Evaluating the reliability of diagnostic test results.
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Biomedical subjects
Publications and source records attributed to B B Gerstman.
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We used data from the American Society for Gastrointestinal Endoscopy's computer-based management system to compare the rates of serious cardiorespiratory complications and death associated with the use of midazolam and diazepam. Data were analyzed from 21,011 procedures. Midazolam was used in 15,061 of these procedures, diazepam in 4,302, and neither in 1,648. We assessed benzodiazepine dose, concomitant drug administration, type of procedure, and selected patient characteristics in each of these three groups. No significant difference between these three groups were noted other than the fact that certain clinical centers tended to exclusively use midazolam, whereas others used both benzodiazepines. Reports of serious cardiorespiratory complications and death were uncommon, occurring in 5.4 and 0.3 per thousand procedures, respectively. Midazolam did not seem to place patients in this sample at greater risk for cardiorespiratory complications than diazepam. Concomitant use of narcotics and urgent and emergent procedures, however, did increase the risk of serious cardiorespiratory events.
BACKGROUND: The purpose of our study was to determine the reliability of nonvolitional muscle function analysis (MFA) by determining the day-to-day and within-day reliability of conventional electrical stimulation and a newer, magneto-electrical stimulation method, using standard laboratory methodology. METHODS: Ten healthy, human immunodeficiency virus-negative adult men volunteered as subjects. MFA consisted of measuring the maximal relaxation rate, for magneto-electrical stimulation at 1 Hz and conventional electrical stimulation at 20 Hz, and force-frequency ratios using conventional electrical stimulation at 10 Hz:20 Hz and 10 Hz:50 Hz. Within-day and day-to-day reliability were determined by calculating the coefficient of variation (CV) for all subjects. RESULTS: Maximal relaxation rate using magneto-electrical stimulation had a significantly lower CV compared with the other nonvolitional MFA methods (p = .002). CONCLUSIONS: Maximal relaxation rate using magneto-electrical stimulation was more reliable and technically easier than the other muscle function parameters examined. However, the day-to-day CV of muscle function parameters is larger than traditional nutrition assessment techniques. Development within the field should strive to improve testing techniques so that the reliability of MFA will allow definition of a range of normal values against which an individual's value can be compared. Until this is available, the precision and reliability of MFA restrict its use to research and population studies.