• 제목/요약/키워드: Intra-rater Reliability

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Assessing Reliability of Medical Record Reviews for the Detection of Hospital Adverse Events

  • Ock, Minsu;Lee, Sang-il;Jo, Min-Woo;Lee, Jin Yong;Kim, Seon-Ha
    • Journal of Preventive Medicine and Public Health
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    • 제48권5호
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    • pp.239-248
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    • 2015
  • Objectives: The purpose of this study was to assess the inter-rater reliability and intra-rater reliability of medical record review for the detection of hospital adverse events. Methods: We conducted two stages retrospective medical records review of a random sample of 96 patients from one acute-care general hospital. The first stage was an explicit patient record review by two nurses to detect the presence of 41 screening criteria (SC). The second stage was an implicit structured review by two physicians to identify the occurrence of adverse events from the positive cases on the SC. The inter-rater reliability of two nurses and that of two physicians were assessed. The intra-rater reliability was also evaluated by using test-retest method at approximately two weeks later. Results: In 84.2% of the patient medical records, the nurses agreed as to the necessity for the second stage review (kappa, 0.68; 95% confidence interval [CI], 0.54 to 0.83). In 93.0% of the patient medical records screened by nurses, the physicians agreed about the absence or presence of adverse events (kappa, 0.71; 95% CI, 0.44 to 0.97). When assessing intra-rater reliability, the kappa indices of two nurses were 0.54 (95% CI, 0.31 to 0.77) and 0.67 (95% CI, 0.47 to 0.87), whereas those of two physicians were 0.87 (95% CI, 0.62 to 1.00) and 0.37 (95% CI, -0.16 to 0.89). Conclusions: In this study, the medical record review for detecting adverse events showed intermediate to good level of inter-rater and intra-rater reliability. Well organized training program for reviewers and clearly defining SC are required to get more reliable results in the hospital adverse event study.

뇌졸중 환자에서 Figure-of-8 walk test의 신뢰도와 타당도 (The Reliability and Validity of Figure-of-8 Walk Test in Patients with Stroke)

  • 김양호;임재헌
    • 대한임상전기생리학회지
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    • 제10권1호
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    • pp.29-37
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    • 2012
  • Purpose : The purpose of this study was to establish intra-rater, inter-rater, test-retest reliability, and concurrent validity of figure-of-8 walk test in people with stroke. Methods : The subjects of this study were 17 patients who were diagnosed with a stroke. Subjects were tested twice by the same raters, with 1 day between tests. Subjects were assessed by two physical therapists. Test-retest reliability was calculated using intraclass correlation coefficients (ICC). The concurrent validity was demonstrated by spearman correlation of F8WT with 10m walking test (10MWT), timed up and go test (TUG), Berg balance scale (BBS), dynamic gait index (DGI) and four square step test (FSST). Results : Intra-rater, inter-rater, test- retest of F8WT time, showed high reliability. Intra-rater, inter-rater, test-retest of F8WT steps demonstrated high reliability. Intra-rater, inter-rater, test-retest of F8WT total smoothness score showed below moderate reliability. There was a significant positive correlation of F8WT time with 10MWT, TUG, FSST. There was a significant negative correlation of F8WT time with DGI, BBS. There was a significant positive correlation of F8WT steps with 10MWT, TUG, FSST. There was a significant negative correlation of F8WT steps with DGI. There was a significant positive correlation of F8WT test total smoothness score with BBS. Conclusion : The time, and number of steps in F8WT show high inter, intra-rater, test-retest reliability. The F8WT smoothness shows below moderate reliability. The F8WT shows high concurrent validity with other comparable balance, and walking tests. The F8WT is a valid and reliable measure for assessing walking function in patients with a stroke.

맥진기 판독의 신뢰도 및 파형의 재현성 연구 (Study on Reliability of Interpretation and Reproducibility of a Pulse Analyser)

  • 박승찬;이지혜;이혜윤;조민경;김도형;김소연;최준용;한창우;박성하;홍진우;이인;권정남
    • 대한한방내과학회지
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    • 제34권3호
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    • pp.231-239
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    • 2013
  • Objectives : This study was performed to evaluate inter-rater and intra-rater reliability of interpretation and reproducibility of a pulse analyser (MAXMAC27-Plus). Methods : 38 of 40 volunteers completed the pulse analysis consecutively. Three Korean medical doctors who had at least 2 years of clinical experience interpreted the pulse waves for 3 aspects of size, depth and shape, then inter-rater reliability and crude agreement was obtained. Reinterpretation was done 2 weeks later and intra-rater reliability and crude agreement was obtained. Intra-rater reliability and crude agreement between 1st and 2nd measurement was calculated. Cohen's weighted kappa for size, Cohen's kappa for depth and shape were used as statistical analysis. Results : Inter-rater reliability of size, depth and shape among 3 raters was 0.598, 0.604, and 0.312, respectively, showing moderate to substantial agreement. Average intra-rater reliability between 1st and 2nd interpretation of size, depth and shape was 0.806, 0.705, and 0.638, respectively, showing substantial to almost perfect agreement. However, intra-rater reliability between consecutive measurements of size, depth and shape was 0.221, 0.121, and 0.194, respectively, which showed only poor to fair agreement. Conclusions : Intra-rater and inter-rater reliability of one pulse wave showed relatively high concordance. Training by a clinical expert may effect better concordance among raters. Test-retest reliability showed poor agreement. Improvement of measurement technique and device performance will be needed.

뇌졸중 환자의 수동적 어깨 관절 가동범위 측정에 관한 스마트폰과 측각기의 측정자내, 측정자간 신뢰도 연구 (Intra- and Inter-Rater Reliability of Measuring Passive Range of Shoulder Motion With Smartphone and Goniometer in Patients With Stroke)

  • 박일우;임원빈;박규남;이충휘
    • 한국전문물리치료학회지
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    • 제21권1호
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    • pp.1-12
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    • 2014
  • The purpose of this study were to determine the intra-rater and inter-rater reliability of shoulder passive range of motion measurement using the "Clinometer + bubble level", a smartphone application and to compare with the intra-rater and inter-rater reliability of measurement using a goniometer. Twenty six patients with stroke were recruited for this study. Two raters measured the passive range of motion of four types of shoulder movements (forward flexion; FF, abduction; ABD, external rotation at $90^{\circ}$ abduction; ER90 and internal rotation at $90^{\circ}$ abduction; IR90) using a goniometer and a smartphone to determine within-day inter-rater reliability. A retest session was performed thirty minutes later to determine within-day intra-rater reliability. The reliability was assessed using intraclass correlation coefficients (ICC) and the standard error of measurement (SEM). The ICC (2,1) for the inter-rater reliabilities of the goniometer and smartphone were good in FF and ABD [ICC (2,1)=.75~.87] and excellent in ER90 [ICC (2,1)=.90~.95]. The intra-rater reliabilities for the goniometer and smartphone were good or more than good, with an ICC (3,1) value >.75, the exception was IR90 measured by rater 2 on the smartphone. These results suggest that smartphone could be used as an alternative method tool for measurement of passive shoulder range of motion in patients with stroke.

An Analysis of the Reliability and Validity of a Korean Version of the Mobility and Gait Assessment Tools for Patients with Stroke

  • Jang, Ho Young;Lee, Jeong-Hoon;Oh, Jung Lim;Lee, Hyun Soo;Lee, Suk Min
    • The Journal of Korean Physical Therapy
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    • 제30권1호
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    • pp.29-34
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    • 2018
  • Purpose: This study aimed to systematically analyze the reliability and validity of Korean versions of mobility and gait assessment tools for patients with stroke. Methods: Two reviewers conducted an independent literature search and systematically reviewed the literature. Literature published until June of 2017 was searched using search engines for electronic databases. The 2 reviewers reviewed the title and abstract of each article. Among the articles examined, we read the full text of those judged to be suitable for our study. We classified the selected data into research methods and results. The determination was made through mutual agreement. Results: The reviewers selected 5 articles related to the purpose of this study. The DGI was found to be moderately associated with BBS, 10MWT, and TUG in intra-rater reliability (ICC=0.92), inter-rater reliability (ICC=0.88), and concurrent validity tests. The FGA demonstrated a high level of reliability with intra-rater (ICC=0.92-0.95) and inter-rater reliability (ICC=0.91, 0.95). The intra-rater reliability of the RMI was high at ICC=0.98. Its concurrent validity showed a high association with STREAM and BI. The intra-rater reliability of the MAS was ICC=0.75-0.99. Its inter-rater reliability was very high, exceeding 0.99. The inter-rater reliability of the Tinetti-gait Scale was ICC=0.91, and its concurrent validity was moderately associated with the DGI, 10WMT, OLST, FM-L/E, and STS. Conclusion: The results of this study revealed that the reliability and validity of the Korean versions of the mobility and gait assessment tools were high.

The reliability of dual rehabilitative ultrasound imaging measurements for muscle co-activation

  • Hahn, Joohee;Ha, Hyun-Geun;Lee, Hwang-Jae;Lim, Seungyeop;Lee, Wan-hee
    • Physical Therapy Rehabilitation Science
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    • 제6권3호
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    • pp.152-157
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    • 2017
  • Objective: The aim of this study was to determine the intra-rater and inter-rater reliability of the dual rehabilitative ultrasound imaging (D-RUSI) when simultaneously measuring muscle thickness changes at rest and during co-contraction of the biceps brachii (BB) and triceps brachii (TB). Design: Cross-sectional study. Methods: This study included 36 healthy participants (23 men, 13 women). The participants sat on a chair in a comfortable position with a cushion placed under their elbow to maintain a 90-degree elbow flexion angle. The muscle thickness of the biceps brachii and triceps brachii was measured twice using the D-RUSI by two examiners during resting and co-contraction states. One week later, the same procedure was performed once again. Results: The intra-class correlation coefficients (ICCs) for intra-rater reliability ranged from 0.887 to 0.989 and the confidence interval was within an acceptable range of 0.778 to 0.994. The standard error of measurement (SEM) values ranged from 0.303 to 0.866 and the minimal detectable change (MDC) values ranged from 0.84 to 2.40. The ICCs for inter-rater reliability ranged from 0.758 to 0.925. The SEM values ranged from 0.702 to 1.486 and the MDC values ranged from 1.95 to 4.12. Conclusions: The use of the D-RUSI of the BB muscle had a very good intra-rater reliability and very good inter-rater reliability at the resting state, and a, good inter-rater reliability at the co-activation state. ICC values showed very good intra-reliability and inter-reliability for the TB muscle. the D-RUSI is a useful tool for simultaneously measuring the thickness of two muscles when the BB is an agonist and the TB is an antagonist during co-activation of the upper arm.

노인 보행환경 평가항목 신뢰도 분석연구 (Reliability Analysis on the Assessment Indicators for Senior Walking Environment)

  • 이형숙
    • KIEAE Journal
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    • 제12권3호
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    • pp.69-75
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    • 2012
  • Developing reliable measures of the environment is important to increase our understanding of the environmental effects on walking among seniors. As a preliminary study for developing an instrument for measuring walkability of seniors' environment, the purpose of this study are to identify important assessment indicators associated with seniors' walking and to test their reliability using inter-rater and intra-rater reliability methods. A set of assessment indicators was identified through literature review, and field studies by trained raters were conducted in three senior centers located in Seongnam area in order to test reliability of the audit tool. The results indicated high percent agreement for most indicators and overall 91.6% and 86.1% of items assessed had good or medium inter-rater and intra-rater reliability, respectively. The reliable assessment indicators would provide reliable data for use in community-based audits of built environment in relation to walking among older adults. The findings showed that the indicators of aesthetics had lower reliability compare to safety, convenience, and access. Rater training with various images would improve rater agreement while reduce rater bias.

뇌졸중 환자의 Scale for Contraversive Pushing의 신뢰도 연구 (A Reliability Study of the Scale for Contraversive Pushing in Stroke Patients)

  • 김중선;장종성
    • The Journal of Korean Physical Therapy
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    • 제21권4호
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    • pp.31-36
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    • 2009
  • Purpose: Pusher syndrome in stroke patients is the tendency to push strongly toward the paretic side with the non-affected limbs. The purpose of this study was to estimated inter-rater and intra-rater reliability of the Scale for Contraversive Pushing (SCP). Methods: Fourteen patients in the acute phase after stroke onset were diagnosed with pusher syndrome. Two physical therapists randomly assessed the same patients on different occasions on the same day. Almost all patients were assessed on more than one day. The inter-rater and intra-rater reliability of the SCP was estimated by calculation of the intraclass correlation coefficient (ICC). Results: The intra-rater reliability of the SCP ranged from 0.87 to 0.97; the inter-rater reliability of the SCP ranged from 0.71 to 0.99 in sitting and standing positions. These results show good reliability for the calculated variables. Conclusion: The results provide support for the use of the SCP in assessing pusher syndrome based on its reliability in stroke patients. It may use the standardized clinical assessments in clinical implication.

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BioRescue의 측정자내와 측정자간 신뢰도 (Intra- and Inter-rater Reliability of BioRescue)

  • 김진홍;최보람
    • 한국콘텐츠학회논문지
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    • 제18권11호
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    • pp.348-352
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    • 2018
  • BioRescue($RMIng{\acute{e}}nierie$, Marseille, France)는 대상자가 일어서거나 앉을 때 동적과 정적인 균형을 평가하기 위해 사용하는 장비이다. 이전부터 다양하게 사용되고 있지만 이 장비에 대한 명확한 신뢰도에 대한 연구는 아직 부족한 상태이다. 본 논문은 균형 능력 측정을 위한 BioRescue의 측정자내와 측정자간 신뢰도를 측정했다. 이 연구의 대상자는 34명의 건강한 대상자들과 2명의 물리치료사 평가자들로 구성되었다. BioRescue는 발지표(면적과 압력), 롬버그 검사, 안정성 검사로 구성되어 있다. 발지표의 면적과 안정성 검사는 모든 방향에서 ICC값이 0.60 이상으로 나왔다. 하지만 발지표의 압력과 롬버그 검사는 모든 방향에서 ICC값이 0.60 이하로 나왔다. BioRescue는 균형검사 시 발지표의 면적과 안정성 검사에서 높은 신뢰도를 나타냈다. 하지만, 발지표의 압력과 롬버그 검사의 수치에서 숙련자와 비숙련자의 차이를 보이기 때문에 장비의 정확성을 위해 숙련이 필요하다.

줄자 및 사진촬영 측정을 이용한 어깨뼈 벌림 측정에 대한 신뢰도 연구 (A Reliability Study of Tape and Photography Measurement Techniques for Scapular Position)

  • 김문환;윤성준;하성민
    • 한국전문물리치료학회지
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    • 제20권3호
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    • pp.74-80
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    • 2013
  • The purpose of this study was to determine the reliability of distance measurements from the medial border of the scapula to the spinous process of the thoracic vertebrae when obtained using tape and photography measurements. The study included 20 healthy subjects (10 males, 10 females); for a total of 40 scapula measurements. The distance measurements made using tape or photography methods were conducted with the subject in a standing position. Repeated tape and photography measurements were conducted in two sessions on different days by two examiners to assess the inter-rater and intra-rater reliability of the two methods. The reliability of scapular distance measured using tape and photography methods was tested using intraclass correlation coefficients (ICC(3,1)) and the standard error of measurement (SEM). The inter-rater reliability of the tape measurement method was excellent (ICC=.77) and the intra-rater reliability was fair to good (ICC=.74). The inter-rater and intra-rater reliabilities of the photography measurement method were excellent (ICC=.76 and .76 respectively). Our results suggest that photography measurement is an objective and qualitative measurement tool for scapular distance measurements.