• Title/Summary/Keyword: Bland-Altman plots

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Reliability and validity of rehabilitative ultrasound images obtained using a hands-free fixed probe in measuring the muscle structures of the tibialis anterior and the gastrocnemius

  • Choi, Mun-Sang;Shin, Jang-Hoon;Park, Hye-Kang;Lee, Wan-Hee
    • Physical Therapy Rehabilitation Science
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    • v.8 no.4
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    • pp.194-201
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    • 2019
  • Objective: This study aimed to investigate the reliability and validity of muscle thickness (MT) and pennation angle (PA) measurements of the ankle muscle, including the tibialis anterior (TA) and the medial gastrocnemius (MGCM), using a hands-free fixed probe and to compare it with the conventional linear probe. Design: Observational inter-rater reliability study. Methods: Thirty-three healthy subjects (20 male, 13 female) were included. In all subjects, ultrasound images were acquired from the TA and MGCM using a hands-free fixed probe and a conventional linear probe in random sequence by two examiners at two time-points within a 7-day interval. MT and PA were calculated on the taken images. Intra-class correlation coefficients (ICC), 95% confidence intervals, standard error of measurement and the Pearson's correlation coefficient were used to estimate reliability and validity. And also, Bland-Altman plots were generated for a visual representation of MT and PA at the TA and MGCM. Results: The ICC for all intra-rater reliability was 0.943 to 0.995 and that for all inter-rater reliability was 0.928 to 0.993, indicating excellent reliability. A significantly high correlation was observed between MT and PA at the TA and MGCM with use of the hands-free fixed probe and the conventional linear probe (r>0.938; p<0.001). Conclusions: The hands-free fixed probe provided excellent images for measurement of the MT and PA of the TA and MGCM and is a useful device for making clinical measurements of muscle structure without grasping of the probe.

Measuring abutment convergence angles using stereovision dental image processing system

  • Yang, Hong-Seok;Park, Ji-Man;Han, Jung-Suk;Lee, Jai-Bong;Kim, Sung-Hun;Yeo, In-Sung
    • The Journal of Advanced Prosthodontics
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    • v.6 no.4
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    • pp.259-265
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    • 2014
  • PURPOSE. The purpose of this study was to develop a dental image processing system using a three-dimensional (3D) camera and stereovision technology. The reliability of the system for measuring axial wall convergence angles was evaluated. MATERIALS AND METHODS. The new system predicted 3D coordinate points from 2D images and calculated distances and angles between points. Two examiners measured axial wall convergence angles for seven artificial abutments using a traditional tracing-based method (TBM) and the stereovision-based method (SVBM). Five wax abutment models of simplified abutment forms were made and axial wall convergence angles of wax models were measured by both methods. The data were statistically analyzed at the level of significance, 0.05. RESULTS. Intraclass correlation coefficients showed excellent intra-examiner and inter-examiner reliabilities for both methods. Bland-Altman plots and paired t-tests showed significant differences between measurements and true values using TBM; differences were not significant with SVBM. CONCLUSION. This study found that the SVBM reflected true angle values more accurately than a TMB and illustrated an example of 3D computer science applied to clinical dentistry.

Assessment of Left Ventricular Function with Single Breath-Hold Magnetic Resonance Cine Imaging in Patients with Arrhythmia

  • Bak, So Hyeon;Kim, Sung Mok;Park, Sung-Ji;Kim, Min-Ji;Choe, Yeon Hyeon
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.1
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    • pp.20-27
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    • 2017
  • Purpose: To evaluate quantification results of single breath-hold (SBH) magnetic resonance (MR) cine imaging compared to results of conventional multiple breath-hold (MBH) technique for left ventricular (LV) function in patients with cardiac arrhythmia. Materials and Methods: MR images of patients with arrhythmia who underwent MBH and SBH cine imaging at the same time on a 1.5T MR scanner were retrospectively reviewed. Both SBH and MBH cine imaging were performed with balanced steady state free precession. SBH scans were acquired using temporal parallel acquisition technique (TPAT). Fifty patients ($65.4{\pm}12.3years$, 72% men) were included. End-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), myocardial mass, and LV regional wall motion were evaluated. Results: EF, myocardial mass, and regional wall motion were not significantly different between SBH and MBH acquisition techniques (all P-values > 0.05). EDV, ESV, and SV were significant difference between the two techniques. These parameters for SBH cine imaging with TPAT tended to lower than those in MBH. EF and myocardial mass of SBH cine imaging with TPAT showed good correlation with values of MBH cine imaging in Passing-Bablok regression charts and Bland-Altman plots. However, SBH imaging required significantly shorter acquisition time than MBH cine imaging ($15{\pm}7sec$ vs. $293{\pm}104sec$, P < 0.001). Conclusion: SBH cine imaging with TPAT permits shorter acquisition time with assessment results of global and regional LV function comparable to those with MBH cine imaging in patients with arrhythmia.

Measurement of Fractional Exhaled Nitric Oxide in Adults: Comparison of Two Different Analyzers (NIOX VERO and NObreath)

  • Kang, Sung-Yoon;Lee, Sang Min;Lee, Sang Pyo
    • Tuberculosis and Respiratory Diseases
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    • v.84 no.3
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    • pp.182-187
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    • 2021
  • Background: Fractional exhaled nitric oxide (FeNO) is a non-invasive marker for eosinophilic airway inflammation and a good predictor of response to corticosteroids. There is a need for a reliable and accurate measurement method, as FeNO measurements have been widely used in clinical practice. Our study aimed to compare two FeNO analyzers and derive a conversion equation for FeNO measurements in adults. Methods: We included 99 participants who had chief complaints of chronic cough and difficulty in breathing. The participants underwent concurrent FeNO measurement using NIOX VERO (Circassia AB) and NObreath (Bedfont). We compared the values of the two devices and analyzed their correlation and agreement. We then formulated an equation to convert FeNO values measured by NObreath into those obtained by NIOX VERO. Results: The mean age of the participants was 51.2±17.1 years, with a female predominance (58.6%). Approximately 60% of the participants had asthma. The FeNO level measured by NIOX VERO (median, 27; interquartile range [IQR], 15-45) was significantly lower than that measured by NObreath (median, 38; IQR, 22-58; p<0.001). There was a strong positive correlation between the two devices (r=0.779, p<0.001). Additionally, Bland-Altman plots and intraclass correlation coefficient demonstrated a good agreement. Using linear regression, we derived the following conversion equation: natural log (Ln) (NObreath)=0.728×Ln (NIOX VERO)+1.244. Conclusion: The FeNO values of NIOX VERO and NObreath were in good agreement and had positive correlations. Our proposed conversion equation could help assess the accuracy of the two analyzers.

Reliability study of the Pectoralis Minor Muscle Thickness Measurement using Rehabilitative Ultrasound Imaging

  • Lim, Ji Young;Lee, Se-Yeong;Jung, Seung-Hwa;Park, Dae-Sung
    • Journal of the Korean Society of Physical Medicine
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    • v.16 no.2
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    • pp.45-52
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    • 2021
  • PURPOSE: This study examined the imaging procedure of pectoralis minor muscle thickness and assessed the intra- and inter-rater reliability of the muscle thickness measured by two raters using rehabilitative ultrasound imaging (RUSI) in healthy individuals. METHODS: Fifteen participants (aged 21 - 28, seven females, and eight males) were involved in the study. The primary rater palpated the coracoid process and the fourth rib, defined as the width of the index finger lateral to the sternum to avoid breast tissues, and lined the two landmarks. The second examiner checked 1 / 3 (1st point) and 1 / 2 (2nd point) of the line length as measurement points. The two raters obtained right side muscle images of the participants at a standardized sitting position using RUSI with a 7.5 MHz linear transducer at 40mm depth. For intra-rater reliability, the principal rater took three images per point and tried to take one more with an interval. For the inter-rater reliability, the other rater performed the same tasks as the principal rater on the same day. The reliability was analyzed using the intra-class correlation coefficient (ICC), the standard error of the measurement (SEM), and Bland and Altman plots. RESULTS: The reliability at all points was excellent for the same rater (ICC3,1 = .973 - .978, SEM = .042 - .046), and between raters (ICC2,1 = .939 - .959, SEM = .059 - .097). CONCLUSION: These findings show that the RUSI could be reliable for examining the pectoralis minor muscle thickness in healthy individuals at all measurement sites.

Reliability and Validity of an Electronic Inspiratory Loading Device for Assessing Pulmonary Function in Patients with COPD

  • Lee, Seugcheol;You, Seongkwang;Yang, Subin;Park, Daesung
    • Physical Therapy Rehabilitation Science
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    • v.10 no.1
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    • pp.40-47
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    • 2021
  • Objective: The purpose of this study is to prove the reliability and validity of the Power breath K5 and to compare it with pony FX. Power breathe K5 is one type of device can assess automatically Maximum inspiratory pressure (MIP), Peak inspiratory pressure, Peak inspiratory flow (PIF). Design: Cross-sectional study. Methods: Thirty-five COPD patients participated in the test to investigate for the intra relater reliability and concurrent validity. The tests MIP, Vital capacity (VC), PIF were measured by Powerbreathe K5 and Pony Fx. Data was analyzed by intraclass correlation reliability (ICC) value and a standard error of measurement and Bland-Altman plots for reliability and pearson correlation for validity. Results: Intra rater reliability of the Powerbreathe K5 was very high at MIP (ICC=0.977 95%CI 0.956~0.989, SEM=8.665, MDC=0.295), PIF (ICC=0.966 95%CI 0.933~0.93, SEM=8.665, MDC=0.295), VC (ICC=0.949 95CI 0.902~0.974, SEM=0.042, MDC=0.116). The Powerbreath K5 was significant correlation compared with Pony Fx in assessment for MIP (r=0.971, p<0.05) and vital capacity (r=0.534, p<0.05). Conclusion: In this study, We investigated the clinical usefulness of the Powerbreath K5 in evaulating the MIP, VC and PIF with COPD patients with high reliability and validity.

Development and application of the sodium index to estimate and assess sodium intake for Korean adults

  • Lee, Yeon-Kyung;Hyun, Taisun;Ro, Heekyong;Heo, Young-Ran;Choi, Mi-Kyeong
    • Nutrition Research and Practice
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    • v.16 no.3
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    • pp.366-378
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    • 2022
  • BACKGROUND/OBJECTIVES: The purpose of this study was to develop a sodium index, which is a tool for estimating and assessing sodium intake easily and quickly, to assist in the prevention of various diseases induced by excess sodium intake in Korean adults. SUBJECTS/METHODS: The 24-h urine collection and dietary behavior surveys were performed on 640 healthy people in 4 regions of South Korea, and an equation for the estimation of 24-h sodium intake was developed. The validity and reliability of the equation were verified with 200 adults. The sodium index was developed by converting the estimated sodium intake using the equation. Finally, the sodium intake status of 1,600 adults was assessed using the sodium index. RESULTS: The equation included sex, age, body mass index, eating habit and dietary behaviors related to sodium intake. In validity test of the equation, the mean bias between sodium intake using 24-h urine analysis and using the equation from the Bland-Altman plots was -1.5 mg/day. The sensitivity and specificity of the equation for estimation of sodium intake were 80.5% and 64.4%, respectively. In the reliability test of the equation, there was no significant difference between the first and second sodium intakes calculated using the equations, and Spearman's correlation coefficient between the 2 sodium intakes was 0.98. Sodium intake can be assessed as 'very moderate' for 75-100 on the sodium index, 'moderate' for 100-150, 'careful' for less than 75 or 150-200, and 'severe' for 250 or more. When sodium intake was assessed using the sodium index in 1,600 subjects, 54.3% and 24.3% of the subjects were assessed to be in the 'careful' and 'severe' categories, respectively. CONCLUSIONS: Using a simple questionnaire, the sodium index can be used to monitor and assess sodium intake status, assisting in nutrition education and counseling in a large population.

A Case Series on Clinical Characteristics of Patients Who Underwent Bone Age Test and Relationships between Methods of Bone Age Measurements (골연령 검사를 시행한 환자들의 임상적 특성과 골연령 측정 방법 간의 상관성에 대한 후향적 연구)

  • Choi Ji U;Min Sang Yeon;Kim Eun Jin
    • The Journal of Pediatrics of Korean Medicine
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    • v.37 no.3
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    • pp.111-120
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    • 2023
  • Objectives The purpose of this study is to analyze the characteristic of the 157 pediatric patients who visited a Korean medical hospital for bone age (BA) measurement and to compare the BA measurement using Tanner-Whitehouse 3-based analysis software and specialists in pediatric Korean medicine to determine the relationships. Methods The study included 157 pediatric patients who visited a Korean medicine hospital for BA measurements from June 2021 to June 2023. They were analyzed to determine the characteristics and agreement of BA measurements using Tanner-Whitehouse 3-based analysis software and specialists using classification by age, intraclass correlation coefficient (ICC), and Bland-Altman plots. Results In total, 61.8% of the study population were boys and 38.2%, girls, with an average age of 11.32 ± 1.87. The types of growth were various, and the average of bone maturity was 0.48 ± 1.13 as concluded by analysis software and 0.38 ± 1.15 as concluded by the specialists. The ICC of two methods were excellent: 0.995 (overall), 0.996 (boys) and 0.994 (girls). However, BA determined by analysis software tended to be higher than that determined by specialists when the patients were young. Conclusions This study showed that patients visited the hospital for BA measurement regardless of their height, and the agreement of BA between the two methods can be used as a reference. However, there was differences in the trends between age and sex, which should be interpreted with caution.

Comparison of Arterial Oxygen Saturation Measured by Pulse Oximetry at Different Sensor Sites in Neurocritical Patients (신경계 중환자의 측정부위별 맥박 산소포화도의 비교)

  • Jeon, Min-Jeong;Hwang, Sun-Kyung
    • Journal of Korean Critical Care Nursing
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    • v.16 no.1
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    • pp.1-14
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    • 2023
  • Purpose : This study aimed to compare peripheral pulse oxygen saturation (SpO2) values, measured at different monitoring sites, and arterial oxygen saturation (SaO2) of neurocritical patients. Methods : The study included 110 patients admitted to the neurosurgical intensive care unit of a university hospital. The patients' SpO2 values were measured in their index fingers, both second toes, both earlobes, and foreheads, using the patient monitoring system. These values were compared with the standard value of SaO2 measured using a blood gas analyzer. Data were analyzed using descriptive values, Pearson's correlation coefficients, Lin's concordance correlation coefficients (CCC), and Bland-Altman plots. Result : Regardless of the measuring site, SpO2 was correlated with the paired measurements of SaO2 (r=.40~.60, p<.001, CCC range=.40~.58). No significant bias in paired measurements of SpO2 and SaO2 was observed at all sites (-0.06~0.19%, p>.05). SpO2 values at the left finger and right earlobe had the narrowest range, with a 95% limits of agreement (LOA) (left finger -3.04~2.93% and right earlobe -3.18~2.79%). SpO2 at the index finger, on the side without an arterial catheter, had a narrower range of 95% LOA than that of the opposing finger (-3.00~2.97% vs. -3.73~3.26%). Conclusion : SpO2 at the finger without an arterial catheter had the highest level of precision. This study suggests using the index finger, on the side without an arterial catheter, for pulse oximetry in neurocritical patients.

Knee Joint Isokinetic Rehabilitation Exercise Equipment Usability Evaluation

  • Byoung-Kwon Lee;Seung-Hwa Jung;Hye-Ri Shin;Dong-Wook Han;Chang-Young Kim;Jong-Min Woo;Dae-Sung Park
    • Physical Therapy Rehabilitation Science
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    • v.11 no.4
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    • pp.414-420
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    • 2022
  • Objective: In this study, the test-retest reliability and validity were presented to evaluate the usability of isokinetic rehabilitation equipment for the knee joint. Design: Cross-sectional design, reliability & validity study. Methods: Thirty healthy adults participated in the study. A CSMI dynamometer was used as a standardized measuring device to present the validity of the equipment. It was measured based on the dominant leg. The average peak torque value was selected as the measurement variable. After the measurement, a questionnaire was conducted on safety, satisfaction, and performance through the usability evaluation questionnaire. Results: The knee joint isokinetic rehabilitation equipment showed high reliability with Intraclass Correlations Coefficients (ICC) =0.883~0.956. In order to check the validity of the equipment, the 95% confidence interval of the mean difference limit was confirmed by the Bland & Altman plot. As a result, all three angular velocities showed a smaller confidence interval in the flexion than in extension. There were less than 10 plots that were not included in 2 Standard Deviation (SD) between all measurements. As a result of the usability evaluation questionnaire, the average of the safety domain(4.9±0.4), satisfaction domain(4.1±0.8), performance domain(4.3±0.8). Conclusions: If the product is improved by supplementing the items identified in the usability evaluation process, it is judged that it can be used as a useful device in various knee joint rehabilitation fields.