buoys (GDP network) and allow the computation of a correction term for wind slippage.

Global assessment of ocean carbon export by combining satellite observations and food-web models

NASA Astrophysics Data System (ADS)

Siegel, D. A.; Buesseler, K. O.; Doney, S. C.; Sailley, S. F.; Behrenfeld, M. J.; Boyd, P. W.

2014-03-01

The export of organic carbon from the surface ocean by sinking particles is an important, yet highly uncertain, component of the global carbon cycle. Here we introduce a mechanistic assessment of the global ocean carbon export using satellite observations, including determinations of net primary production and the slope of the particle size spectrum, to drive a food-web model that estimates the production of sinking zooplankton feces and algal aggregates comprising the sinking particle flux at the base of the euphotic zone. The synthesis of observations and models reveals fundamentally different and ecologically consistent regional-scale patterns in export and export efficiency not found in previous global carbon export assessments. The model reproduces regional-scale particle export field observations and predicts a climatological mean global carbon export from the euphotic zone of 6 Pg C yr-1. Global export estimates show small variation (typically < 10%) to factor of 2 changes in model parameter values. The model is also robust to the choices of the satellite data products used and enables interannual changes to be quantified. The present synthesis of observations and models provides a path for quantifying the ocean's biological pump.

[The aggression in SPDC: an observational study. Preliminary data].

PubMed

Minutolo, Giuseppe; Cannavò, Dario; Petralia, Antonino; Gandolfo, Liliana; Palermo, Filippo; Aguglia, Eugenio

2010-01-01

In the different psychiatric disorders the aggression often leads to uncontrolled events, taking aspects of impulsiveness and irrationality. Our research proposes the assessment of socio-demographic and clinical characteristics of patients with a psychiatric disorder, who presented an aggressive event. The observational study was conducted on a sample of 50 patients (34 men and 16 women), hospitalized following the manifestation of an aggressive event. For each patient was provided an assessment of socio-demographic and clinical variables and a psychometric investigation through: the OAS, for the analysis of aggressive episodes; the BDHI, for the hostile behavior and attitudes; the BIS-11, for the impulsiveness and the BPRS for the psychopathological aspects. Among the socio-demographic features investigated, the highest correlation with aggressive behavior was related to the concomitant substance abuse, type of admission to psychiatric hospital and the male gender. The OAS has shown a greater propensity to directed-aggression in males with schizophrenia, and self-directed in females with major depression. The BPRS has shown a positive correlation between hetero-directed aggressive behavior and positive symptomatology, and between the self-directed and depression, risk of suicide, feelings of guilt and somatic concerns. The BDHI has indicated greater suspicion in women's group. The hypothesis that aggression is otherwise related to specific socio-demographic and clinical characteristics was confirmed by our study. The data suggest that early identification and assessment of potential risk factors involved in the genesis of aggressive episodes would allow the clinician to implement a better strategy for prevention and intervention.

Assessment of Two Types of Observations (SATWND and GPSRO) for the Operational Global 4DVAR System

NASA Astrophysics Data System (ADS)

Leng, H.

2017-12-01

The performance of a data assimilation system is significantly dependent on the quality and quantity of observations assimilated. In these years, more and more satellite observations have been applied in many operational assimilation systems. In this paper, the assessment of satellite-derived winds (SATWND) and GPS radio occultation (GPSRO) bending angles has been performed using a range of diagnostics. The main positive impacts are made when satellite-derived cloud data (GOES cloud data and MODIS cloud data) is assimilated, but benefit is hardly obtained from GPSRO data in the Operational Global 4DVAR System. In a full system configuration, the assimilation of satellite-derived observations is globally beneficial on the analysis, and the benefit can be well propagated into the forecast. The assimilation of the GPSRO observations has a slightly positive impact in the Tropics, but is neutral in the Northern Hemisphere and in the Southern Hemisphere. To assess the synergies of satellite-derived observations with other types of observation, experiments assimilating satellite-derived data and AMSU-A and AMSU-B observations were run. The results show that the analysis increments structure is not modified when AMSU-A and AMSU-B observations are also assimilated. This suggests that the impact of satellite-derived observations is not limited by the large impact of satellite radiance observations.

A Comparison of Assessment Tools: Is Direct Observation an Improvement Over Objective Structured Clinical Examinations for Communications Skills Evaluation?

PubMed

Goch, Abraham M; Karia, Raj; Taormina, David; Kalet, Adina; Zuckerman, Joseph; Egol, Kenneth A; Phillips, Donna

2018-04-01

Evaluation of resident physicians' communications skills is a challenging task and is increasingly accomplished with standardized examinations. There exists a need to identify the effective, efficient methods for assessment of communications skills. We compared objective structured clinical examination (OSCE) and direct observation as approaches for assessing resident communications skills. We conducted a retrospective cohort analysis of orthopaedic surgery resident physicians at a single tertiary care academic institution, using the Institute for Healthcare Communication "4 Es" model for effective communication. Data were collected between 2011 and 2015. A total of 28 residents, each with OSCE and complete direct observation assessment checklists, were included in the analysis. Residents were included if they had 1 OSCE assessment and 2 or more complete direct observation assessments. There were 28 of a possible 59 residents (47%) included. A total of 89% (25 of 28) of residents passed the communications skills OSCE; only 54% (15 of 28) of residents passed the direct observation communications assessment. There was a positive, moderate correlation between OSCE and direct observation scores overall ( r  = 0.415, P  = .028). There was no agreement between OSCE and direct observation in categorizing residents into passing and failing scores (κ = 0.205, P  = .16), after adjusting for chance agreement. Our results suggest that OSCE and direct observation tools provide different insights into resident communications skills (simulation of rare and challenging situations versus real-life daily encounters), and may provide useful perspectives on resident communications skills in different contexts.

Observer variation in the assessment of root canal curvature.

PubMed

Faraj, S; Boutsioukis, C

2017-02-01

To evaluate the inter- and intra-observer agreement between training/trained endodontists regarding the ex vivo classification of root canal curvature into three categories and its measurement using three quantitative methods. Periapical radiographs of seven extracted human posterior teeth with varying degrees of curvature were exposed ex vivo. Twenty training/trained endodontists were asked to classify the root canal curvature into three categories (<10°, 10-30°, >30°), to measure the curvature using three quantitative methods (Schneider, Weine, Pruett) and to draw angles of 10° or 30°, as a control experiment. The procedure was repeated after six weeks. Inter- and intra-observer agreement was evaluated by the intraclass correlation coefficient and weighted kappa. The inter-observer agreement on the visual classification of root canal curvature was substantial (ICC = 0.65, P < 0.018), but a trend towards underestimation of the angle was evident. Participants modified their classifications both within and between the two sessions. Median angles drawn as a control experiment were not significantly different from the target values (P > 0.10), but the results of individual participants varied. When quantitative methods were used, the inter- and intra-observer agreement on the angle measurements was considerably better (ICC = 0.76-0.82, P < 0.001) than on the radius measurements (ICC = 0.16-0.19, P > 0.895). Visual estimation of root canal curvature was not reliable. The use of computer-based quantitative methods is recommended. The measurement of radius of curvature was more subjective than angle measurement. Endodontic Associations need to provide specific guidelines on how to estimate root canal curvature in case difficulty assessment forms. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Incorporating Animals in Phenological Assessments: USA National Phenology Network Methods to Observe Animal Phenology

NASA Astrophysics Data System (ADS)

Miller-Rushing, A. J.; Weltzin, J. F.

2009-12-01

Many assessments of phenology, particularly those operating at large scales, focus on the phenology of plants, in part because of the relevance of plants in cycles of leaf greening and browning that are visible from satellite-based remote sensing, and because plants contribute significantly to global and regional biogeochemical cycles. The USA National Phenology Network (USA-NPN), a consortium of individuals, agencies, and organizations, promotes integrated assessments of both plant and animal phenology. The network is currently developing standard methods to add animal phenology to existing assessments of plant phenology. The first phase will of the standard methods will be implemented online in spring 2010. The methods for observing animals will be similar to the standard methods for making on-the-ground observations of plants—observers will be asked to monitor a fixed location regularly throughout the year. During each visit, observers will answer a series of “yes-no” questions that address the phenological state of the species of interest: Is the species present? Is it mating? Is it feeding? And so on. We are currently testing this method in several national parks in the northeastern United States, including Acadia National Park and the Appalachian Trail. By collecting new observations of this sort for a range of animals—amphibians, birds, fish, insects, mammals, and reptiles—we will greatly increase the ability of scientists and natural resource managers to understand how temporal relationships among these species and the plants on which they depend may be changing. To bolster the data available, we are collaborating with existing monitoring programs to develop common monitoring techniques, data sharing technologies, and visualizations. We are also beginning to collect legacy datasets, such as one from North American Bird Phenology Program that includes 90 years of observations of bird migration times from across the continent. We believe that

Safety Hazards During Intrahospital Transport: A Prospective Observational Study.

PubMed

Bergman, Lina M; Pettersson, Monica E; Chaboyer, Wendy P; Carlström, Eric D; Ringdal, Mona L

2017-10-01

To identify, classify, and describe safety hazards during the process of intrahospital transport of critically ill patients. A prospective observational study. Data from participant observations of the intrahospital transport process were collected over a period of 3 months. The study was undertaken at two ICUs in one university hospital. Critically ill patients transported within the hospital by critical care nurses, unlicensed nurses, and physicians. None. Content analysis was performed using deductive and inductive approaches. We detected a total of 365 safety hazards (median, 7; interquartile range, 4-10) during 51 intrahospital transports of critically ill patients, 80% of whom were mechanically ventilated. The majority of detected safety hazards were assessed as increasing the risk of harm, compromising patient safety (n = 204). Using the System Engineering Initiative for Patient Safety, we identified safety hazards related to the work system, as follows: team (n = 61), tasks (n = 83), tools and technologies (n = 124), environment (n = 48), and organization (n = 49). Inductive analysis provided an in-depth description of those safety hazards, contributing factors, and process-related outcomes. Findings suggest that intrahospital transport is a hazardous process for critically ill patients. We have identified several factors that may contribute to transport-related adverse events, which will provide the opportunity for the redesign of systems to enhance patient safety.

Medication safety research by observational study design.

PubMed

Lao, Kim S J; Chui, Celine S L; Man, Kenneth K C; Lau, Wallis C Y; Chan, Esther W; Wong, Ian C K

2016-06-01

Observational studies have been recognised to be essential for investigating the safety profile of medications. Numerous observational studies have been conducted on the platform of large population databases, which provide adequate sample size and follow-up length to detect infrequent and/or delayed clinical outcomes. Cohort and case-control are well-accepted traditional methodologies for hypothesis testing, while within-individual study designs are developing and evolving, addressing previous known methodological limitations to reduce confounding and bias. Respective examples of observational studies of different study designs using medical databases are shown. Methodology characteristics, study assumptions, strengths and weaknesses of each method are discussed in this review.

Primary or recurring extra-abdominal desmoid fibromatosis: assessment of treatment by observation only.

PubMed

Barbier, O; Anract, P; Pluot, E; Larouserie, F; Sailhan, F; Babinet, A; Tomeno, B

2010-12-01

Extra-abdominal desmoid fibromatosis (EADF) is a benign tumoral condition, classically managed by more or less radical and sometimes mutilating excision. This treatment strategy is associated with a recurrence rate of nearly 50% according to various reports. EADF may show spontaneous stabilization over time. A retrospective series of 26 cases of EADF managed by simple observation was studied to assess spontaneous favorable evolution and identify possible factors impacting evolution. Eleven cases were of primary EADF with no treatment or surgery, and 15 of recurrence after surgery with no adjuvant treatment. MRI was the reference examination during follow-up. Twenty-four cases showed stabilization at a median 14 months; there were no cases of renewed evolution after stabilization. One primary tumor showed spontaneous regression, and one recurrence still showed evolution at end of follow-up (23 months). The sole factor impacting potential for evolution was prior surgery. No radiologic or pathologic criteria of evolution emerged from analysis. The present series, one of the largest dedicated to EADF managed by observation, confirmed recent literature findings: a conservative "wait-and-see" attitude is reasonable and should be considered when large-scale resection would entail significant functional or esthetic impairment. Level IV, retrospective study. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

A global logrank test for adaptive treatment strategies based on observational studies.

PubMed

Li, Zhiguo; Valenstein, Marcia; Pfeiffer, Paul; Ganoczy, Dara

2014-02-28

In studying adaptive treatment strategies, a natural question that is of paramount interest is whether there is any significant difference among all possible treatment strategies. When the outcome variable of interest is time-to-event, we propose an inverse probability weighted logrank test for testing the equivalence of a fixed set of pre-specified adaptive treatment strategies based on data from an observational study. The weights take into account both the possible selection bias in an observational study and the fact that the same subject may be consistent with more than one treatment strategy. The asymptotic distribution of the weighted logrank statistic under the null hypothesis is obtained. We show that, in an observational study where the treatment selection probabilities need to be estimated, the estimation of these probabilities does not have an effect on the asymptotic distribution of the weighted logrank statistic, as long as the estimation of the parameters in the models for these probabilities is n-consistent. Finite sample performance of the test is assessed via a simulation study. We also show in the simulation that the test can be pretty robust to misspecification of the models for the probabilities of treatment selection. The method is applied to analyze data on antidepressant adherence time from an observational database maintained at the Department of Veterans Affairs' Serious Mental Illness Treatment Research and Evaluation Center. Copyright © 2013 John Wiley & Sons, Ltd.

Studies of Arctic Tropospheric Ozone Depletion Events Through Buoy-Borne Observations and Laboratory Studies

NASA Astrophysics Data System (ADS)

Halfacre, John W.

The photochemically-induced destruction of ground-level Arctic ozone in the Arctic occurs at the onset of spring, in concert with polar sunrise. Solar radiation is believed to stimulate a series of reactions that cause the production and release of molecular halogens from frozen, salty surfaces, though this mechanism is not yet well understood. The subsequent photolysis of molecular halogens produces reactive halogen atoms that remove ozone from the atmosphere in these so-called "Ozone Depletion Events" (ODEs). Given that much of the Arctic region is sunlit, meteorologically stable, and covered by saline ice and snow, it is expected that ODEs could be a phenomenon that occurs across the entire Arctic region. Indeed, an ever-growing body of evidence from coastal sites indicates that Arctic air masses devoid of O3 most often pass over sea ice-covered regions before arriving at an observation site, suggesting ODE chemistry occurs upwind over the frozen Arctic Ocean. However, outside of coastal observations, there exist very few long-term observations from the Arctic Ocean from which quantitative assessments of basic ODE characteristics can be made. This work presents the interpretation of ODEs through unique chemical and meteorological observations from several ice-tethered buoys deployed around the Arctic Ocean. These observations include detection of ozone, bromine monoxide, and measurements of temperature, relative humidity, atmospheric pressure, wind speed, and wind direction. To assess whether the O-Buoys were observing locally based depletion chemistry or the transport of ozone-poor air masses, periods of ozone decay were interpreted based on current understanding of ozone depletion kinetics, which are believed to follow a pseudo-first order rate law. In addition, the spatial extents of ODEs were estimated using air mass trajectory modeling to assess whether they are a localized or synoptic phenomenon. Results indicate that current understanding of the

Application of a Topological Metric for Assessing Numerical Ocean Models with Satellite Observations

NASA Astrophysics Data System (ADS)

Morey, S. L.; Dukhovskoy, D. S.; Hiester, H. R.; Garcia-Pineda, O. G.; MacDonald, I. R.

2015-12-01

Satellite-based sensors provide a vast amount of observational data over the world ocean. Active microwave radars measure changes in sea surface height and backscattering from surface waves. Data from passive radiometers sensing emissions in multiple spectral bands can directly measure surface temperature, be combined with other data sources to estimate salinity, or processed to derive estimates of optically significant quantities, such as concentrations of biochemical properties. Estimates of the hydrographic variables can be readily used for assimilation or assessment of hydrodynamic ocean models. Optical data, however, have been underutilized in ocean circulation modeling. Qualitative assessments of oceanic fronts and other features commonly associated with changes in optically significant quantities are often made through visual comparison. This project applies a topological approach, borrowed from the field of computer image recognition, to quantitatively evaluate ocean model simulations of features that are related to quantities inferred from satellite imagery. The Modified Hausdorff Distance (MHD) provides a measure of the similarity of two shapes. Examples of applications of the MHD to assess ocean circulation models are presented. The first application assesses several models' representation of the freshwater plume structure from the Mississippi River, which is associated with a significant expression of color, using a satellite-derived ocean color index. Even though the variables being compared (salinity and ocean color index) differ, the MHD allows contours of the fields to be compared topologically. The second application assesses simulations of surface oil transport driven by winds and ocean model currents using surface oil maps derived from synthetic aperture radar backscatter data. In this case, maps of time composited oil coverage are compared between the simulations and satellite observations.

Usability and reliability of a remotely administered adult autism assessment, the autism diagnostic observation schedule (ADOS) module 4.

PubMed

Schutte, Jamie L; McCue, Michael P; Parmanto, Bambang; McGonigle, John; Handen, Benjamin; Lewis, Allen; Pulantara, I Wayan; Saptono, Andi

2015-03-01

The Autism Diagnostic Observation Schedule (ADOS) Module 4 is an autism assessment designed for verbally fluent adolescents and adults. Because of a shortage of available clinical expertise, it can be difficult for adults to receive a proper autism spectrum disorder (ASD) diagnostic assessment. A potential option to address this shortage is remote assessment. The objective of this study was to examine the feasibility, usability, and reliability of administering the ADOS Module 4 remotely using the Versatile and Integrated System for Telerehabilitation (VISYTER). VISYTER consists of computer stations at the client site and clinician site for video communication and a Web portal for managing and coordinating the assessment process. Twenty-three adults with an ASD diagnosis participated in a within-subject crossover design study in which both a remote ADOS and a face-to-face ADOS were administered. After completing the remote ADOS, participants completed a satisfaction survey. Participant satisfaction with the remote ADOS delivery system was high. The kappa value was greater than 0.61 on 21 of 31 ADOS items. There was substantial agreement on ADOS classification (i.e., diagnosis) between assessments delivered face-to-face versus assessments delivered remotely (interclass coefficient=0.92). Non-agreement may have been due to outside factors or practice effect despite a washout period. The results of this study demonstrate that an autism assessment designed to be delivered face to face can be administered remotely using an integrated Web-based system with high levels of usability and reliability.

Decision-making in multiple sclerosis consultations in Italy: third observer and patient assessments.

PubMed

Pietrolongo, Erika; Giordano, Andrea; Kleinefeld, Monica; Confalonieri, Paolo; Lugaresi, Alessandra; Tortorella, Carla; Pugliatti, Maura; Radice, Davide; Goss, Claudia; Heesen, Christoph; Solari, Alessandra

2013-01-01

To assess decision-making in multiple sclerosis (MS) from third observer and patient perspectives. Audio recordings of first-ever consultations with a participating physician (88 outpatients, 10 physicians) at four tertiary MS care clinics in Italy, were rated by a third observer using the Observing Patient Involvement in Shared Decision Making (OPTION) and by patients using the Perceived Involvement in Care Scale (PICS). Mean patient age was 37.5, 66% were women, 72% had MS, and 28% had possible MS or other disease. Mean PICS subscale scores (range 0 poor, 100 best possible) were 71.9 (SD 24.3) for "physician facilitation" (PICS-F); 74.6 (SD 22.9) for "patient information exchange" (PICS-I); and only 22.5 (SD 16.2) for "patient decision making" (PICS-DM). Mean OPTION total score (0 poor, 100 best possible) was 29.6 (SD 10.3). Poorest OPTION scores were found for items assessing "preferred patient approach to receiving information" and "preferred patient level of involvement." Highest scores were for "clinician drawing attention to identified problem", "indicating need for decision making," and "need to review the decision." Consultation time, woman physician, patient-physician gender concordance and PICS-F were associated with higher OPTION total score; older physician and second opinion consultation were associated with lower OPTION score. In line with findings in other settings, our third observer findings indicated limited patient involvement abilities of MS physicians during first consultations. Patient perceptions of physician skills were better than third observers', although they correlated. Consultations with women physicians, and younger physicians, were associated with higher third observer and patient-based scores. Our findings reveal a need to empower Italian MS physicians with better communication and shared decision-making skills, and show in particular that attention to MS patient preferences for reception of information and involvement in health

Development of the General Parenting Observational Scale to assess parenting during family meals.

PubMed

Rhee, Kyung E; Dickstein, Susan; Jelalian, Elissa; Boutelle, Kerri; Seifer, Ronald; Wing, Rena

2015-04-10

There is growing interest in the relationship between general parenting and childhood obesity. However, assessing general parenting via surveys can be difficult due to issues with self-report and differences in the underlying constructs being measured. As a result, different aspects of parenting have been associated with obesity risk. We developed a more objective tool to assess general parenting by using observational methods during a mealtime interaction. The General Parenting Observational Scale (GPOS) was based on prior work of Baumrind, Maccoby and Martin, Barber, and Slater and Power. Ten dimensions of parenting were included; 4 were classified in the emotional dimension of parenting (warmth and affection, support and sensitivity, negative affect, detachment), and 6 were classified in the behavioral dimension of parenting (firm discipline and structure, demands for maturity, psychological control, physical control, permissiveness, neglect). Overweight children age 8-12 years old and their parent (n = 44 dyads) entering a weight control program were videotaped eating a family meal. Parents were coded for their general parenting behaviors. The Mealtime Family Interaction Coding System (MICS) and several self-report measures of general parenting were also used to assess the parent-child interaction. Spearman's correlations were used to assess correlation between measures. The emotional dimensions of warmth/affection and support/sensitivity, and the behavioral dimension of firm discipline/structure were robustly captured during the family meals. Warmth/affection and support/sensitivity were significantly correlated with affect management, interpersonal involvement, and communication from the MICS. Firm discipline/structure was inversely correlated with affect management, behavior control, and task accomplishment. Parents who were older, with higher educational status, and lower BMIs were more likely to display warmth/affection and support/sensitivity. Several

Effects of artificial light at night on human health: A literature review of observational and experimental studies applied to exposure assessment.

PubMed

Cho, YongMin; Ryu, Seung-Hun; Lee, Byeo Ri; Kim, Kyung Hee; Lee, Eunil; Choi, Jaewook

2015-01-01

It has frequently been reported that exposure to artificial light at night (ALAN) may cause negative health effects, such as breast cancer, circadian phase disruption and sleep disorders. Here, we reviewed the literature assessing the effects of human exposure to ALAN in order to list the health effects of various aspects of ALAN. Several electronic databases were searched for articles, published through August 2014, related to assessing the effects of exposure to ALAN on human health; these also included the details of experiments on such exposure. A total of 85 articles were included in the review. Several observational studies showed that outdoor ALAN levels are a risk factor for breast cancer and reported that indoor light intensity and individual lighting habits were relevant to this risk. Exposure to artificial bright light during the nighttime suppresses melatonin secretion, increases sleep onset latency (SOL) and increases alertness. Circadian misalignment caused by chronic ALAN exposure may have negative effects on the psychological, cardiovascular and/or metabolic functions. ALAN also causes circadian phase disruption, which increases with longer duration of exposure and with exposure later in the evening. It has also been reported that shorter wavelengths of light preferentially disturb melatonin secretion and cause circadian phase shifts, even if the light is not bright. This literature review may be helpful to understand the health effects of ALAN exposure and suggests that it is necessary to consider various characteristics of artificial light, beyond mere intensity.

Is Structured Observation a Valid Technique to Measure Handwashing Behavior? Use of Acceleration Sensors Embedded in Soap to Assess Reactivity to Structured Observation

PubMed Central

Ram, Pavani K.; Halder, Amal K.; Granger, Stewart P.; Jones, Therese; Hall, Peter; Hitchcock, David; Wright, Richard; Nygren, Benjamin; Islam, M. Sirajul; Molyneaux, John W.; Luby, Stephen P.

2010-01-01

Structured observation is often used to evaluate handwashing behavior. We assessed reactivity to structured observation in rural Bangladesh by distributing soap containing acceleration sensors and performing structured observation 4 days later. Sensors recorded the number of times soap was moved. In 45 participating households, the median number of sensor soap movements during the 5-hour time block on pre-observation days was 3.7 (range 0.3–10.6). During the structured observation, the median number of sensor soap movements was 5.0 (range 0–18.0), a 35% increase, P = 0.0004. Compared with the same 5-hour time block on pre-observation days, the number of sensor soap movements increased during structured observation by ≥ 20% in 62% of households, and by ≥ 100% in 22% of households. The increase in sensor soap movements during structured observation, compared with pre-observation days, indicates substantial reactivity to the presence of the observer. These findings call into question the validity of structured observation for measurement of handwashing behavior. PMID:21036840

Is structured observation a valid technique to measure handwashing behavior? Use of acceleration sensors embedded in soap to assess reactivity to structured observation.

PubMed

Ram, Pavani K; Halder, Amal K; Granger, Stewart P; Jones, Therese; Hall, Peter; Hitchcock, David; Wright, Richard; Nygren, Benjamin; Islam, M Sirajul; Molyneaux, John W; Luby, Stephen P

2010-11-01

Structured observation is often used to evaluate handwashing behavior. We assessed reactivity to structured observation in rural Bangladesh by distributing soap containing acceleration sensors and performing structured observation 4 days later. Sensors recorded the number of times soap was moved. In 45 participating households, the median number of sensor soap movements during the 5-hour time block on pre-observation days was 3.7 (range 0.3-10.6). During the structured observation, the median number of sensor soap movements was 5.0 (range 0-18.0), a 35% increase, P = 0.0004. Compared with the same 5-hour time block on pre-observation days, the number of sensor soap movements increased during structured observation by ≥ 20% in 62% of households, and by ≥ 100% in 22% of households. The increase in sensor soap movements during structured observation, compared with pre-observation days, indicates substantial reactivity to the presence of the observer. These findings call into question the validity of structured observation for measurement of handwashing behavior.

Assessment of bioelectrical activity of synergistic muscles during pelvic floor muscles activation in postmenopausal women with and without stress urinary incontinence: a preliminary observational study

PubMed Central

Ptaszkowski, Kuba; Paprocka-Borowicz, Małgorzata; Słupska, Lucyna; Bartnicki, Janusz; Dymarek, Robert; Rosińczuk, Joanna; Heimrath, Jerzy; Dembowski, Janusz; Zdrojowy, Romuald

2015-01-01

Objective Muscles such as adductor magnus (AM), gluteus maximus (GM), rectus abdominis (RA), and abdominal external and internal oblique muscles are considered to play an important role in the treatment of stress urinary incontinence (SUI), and the relationship between contraction of these muscles and pelvic floor muscles (PFM) has been established in previous studies. Synergistic muscle activation intensifies a woman’s ability to contract the PFM. In some cases, even for continent women, it is not possible to fully contract their PFM without involving the synergistic muscles. The primary aim of this study was to assess the surface electromyographic activity of synergistic muscles to PFM (SPFM) during resting and functional PFM activation in postmenopausal women with and without SUI. Materials and methods This study was a preliminary, prospective, cross-sectional observational study and included volunteers and patients who visited the Department and Clinic of Urology, University Hospital in Wroclaw, Poland. Forty-two patients participated in the study and were screened for eligibility criteria. Thirty participants satisfied the criteria and were categorized into two groups: women with SUI (n=16) and continent women (n=14). The bioelectrical activity of PFM and SPFM (AM, RA, GM) was recorded with a surface electromyographic instrument in a standing position during resting and functional PFM activity. Results Bioelectrical activity of RA was significantly higher in the incontinent group than in the continent group. These results concern the RA activity during resting and functional PFM activity. The results for other muscles showed no significant difference in bioelectrical activity between groups. Conclusion In women with SUI, during the isolated activation of PFM, an increased synergistic activity of RA muscle was observed; however, this activity was not observed in asymptomatic women. This may indicate the important accessory contribution of these muscles in the

Assessment of bioelectrical activity of synergistic muscles during pelvic floor muscles activation in postmenopausal women with and without stress urinary incontinence: a preliminary observational study.

PubMed

Ptaszkowski, Kuba; Paprocka-Borowicz, Małgorzata; Słupska, Lucyna; Bartnicki, Janusz; Dymarek, Robert; Rosińczuk, Joanna; Heimrath, Jerzy; Dembowski, Janusz; Zdrojowy, Romuald

2015-01-01

Muscles such as adductor magnus (AM), gluteus maximus (GM), rectus abdominis (RA), and abdominal external and internal oblique muscles are considered to play an important role in the treatment of stress urinary incontinence (SUI), and the relationship between contraction of these muscles and pelvic floor muscles (PFM) has been established in previous studies. Synergistic muscle activation intensifies a woman's ability to contract the PFM. In some cases, even for continent women, it is not possible to fully contract their PFM without involving the synergistic muscles. The primary aim of this study was to assess the surface electromyographic activity of synergistic muscles to PFM (SPFM) during resting and functional PFM activation in postmenopausal women with and without SUI. This study was a preliminary, prospective, cross-sectional observational study and included volunteers and patients who visited the Department and Clinic of Urology, University Hospital in Wroclaw, Poland. Forty-two patients participated in the study and were screened for eligibility criteria. Thirty participants satisfied the criteria and were categorized into two groups: women with SUI (n=16) and continent women (n=14). The bioelectrical activity of PFM and SPFM (AM, RA, GM) was recorded with a surface electromyographic instrument in a standing position during resting and functional PFM activity. Bioelectrical activity of RA was significantly higher in the incontinent group than in the continent group. These results concern the RA activity during resting and functional PFM activity. The results for other muscles showed no significant difference in bioelectrical activity between groups. In women with SUI, during the isolated activation of PFM, an increased synergistic activity of RA muscle was observed; however, this activity was not observed in asymptomatic women. This may indicate the important accessory contribution of these muscles in the mechanism of continence.

Night Shift Work and Risk of Depression: Meta-analysis of Observational Studies.

PubMed

Lee, Aeyoung; Myung, Seung Kwon; Cho, Jung Jin; Jung, Yu Jin; Yoon, Jong Lull; Kim, Mee Young

2017-07-01

This study aimed to assess whether night shift work is associated with the risk of depression by using a meta-analysis of observational studies. We searched PubMed and EMBASE in August, 2016 to locate eligible studies and investigated the association between night shift work and the risk of depression, reporting outcome measures with adjusted odds ratios (ORs) or relative risks (RRs) and 95% confidence intervals (CIs). In the meta-analysis of a total of 11 observational studies with 9 cross-sectional study, 1 longitudinal study, and 1 cohort study, night shift work was significantly associated with an increased risk of depression (OR/RR, 1.43; 95% CI, 1.24-1.64; I² = 78.0%). Also, subgroup meta-analyses by gender, night shift work duration, type of occupation, continent, and type of publication showed that night shift work was consistently associated with the increased risk of depression. The current meta-analysis suggests that night shift work is associated with the increased risk of depression. However, further large prospective cohort studies are needed to confirm this association. © 2017 The Korean Academy of Medical Sciences.

Development, initial reliability and validity testing of an observational tool for assessing technical skills of operating room nurses.

PubMed

Sevdalis, Nick; Undre, Shabnam; Henry, Janet; Sydney, Elaine; Koutantji, Mary; Darzi, Ara; Vincent, Charles A

2009-09-01

The recent emergence of the Systems Approach to the safety and quality of surgical care has triggered individual and team skills training modules for surgeons and anaesthetists and relevant observational assessment tools have been developed. To develop an observational tool that captures operating room (OR) nurses' technical skill and can be used for assessment and training. The Imperial College Assessment of Technical Skills for Nurses (ICATS-N) assesses (i) gowning and gloving, (ii) setting up instrumentation, (iii) draping, and (iv) maintaining sterility. Three to five observable behaviours have been identified for each skill and are rated on 1-6 scales. Feasibility and aspects of reliability and validity were assessed in 20 simulation-based crisis management training modules for trainee nurses and doctors, carried out in a Simulated Operating Room. The tool was feasible to use in the context of simulation-based training. Satisfactory reliability (Cronbach alpha) was obtained across trainers' and trainees' scores (analysed jointly and separately). Moreover, trainer nurse's ratings of the four skills correlated positively, thus indicating adequate content validity. Trainer's and trainees' ratings did not correlate. Assessment of OR nurses' technical skill is becoming a training priority. The present evidence suggests that the ICATS-N could be considered for use as an assessment/training tool for junior OR nurses.

Wound healing in pre-tibial injuries--an observation study.

PubMed

McClelland, Heather M; Stephenson, John; Ousey, Karen J; Gillibrand, Warren P; Underwood, Paul

2012-06-01

Pre-tibial lacerations are complex wounds affecting a primarily aged population, with poor healing and a potentially significant impact on social well-being. Management of these wounds has changed little in 20 years, despite significant advances in wound care. A retrospective observational study was undertaken to observe current wound care practice and to assess the effect of various medical factors on wound healing time on 24 elderly patients throughout their wound journey. Wound length was found to be substantively and significantly associated with wound healing time, with a reduction in instantaneous healing rate of about 30% for every increase of 1 cm in wound length. Hence, longer wounds are associated with longer wound healing times. Prescription of several categories of drugs, including those for ischaemic heart disease (IHD), hypertension, respiratory disease or asthma; and the age of the patient were not significantly associated with wound healing times, although substantive significance could be inferred in the case of prescription for IHD and asthma. Despite the small sample size, this study identified a clear association between healing and length of wound. Neither the comorbidities nor prescriptions explored showed any significant association although some seem to be more prevalent in this patient group. The study also highlighted other issues that require further exploration including the social and economic impact of these wounds. © 2011 The Authors. © 2011 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

A concealed observational study of infection control and safe injection practices in Jordanian governmental hospitals.

PubMed

Al-Rawajfah, Omar M; Tubaishat, Ahmad

2017-10-01

The recognized international organizations on infection prevention recommend using an observational method as the gold standard procedure for assessing health care professional's compliance with standard infection control practices. However, observational studies are rarely used in Jordanian infection control studies. This study aimed to evaluate injection practices among nurses working in Jordanian governmental hospitals. A cross-sectional concealed observational design is used for this study. A convenience sampling technique was used to recruit a sample of nurses working in governmental hospitals in Jordan. Participants were unaware of the time and observer during the observation episode. A total of 384 nurses from 9 different hospitals participated in the study. A total of 835 injections events were observed, of which 73.9% were performed without handwashing, 64.5% without gloving, and 27.5% were followed by needle recapping. Handwashing rate was the lowest (18.9%) when injections were performed by beginner nurses. Subcutaneous injections were associated with the lowest rate (26.7%) of postinjection handwashing compared with other routes. This study demonstrates the need for focused and effective infection control educational programs in Jordanian hospitals. Future studies should consider exploring the whole infection control practices related to waste disposal and the roles of the infection control nurse in this process in Jordanian hospitals. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Establishing the reliability of rhesus macaque social network assessment from video observations

PubMed Central

Feczko, Eric; Mitchell, Thomas A. J.; Walum, Hasse; Brooks, Jenna M.; Heitz, Thomas R.; Young, Larry J.; Parr, Lisa A.

2015-01-01

Understanding the properties of a social environment is important for understanding the dynamics of social relationships. Understanding such dynamics is relevant for multiple fields, ranging from animal behaviour to social and cognitive neuroscience. To quantify social environment properties, recent studies have incorporated social network analysis. Social network analysis quantifies both the global and local properties of a social environment, such as social network efficiency and the roles played by specific individuals, respectively. Despite the plethora of studies incorporating social network analysis, methods to determine the amount of data necessary to derive reliable social networks are still being developed. Determining the amount of data necessary for a reliable network is critical for measuring changes in the social environment, for example following an experimental manipulation, and therefore may be critical for using social network analysis to statistically assess social behaviour. In this paper, we extend methods for measuring error in acquired data and for determining the amount of data necessary to generate reliable social networks. We derived social networks from a group of 10 male rhesus macaques, Macaca mulatta, for three behaviours: spatial proximity, grooming and mounting. Behaviours were coded using a video observation technique, where video cameras recorded the compound where the 10 macaques resided. We collected, coded and used 10 h of video data to construct these networks. Using the methods described here, we found in our data that 1 h of spatial proximity observations produced reliable social networks. However, this may not be true for other studies due to differences in data acquisition. Our results have broad implications for measuring and predicting the amount of error in any social network, regardless of species. PMID:26392632

The utility of observational studies in clinical decision making: lessons learned from statin trials.

PubMed

Foody, JoAnne M; Mendys, Phillip M; Liu, Larry Z; Simpson, Ross J

2010-05-01

Contemporary clinical decision making is well supported by a wide variety of information sources, including clinical practice guidelines, position papers, and insights from randomized controlled trials (RCTs). Much of our fundamental understanding of cardiovascular risk factors is based on multiple observations from major epidemiologic studies, such as The Seven Country Studies and the US-based Framingham Heart Study. These studies provided the framework for the development of clinical practice guidelines, including the National Cholesterol Education Program Adult Treatment Panel series. The objective of this article is to highlight the value of observational studies as a complement to clinical trial data for clinical decision making in real-world practice. Although RCTs are still the benchmark for assessing clinical efficacy and safety of a specific therapeutic approach, they may be of limited utility to practitioners who must then adapt the lessons learned from the trial into the patient care environment. The use of well-structured observational studies can improve our understanding of the translation of clinical trials into clinical practice, as demonstrated here with the example of statins. Although such studies have their own limitations, improved techniques for design and analysis have reduced the impact of bias and confounders. The introduction of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines has provided more uniformity for such studies. When used together with RCTs, observational studies can enhance our understanding of effectiveness and utility in real-world clinical practice. In the examples of statin observational studies, the results suggest that relative effectiveness of different statins and potential impact of switching statins should be carefully considered in treating individual patients by practicing physicians.

Clinical assessment of patients with recalcitrant psoriasis in a randomized, observer-blind, vehicle-controlled trial using indigo naturalis.

PubMed

Lin, Yin-Ku; Chang, Chee-Jen; Chang, Ya-Ching; Wong, Wen-Rou; Chang, Shu-Chen; Pang, Jong-Hwei Su

2008-11-01

To evaluate the efficacy and safety of treatment with indigo naturalis in patients with recalcitrant plaque-type psoriasis. Randomized, observer-blind, vehicle-controlled, intrapatient comparison study. Ambulatory department of a hospital. Forty-two outpatients with chronic plaque psoriasis were enrolled in the study from May 1, 2004, to April 30, 2005. The patients applied either indigo naturalis ointment or vehicle ointment topically to each of 2 bilaterally symmetrical psoriatic plaque lesions for 12 weeks (depending on the date of enrollment in the study). The outcomes were assessed using the following criteria: the sum of erythema, scaling, and induration scores and the clearing percentage of the target plaque lesion assessed by 2 blinded observers. Significant reductions in the sum of scaling, erythema, and induration scores (P < .001) (mean score, 6.3 after indigo naturalis treatment vs 12.8 in control subjects) and plaque area percentage (P < .001) (mean percentage, 38.5% after indigo naturalis treatment vs 90% in controls) were achieved with topical application of indigo naturalis ointment. Approximately 31 of 42 patients (74%) experienced clearance or near clearance of their psoriasis in the indigo ointment-treated lesion. Topical indigo naturalis ointment was a novel, safe, and effective therapy for plaque-type psoriasis.

The Observing Working Group for the Asteroid Impact & Delfection Assessment (AIDA) Mission

NASA Astrophysics Data System (ADS)

Osip, David J.; Rivkin, Andrew S.; Pravec, Petr; Moskovitz, Nicholas; Thirouin, Audrey; Scheirich, Peter; Oszkiewicz, Dagmara Anna; Richardson, Derek C.; Polishook, David; Ryan, William; Thomas, Cristina; Busch, Michael W.; Cheng, Andrew F.; Michel, Patrick; AIDA Observing Working Group

2016-10-01

The Asteroid Impact & Deflection Assessment (AIDA) mission is a joint ESA-NASA mission concept currently under study. AIDA has two components: the Double Asteroid Redirect Test (DART) is the US component designed to demonstrate a kinetic impactor, while the Asteroid Impact Mission (AIM) spacecraft is on station to do a thorough pre- and post-impact survey of the Didymos system.Members of the DART and AIM Investigation teams have been organized into several joint and independent working groups. While there is overlap in subject matter and membership between the groups, we focus here on the activities of the Observing Working Group.The first work by the group was undertaken during the spring of 2015, before DART entered Phase A. During this period Didymos made an apparition reaching roughly V ~ 20.5 in brightness, and our top priority was constraining which of two very different pole positions for the Didymos system was correct. Several telescopes in the 2-4-m aperture range around the world attempted observations. An observed mutual event allowed the one pole position to be ruled out. Didymos is now thought to be a low-obliquity, retrograde rotator, similar to many other asteroid binary systems and consistent with expectations from a YORP-driven origin for the satellite.We have begun planning for the 2017 apparition, occurring in the first half of the year. Didymos will be ~20% brighter at opposition than the 2015 apparition. Scaling from the successful observations with the 4.3-m Lowell Discovery Channel Telescope indicates that we will need telescopes at least 4 m (or larger, for some of the tasks, or at times longer before or after the opposition) in primary diameter for the advanced characterization in 2017.Currently, we have four goals for this apparition: 1) confirming the preferred retrograde pole position; 2) gathering data to allow BYORP-driven changes in the mutual orbit to potentially be determined by later observations; 3) establishing whether or not the

The implementation of a mobile problem-specific electronic CEX for assessing directly observed student-patient encounters.

PubMed

Ferenchick, Gary S; Foreback, Jami; Towfiq, Basim; Kavanaugh, Kevin; Solomon, David; Mohmand, Asad

2010-01-29

Facilitating direct observation of medical students' clinical competencies is a pressing need. We developed an electronic problem-specific Clinical Evaluation Exercise (eCEX) based on a national curriculum. We assessed its feasibility in monitoring and recording students' competencies and the impact of a grading incentive on the frequency of direct observations in an internal medicine clerkship. Students (n = 56) at three clinical sites used the eCEX and comparison students (n = 56) at three other clinical sites did not. Students in the eCEX group were required to arrange 10 evaluations with faculty preceptors. Students in the second group were required to document a single, faculty observed 'Full History and Physical' encounter with a patient. Students and preceptors were surveyed at the end of each rotation. eCEX increased students' and evaluators' understanding of direct-observation objectives and had a positive impact on the evaluators' ability to provide feedback and assessments. The grading incentive increased the number of times a student reported direct observation by a resident preceptor. eCEX appears to be an effective means of enhancing student evaluation.

Embedding clinical interventions into observational studies

PubMed Central

Newman, Anne B.; Avilés-Santa, M. Larissa; Anderson, Garnet; Heiss, Gerardo; Howard, Wm. James; Krucoff, Mitchell; Kuller, Lewis H.; Lewis, Cora E.; Robinson, Jennifer G.; Taylor, Herman; Treviño, Roberto P.; Weintraub, William

2017-01-01

Novel approaches to observational studies and clinical trials could improve the cost-effectiveness and speed of translation of research. Hybrid designs that combine elements of clinical trials with observational registries or cohort studies should be considered as part of a long-term strategy to transform clinical trials and epidemiology, adapting to the opportunities of big data and the challenges of constrained budgets. Important considerations include study aims, timing, breadth and depth of the existing infrastructure that can be leveraged, participant burden, likely participation rate and available sample size in the cohort, required sample size for the trial, and investigator expertise. Community engagement and stakeholder (including study participants) support are essential for these efforts to succeed. PMID:26611435

Alcohol Intake and Risk of Thyroid Cancer: A Meta-Analysis of Observational Studies.

PubMed

Hong, Seung-Hee; Myung, Seung-Kwon; Kim, Hyeon Suk

2017-04-01

The purpose of this study was to assess whether alcohol intake is associated with the risk of thyroid cancer by a meta-analysis of observational studies. We searched PubMed and EMBASE in June of 2015 to locate eligible studies. We included observational studies such as cross-sectional studies, case-control studies, and cohort studies reporting odd ratios (ORs) or relative risk (RRs) with 95% confidence intervals (CIs). We included 33 observational studies with two cross-sectional studies, 20 case-controls studies, and 11 cohort studies, which involved a total of 7,725 thyroid cancer patients and 3,113,679 participants without thyroid cancer in the final analysis. In the fixed-effect model meta-analysis of all 33 studies, we found that alcohol intake was consistently associated with a decreased risk of thyroid cancer (OR or RR, 0.74; 95% CI, 0.67 to 0.83; I 2 =38.6%). In the subgroup meta-analysis by type of study, alcohol intake also decreased the risk of thyroid cancer in both case-control studies (OR, 0.77; 95% CI, 0.65 to 0.92; I 2 =29.5%; n=20) and cohort studies (RR, 0.70; 95% CI, 0.60 to 0.82; I 2 =0%; n=11). Moreover, subgroup meta-analyses by type of thyroid cancer, gender, amount of alcohol consumed, and methodological quality of study showed that alcohol intake was significantly associated with a decreased risk of thyroid cancer. The current meta-analysis of observational studies found that, unlike most of other types of cancer, alcohol intake decreased the risk of thyroid cancer.

Alcohol Intake and Risk of Thyroid Cancer: A Meta-Analysis of Observational Studies

PubMed Central

Hong, Seung-Hee; Myung, Seung-Kwon; Kim, Hyeon Suk

2017-01-01

Purpose The purpose of this study was to assess whether alcohol intake is associated with the risk of thyroid cancer by a meta-analysis of observational studies. Materials and Methods We searched PubMed and EMBASE in June of 2015 to locate eligible studies. We included observational studies such as cross-sectional studies, case-control studies, and cohort studies reporting odd ratios (ORs) or relative risk (RRs) with 95% confidence intervals (CIs). Results We included 33 observational studies with two cross-sectional studies, 20 case-controls studies, and 11 cohort studies, which involved a total of 7,725 thyroid cancer patients and 3,113,679 participants without thyroid cancer in the final analysis. In the fixed-effect model meta-analysis of all 33 studies, we found that alcohol intake was consistently associated with a decreased risk of thyroid cancer (OR or RR, 0.74; 95% CI, 0.67 to 0.83; I2=38.6%). In the subgroup meta-analysis by type of study, alcohol intake also decreased the risk of thyroid cancer in both case-control studies (OR, 0.77; 95% CI, 0.65 to 0.92; I2=29.5%; n=20) and cohort studies (RR, 0.70; 95% CI, 0.60 to 0.82; I2=0%; n=11). Moreover, subgroup meta-analyses by type of thyroid cancer, gender, amount of alcohol consumed, and methodological quality of study showed that alcohol intake was significantly associated with a decreased risk of thyroid cancer. Conclusion The current meta-analysis of observational studies found that, unlike most of other types of cancer, alcohol intake decreased the risk of thyroid cancer. PMID:27456949

Direct observation of students during clerkship rotations: a multiyear descriptive study.

PubMed

Howley, Lisa D; Wilson, William G

2004-03-01

To determine how often students report that they are observed while performing physical examinations and taking histories during clerkship rotations. From 1999-2001, 397 students at the University of Virginia School of Medicine were asked at the end of their third year to report the number of times they had been observed by a resident or faculty member while taking histories and performing physical examinations on six rotations. Three hundred and forty-five students (87%) returned the survey instrument; of these, 322 (81%) returned instruments with complete information. On average, the majority reported that they had never been observed by a faculty member while taking a history (51%), performing a focused physical examination (54%), or a complete physical examination (81%). The majority (60%) reported that they had never been observed by a resident while performing a complete physical examination. Faculty observations occurred most frequently during the four-week family medicine rotation and least frequently during the 12-week surgery rotation. The length of the clerkship rotation was inversely related to the number of reported observations, chi(2) (5, n = 295) = 127.85, p <.000. Although alternative assessments of clinical skills are becoming more common in medical education, faculty ratings based on direct observation are still prominent. The data in this study reflect that these observations may actually be occurring quite infrequently, if at all. Decreasing the evaluative weight of faculty and resident ratings during the clerkship rotation may be necessary. Otherwise, efforts should be made to increase the validity of these ratings.

A comparison of three observational techniques for assessing postural loads in industry.

PubMed

Kee, Dohyung; Karwowski, Waldemar

2007-01-01

This study aims to compare 3 observational techniques for assessing postural load, namely, OWAS, RULA, and REBA. The comparison was based on the evaluation results generated by the classification techniques using 301 working postures. All postures were sampled from the iron and steel, electronics, automotive, and chemical industries, and a general hospital. While only about 21% of the 301 postures were classified at the action category/level 3 or 4 by both OWAS and REBA, about 56% of the postures were classified into action level 3 or 4 by RULA. The inter-method reliability for postural load category between OWAS and RULA was just 29.2%, and the reliability between RULA and REBA was 48.2%. These results showed that compared to RULA, OWAS, and REBA generally underestimated postural loads for the analyzed postures, irrespective of industry, work type, and whether or not the body postures were in a balanced state.

Registration practices for observational studies on ClinicalTrials.gov indicated low adherence.

PubMed

Boccia, Stefania; Rothman, Kenneth J; Panic, Nikola; Flacco, Maria Elena; Rosso, Annalisa; Pastorino, Roberta; Manzoli, Lamberto; La Vecchia, Carlo; Villari, Paolo; Boffetta, Paolo; Ricciardi, Walter; Ioannidis, John P A

2016-02-01

The study aims to assess the status of registration of observational studies. We identified studies on cancer research with prospective recruitment of participants that were registered from February 2000 to December 2011 in ClinicalTrials.gov. We recorded the dates of registration and start of recruitment, outcomes, and description of statistical method. We searched for publications corresponding to the registered studies through May 31, 2014. One thousand one hundred nine registered studies were eligible. Primary and secondary outcomes were reported in 809 (73.0%) and 464 (41.8%) of them. The date of registration preceded the month of the study start in 145 (13.8%) and coincided in 205 (19.5%). A total of 151 publications from 120 (10.8%) registered studies were identified. In 2 (33.3%) of the 6 publications where ClinicalTrials.gov reported that the study started recruitment after registration, and in 9 (50.0%) of 18 publications where ClinicalTrials.gov reported the same date for registration and start of recruitment, the articles showed that the study had actually started recruiting before registration. During the period reviewed, few observational studies have been registered. Registration usually occurred after the study started, and prespecification of outcomes and statistical analysis rarely occurred. Copyright © 2016 Elsevier Inc. All rights reserved.

Exposure to fluoride in drinking water and hip fracture risk: a meta-analysis of observational studies.

PubMed

Yin, Xin-Hai; Huang, Guang-Lei; Lin, Du-Ren; Wan, Cheng-Cheng; Wang, Ya-Dong; Song, Ju-Kun; Xu, Ping

2015-01-01

Many observational studies have shown that exposure to fluoride in drinking water is associated with hip fracture risk. However, the findings are varied or even contradictory. In this work, we performed a meta-analysis to assess the relationship between fluoride exposure and hip fracture risk. PubMed and EMBASE databases were searched to identify relevant observational studies from the time of inception until March 2014 without restrictions. Data from the included studies were extracted and analyzed by two authors. Summary relative risks (RRs) with corresponding 95% confidence intervals (CIs) were pooled using random- or fixed-effects models as appropriate. Sensitivity analyses and meta-regression were conducted to explore possible explanations for heterogeneity. Finally, publication bias was assessed. Fourteen observational studies involving thirteen cohort studies and one case-control study were included in the meta-analysis. Exposure to fluoride in drinking water does not significantly increase the incidence of hip fracture (RRs, 1.05; 95% CIs, 0.96-1.15). Sensitivity analyses based on adjustment for covariates, effect measure, country, sex, sample size, quality of Newcastle-Ottawa Scale scores, and follow-up period validated the strength of the results. Meta-regression showed that country, gender, quality of Newcastle-Ottawa Scale scores, adjustment for covariates and sample size were not sources of heterogeneity. Little evidence of publication bias was observed. The present meta-analysis suggests that chronic fluoride exposure from drinking water does not significantly increase the risk of hip fracture. Given the potential confounding factors and exposure misclassification, further large-scale, high-quality studies are needed to evaluate the association between exposure to fluoride in drinking water and hip fracture risk.

Exposure to Fluoride in Drinking Water and Hip Fracture Risk: A Meta-Analysis of Observational Studies

PubMed Central

Yin, Xin-Hai; Huang, Guang-Lei; Lin, Du-Ren; Wan, Cheng-Cheng; Wang, Ya-Dong; Song, Ju-Kun; Xu, Ping

2015-01-01

Background Many observational studies have shown that exposure to fluoride in drinking water is associated with hip fracture risk. However, the findings are varied or even contradictory. In this work, we performed a meta-analysis to assess the relationship between fluoride exposure and hip fracture risk. Methods PubMed and EMBASE databases were searched to identify relevant observational studies from the time of inception until March 2014 without restrictions. Data from the included studies were extracted and analyzed by two authors. Summary relative risks (RRs) with corresponding 95% confidence intervals (CIs) were pooled using random- or fixed-effects models as appropriate. Sensitivity analyses and meta-regression were conducted to explore possible explanations for heterogeneity. Finally, publication bias was assessed. Results Fourteen observational studies involving thirteen cohort studies and one case-control study were included in the meta-analysis. Exposure to fluoride in drinking water does not significantly increase the incidence of hip fracture (RRs, 1.05; 95% CIs, 0.96–1.15). Sensitivity analyses based on adjustment for covariates, effect measure, country, sex, sample size, quality of Newcastle–Ottawa Scale scores, and follow-up period validated the strength of the results. Meta-regression showed that country, gender, quality of Newcastle–Ottawa Scale scores, adjustment for covariates and sample size were not sources of heterogeneity. Little evidence of publication bias was observed. Conclusion The present meta-analysis suggests that chronic fluoride exposure from drinking water does not significantly increase the risk of hip fracture. Given the potential confounding factors and exposure misclassification, further large-scale, high-quality studies are needed to evaluate the association between exposure to fluoride in drinking water and hip fracture risk. PMID:26020536

Embedding clinical interventions into observational studies.

PubMed

Newman, Anne B; Avilés-Santa, M Larissa; Anderson, Garnet; Heiss, Gerardo; Howard, Wm James; Krucoff, Mitchell; Kuller, Lewis H; Lewis, Cora E; Robinson, Jennifer G; Taylor, Herman; Treviño, Roberto P; Weintraub, William

2016-01-01

Novel approaches to observational studies and clinical trials could improve the cost-effectiveness and speed of translation of research. Hybrid designs that combine elements of clinical trials with observational registries or cohort studies should be considered as part of a long-term strategy to transform clinical trials and epidemiology, adapting to the opportunities of big data and the challenges of constrained budgets. Important considerations include study aims, timing, breadth and depth of the existing infrastructure that can be leveraged, participant burden, likely participation rate and available sample size in the cohort, required sample size for the trial, and investigator expertise. Community engagement and stakeholder (including study participants) support are essential for these efforts to succeed. Copyright © 2015. Published by Elsevier Inc.

Development of a systematic observation protocol of physical exposure of the back: a preliminary study.

PubMed

Tousignant, M; Tougas, G; Rossignol, M; Goulet, L

2002-04-01

At present there is no systematic observation protocol for the assessment of the multi-factorial aspects of physical exposure related to the back used within the constraints of occupational epidemiological research. In this context, a new preliminary systematic observation protocol is proposed to assess exposure to physical loading of the back using nine categories of physical risk factors: the SOPE back protocol. The objective of this study was to investigate whether the new protocol can correctly identify the level of exposure related to measured physical loading of the back. The subjects of this closed cohort study were 451 manual workers at a natural gas distribution company. The assessment of exposure was made with the protocol using groups with different job titles. The workers were followed for a 2 yr period to establish the risk of a new occurrence of complete disability related to the back (NOCD back injury) in each job grouping. Based on the median of the total scores derived from the protocol, two levels of exposure were identified (high and low). Taking into account the limitations of this study, the protocol in development may be a good tool to establish two levels of exposure to physical loading of the back in large epidemiological studies of occupational low back pain. Further research is needed to replicate these results with larger samples and to test the reliability and predictive validity of the protocol.

Distracted Biking: An Observational Study.

PubMed

Wolfe, Elizabeth Suzanne; Arabian, Sandra Strack; Breeze, Janis L; Salzler, Matthew J

2016-01-01

Commuting via bicycle is a very popular mode of transportation in the Northeastern United States. Boston, MA, has seen a rapid increase in bicycle ridership over the past decade, which has raised concerns and awareness about bicycle safety. An emerging topic in this field is distracted bicycle riding. This study was conducted to provide descriptive data on the prevalence and type of distracted bicycling in Boston at different times of day. This was a cross-sectional study in which observers tallied bicyclists at 4 high traffic intersections in Boston during various peak commuting hours for 2 types of distractions: auditory (earbuds/phones in or on ears), and visual/tactile (electronic device or other object in hand). Nineteen hundred seventy-four bicyclists were observed and 615 (31.2%), 95% CI [29, 33%], were distracted. Of those observed, auditory distractions were the most common (N = 349; 17.7%), 95% CI [16, 19], p = .0003, followed by visual/tactile distractions (N = 266; 13.5%), 95% CI [12, 15]. The highest proportion (40.7%), 95% CI [35, 46], of distracted bicyclists was observed during the midday commute (between 13:30 and 15:00). Distracted bicycling is a prevalent safety concern in the city of Boston, as almost a third of all bicyclists exhibited distracted behavior. Education and public awareness campaigns should be designed to decrease distracted bicycling behaviors and promote bicycle safety in Boston. An awareness of the prevalence of distracted biking can be utilized to promote bicycle safety campaigns dedicated to decreasing distracted bicycling and to provide a baseline against which improvements can be measured.

A Numerical Climate Observing Network Design Study

NASA Technical Reports Server (NTRS)

Stammer, Detlef

2003-01-01

This project was concerned with three related questions of an optimal design of a climate observing system: 1. The spatial sampling characteristics required from an ARGO system. 2. The degree to which surface observations from ARGO can be used to calibrate and test satellite remote sensing observations of sea surface salinity (SSS) as it is anticipated now. 3. The more general design of an climate observing system as it is required in the near future for CLIVAR in the Atlantic. An important question in implementing an observing system is that of the sampling density required to observe climate-related variations in the ocean. For that purpose this project was concerned with the sampling requirements for the ARGO float system, but investigated also other elements of a climate observing system. As part of this project we studied the horizontal and vertical sampling characteristics of a global ARGO system which is required to make it fully complementary to altimeter data with the goal to capture climate related variations on large spatial scales (less thanAttachment: 1000 km). We addressed this question in the framework of a numerical model study in the North Atlantic with an 1/6 horizontal resolution. The advantage of a numerical design study is the knowledge of the full model state. Sampled by a synthetic float array, model results will therefore allow to test and improve existing deployment strategies with the goal to make the system as optimal and cost-efficient as possible. Attachment: "Optimal observations for variational data assimilation".

Design and implementation of observational studies to measure disease burden with a focus on stroke.

PubMed

Howard, George; Howard, Virginia J

2018-02-01

Observational epidemiological studies have the dual goals of measuring disease burden and assessing the association between exposures and outcomes. This report focuses on the first of these goals and provides an overview of design considerations of commonly used approaches, specifically community surveillance studies, cross-sectional studies, and longitudinal cohort studies. Each of these designs has strengths and weaknesses, with no study design being superior in all cases. Rather, these designs are complementary to achieve a better understanding of the burden of stroke.

Questionnaire-based assessment of executive functioning: Case studies.

PubMed

Kronenberger, William G; Castellanos, Irina; Pisoni, David B

2018-01-01

Delays in the development of executive functioning skills are frequently observed in pediatric neuropsychology populations and can have a broad and significant impact on quality of life. As a result, assessment of executive functioning is often relevant for the development of formulations and recommendations in pediatric neuropsychology clinical work. Questionnaire-based measures of executive functioning behaviors in everyday life have unique advantages and complement traditional neuropsychological measures of executive functioning. Two case studies of children with spina bifida are presented to illustrate the clinical use of a new questionnaire measure of executive and learning-related functioning, the Learning, Executive, and Attention Functioning Scale (LEAF). The LEAF emphasizes clinical utility in assessment by incorporating four characteristics: brevity in administration, breadth of additional relevant content, efficiency of scoring and interpretation, and ease of availability for use. LEAF results were consistent with another executive functioning checklist in documenting everyday behavior problems related to working memory, planning, and organization while offering additional breadth of assessment of domains such as attention, processing speed, and novel problem-solving. These case study results demonstrate the clinical utility of questionnaire-based measurement of executive functioning in pediatric neuropsychology and provide a new measure for accomplishing this goal.

Single-Dose Hepatitis A Immunization: 7.5-Year Observational Pilot Study in Nicaraguan Children to Assess Protective Effectiveness and Humoral Immune Memory Response.

PubMed

Mayorga, Orlando; Bühler, Silja; Jaeger, Veronika K; Bally, Seraina; Hatz, Christoph; Frösner, Gert; Protzer, Ulrike; Van Damme, Pierre; Egger, Matthias; Herzog, Christian

2016-11-15

 Universal 2-dose hepatitis A virus (HAV) vaccination of toddlers effectively controls hepatitis A. High vaccine costs, however, impede implementation in endemic countries. To test single-dose vaccination as a possible alternative, we initiated an observational, longitudinal study in Nicaragua, to assess protective effectiveness and-through challenge vaccination-humoral immune memory response.  After a 2003 serosurvey, 130 originally seronegative children received one dose of virosomal HAV vaccine in 2005, followed by yearly serological and clinical assessments until 2012. After 7.5 years, a vaccine booster was administered. Concurrent antibody screening of patients presenting with hepatitis symptoms documented persistent HAV circulation in the communities studied.  Between serosurvey and vaccination, 25 children contracted hepatitis A subclinically (>8000 mIU/mL anti-HAV). In the remaining 105 children, immunization resulted in anti-HAV levels of 17-572 mIU/mL. Based on the ≥15% annual infection risk, an estimated 60% of children were exposed to HAV encounters during follow-up. No child presented with hepatitis symptoms. Serological breakthrough infection (7106 mIU/mL) was documented in 1 child, representing an estimated protective effectiveness of 98.3% (95% confidence interval, 87.9-99.8). Boosting elicited an average 29.7-fold increase of anti-HAV levels.  In children living in hyperendemic settings, a single dose of virosomal HAV vaccine is sufficient to activate immune memory and may provide long-term protection. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Performing Gram stain directly on catheter tips: assessment of the quality of the observation process.

PubMed

Guembe, M; Pérez-Granda, M J; Rivera, M L; Martín-Rabadán, P; Bouza, E

2015-06-01

A previous study performed in our institution showed that catheter tip (CT) staining by combining acridine orange and Gram stain (GS) before culture anticipated catheter colonization with exhaustive and careful observation by a highly trained technician. Our objective was to assess the validity values of GS without acridine orange on an external smear of CT for predicting catheter colonization and catheter-related bloodstream infection (C-RBSI). We compared different periods of observation and the results of two technicians with different levels of professional experience. Over a 5-month period, the roll-plate technique was preceded by direct GS of all CTs sent to the microbiology laboratory. The reading was taken at ×100 by two observers with different skill levels. Each observer performed a routine examination (3 min along three longitudinal lines) and an exhaustive examination (5 min along five longitudinal lines). The presence of at least one cell was considered positive. All slides were read before culture results were known. We included a total of 271 CTs from 209 patients. The prevalence of catheter colonization and C-RBSI was 16.2 % and 5.1 %, respectively. Routine and exhaustive examinations revealed only 29.5 % and 40.9 % of colonized catheters, respectively (p < 0.001). In contrast, they revealed high negative predictive values for C-RBSI (96.5 % and 96.3 %, respectively). Our study shows that the yield of GS performed directly on CTs is greater when staining is performed exhaustively. However, the decision to implement this approach in daily routine will depend on the prevalence rate of catheter colonization at each institution.

Using climate derivatives for assessment of meteorological parameter relationships in RCM and observations

NASA Astrophysics Data System (ADS)

Timuhins, Andrejs; Bethers, Uldis; Bethers, Peteris; Klints, Ilze; Sennikovs, Juris; Frishfelds, Vilnis

2017-04-01

In a changing climate it is essential to estimate its impacts on different economic fields. In our study we tried to create a framework for climate change assessment and climate change impact estimation for the territory of Latvia and to create results which are also understandable for non-scientists (stakeholder, media and public). This approach allowed us to more carefully assess the presentation and interpretation of results and their validation, for public viewing. For the presentation of our work a website was created (www.modlab.lv/klimats) containing two types of documents in a unified framework, meteorological parameter analysis of different easily interpretable derivative values. Both of these include analysis of the current situation as well as illustrate the projection for future time periods. Derivate values are calculated using two data sources: the bias corrected regional climate data and meteorological observation data. Derivative documents contain description of derived value, some interesting facts and conclusions. Additionally, all results may be viewed in temporal and spatial graphs and maps, for different time periods as well as different seasons. Bias correction (Sennikovs and Bethers, 2009) for the control period 1961-1990 is applied to RCM data series. Meteorological observation data of the Latvian Environment, Geology, and Meteorology Agency and ENSEMBLES project daily data of 13 RCM runs for the period 1960-2100 are used. All the documents are prepared in python notebooks, which allow for flexible changes. At the moment following derivative values have been published: forest fire risk index, wind energy, phenology (Degree days), road condition (friction, ice conditions), daily minimal meteorological visibility, headache occurrence rate, firs snow date and meteorological parameter analysis: temperature, precipitation, wind speed, relative humidity, and cloudiness. While creating these products RCM ability to represent the actual climate was

Steroidal contraceptives and bone fractures in women: evidence from observational studies.

PubMed

Lopez, Laureen M; Chen, Mario; Mullins Long, Sarah; Curtis, Kathryn M; Helmerhorst, Frans M

2015-07-21

Age-related decline in bone mass increases the risk of skeletal fractures, especially those of the hip, spine, and wrist. Steroidal contraceptives have been associated with changes in bone mineral density in women. Whether such changes affect the risk of fractures later in life is unclear. Hormonal contraceptives are among the most effective and most widely-used contraceptives. Concern about fractures may limit the use of these effective contraceptives. Observational studies can collect data on premenopausal contraceptive use as well as fracture incidence later in life. We systematically reviewed the evidence from observational studies of hormonal contraceptive use for contraception and the risk of fracture in women. Through June 2015, we searched for observational studies. The databases included PubMed, POPLINE, Cochrane Central Register of Controlled Trials (CENTRAL), LILACS, EMBASE, CINAHL, and Web of Science. We also searched for recent clinical trials through ClinicalTrials.gov and the ICTRP. For other studies, we examined reference lists of relevant articles and wrote to investigators for additional reports. We included cohort and case-control studies of hormonal contraceptive use. Interventions included comparisons of a hormonal contraceptive with a non-hormonal contraceptive, no contraceptive, or another hormonal contraceptive. The primary outcome was the risk of fracture. Two authors independently extracted the data. One author entered the data into RevMan, and a second author verified accuracy. We examined the quality of evidence using the Newcastle-Ottawa Quality Assessment Scale (NOS), developed for case-control and cohort studies. Sensitivity analysis included studies of moderate or high quality based on our assessment with the NOS.Given the need to control for confounding factors in observational studies, we used adjusted estimates from the models as reported by the authors. Where we did not have adjusted analyses, we calculated the odds ratio (OR

Inter-observer agreement of standard joint count examination and disease global assessment in a cohort of Egyptian Rheumatoid Arthritis patients.

PubMed

El-Hadidi, Khaled; Gamal, Sherif M; Saad, Sahar

2017-12-21

To assess the inter-observer agreement of standard joint count between experienced Rheumatology professor (Prof) and young Rheumatology fellow (candidate), and to compare disease global assessment between professor, young candidate and patients. This study included one hundred rheumatoid arthritis patients. For all patients independent clinical evaluation was done by two rheumatologists (professor and candidate) for detection of tenderness in 28 joints and swelling in 26 joints. The study also involved global assessment of disease activity by the provider (Prof and candidate) (EGA) as well as by the patient (PGA). The EGA was determined without previous knowledge of the patient's laboratory test results. A highly significant accordance (correlation) between professor and candidate was found in both the number of tender joints (p<0.001) (r=0.946), and the number of swollen joints (p<0.001) (r=0.797). Regarding swollen joints, the highest agreement was in right knee (0.929), while poor agreement was found in the right 5th MCP (0.049). Regarding tender joints, the highest analogy was in the right elbow (0.899), in contrast to the left 3rd PIP (0.462) which showed the least congruence. Agreement study using kappa measurement for disease global assessment showed: moderate agreement (between professor and candidate) (0.405), fair agreement between (professor and patient) (0.213), fair agreement between (candidate and patient) (0.367). Inter-observer reliability was better for TJCs than SJCs. Regarding SJCs agreement was better in large joints such as the knees compared to the small joints such as the MCPs. Disease global assessment may show discrepancy between patients and physicians. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Assessment of Evapotranspiration and Soil Moisture Content Across Different Scales of Observation.

PubMed

Verstraeten, Willem W; Veroustraete, Frank; Feyen, Jan

2008-01-09

The proper assessment of evapotranspiration and soil moisture content arefundamental in food security research, land management, pollution detection, nutrient flows,(wild-) fire detection, (desert) locust, carbon balance as well as hydrological modelling; etc.This paper takes an extensive, though not exhaustive sample of international scientificliterature to discuss different approaches to estimate land surface and ecosystem relatedevapotranspiration and soil moisture content. This review presents:(i) a summary of the generally accepted cohesion theory of plant water uptake andtransport including a shortlist of meteorological and plant factors influencing planttranspiration;(ii) a summary on evapotranspiration assessment at different scales of observation (sapflow,porometer, lysimeter, field and catchment water balance, Bowen ratio,scintillometer, eddy correlation, Penman-Monteith and related approaches);(iii) a summary on data assimilation schemes conceived to estimate evapotranspirationusing optical and thermal remote sensing; and(iv) for soil moisture content, a summary on soil moisture retrieval techniques atdifferent spatial and temporal scales is presented.Concluding remarks on the best available approaches to assess evapotranspiration and soilmoisture content with and emphasis on remote sensing data assimilation, are provided.

Assessment of human health impact from exposure to multiple air pollutants in China based on satellite observations

NASA Astrophysics Data System (ADS)

Yu, Tao; Wang, Wen; Ciren, Pubu; Zhu, Yan

2016-10-01

Assessment of human health impact caused by air pollution is crucial for evaluating environmental hazards. In this paper, concentrations of six air pollutants (PM10, PM2.5, NO2, SO2, O3, and CO) were first derived from satellite observations, and then the overall human health risks in China caused by multiple air pollutants were assessed using an aggregated health risks index. Unlike traditional approach for human health risks assessment, which relied on the in-situ air pollution measurements, the spatial distribution of aggregated human health risks in China were obtained using satellite observations in this research. It was indicated that the remote sensing data have advantages over in-situ data in accessing human health impact caused by air pollution.

Distracted Biking: An Observational Study

PubMed Central

Wolfe, Elizabeth Suzanne; Arabian, Sandra Strack; Breeze, Janis L; Salzler, Matthew J.

2016-01-01

Commuting via bicycle is a very popular mode of transportation in the Northeastern United States (US). Boston, MA has seen a rapid increase in bicycle ridership over the past decade which has raised concerns and awareness about bicycle safety. An emerging topic in this field is distracted bicycle riding. This study was conducted to provide descriptive data on the prevalence and type of distracted bicycling in Boston at different times of day. This was a cross-sectional study in which observers tallied bicyclists at four high traffic intersections in Boston during various peak commuting hours for two types of distractions: auditory (ear buds/phones in or on ears), and visual/tactile (electronic device or other object in hand). Nineteen hundred seventy-four bicyclists were observed and 615 (31.2%, 95% CI: 29%-33%) were distracted. Of those observed, auditory distractions were the most common (N= 349 [17.7%, 95% CI: 16%-19%], p=0.0003) followed by visual/tactile distractions (N= 266 [13.5%, 95% CI: 12%-15%]). The highest proportion (40.7%, 95% CI: 35%-46%) of distracted bicyclists was observed during the midday commute (between 13:30-15:00). Distracted bicycling is a prevalent safety concern in the city of Boston, as almost one-third of all bicyclists exhibited distracted behavior. Education and public awareness campaigns should be designed to decrease distracted bicycling behaviors and promote bicycle safety in Boston. An awareness of the prevalence of distracted biking can be utilized to promote bicycle safety campaigns dedicated to decreasing distracted bicycling and to provide a baseline against which improvements can be measured. PMID:26953533

Determination of the anaerobic threshold in the pre-operative assessment clinic: inter-observer measurement error.

PubMed

Sinclair, R C F; Danjoux, G R; Goodridge, V; Batterham, A M

2009-11-01

The variability between observers in the interpretation of cardiopulmonary exercise tests may impact upon clinical decision making and affect the risk stratification and peri-operative management of a patient. The purpose of this study was to quantify the inter-reader variability in the determination of the anaerobic threshold (V-slope method). A series of 21 cardiopulmonary exercise tests from patients attending a surgical pre-operative assessment clinic were read independently by nine experienced clinicians regularly involved in clinical decision making. The grand mean for the anaerobic threshold was 10.5 ml O(2).kg body mass(-1).min(-1). The technical error of measurement was 8.1% (circa 0.9 ml.kg(-1).min(-1); 90% confidence interval, 7.4-8.9%). The mean absolute difference between readers was 4.5% with a typical random error of 6.5% (6.0-7.2%). We conclude that the inter-observer variability for experienced clinicians determining the anaerobic threshold from cardiopulmonary exercise tests is acceptable.

Potentially Inappropriate Antihypertensive Prescriptions to Elderly Patients: Results of a Prospective, Observational Study.

PubMed

Márquez, Paola H Ponte; Torres, Olga H; San-José, Anonio; Vidal, Xavier; Agustí, Antonia; Formiga, Francesc; López-Soto, Alfonso; Ramírez-Duque, Nieves; Fernández-Moyano, Antonio; Garcia-Moreno, Juana; Arroyo, Juan A; Ruiz, Domingo

2017-06-01

Previous studies of antihypertensive treatment of older patients have focused on blood pressure control, cardiovascular risk or adherence, whereas data on inappropriate antihypertensive prescriptions to older patients are scarce. The aim of the study was to assess inappropriate antihypertensive prescriptions to older patients. An observational, prospective multicentric study was conducted to assess potentially inappropriate prescription of antihypertensive drugs, in patients aged 75 years and older with arterial hypertension (HTN), in the month prior to hospital admission, using four instruments: Beers, Screening Tool of Older Person's Prescriptions (STOPP), Screening Tool to Alert Doctors to the Right Treatment (START) and Assessing Care of Vulnerable Elders 3 (ACOVE-3). Primary care and hospital electronic records were reviewed for HTN diagnoses, antihypertensive treatment and blood pressure readings. Of 672 patients, 532 (median age 85 years, 56% female) had HTN. 21.6% received antihypertensive monotherapy, 4.7% received no hypertensive treatment, and the remainder received a combination of antihypertensive therapies. The most frequently prescribed antihypertensive drugs were diuretics (53.5%), angiotensin-converting enzyme inhibitors (ACEIs) (41%), calcium antagonists (32.2%), angiotensin receptor blockers (29.7%) and beta-blockers (29.7%). Potentially inappropriate prescription was observed in 51.3% of patients (27.8% overprescription and 35% underprescription). The most frequent inappropriately prescribed drugs were calcium antagonists (overprescribed), ACEIs and beta-blockers (underprescribed). ACEI and beta-blocker underprescriptions were independently associated with heart failure admissions [beta-blockers odds ratio (OR) 0.53, 95% confidence interval (CI) 0.39-0.71, p < 0.001; ACEIs OR 0.50, 95% CI 0.36-0.70, p < 0.001]. Potentially inappropriate prescription was detected in more than half of patients receiving antihypertensive treatment

Assessing Greenhouse Gas emissions in the Greater Toronto Area using atmospheric observations (Invited)

NASA Astrophysics Data System (ADS)

Vogel, F. R.; Chan, E.; Huang, L.; Levin, I.; Worthy, D.

2013-12-01

Urban areas are said to be responsible for approximately 75% of anthropogenic Greenhouse Gases (GHGs) emissions while comprising only two percent of the land area [1]. This limited spatial expansion should facilitate a monitoring of anthropogenic GHGs from atmospheric observations. As major sources of emissions, cities also have a huge potential to drive emissions reductions. To effectively manage emissions, cities must however, first measure and report these publicly [2]. Modelling studies and measurements of CO2 from fossil fuel burning (FFCO2) in densely populated areas does, however, pose several challenges: Besides continuous in-situ observations, i.e. finding an adequate atmospheric transport model, a sufficiently fine-grained FFCO2 emission model and the proper background reference observations to distinguish the large-scale from the local/urban contributions to the observed FFCO2 concentration offsets ( ΔFFCO2) are required. Pilot studies which include the data from two 'sister sites*' in the vicinity of Toronto, Canada helped to derive flux estimates for Non-CO2 GHGs [3] and improve our understanding of urban FFCO2 emissions. Our 13CO2 observations reveal that the contribution of natural gas burning (mostly due to domestic heating) account for 80%×7% of FFCO2 emissions in the Greater Toronto Area (GTA) during winter. Our 14CO2 observations in the GTA, furthermore, show that the local offset of CO2 (ΔCO2) between our two sister sites can be largely attributed to urban FFCO2 emissions. The seasonal cycle of the observed ΔFFCO2 in Toronto, combined with high-resolution atmospheric modeling, helps to independently assess the contribution from different emission sectors (transportation, primary energy and industry, domestic heating) as predicted by a dedicated city-scale emission inventory, which deviates from a UNFCCC-based inventory. [1] D. Dodman. 2009. Blaming cities for climate change? An analysis of urban greenhouse gas emissions inventories

Development of a novel observational measure for anxiety in young children: The Anxiety Dimensional Observation Scale

PubMed Central

Mian, Nicholas D.; Carter, Alice S.; Pine, Daniel S.; Wakschlag, Lauren S.; Briggs-Gowan, Margaret J.

2015-01-01

Background Identifying anxiety disorders in preschool-age children represents an important clinical challenge. Observation is essential to clinical assessment and can help differentiate normative variation from clinically significant anxiety. Yet, most anxiety assessment methods for young children rely on parent-reports. The goal of this article is to present and preliminarily test the reliability and validity of a novel observational paradigm for assessing a range of fearful and anxious behaviors in young children, the Anxiety Dimensional Observation Schedule (Anx-DOS). Methods A diverse sample of 403 children, aged 3 to 6 years, and their mothers was studied. Reliability and validity in relation to parent reports (Preschool Age Psychiatric Assessment) and known risk factors, including indicators of behavioral inhibition (latency to touch novel objects) and attention bias to threat (in the dot-probe task) were investigated. Results The Anx-DOS demonstrated good inter-rater reliability and internal consistency. Evidence for convergent validity was demonstrated relative to mother-reported separation anxiety, social anxiety, phobic avoidance, trauma symptoms, and past service use. Finally, fearfulness was associated with observed latency and attention bias toward threat. Conclusions Findings support the Anx-DOS as a method for capturing early manifestations of fearfulness and anxiety in young children. Multimethod assessments incorporating standardized methods for assessing discrete, observable manifestations of anxiety may be beneficial for early identification and clinical intervention efforts. PMID:25773515

Utility as a rationale for choosing observer performance assessment paradigms for detection tasks in medical imaging.

PubMed

Wunderlich, Adam; Abbey, Craig K

2013-11-01

Studies of lesion detectability are often carried out to evaluate medical imaging technology. For such studies, several approaches have been proposed to measure observer performance, such as the receiver operating characteristic (ROC), the localization ROC (LROC), the free-response ROC (FROC), the alternative free-response ROC (AFROC), and the exponentially transformed FROC (EFROC) paradigms. Therefore, an experimenter seeking to carry out such a study is confronted with an array of choices. Traditionally, arguments for different approaches have been made on the basis of practical considerations (statistical power, etc.) or the gross level of analysis (case-level or lesion-level). This article contends that a careful consideration of utility should form the rationale for matching the assessment paradigm to the clinical task of interest. In utility theory, task performance is commonly evaluated with total expected utility, which integrates the various event utilities against the probability of each event. To formalize the relationship between expected utility and the summary curve associated with each assessment paradigm, the concept of a "natural" utility structure is proposed. A natural utility structure is defined for a summary curve when the variables associated with the summary curve axes are sufficient for computing total expected utility, assuming that the disease prevalence is known. Natural utility structures for ROC, LROC, FROC, AFROC, and EFROC curves are introduced, clarifying how the utilities of correct and incorrect decisions are aggregated by summary curves. Further, conditions are given under which general utility structures for localization-based methodologies reduce to case-based assessment. Overall, the findings reveal how summary curves correspond to natural utility structures of diagnostic tasks, suggesting utility as a motivating principle for choosing an assessment paradigm.

Assessment of safety and efficacy of lamotrigine over the course of 1-year observation in Japanese patients with bipolar disorder: post-marketing surveillance study report

PubMed Central

Terao, Takeshi; Ishida, Atsuko; Kimura, Toshifumi; Yoshida, Mitsuhiro; Hara, Terufumi

2017-01-01

Background A post-marketing surveillance (PMS) study was conducted with a 1-year observation period to assess the safety and efficacy of lamotrigine in routine clinical practice in patients with bipolar disorder (BD). Patients and methods Central enrollment method was used to recruit patients diagnosed with BD who were being treated for the first time with lamotrigine to prevent the recurrence/relapse of BD mood episodes. Adverse drug reactions (ADRs) and recurrence/relapse were assessed. Improvement of mania and depression was also assessed using the Hamilton’s Rating Scale for Depression (HAM-D) and the Young Mania Rating Scale (YMRS) at treatment initiation, 4–6 months post treatment initiation, and 10–12 months post treatment initiation. Results A total of 237/989 patients (24.0%) reported ADRs, most commonly rash (9.1%), and the incidence of serious ADRs was 3.3% (33/989 patients). Skin disorders occurred in 130 patients (13.1%), mostly within 8 weeks post treatment. A total of 237/703 patients (33.7%) experienced recurrence/relapse of mood episodes. The 25th percentile of the time to recurrence/relapse of mood episodes was 105 days. Remission of depression symptoms (HAM-D ≤7) occurred in 147/697 patients (21.1%) at treatment initiation, rising to 361 patients (67.4%) at 10–12 months post treatment. Remission of manic symptoms (YMRS ≤13) occurred in 615/676 patients (91.0%) at treatment initiation, rising to 500 patients (97.3%) at 10–12 months post treatment. Conclusion The results of this PMS study suggest that lamotrigine is a well-tolerated and effective drug for preventing recurrence/relapse of BD in clinical practice. PMID:28652744

Design of a practical model-observer-based image quality assessment method for x-ray computed tomography imaging systems

PubMed Central

Tseng, Hsin-Wu; Fan, Jiahua; Kupinski, Matthew A.

2016-01-01

Abstract. The use of a channelization mechanism on model observers not only makes mimicking human visual behavior possible, but also reduces the amount of image data needed to estimate the model observer parameters. The channelized Hotelling observer (CHO) and channelized scanning linear observer (CSLO) have recently been used to assess CT image quality for detection tasks and combined detection/estimation tasks, respectively. Although the use of channels substantially reduces the amount of data required to compute image quality, the number of scans required for CT imaging is still not practical for routine use. It is our desire to further reduce the number of scans required to make CHO or CSLO an image quality tool for routine and frequent system validations and evaluations. This work explores different data-reduction schemes and designs an approach that requires only a few CT scans. Three different kinds of approaches are included in this study: a conventional CHO/CSLO technique with a large sample size, a conventional CHO/CSLO technique with fewer samples, and an approach that we will show requires fewer samples to mimic conventional performance with a large sample size. The mean value and standard deviation of areas under ROC/EROC curve were estimated using the well-validated shuffle approach. The results indicate that an 80% data reduction can be achieved without loss of accuracy. This substantial data reduction is a step toward a practical tool for routine-task-based QA/QC CT system assessment. PMID:27493982

Comparison of tools for assessing the methodological quality of primary and secondary studies in health technology assessment reports in Germany.

PubMed

Dreier, Maren; Borutta, Birgit; Stahmeyer, Jona; Krauth, Christian; Walter, Ulla

2010-06-14

HEALTH CARE POLICY BACKGROUND: Findings from scientific studies form the basis for evidence-based health policy decisions. Quality assessments to evaluate the credibility of study results are an essential part of health technology assessment reports and systematic reviews. Quality assessment tools (QAT) for assessing the study quality examine to what extent study results are systematically distorted by confounding or bias (internal validity). The tools can be divided into checklists, scales and component ratings. What QAT are available to assess the quality of interventional studies or studies in the field of health economics, how do they differ from each other and what conclusions can be drawn from these results for quality assessments? A systematic search of relevant databases from 1988 onwards is done, supplemented by screening of the references, of the HTA reports of the German Agency for Health Technology Assessment (DAHTA) and an internet search. The selection of relevant literature, the data extraction and the quality assessment are carried out by two independent reviewers. The substantive elements of the QAT are extracted using a modified criteria list consisting of items and domains specific to randomized trials, observational studies, diagnostic studies, systematic reviews and health economic studies. Based on the number of covered items and domains, more and less comprehensive QAT are distinguished. In order to exchange experiences regarding problems in the practical application of tools, a workshop is hosted. A total of eight systematic methodological reviews is identified as well as 147 QAT: 15 for systematic reviews, 80 for randomized trials, 30 for observational studies, 17 for diagnostic studies and 22 for health economic studies. The tools vary considerably with regard to the content, the performance and quality of operationalisation. Some tools do not only include the items of internal validity but also the items of quality of reporting and

Observational study of Arctium lappa in the treatment of acne vulgaris.

PubMed

Miglani, Anjali; Manchanda, Raj K

2014-07-01

Arctium lappa (Lappa) is used in traditional Western and Chinese medicine for acne. It is mentioned in homeopathic literature for acne, but its effect has not previously been evaluated. To determine the effectiveness of homeopathic medicine Lappa in treatment of acne vulgaris. An uncontrolled observational interventional study was conducted on human subjects who fulfilled the inclusion criteria and gave written informed consent. Lappa was prescribed in potencies starting from 6c rising to 1M as required, over a period of 6 months. Objective assessment was change in acne lesion counts supplemented with Global Acne Grading System (GAGS) and subjective assessment by using Acne-Specific Quality of Life questionnaire (Acne-QoL). Out of 34 human subjects, 32 completed the follow-up. Statistical significant results were seen in lesion counts, GAGS and Acne-QoL score (p value <0.001). Lappa has shown positive effects in the treatment of acne especially of inflammatory type. Further controlled, randomized studies with larger sample size are desirable. Trial is registered at ClinicalTrials.gov Identifier: NCT01040390. Copyright © 2013 The Faculty of Homeopathy. Published by Elsevier Ltd. All rights reserved.

Reporting and Methodology of Multivariable Analyses in Prognostic Observational Studies Published in 4 Anesthesiology Journals: A Methodological Descriptive Review.

PubMed

Guglielminotti, Jean; Dechartres, Agnès; Mentré, France; Montravers, Philippe; Longrois, Dan; Laouénan, Cedric

2015-10-01

Prognostic research studies in anesthesiology aim to identify risk factors for an outcome (explanatory studies) or calculate the risk of this outcome on the basis of patients' risk factors (predictive studies). Multivariable models express the relationship between predictors and an outcome and are used in both explanatory and predictive studies. Model development demands a strict methodology and a clear reporting to assess its reliability. In this methodological descriptive review, we critically assessed the reporting and methodology of multivariable analysis used in observational prognostic studies published in anesthesiology journals. A systematic search was conducted on Medline through Web of Knowledge, PubMed, and journal websites to identify observational prognostic studies with multivariable analysis published in Anesthesiology, Anesthesia & Analgesia, British Journal of Anaesthesia, and Anaesthesia in 2010 and 2011. Data were extracted by 2 independent readers. First, studies were analyzed with respect to reporting of outcomes, design, size, methods of analysis, model performance (discrimination and calibration), model validation, clinical usefulness, and STROBE (i.e., Strengthening the Reporting of Observational Studies in Epidemiology) checklist. A reporting rate was calculated on the basis of 21 items of the aforementioned points. Second, they were analyzed with respect to some predefined methodological points. Eighty-six studies were included: 87.2% were explanatory and 80.2% investigated a postoperative event. The reporting was fairly good, with a median reporting rate of 79% (75% in explanatory studies and 100% in predictive studies). Six items had a reporting rate <36% (i.e., the 25th percentile), with some of them not identified in the STROBE checklist: blinded evaluation of the outcome (11.9%), reason for sample size (15.1%), handling of missing data (36.0%), assessment of colinearity (17.4%), assessment of interactions (13.9%), and calibration (34

Study on individual stochastic model of GNSS observations for precise kinematic applications

NASA Astrophysics Data System (ADS)

Próchniewicz, Dominik; Szpunar, Ryszard

2015-04-01

The proper definition of mathematical positioning model, which is defined by functional and stochastic models, is a prerequisite to obtain the optimal estimation of unknown parameters. Especially important in this definition is realistic modelling of stochastic properties of observations, which are more receiver-dependent and time-varying than deterministic relationships. This is particularly true with respect to precise kinematic applications which are characterized by weakening model strength. In this case, incorrect or simplified definition of stochastic model causes that the performance of ambiguity resolution and accuracy of position estimation can be limited. In this study we investigate the methods of describing the measurement noise of GNSS observations and its impact to derive precise kinematic positioning model. In particular stochastic modelling of individual components of the variance-covariance matrix of observation noise performed using observations from a very short baseline and laboratory GNSS signal generator, is analyzed. Experimental test results indicate that the utilizing the individual stochastic model of observations including elevation dependency and cross-correlation instead of assumption that raw measurements are independent with the same variance improves the performance of ambiguity resolution as well as rover positioning accuracy. This shows that the proposed stochastic assessment method could be a important part in complex calibration procedure of GNSS equipment.

Rule-based exposure assessment versus case-by-case expert assessment using the same information in a community-based study.

PubMed

Peters, Susan; Glass, Deborah C; Milne, Elizabeth; Fritschi, Lin

2014-03-01

Retrospective exposure assessment in community-based studies is largely reliant on questionnaire information. Expert assessment is often used to assess lifetime occupational exposures, but these assessments generally lack transparency and are very time-consuming. We explored the agreement between a rule-based assessment approach and case-by-case expert assessment of occupational exposures in a community-based study. We used data from a case-control study of childhood acute lymphoblastic leukaemia in which parental occupational exposures were originally assigned by expert assessment. Key questions were identified from the completed parent questionnaires and, on the basis of these, rules were written to assign exposure levels to diesel exhaust, pesticides and solvents. We estimated exposure prevalence separately for fathers and mothers, and used κ statistics to assess the agreement between the two exposure assessment methods. Exposures were assigned to 5829 jobs among 1079 men and 6189 jobs among 1234 women. For both sexes, agreement was good for the two assessment methods of exposure to diesel exhaust at a job level (κ=0.70 for men and κ=0.71 for women) and at a person level (κ=0.74 and κ=0.75). The agreement was good to excellent for pesticide exposure among men (κ=0.74 for jobs and κ=0.84 at a person level) and women (κ=0.68 and κ=0.71 at a job and person level, respectively). Moderate to good agreement was observed for assessment of solvent exposure, which was better for women than men. The rule-based assessment approach appeared to be an efficient alternative for assigning occupational exposures in a community-based study for a selection of occupational exposures.

Validity of an observation method for assessing pain behavior in individuals with multiple sclerosis.

PubMed

Cook, Karon F; Roddey, Toni S; Bamer, Alyssa M; Amtmann, Dagmar; Keefe, Francis J

2013-09-01

Pain is a common and complex experience for individuals who live with multiple sclerosis (MS) and it interferes with physical, psychological, and social function. A valid and reliable tool for quantifying observed pain behaviors in MS is critical to understand how pain behaviors contribute to pain-related disability in this clinical population. To evaluate the reliability and validity of a pain behavioral observation protocol in individuals who have MS. Community-dwelling volunteers with MS (N=30), back pain (N=5), or arthritis (N=8) were recruited based on clinician referrals, advertisements, fliers, web postings, and participation in previous research. Participants completed the measures of pain severity, pain interference, and self-reported pain behaviors and were videotaped doing typical activities (e.g., walking and sitting). Two coders independently recorded frequencies of pain behaviors by category (e.g., guarding and bracing) and interrater reliability statistics were calculated. Naïve observers reviewed videotapes of individuals with MS and rated their pain. The Spearman's correlations were calculated between pain behavior frequencies and self-reported pain and pain ratings by naïve observers. Interrater reliability estimates indicated the reliability of pain codes in the MS sample. Kappa coefficients ranged from moderate (sighing=0.40) to substantial agreements (guarding=0.83). These values were comparable with those obtained in the combined back pain and arthritis sample. Concurrent validity was supported by correlations with self-reported pain (0.46-0.53) and with self-reports of pain behaviors (0.58). Construct validity was supported by a finding of 0.87 correlation between total pain behaviors observed by coders and mean pain ratings by naïve observers. Results support the use of the pain behavior observation protocol for assessing pain behaviors of individuals with MS. Valid assessments of pain behaviors of individuals with MS could lead to

Validity of an Observation Method for Assessing Pain Behavior in Individuals With Multiple Sclerosis

PubMed Central

Cook, Karon F.; Roddey, Toni S.; Bamer, Alyssa M.; Amtmann, Dagmar; Keefe, Francis J

2012-01-01

Context Pain is a common and complex experience for individuals who live with multiple sclerosis (MS) that interferes with physical, psychological and social function. A valid and reliable tool for quantifying observed pain behaviors in MS is critical to understanding how pain behaviors contribute to pain-related disability in this clinical population. Objectives To evaluate the reliability and validity of a pain behavioral observation protocol in individuals who have MS. Methods Community-dwelling volunteers with multiple sclerosis (N=30), back pain (N=5), or arthritis (N=8) were recruited based on clinician referrals, advertisements, fliers, web postings, and participation in previous research. Participants completed measures of pain severity, pain interference, and self-reported pain behaviors and were videotaped doing typical activities (e.g., walking, sitting). Two coders independently recorded frequencies of pain behaviors by category (e.g., guarding, bracing) and inter-rater reliability statistics were calculated. Naïve observers reviewed videotapes of individuals with MS and rated their pain. Spearman correlations were calculated between pain behavior frequencies and self-reported pain and pain ratings by naïve observers. Results Inter-rater reliability estimates indicated the reliability of pain codes in the MS sample. Kappa coefficients ranged from moderate agreement (sighing = 0.40) to substantial agreement (guarding = 0.83). These values were comparable to those obtained in the combined back pain and arthritis sample. Concurrent validity was supported by correlations with self-reported pain (0.46-0.53) and with self-reports of pain behaviors (0.58). Construct validity was supported by finding of 0.87 correlation between total pain behaviors observed by coders and mean pain ratings by naïve observers. Conclusion Results support use of the pain behavior observation protocol for assessing pain behaviors of individuals with MS. Valid assessments of pain

Nutrition and physical activity in child care centers: the impact of a wellness policy initiative on environment and policy assessment and observation outcomes, 2011.

PubMed

Lyn, Rodney; Maalouf, Joyce; Evers, Sarah; Davis, Justin; Griffin, Monica

2013-05-23

The child care environment has emerged as an ideal setting in which to implement policies that promote healthy body weight of children. The purpose of this study was to assess the effect of a wellness policy and training program on the physical activity and nutrition environment in 24 child care centers in Georgia. We used the Environment and Policy Assessment and Observation instrument to identify changes to foods served, staff behaviors, and physical activity opportunities. Observations were performed over 1 day, beginning with breakfast and concluding when the program ended for the day. Observations were conducted from February 2010 through April 2011 for a total of 2 observations in each center. Changes to nutrition and physical activity in centers were assessed on the basis of changes in scores related to the physical activity and nutrition environment documented in the observations. Paired t test analyses were performed to determine significance of changes. Significant improvements to total nutrition (P < .001) and physical activity scores (P < .001) were observed. Results indicate that centers significantly improved the physical activity environments of centers by enhancing active play (P = .02), the sedentary environment (P = .005), the portable environment (P = .002), staff behavior (P = .004), and physical activity training and education (P < .001). Significant improvements were found for the nutrition environment (P < .001), and nutrition training and education (P < .001). Findings from this study suggest that implementing wellness policies and training caregivers in best practices for physical activity and nutrition can promote healthy weight for young children in child care settings.

Examining construct validity of a new naturalistic observational assessment of hand skills for preschool- and school-age children.

PubMed

Chien, Chi-Wen; Brown, Ted; McDonald, Rachael

2012-04-01

The Assessment of Children's Hand Skills is a new assessment that utilises a naturalistic observational method to capture children's real-life hand skill performance when engaged at various types of daily activities in everyday living contexts. The Assessment of Children's Hand Skills is designed for use with 2- to 12-year-old children with a range of disabilities or health conditions. The study aimed to investigate construct validity of the Assessment of Children's Hand Skills in Australian children. Rasch analysis was used to examine internal construct validity of the Assessment of Children's Hand Skills in a mixed sample of 53 children with disabilities (including autism spectrum disorder, developmental/genetic disorders and physical disabilities) and 85 typically developing children. External construct validity was examined by correlating with three questionnaires evaluating daily living skills and hand skills. Rasch goodness-of-fit analysis suggested that all 22 activity items and 19 of 20 hand skill items in the Assessment of Children's Hand Skills measured a single construct. The Assessment of Children's Hand Skills items were placed in a clinically meaningful hierarchy from easy to hard, and the difficulty range of the items also matched the majority of children with disabilities and typically developing preschool-aged children. Moderate to high correlations (0.59 ≤ Spearman's ρ coefficients ≤ 0.89, P < 0.01) were found with the assessments of daily living and fine motor skills. This study provided preliminary evidence supporting the construct validity of the Assessment of Children's Hand Skills for its clinical application in assessing children's real-life hand skill performance in Australian contexts. © 2012 The Authors Australian Occupational Therapy Journal © 2012 Occupational Therapy Australia.

Perceptions of participation in an observational epidemiologic study of cancer among African Americans.

PubMed

Gooden, Kyna M; Carter-Edwards, Lori; Hoyo, Cathrine; Akbar, Jabar; Cleveland, Rebecca J; Oates, Veronica; Jackson, Ethel; Furberg, Helena; Gammon, Marilie D

2005-01-01

Recruitment and retention of African Americans in cancer research studies has become increasingly important. However, little is known about factors bearing on recruitment and retention in etiologic observational studies of cancer. We assessed perceptions and attitudes of African Americans towards participation in an observational epidemiologic study of cancer, and attitudes toward the data collection process. Five focus groups, each lasting approximately 2 hours, were conducted. Participants were comprised of men and women between 41-65 years of age. A total of 35 adults from three rural and two urban counties in North Carolina participated. Data were analyzed using NVivo software. Four key themes emerged on the perception of participation and retention in an epidemiologic study of cancer: (1) fear of cancer prognosis; (2) conflicts between mistrust and trust in researchers; (3) comprehension of prospective study purpose, structure, and participation strategies; and (4) the necessity for and obligation to provide feedback. Results indicate that African Americans would be willing to participate in epidemiologic studies to identify etiologic risk factors for cancer. However, culturally appropriate efforts to thoroughly inform them of study process and progress are deemed essential for successful recruitment and retention.

Safety assessment for hair-spray resins: risk assessment based on rodent inhalation studies.

PubMed

Carthew, Philip; Griffiths, Heather; Keech, Stephen; Hartop, Peter

2002-04-01

The methods involved in the safety assessment of resins used in hair-spray products have received little peer review, or debate in the published literature, despite their widespread use, in both hairdressing salons and the home. The safety assessment for these resins currently involves determining the type of lung pathology that can be caused in animal inhalation exposure studies, and establishing the no-observable-effect level (NOEL) for these pathologies. The likely human consumer exposure is determined by techniques that model the simulated exposure under "in use" conditions. From these values it is then possible to derive the likely safety factors for human exposure. An important part of this process would be to recognize the intrinsic differences between rodents and humans in terms of the respiratory doses that each species experiences during inhalation exposures, for the purpose of the safety assessment. Interspecies scaling factors become necessary when comparing the exposure doses experienced by rats, compared to humans, because of basic differences between species in lung clearance rates and the alveolar area in the lungs. The rodent inhalation data and modeled human exposure to Resin 6965, a resin polymer that is based on vinyl acetate, has been used to calculate the safety factor for human consumer exposure to this resin, under a range of "in use" exposure conditions. The use of this safety assessment process clearly demonstrates that Resin 6965 is acceptable for human consumer exposure under the conditions considered in this risk assessment.

Inter- and intra-observer agreement of BI-RADS-based subjective visual estimation of amount of fibroglandular breast tissue with magnetic resonance imaging: comparison to automated quantitative assessment.

PubMed

Wengert, G J; Helbich, T H; Woitek, R; Kapetas, P; Clauser, P; Baltzer, P A; Vogl, W-D; Weber, M; Meyer-Baese, A; Pinker, Katja

2016-11-01

To evaluate the inter-/intra-observer agreement of BI-RADS-based subjective visual estimation of the amount of fibroglandular tissue (FGT) with magnetic resonance imaging (MRI), and to investigate whether FGT assessment benefits from an automated, observer-independent, quantitative MRI measurement by comparing both approaches. Eighty women with no imaging abnormalities (BI-RADS 1 and 2) were included in this institutional review board (IRB)-approved prospective study. All women underwent un-enhanced breast MRI. Four radiologists independently assessed FGT with MRI by subjective visual estimation according to BI-RADS. Automated observer-independent quantitative measurement of FGT with MRI was performed using a previously described measurement system. Inter-/intra-observer agreements of qualitative and quantitative FGT measurements were assessed using Cohen's kappa (k). Inexperienced readers achieved moderate inter-/intra-observer agreement and experienced readers a substantial inter- and perfect intra-observer agreement for subjective visual estimation of FGT. Practice and experience reduced observer-dependency. Automated observer-independent quantitative measurement of FGT was successfully performed and revealed only fair to moderate agreement (k = 0.209-0.497) with subjective visual estimations of FGT. Subjective visual estimation of FGT with MRI shows moderate intra-/inter-observer agreement, which can be improved by practice and experience. Automated observer-independent quantitative measurements of FGT are necessary to allow a standardized risk evaluation. • Subjective FGT estimation with MRI shows moderate intra-/inter-observer agreement in inexperienced readers. • Inter-observer agreement can be improved by practice and experience. • Automated observer-independent quantitative measurements can provide reliable and standardized assessment of FGT with MRI.

Workflow interruptions and mental workload in hospital pediatricians: an observational study.

PubMed

Weigl, Matthias; Müller, Andreas; Angerer, Peter; Hoffmann, Florian

2014-09-24

Pediatricians' workload is increasingly thought to affect pediatricians' quality of work life and patient safety. Workflow interruptions are a frequent stressor in clinical work, impeding clinicians' attention and contributing to clinical malpractice. We aimed to investigate prospective associations of workflow interruptions with multiple dimensions of mental workload in pediatricians during clinical day shifts. In an Academic Children's Hospital a prospective study of 28 full shift observations was conducted among pediatricians providing ward coverage. The prevalence of workflow interruptions was based on expert observation using a validated observation instrument. Concurrently, Pediatricians' workload ratings were assessed with three workload dimensions of the well-validated NASA-Task Load Index: mental demands, effort, and frustration. Observed pediatricians were, on average, disrupted 4.7 times per hour. Most frequent were interruptions by colleagues (30.2%), nursing staff (29.7%), and by telephone/beeper calls (16.3%). Interruption measures were correlated with two workload outcomes of interest: frequent workflow interruptions were related to less cognitive demands, but frequent interruptions were associated with increased frustration. With regard to single sources, interruptions by colleagues showed the strongest associations to workload. The findings provide insights into specific pathways between different types of interruptions and pediatricians' mental workload. These findings suggest further research and yield a number of work and organization re-design suggestions for pediatric care.

Assessment of prostate cancer detection with a visual-search human model observer

NASA Astrophysics Data System (ADS)

Sen, Anando; Kalantari, Faraz; Gifford, Howard C.

2014-03-01

Early staging of prostate cancer (PC) is a significant challenge, in part because of the small tumor sizes in- volved. Our long-term goal is to determine realistic diagnostic task performance benchmarks for standard PC imaging with single photon emission computed tomography (SPECT). This paper reports on a localization receiver operator characteristic (LROC) validation study comparing human and model observers. The study made use of a digital anthropomorphic phantom and one-cm tumors within the prostate and pelvic lymph nodes. Uptake values were consistent with data obtained from clinical In-111 ProstaScint scans. The SPECT simulation modeled a parallel-hole imaging geometry with medium-energy collimators. Nonuniform attenua- tion and distance-dependent detector response were accounted for both in the imaging and the ordered-subset expectation-maximization (OSEM) iterative reconstruction. The observer study made use of 2D slices extracted from reconstructed volumes. All observers were informed about the prostate and nodal locations in an image. Iteration number and the level of postreconstruction smoothing were study parameters. The results show that a visual-search (VS) model observer correlates better with the average detection performance of human observers than does a scanning channelized nonprewhitening (CNPW) model observer.

Observational study of sleep disturbances in advanced cancer.

PubMed

Davies, Andrew Neil; Patel, Shuchita D; Gregory, Amanda; Lee, Bernadette

2017-12-01

To determine the prevalence of nightmares, sleep terrors and vivid dreams in patients with advanced cancer (and the factors associated with them in this group of patients). The study was a multicentre, prospective observational study. Participants were patients with locally advanced/metastatic cancer, who were under the care of a specialist palliative care team. Data were collected on demographics, cancer diagnosis, cancer treatment, current medication, performance status, sleep quality (Pittsburgh Sleep Quality Index), dreams and nightmares, and physical and psychological symptoms (Memorial Symptom Assessment Scale-Short Form). 174 patients completed the study. Sleep quality was poor in 70.5% participants and was worse in younger patients and in inpatients (hospital, hospice). 18% of patients reported nightmares, 8% sleep terrors and 34% vivid dreams. Nightmares were associated with poor sleep quality and greater sleep disturbance; nightmares were also associated with greater physical and psychological burden. Nightmares (and vivid dreams) were not associated with the use of opioid analgesics. Nightmares do not seem to be especially common in patients with advanced cancer, and when they do occur, there is often an association with sleep disturbance, and/or physical and psychological burden. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The National Eclipse Weather Experiment: an assessment of citizen scientist weather observations

PubMed Central

2016-01-01

The National Eclipse Weather Experiment (NEWEx) was a citizen science project designed to assess the effects of the 20 March 2015 partial solar eclipse on the weather over the United Kingdom (UK). NEWEx had two principal objectives: to provide a spatial network of meteorological observations across the UK to aid the investigation of eclipse-induced weather changes, and to develop a nationwide public engagement activity-based participation of citizen scientists. In total, NEWEx collected 15 606 observations of air temperature, cloudiness and wind speed and direction from 309 locations across the UK, over a 3 h window spanning the eclipse period. The headline results were processed in near real time, immediately published online, and featured in UK national press articles on the day of the eclipse. Here, we describe the technical development of NEWEx and how the observations provided by the citizen scientists were analysed. By comparing the results of the NEWEx analyses with results from other investigations of the same eclipse using different observational networks, including measurements from the University of Reading’s Atmospheric Observatory, we demonstrate that NEWEx provided a fair representation of the change in the UK meteorological conditions throughout the eclipse. Despite the simplicity of the approach adopted, robust reductions in both temperature and wind speed during the eclipse were observed. This article is part of the themed issue ‘Atmospheric effects of solar eclipses stimulated by the 2015 UK eclipse’. PMID:27550767

External Validation of the HERNIAscore: An Observational Study.

PubMed

Cherla, Deepa V; Moses, Maya L; Mueck, Krislynn M; Hannon, Craig; Ko, Tien C; Kao, Lillian S; Liang, Mike K

2017-09-01

The HERNIAscore is a ventral incisional hernia (VIH) risk assessment tool that uses only preoperative variables and predictable intraoperative variables. The aim of this study was to validate and modify, if needed, the HERNIAscore in an external dataset. This was a retrospective observational study of all patients undergoing resection for gastrointestinal malignancy from 2011 through 2015 at a safety-net hospital. The primary end point was clinical postoperative VIH. Patients were stratified into low-risk, medium-risk, and high-risk groups based on HERNIAscore. A revised HERNIAscore was calculated with the addition of earlier abdominal operation as a categorical variable. Cox regression of incisional hernia with stratification by risk class was performed. Incidence rates of clinical VIH formation within each risk class were also calculated. Two hundred and forty-seven patents were enrolled. On Cox regression, in addition to the 3 variables of the HERNIAscore (BMI, COPD, and incision length), earlier abdominal operation was also predictive of VIH. The revised HERNIAscore demonstrated improved predictive accuracy for clinical VIH. Although the original HERNIAscore effectively stratified the risk of an incisional radiographic VIH developing, the revised HERNIAscore provided a statistically significant stratification for both clinical and radiographic VIHs in this patient cohort. We have externally validated and improved the HERNIAscore. The revised HERNIAscore uses BMI, incision length, COPD, and earlier abdominal operation to predict risk of postoperative incisional hernia. Future research should assess methods to prevent incisional hernias in moderate-to-high risk patients. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Impact of aphasia on consciousness assessment: a cross-sectional study.

PubMed

Schnakers, Caroline; Bessou, Helene; Rubi-Fessen, Ilona; Hartmann, Alexander; Fink, Gereon R; Meister, Ingo; Giacino, Joseph T; Laureys, Steven; Majerus, Steve

2015-01-01

Previous findings suggest that language disorders may occur in severely brain-injured patients and could interfere with behavioral assessments of consciousness. However, no study investigated to what extent language impairment could affect patients' behavioral responses. Objective. To estimate the impact of receptive and/or productive language impairments on consciousness assessment. Twenty-four acute and subacute stroke patients with different types of aphasia (global, n = 11; Broca, n = 4; Wernicke, n = 3; anomic, n = 4; mixed, n = 2) were recruited in neurology and neurosurgery units as well as in rehabilitation centers. The Coma Recovery Scale-Revised (CRS-R) was administered. We observed that 25% (6 out of 24) of stroke patients with a diagnosis of aphasia and 54% (6 out of 11) of patients with a diagnosis of global aphasia did not reach the maximal CRS-R total score of 23. An underestimation of the consciousness level was observed in 3 patients with global aphasia who could have been misdiagnosed as being in a minimally conscious state, even in the absence of any documented period of coma. More precisely, lower subscores were observed on the communication, motor, oromotor, and arousal subscales. Consciousness assessment may be complicated by the co-occurrence of severe language deficits. This stresses the importance of developing new tools or identifying items in existing scales, which may allow the detection of language impairment in severely brain-injured patients. © The Author(s) 2014.

Review of quality assessment tools for the evaluation of pharmacoepidemiological safety studies

PubMed Central

Neyarapally, George A; Hammad, Tarek A; Pinheiro, Simone P; Iyasu, Solomon

2012-01-01

Objectives Pharmacoepidemiological studies are an important hypothesis-testing tool in the evaluation of postmarketing drug safety. Despite the potential to produce robust value-added data, interpretation of findings can be hindered due to well-recognised methodological limitations of these studies. Therefore, assessment of their quality is essential to evaluating their credibility. The objective of this review was to evaluate the suitability and relevance of available tools for the assessment of pharmacoepidemiological safety studies. Design We created an a priori assessment framework consisting of reporting elements (REs) and quality assessment attributes (QAAs). A comprehensive literature search identified distinct assessment tools and the prespecified elements and attributes were evaluated. Primary and secondary outcome measures The primary outcome measure was the percentage representation of each domain, RE and QAA for the quality assessment tools. Results A total of 61 tools were reviewed. Most tools were not designed to evaluate pharmacoepidemiological safety studies. More than 50% of the reviewed tools considered REs under the research aims, analytical approach, outcome definition and ascertainment, study population and exposure definition and ascertainment domains. REs under the discussion and interpretation, results and study team domains were considered in less than 40% of the tools. Except for the data source domain, quality attributes were considered in less than 50% of the tools. Conclusions Many tools failed to include critical assessment elements relevant to observational pharmacoepidemiological safety studies and did not distinguish between REs and QAAs. Further, there is a lack of considerations on the relative weights of different domains and elements. The development of a quality assessment tool would facilitate consistent, objective and evidence-based assessments of pharmacoepidemiological safety studies. PMID:23015600

Assessment of Evapotranspiration and Soil Moisture Content Across Different Scales of Observation

PubMed Central

Verstraeten, Willem W.; Veroustraete, Frank; Feyen, Jan

2008-01-01

The proper assessment of evapotranspiration and soil moisture content are fundamental in food security research, land management, pollution detection, nutrient flows, (wild-) fire detection, (desert) locust, carbon balance as well as hydrological modelling; etc. This paper takes an extensive, though not exhaustive sample of international scientific literature to discuss different approaches to estimate land surface and ecosystem related evapotranspiration and soil moisture content. This review presents: (i)a summary of the generally accepted cohesion theory of plant water uptake and transport including a shortlist of meteorological and plant factors influencing plant transpiration;(ii)a summary on evapotranspiration assessment at different scales of observation (sap-flow, porometer, lysimeter, field and catchment water balance, Bowen ratio, scintillometer, eddy correlation, Penman-Monteith and related approaches);(iii)a summary on data assimilation schemes conceived to estimate evapotranspiration using optical and thermal remote sensing; and(iv)for soil moisture content, a summary on soil moisture retrieval techniques at different spatial and temporal scales is presented. Concluding remarks on the best available approaches to assess evapotranspiration and soil moisture content with and emphasis on remote sensing data assimilation, are provided. PMID:27879697

Basal cortisol levels and metabolic syndrome: A systematic review and meta-analysis of observational studies.

PubMed

Garcez, Anderson; Leite, Heloísa Marquardt; Weiderpass, Elisabete; Paniz, Vera Maria Vieira; Watte, Guilherme; Canuto, Raquel; Olinto, Maria Teresa Anselmo

2018-05-17

To perform a qualitative synthesis (systematic review) and quantitative analysis (meta-analysis) to summarize the evidence regarding the relationship between basal cortisol levels and metabolic syndrome (MetS) in adults. A systematic search was performed in the PubMed, Embase, and PsycINFO databases for observational studies on the association between basal cortisol levels and MetS. The quality of individual studies was assessed by the Newcastle-Ottawa score. A random effects model was used to report pooled quantitative results and the I 2 statistic was used to assess heterogeneity. Egger's and Begg's tests were used to evaluate publication bias. Twenty-six studies (19 cross-sectional and seven case-control) met the inclusion criteria for the systematic review. The majority was classified as having a low risk of bias and used established criteria for the diagnosis of MetS. Twenty-one studies provided data on basal cortisol levels as continuous values and were included in the meta-analysis; they comprised 35 analyses and 11,808 subjects. Pooled results showed no significant difference in basal cortisol levels between subjects with and without MetS (standardized mean difference [SMD] = 0.02, 95% confidence interval [CI]=-0.11 to 0.14). There was high heterogeneity between the studies when all comparisons were considered (I 2  = 83.1%;p < 0.001). Paradoxically, meta-analysis of studies evaluating saliva samples showed no significantly lower basal cortisol levels among subjects with MetS (SMD=-0.18, 95% CI=-0.37 to 0.01), whereas those studies that evaluated serum samples (SMD = 0.11, 95% CI=-0.02 to 0.24) and urine samples (SMD = 0.73, 95% CI=-0.40 to 1.86) showed no significantly higher basal cortisol levels among subjects with MetS. In the subgroup and meta-regression analyses, a significant difference in basal cortisol levels was observed according to study design, population base, age, gender, cortisol level assessment method, and study quality

Watching the Babies: The Why, What, and How of Observation as Assessment in Infant and Toddler Care

ERIC Educational Resources Information Center

Bell, Douglas D., Jr.

2017-01-01

Observation is a useful tool, even in infant and toddler classrooms. Applied correctly, observation and assessment can help lay a foundation for a successful education throughout life. As appropriate practices are researched and policies change, teachers and caregivers of the youngest children (referred to as careteachers for this article) find…

Team Objective Structured Bedside Assessment (TOSBA) as formative assessment in undergraduate Obstetrics and Gynaecology: a cohort study.

PubMed

Deane, Richard P; Joyce, Pauline; Murphy, Deirdre J

2015-10-09

Team Objective Structured Bedside Assessment (TOSBA) is a learning approach in which a team of medical students undertake a set of structured clinical tasks with real patients in order to reach a diagnosis and formulate a management plan and receive immediate feedback on their performance from a facilitator. TOSBA was introduced as formative assessment to an 8-week undergraduate teaching programme in Obstetrics and Gynaecology (O&G) in 2013/14. Each student completed 5 TOSBA sessions during the rotation. The aim of the study was to evaluate TOSBA as a teaching method to provide formative assessment for medical students during their clinical rotation. The research questions were: Does TOSBA improve clinical, communication and/or reasoning skills? Does TOSBA provide quality feedback? A prospective cohort study was conducted over a full academic year (2013/14). The study used 2 methods to evaluate TOSBA as a teaching method to provide formative assessment: (1) an online survey of TOSBA at the end of the rotation and (2) a comparison of the student performance in TOSBA with their performance in the final summative examination. During the 2013/14 academic year, 157 students completed the O&G programme and the final summative examination . Each student completed the required 5 TOSBA tasks. The response rate to the student survey was 68 % (n = 107/157). Students reported that TOSBA was a beneficial learning experience with a positive impact on clinical, communication and reasoning skills. Students rated the quality of feedback provided by TOSBA as high. Students identified the observation of the performance and feedback of other students within their TOSBA team as key features. High achieving students performed well in both TOSBA and summative assessments. The majority of students who performed poorly in TOSBA subsequently passed the summative assessments (n = 20/21, 95 %). Conversely, the majority of students who failed the summative assessments had

An Exploration of Latent Structure in Observational Huntington’s Disease Studies

PubMed Central

Ghosh, Soumya; Sun, Zhaonan; Li, Ying; Cheng, Yu; Mohan, Amrita; Sampaio, Cristina; Hu, Jianying

2017-01-01

Huntington’s disease (HD) is a monogenic neurodegenerative disorder characterized by the progressive decay of motor and cognitive abilities accompanied by psychiatric episodes. Tracking and modeling the progression of the multi-faceted clinical symptoms of HD is a challenging problem that has important implications for staging of HD patients and the development of improved enrollment criteria for future HD studies and trials. In this paper, we describe the first steps towards this goal. We begin by curating data from four recent observational HD studies, each containing a diverse collection of clinical assessments. The resulting dataset is unprecedented in size and contains data from 19,269 study participants. By analyzing this large dataset, we are able to discover hidden low dimensional structure in the data that correlates well with surrogate measures of HD progression. The discovered structures are promising candidates for future consumption by downstream statistical HD progression models. PMID:28815114

An action research study of secondary science assessment praxes

NASA Astrophysics Data System (ADS)

Ryan, Thomas Gerald

This practical participatory action research study illuminates the assessment praxes of four Ontario secondary level science teachers at one school using a facilitative approach. Participants were joined by a thematic concern, that is, a commitment to inform and improve assessment. Hence, two distinct sets of research questions emerged. The first involves the nature of assessment as we asked, what was the current state of assessment practice in secondary science? What were participants' initial understandings of assessment and actual practices at the onset of this research? To what extent did these initial understandings and actual practices change due to the illumination of assessment praxes through action research involvement? What was their level of awareness of current Ontario government pronouncements and in what ways did they implement this knowledge? The second theme, concerning the nature of action research, was realised by asking what did participants learn about action research? What other learning and professional gains were realised during this study? And, what did I learn about action research and assessment through my involvement in this study? Data were collected via supportive discussion groups, individual interviews, classroom visitations, journals and documentation. This professional development experience facilitated 'interactive professionalism' as teachers worked in a small group and interacted frequently in the course of planning, testing new ideas, attempting to solve different problems, and assess the effectiveness of those ideas. In addition, this action research effort was strategic and systematic, to attain a high degree of specific interactions, (personal interviews, group meetings, classroom observations, evidence collection). This series of deliberate and planned intentions helped participants solve assessment dilemmas. We developed an awareness and understanding of the need for more preservice and inservice assessment training

HIV and herpes simplex virus type 2 epidemiological synergy: misguided observational evidence? A modelling study.

PubMed

Omori, Ryosuke; Nagelkerke, Nico; Abu-Raddad, Laith J

2017-12-04

To investigate whether observational studies of HIV and herpes simplex virus type 2 (HSV-2) infections have the capacity to assess the HIV/HSV-2 epidemiological synergy. An individual-based Monte Carlo model was used to simulate HIV/HSV-2 epidemics in two scenarios: no HIV/HSV-2 biological interaction and HSV-2 seropositivity enhancing HIV acquisition. Cross-sectional observational studies were simulated by sampling individuals from the population to assess resulting crude and adjusted ORs of the HIV/HSV-2 association. Meta-analyses were conducted to estimate the pooled mean ORs. Impact of under-reporting of sexual behaviour and miscapture of high-risk individuals was assessed through sensitivity analyses. Assuming no HIV/HSV-2 biological interaction, the crude HIV/HSV-2 OR ranged between 1.38 and 9.93, with a pooled mean of 6.45 (95% CI 5.81 to 7.17). Adjustment for the number of sexual partners over last year, over lifetime and for both partner numbers simultaneously reduced the mean OR to 5.45 (95% CI 4.90 to 6.06), 3.70 (95% CI 3.32 to 4.12) and 3.54 (95% CI 3.17 to 3.94), respectively. Assuming HIV/HSV-2 biological interaction, the crude OR ranged between 3.44 and 9.95, with a pooled mean of 8.05 (95% CI 7.14 to 9.07). The adjustments reduced the mean OR to 7.00 (95% CI 6.21 to 7.90), 3.76 (95% CI 3.32 to 4.25) and 3.68 (95% CI 3.25 to 4.17), respectively. Under-reporting of partners reduced the confounder-adjustment effects. Miscapture of high-risk individuals considerably lowered the estimated ORs. It is difficult to control for sexual-behaviour confounding in observational studies. The observed HIV/HSV-2 association appears more consistent with two infections sharing the same mode of transmission, rather than with HSV-2 enhancing HIV acquisition. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Patient-Related Benefits for Adults with Cochlear Implantation: A Multicultural Longitudinal Observational Study

PubMed Central

Lenarz, Thomas; Muller, Lida; Czerniejewska-Wolska, Hanna; Vallés Varela, Hector; Orús Dotú, César; Durko, Marcin; Huarte Irujo, Alicia; Piszczatowski, Bartosz; Zadrożniak, Marek; Irwin, Colin; Graham, Petra L.; Wyss, Josie

2017-01-01

Objectives To assess subjectively perceived, real-world benefits longitudinally for unilateral cochlear implant (CI) recipients in a multinational population treated routinely. To identify possible predictors of self-reported benefits. Design This was a prospective, multicenter, repeated-measures study. Self-assessment of performance at preimplantation and postimplantation at 1, 2, and 3 years using standardized, validated, local language versions of the Speech, Spatial, and Qualities of Hearing Scale (SSQ), and the Health Utilities Index Mark 3 (HUI3) was performed. Outcomes were analyzed using a longitudinal mixed-effects model incorporating country effect. Patient demographics were explored for associations with change over time. Subjects Two hundred ninety-one routinely treated, unilateral CI recipients, aged 137–81 years, from 9 clinics across 4 countries. Results Highly significant improvements were observed for all outcome measures (p < 0.0001). Postimplantation, mean outcome scores remained stable beyond 1 year, with notable individual variability. A significant association for one or more outcomes with preimplantation contralateral hearing aid use, telephone use, age at implantation, implantation side, preimplantation comorbidities, dizziness, and tinnitus was observed (p < 0.004). Conclusions Longitudinal benefits of CI treatment can be measured using clinically standardized self-assessment tools to provide a holistic view of patient-related benefits in routine clinical practice for aggregated data from multinational populations. Self-reported outcomes can provide medical-based evidence regarding CI treatment to support decision-making by health service providers. PMID:28719901

Patient-Related Benefits for Adults with Cochlear Implantation: A Multicultural Longitudinal Observational Study.

PubMed

Lenarz, Thomas; Muller, Lida; Czerniejewska-Wolska, Hanna; Vallés Varela, Hector; Orús Dotú, César; Durko, Marcin; Huarte Irujo, Alicia; Piszczatowski, Bartosz; Zadrożniak, Marek; Irwin, Colin; Graham, Petra L; Wyss, Josie

2017-01-01

To assess subjectively perceived, real-world benefits longitudinally for unilateral cochlear implant (CI) recipients in a multinational population treated routinely. To identify possible predictors of self-reported benefits. This was a prospective, multicenter, repeated-measures study. Self-assessment of performance at preimplantation and postimplantation at 1, 2, and 3 years using standardized, validated, local language versions of the Speech, Spatial, and Qualities of Hearing Scale (SSQ), and the Health Utilities Index Mark 3 (HUI3) was performed. Outcomes were analyzed using a longitudinal mixed-effects model incorporating country effect. Patient demographics were explored for associations with change over time. Two hundred ninety-one routinely treated, unilateral CI recipients, aged 13-81 years, from 9 clinics across 4 countries. Highly significant improvements were observed for all outcome measures (p < 0.0001). Postimplantation, mean outcome scores remained stable beyond 1 year, with notable individual variability. A significant association for one or more outcomes with preimplantation contralateral hearing aid use, telephone use, age at implantation, implantation side, preimplantation comorbidities, dizziness, and tinnitus was observed (p < 0.004). Longitudinal benefits of CI treatment can be measured using clinically standardized self-assessment tools to provide a holistic view of patient-related benefits in routine clinical practice for aggregated data from multinational populations. Self-reported outcomes can provide medical-based evidence regarding CI treatment to support decision-making by health service providers. © 2017 The Author(s) Published by S. Karger AG, Basel.

Observational studies of roAp stars

NASA Astrophysics Data System (ADS)

Sachkov, M.

2014-11-01

Rapidly oscillating Ap (roAp) stars are high-overtone, low-degree p-mode pulsators that are also chemically peculiar magnetic A stars. Until recently the classical asteroseismic analysis i.e. frequency analysis, of these stars was based on ground and space photometric observations. Significant progress was achieved through access to uninterrupted, ultra-high-precision data from MOST, COROT and Kepler satellites. Over the last ten years the study of roAp stars has been altered drastically from an observational point of view through studies of time-resolved, high-resolution spectra. Their unusual pulsational characteristics, caused by an interplay between the short vertical lengths of the pulsation waves and strong stratification of chemical elements, allow us to examine the upper roAp atmosphere in more detail than is possible for any star except the Sun. In this paper I review the results of recent studies of the pulsations of roAp stars.

Observational studies of the association between glucose-lowering medications and cardiovascular outcomes: addressing methodological limitations.

PubMed

Patorno, Elisabetta; Patrick, Amanda R; Garry, Elizabeth M; Schneeweiss, Sebastian; Gillet, Victoria G; Bartels, Dorothee B; Masso-Gonzalez, Elvira; Seeger, John D

2014-11-01

Recent years have witnessed a growing body of observational literature on the association between glucose-lowering treatments and cardiovascular disease. However, many of the studies are based on designs or analyses that inadequately address the methodological challenges involved. We reviewed recent observational literature on the association between glucose-lowering medications and cardiovascular outcomes and assessed the design and analysis methods used, with a focus on their ability to address specific methodological challenges. We describe and illustrate these methodological issues and their impact on observed associations, providing examples from the reviewed literature. We suggest approaches that may be employed to manage these methodological challenges. From the evaluation of 81 publications of observational investigations assessing the association between glucose-lowering treatments and cardiovascular outcomes, we identified the following methodological challenges: 1) handling of temporality in administrative databases; 2) handling of risks that vary with time and treatment duration; 3) definitions of the exposure risk window; 4) handling of exposures that change over time; and 5) handling of confounding by indication. Most of these methodological challenges may be suitably addressed through application of appropriate methods. Observational research plays an increasingly important role in the evaluation of the clinical effects of diabetes treatment. Implementation of appropriate research methods holds the promise of reducing the potential for spurious findings and the risk that the spurious findings will mislead the medical community about risks and benefits of diabetes medications.

Clinical information transfer and data capture in the acute myocardial infarction pathway: an observational study.

PubMed

Kesavan, Sujatha; Kelay, Tanika; Collins, Ruth E; Cox, Benita; Bello, Fernando; Kneebone, Roger L; Sevdalis, Nick

2013-10-01

Acute myocardial infarctions (MIs) or heart attacks are the result of a complete or an incomplete occlusion of the lumen of the coronary artery with a thrombus. Prompt diagnosis and early coronary intervention results in maximum myocardial salvage, hence time to treat is of the essence. Adequate, accurate and complete information is vital during the early stages of admission of an MI patient and can impact significantly on the quality and safety of patient care. This study aimed to record how clinical information between different clinical teams during the journey of a patient in the MI care pathway is captured and to review the flow of information within this care pathway. A prospective, descriptive, structured observational study to assess (i) current clinical information systems (CIS) utilization and (ii) real-time information availability within an acute cardiac care setting was carried out. Completeness and availability of patient information capture across four key stages of the MI care pathway were assessed prospectively. Thirteen separate information systems were utilized during the four phases of the MI pathway. Observations revealed fragmented CIS utilization, with users accessing an average of six systems to gain a complete set of patient information. Data capture was found to vary between each pathway stage and in both patient cohort risk groupings. The highest level of information completeness (100%) was observed only in the discharge stage of the MI care pathway. The lowest level of information completeness (58%) was observed in the admission stage. The study highlights fragmentation, CIS duplication, and discrepancies in the current clinical information capture and data transfer across the MI care pathway in an acute cardiac care setting. The development of an integrated and user-friendly electronic data capture and transfer system would reduce duplication and would facilitate efficient and complete information provision at the point of care. © 2012

The GRACE checklist for rating the quality of observational studies of comparative effectiveness: a tale of hope and caution.

PubMed

Dreyer, Nancy A; Velentgas, Priscilla; Westrich, Kimberly; Dubois, Robert

2014-03-01

While there is growing demand for information about comparative effectiveness (CE), there is substantial debate about whether and when observational studies have sufficient quality to support decision making. To develop and test an item checklist that can be used to qualify those observational CE studies sufficiently rigorous in design and execution to contribute meaningfully to the evidence base for decision support. An 11-item checklist about data and methods (the GRACE checklist) was developed through literature review and consultation with experts from professional societies, payer groups, the private sector, and academia. Since no single gold standard exists for validation, checklist item responses were compared with 3 different types of external quality ratings (N=88 articles). The articles compared treatment effectiveness and/or safety of drugs, medical devices, and medical procedures. We validated checklist item responses 3 ways against external quality ratings, using published articles of observational CE or safety studies: (a) Systematic Review-quality assessment from a published systematic review; (b) Single Expert Review-quality assessment made according to the solicited "expert opinion" of a senior researcher; and (c) Concordant Expert Review-quality assessments from 2 experts for which there was concordance. Volunteers (N=113) from 5 continents completed 280 article assessments using the checklist. Positive and negative predictive values (PPV, NPV, respectively) of individual items were estimated to compare testers' assessments with those of experts. Taken as a whole, the scale had better NPV than PPV, for both data and methods. The most consistent predictor of quality relates to the validity of the primary outcomes measurement for the study purpose. Other consistent markers of quality relate to using concurrent comparators, minimizing the effects of bias by prudent choice of covariates, and using sensitivity analysis to test robustness of results