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At least 181 records · Page 10Linked to original sources

PubMed1995

Measuring physical function in community-dwelling older persons: a comparison of self-administered, interviewer-administered, and performance-based measures.

PURPOSE: To compare two self-administered, one interviewer-administered, and one performance-based measure of physical function in community-based older persons. METHODS: Eighty-three subjects were recruited from meal sites, senior recreation centers, and senior housing units for a comprehensive geriatric assessment program. At the time of screening, study participants self-administered the Functional Status Questionnaire (FSQ) and were administered the Katz Activities of Daily Living (ADL) and the Older Americans Resources and Services Instrumental Activities of Daily Living (OARS-IADL) instruments by interview. Participants also completed the Physical Performance Test (PPT) and were given the Medical Outcomes Study SF-36 to self-administer on site or at home and return by mail. RESULTS: All 83 subjects completed FSQ, Katz ADL, OARS-IADL, and PPT; 72 returned SF-36 forms. Correlations between the two self-administered physical function measures (FSQ and SF-36) were higher than between self-administered and interviewer-assessed (ADL and OARS-IADL) or performance-based (PPT) measures. When assessed for construct validity, the self-administered, OARS, and PPT measures had comparable correlations with role limitations as a result of physical health problems, but relationships between physical functional status measures and other SF-36 measures of health were inconsistent. CONCLUSION: The relationships between commonly used self-administered, interviewer-administered, and performance-based measures of physical function were inconsistent and weak, suggesting that these instruments are not measuring the same construct.

Activities of Daily Living↗

PubMed1993

The effect of the articulator settings on the cusp inclines as measured by a coordinate measuring machine.

PURPOSE: The purpose of the study was to learn the effect of changes in the articulator settings on the cusp angles during working, nonworking, and protrusive movements; the purpose was also to determine the ability of the coordinate measuring machine to measure the movements. MATERIALS AND METHODS: The condylar angles and the anterior guide angles on a Hanau 96H2 articulator (Teledyne Hanau Corp, Buffalo, NY) were varied; 432 working, nonworking, and protrusive cusp angles were measured at the first molar by a coordinate measuring machine. RESULTS: The data from the coordinate measuring machine was used to produce formulas. The formulas were used to calculate the working, nonworking, and protrusive cusp angles that will occur as a result of 72 different articulator settings. CONCLUSIONS: The coordinate measuring machine is useful for making measurements of articulator movements. Additional research may measure the movements of other articulators or compare articulators (such as the arcon and nonarcon).

Dental Articulators↗

PubMedDate not supplied

A comparison of standardized measures of psychosocial variables with single-item screening measures used in an urban obstetric clinic.

OBJECTIVE: To compare standardized, psychometrically sound measures of psychosocial variables and physical violence with single-item measures currently used for screening purposes in an obstetric clinic. STUDY DESIGN: Two hundred multiethnic women were interviewed during scheduled prenatal visits at an urban perinatal center. Participants previously completed a standard perinatal self-administered inventory, which included several single-item psychosocial questions. Medical and obstetric history, current risk factors, and intrapartum complications were collected from medical records. RESULTS: Correlational analyses indicated that single-item self-report measures were more appropriate for certain types of variables than for others. Specifically, for anxiety, depression, and social support, single-item measures were significantly correlated with standardized, psychometrically sound measures, whereas this was not true for stress and domestic violence. CONCLUSION: It may be appropriate to rely on self-reported single-item measures to detect some psychosocial risk factors in clinical settings for the purposes of referral. When assessing for domestic violence, single-item measures may not be adequate, as personal interviews using a standardized, psychometrically sound measure resulted in higher rates of reporting.

Adolescent↗

PubMed1999

Uni- and bipolar pacing threshold measurements with capturecontrol, a new automatic pacemaker function for capture verification. Comparison of the automatic and the manual pacing threshold measurement.

It is mandatory in pacemaker patients to determine the pacing threshold at each follow-up visit. To facilitate the pacing threshold measurements, complete automatic pacemaker tests are being developed. A new pacemaker algorithm for automatic capture verification (Capturecontrol) detects the presence of the evoked response signal 70-100 ms after the pacing pulse. The aim of this study was to determine the uni- and bipolar pacing thresholds using this automatic pacemaker function and compare them with the manually determined threshold. The study included 14 patients with the DDD pacemaker Logos (Biotronik) connected to the high-ohmic ventricular pacing lead Synox SX 60-BP (Biotronik). At predischarge and 8, 14, 20 and 26 weeks after implantation the uni- and bipolar pacing thresholds were assessed manually and with the automatic pacemaker function at 0.4 ms duration. Mean pacing thresholds determined with the automatic pacemaker function were not different from the manually measured values. This applied to uni- and bipolar pacing. Seventy percent of all unipolar and 67% of all bipolar measurements had no deviation. A deviation of 0.1 V between manual and automatic threshold measurement was observed in 25% (unipolar) and 28% (bipolar), respectively. A 0.2-volt difference occurred in 3% in the unipolar measurements. Deviations >/=0.3 V were found in 2% of all unipolar and in 5% of all bipolar measurements. In conclusion, automatic pacing threshold measurements using the Capturecontrol algorithm were similar compared to the manually determined thresholds. The excellent agreement between the two methods was observed for bipolar as well as unipolar pacing and on condition that all patients had a high-ohmic ventricular pacing lead. Therefore, fewer requirements are necessary for Capturecontrol than for presently available systems. Such pacemaker functions can help to speed up the measurements during follow-up visits.

Aged↗

PubMed1999

Measurement of glomerular filtration rate by the 99mTc-DTPA renogram is less precise than measured and predicted creatinine clearance.

The work was devised to compare measurements of glomerular filtration rate (GFR) by technetium-99m-diethylenetriaminepentacetic acid (99mTc-DTPA) renogram to those by creatinine clearance (measured and predicted by Cockroft and Gault) and by inulin clearance. A total number of 65 individuals were enrolled: 15 healthy controls and 50 patients with renal disease. Compared to inulin clearance used as the gold standard, 99mTc-DTPA overestimated at low and underestimated at high GFRs. 99mTc-DTPA measurements were less precise than creatinine clearance except for individuals with GFR >100 ml/min x 1.73 m2. Measured creatinine clearance had the highest correlation coefficient with inulin clearance, 99mTc-DTPA clearance the lowest. In correlation analyses, 81.5% of the interindividual variability for measured creatinine clearance could be explained by true differences in inulin clearance; this value dropped to 59.1 and 57.4% for predicted creatinine clearance and 99mTc-DTPA, respectively. In patients with GFR <25 ml/min x 1.73 m2, all 99mTc-DTPA measurements were out of the 95% confidence interval for the inulin measurement. It can be inferred that 99mTc-DTPA clearance from the renogram is less precise than measured and predicted creatinine clearance.

Adult↗

PubMed2005

Recommendations for blood pressure measurement in humans and experimental animals: part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research.

Accurate measurement of blood pressure is essential to classify individuals, to ascertain blood pressure-related risk, and to guide management. The auscultatory technique with a trained observer and mercury sphygmomanometer continues to be the method of choice for measurement in the office, using the first and fifth phases of the Korotkoff sounds, including in pregnant women. The use of mercury is declining, and alternatives are needed. Aneroid devices are suitable, but they require frequent calibration. Hybrid devices that use electronic transducers instead of mercury have promise. The oscillometric method can be used for office measurement, but only devices independently validated according to standard protocols should be used, and individual calibration is recommended. They have the advantage of being able to take multiple measurements. Proper training of observers, positioning of the patient, and selection of cuff size are all essential. It is increasingly recognized that office measurements correlate poorly with blood pressure measured in other settings, and that they can be supplemented by self-measured readings taken with validated devices at home. There is increasing evidence that home readings predict cardiovascular events and are particularly useful for monitoring the effects of treatment. Twenty-four-hour ambulatory monitoring gives a better prediction of risk than office measurements and is useful for diagnosing white-coat hypertension. There is increasing evidence that a failure of blood pressure to fall during the night may be associated with increased risk. In obese patients and children, the use of an appropriate cuff size is of paramount importance.

Adult↗

PubMed2004

Recommendations for blood pressure measurement in humans and experimental animals: Part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research.

Adult↗

PubMed2003

How many repeated measures in repeated measures designs? Statistical issues for comparative trials.

BACKGROUND: In many randomized and non-randomized comparative trials, researchers measure a continuous endpoint repeatedly in order to decrease intra-patient variability and thus increase statistical power. There has been little guidance in the literature as to selecting the optimal number of repeated measures. METHODS: The degree to which adding a further measure increases statistical power can be derived from simple formulae. This "marginal benefit" can be used to inform the optimal number of repeat assessments. RESULTS: Although repeating assessments can have dramatic effects on power, marginal benefit of an additional measure rapidly decreases as the number of measures rises. There is little value in increasing the number of either baseline or post-treatment assessments beyond four, or seven where baseline assessments are taken. An exception is when correlations between measures are low, for instance, episodic conditions such as headache. CONCLUSIONS: The proposed method offers a rational basis for determining the number of repeat measures in repeat measures designs.

Controlled Clinical Trials as Topic↗

PubMed2006

Many quality measurements, but few quality measures assessing the quality of breast cancer care in women: a systematic review.

BACKGROUND: Breast cancer in women is increasingly frequent, and care is complex, onerous and expensive, all of which lend urgency to improvements in care. Quality measurement is essential to monitor effectiveness and to guide improvements in healthcare. METHODS: Ten databases, including Medline, were searched electronically to identify measures assessing the quality of breast cancer care in women (diagnosis, treatment, followup, documentation of care). Eligible studies measured adherence to standards of breast cancer care in women diagnosed with, or in treatment for, any histological type of adenocarcinoma of the breast. Reference lists of studies, review articles, web sites, and files of experts were searched manually. Evidence appraisal entailed dual independent assessments of data (e.g., indicators used in quality measurement). The extent of each quality indicator's scientific validation as a measure was assessed. The American Society of Clinical Oncology (ASCO) was asked to contribute quality measures under development. RESULTS: Sixty relevant reports identified 58 studies with 143 indicators assessing adherence to quality breast cancer care. A paucity of validated indicators (n = 12), most of which assessed quality of life, only permitted a qualitative data synthesis. Most quality indicators evaluated processes of care. CONCLUSION: While some studies revealed patterns of under-use of care, all adherence data require confirmation using validated quality measures. ASCO's current development of a set of quality measures relating to breast cancer care may hold the key to conducting definitive studies.

Breast Neoplasms↗

PubMed1998

Effect of training and different measurement strategies on the reproducibility of brain MRI lesion load measurements in multiple sclerosis.

In this study, we evaluated the intra- and interobserver variabilities in measuring lesion load of brain MRI abnormalities present on proton-density scans from patients with MS, using using both manual outlining or a semiautomated local thresholding technique (LTT). We also evaluated how these variabilities were affected by the use of standard rules for lesion load measurements, training, and different measurement strategies. The intraobserver variabilities obtained after establishing rules for lesion load measurements and training were not significantly different from those obtained before any consensus among the observers, both for manual outlining and for the LTT. On the contrary, the interobserver variabilities obtained with manual outlining or the LTT were significantly reduced when rules for lesion load measurements were used. For manual outlining, the intraobserver variability did not significantly change when the measurements were performed after an experienced radiologist identified lesions or when using adjacent slices and the corresponding T2-weighted images as reference for lesion identification. On the contrary, for the LTT, the intraobserver variability was significantly reduced by the use of the radiologic marking. The interobserver variabilities for both manual outlining and the LTT were reduced compared with the free condition when these measurement strategies were used. Our findings demonstrate that both lesion identification and outlining are important sources of variation for MRI lesion load measurements in MS and that there are simple strategies to reduce such variation that might be useful when planning clinical trials.

Brain↗

PubMed1985

The clinical value of measurements of the symphysis-fundus distance and ultrasonic measurements of the biparietal diameter in the diagnosis of intrauterine growth retardation.

The diagnostic efficiency in the prediction of intrauterine growth retardation (IUGR) of repeated measurements of the symphysis-fundus (SF) distance and repeated ultrasonic measurements of the biparietal diameter (BPD) was investigated in 377 pregnancies, all at risk for IUGR. Measurements of the SF distance were found to be more effective than ultrasonic BPD measurements for antenatal diagnosis of IUGR. For every correct diagnosis there were three false positive when using SF measurements and ten when using ultrasonic BPD measurements. When the SF method is used, repeated ultrasonic BPD measurements add very little information. The SF curve is a very simple and inexpensive method and should be used as a screening instrument for severe IUGR. When the SF curve is assessed as pathological, ultrasonic measurements also including other fetal dimensions than only BPD are recommended as a way of diagnosing IUGR.

Cephalometry↗

PubMed2006

[Correlation and concordance between echocardiographic measurements obtained during echocardiography and digitized image measurements--transversal study].

OBJECTIVE: To evaluate the correlation and concordance between the measurements of echocardiographic analysis of cardiac dimensions obtained through the Echo off-line applicative (software for obtaining digitized image measurements in a dedicated workstation) available to public domain, and those obtained through the conventional method. METHOD: Transversal contemporary study, of 56 randomized patients whose images were obtained during examinations. The measurements of the M mode and 2D, were done in the ventricles, left atrium, and aorta by the Echo off-line program. These measurements were compared to those obtained by another professional, through Pearson's correlation test (r), alpha = 0.05 and by concordance analysis (Bland and Altman). RESULT: The measurements carried out by the Echo off-line system showed r that varied from 0.85 to 0.98. The analysis of concordance showed that for most measurements, the mean difference between the methods was approximately zero. The variation of absolute values did not show, in average, a clinical significance. The Echo off-line applicative allows a reduction of approximately 30% in the time spent to obtain the measurements. CONCLUSION: This study demonstrated the accuracy of the Echo off-line program to measure cardiac dimensions in a dedicated workstation, showing that it can be routinely used in echocardiography labs.

Adolescent↗

PubMed2001

Blood pressure measurement--does anyone do it right?: An assessment of the reliability of equipment in use and the measurement techniques of clinicians.

OBJECTIVE: To assess the accuracy and consistency of blood pressure measurement techniques among individual clinicians and the reliability of the equipment in everyday use. DESIGN: Professional survey. PARTICIPANTS: The senior nurse at each of 28 clinics was sent two questionnaires about equipment, and 55 health professionals were sent a questionnaire about their measurement technique. MAIN OUTCOME MEASURES: Faulty equipment, date of last service, named individual responsible for equipment, knowledge of protocols regarding mercury spillage, correct technique for measuring blood pressure, training in blood pressure measurement. RESULTS: An 82% response rate on equipment showed it to be in relatively good condition, although maintenance problems and some potentially dangerous health and safety issues were highlighted. A 67% response rate on measurement technique showed that there was considerable variation in individual measurement technique that could lead to inappropriate action. COMMENT: This study has lead to replacing all mercury with aneroid devices, and to the development of staff guidelines and updating on measurement techniques. A re-audit will be carried out to complete the cycle.

Blood Pressure Determination↗

PubMed1991

Comparison of real-time ultrasound and other live measures to carcass measures as predictors of beef cow energy stores.

Thirty-nine mature cows were divided into three condition groups on the basis of their subcutaneous fat thickness as determined by real-time ultrasound. A representative animal from each group was measured and slaughtered. The remaining cows with each group were stratified evenly into two groups with one group fed to gain weight and the other to lose weight. Several ultrasound and other live measures were taken every 4 wk and two animals per subgroup were randomly slaughtered. Carcass data were collected and one side of each carcass was boned, ground, mixed, and subsampled for fat and protein determination. Four regression equations were generated to predict percentage of fat (FAT), percentage of protein (PROT), total fat (TOTFAT), total protein (TOTPROT), total calories (CAL), CAL per live weight (CAL/WT), yield grade (YG), and marbling (MARB). The first equation used all live measures (SUB), the second equation used only objective live measures (OBJ), the third equation incorporated traditional live measures (EAS), and the fourth equation used only carcass data (CAR). Adjusted R-squares of the most appropriate equation using the SUB, OBJ, EAS, and CAR measurements were .82, .73, .82, and .82 for FAT; .82, .57, .61, and .66 for PROT; .89, .87, .86, and .85 for TOTFAT; .95, .95, .93, and .74 for TOTPROT; .93, .92, .91, and .90 for CAL; .83, .78, .83, and .82 for CAL/WT; .86, .86, .78, and .93 for YG; and .75, .70, .74, and .74 for MARB, respectively. It seems that condition score or ultrasound with other objective live measures is as accurate in predicting cow composition as carcass measures.

Adipose Tissue↗

PubMed2006

Quality measurement: who is measuring outcomes and what are patients being told?

Change is inevitable, but participation is optional. An array of quality measures is being used by various government entities, health care purchasers and payers, and other groups. Many of the quality-measurement initiatives have not only gained the attention of large employers, but are also beginning to pique the public's interest. Novel approaches to measuring and rewarding quality are also emerging, such as pay-for-performance schemes and the use of APR-DRGs. Health care organizations that participate in the quality-measurement process and provide input will benefit by the type of measures that are ultimately created. It is much better to be part of the development process than to have insurer- or employer-designed quality measures imposed on your institution. At the very least, health care organizations would be wise to serve as watchdogs to ensure that currently proposed quality measures truly measure high-quality care.

Humans↗

PubMed1998

Superiority of home blood pressure measurements over office measurements for testing antihypertensive drugs.

OBJECTIVE: To compare the effects on office blood pressure and home blood pressure of placebo and active drug administration. DESIGN: After a 2-week wash-out period, patients with mild-to-moderate hypertension entered a 2-week single-blind placebo period and then a 4-week double-blind period. Patients were randomly assigned to be administered either 2 mg trandolapril once daily or its placebo in a 2:1 proportion. Office blood pressure was measured by a physician at the end of each period, using a mercury sphygmomanometer (mean of three consecutive measurements). Home blood pressure was measured during the last week of each period according to standard procedure carefully taught to each patient by the physician. Compliance was checked by using electronic pill boxes. RESULTS: Data for 34 of the 44 patients who entered the study were eligible for analysis. Baseline systolic blood pressure/diastolic blood pressure were significantly (P = 0.0001/P = 0.0001) higher for office blood pressure (161/101 mmHg) than they were for home blood pressure (145/93 mmHg). There was no statistically significant difference between the placebo and active-treatment groups at baseline. During the single-blind period, blood pressures measured at the office and at home did not change significantly. Office blood pressure decreased by 2.7 +/- 10 mmHg for systolic blood pressure and by 0.5 +/- 4 mmHg for diastolic blood pressure whereas home blood pressure increased by 0.8 +/- 6 mmHg for systolic blood pressure and by 0.7 +/- 4 mmHg for diastolic blood pressure. During the double-blind period, office blood pressure fell significantly with trandolapril treatment (systolic by 10.2 +/- 12 mmHg, diastolic by 8.3 +/- 6 mmHg; P = 0.0005/0.0001, versus single-blind placebo period) but this decrease was not significantly different (P = 0.45/0.92) from the fall in members of the placebo group (systolic by 6.9 +/- 9 mmHg, diastolic by 8.0 +/-6 mmHg; P = 0.04/0.002, versus single-blind placebo period). Thus, no antihypertensive effect of trandolapril was demonstrated. The fall lin home blood pressure with trandolapril treatment was significant (systolic by 10.7 +/- 8 mmHg, diastolic by 5.8 +/- 5 mmHg; both P = 0.0001, versus single-blind placebo period) and was significantly greater (P = 0.0004/0.004) than the minimal change observed with placebo (systolic fell by 0.2 +/- 5mmHg, diastolic fell by 0.6 +/- 4 mmHg; P = 0.90/0.62, respectively, versus single-blind placebo period). The evening decrease in home blood pressure was similar to the morning decrease in home blood pressure in members of the trandolapril-treated group. The resulting morning:evening decrease in blood pressure ratio was 0.83 for diastolic blood pressure and 0.95 for systolic blood pressure. For the subgroup of responders, mean of individual ratios was 0.77 +/- 0.43 for diastolic blood pressure and 0.70 +/- 0.39 for systolic blood pressure. CONCLUSION: The placebo effect observed with office blood pressure measurements does not occur with home blood pressure measurements. Expected treatment effect can alter a physician's blood pressure readings. The precision of measurements is greater with home blood pressure (there is a lower SD). Use of home blood pressure measurements increases the power of comparative trials, allowing one either to study fewer subjects or to detect a smaller difference in blood pressure.

Journal Article↗

PubMed1999

Residential magnetic field measurements in France: comparison of indoor and outdoor measurements.

Residential magnetic field (MF) measurements were performed for the first time in a representative sample of French dwellings. Exposure levels were assessed by two methods: indoor and outdoor measurements. Linear and logistic regression models were used to determine factors associated with the time-weighted average (TWA) home MF. TWA magnetic field magnitudes were approximately log-normally distributed with geometric means under 0.010 microT for both indoor and outdoor measurements. Only 5% of the dwellings presented indoor MF levels greater than 0.120 microT (1.2 mG). Both indoor and outdoor MF variations were explained by three factors: wiring configuration, the dwelling's location (i.e., urban or rural), and housing characteristics (individual houses or apartment building). The reliability of outdoor spot measurements with 30-min bedroom recordings was assessed by an intraclass correlation coefficient. The measurements were accurate in rural areas and small towns. In urban centers, local MF variations spoil the outdoor measurement's reliability. If indoor measurements are taken as the reference method, the use of outdoor instead of indoor measurement leads to an important decrease in statistical power. Further assessment of MF near high power transmission lines is necessary to evaluate the usefulness of outdoor spot recordings near such lines. The urban MF environment also has to be explored to identify extraneous sources.

Case-Control Studies↗

PubMed2000

[Roaming through methodology. XXV. Outcome measures, surrogate outcomes, and intermediate measures].

Clinical medicine is aimed at decreasing the current or future burden of disease. Disease outcome is best expressed as burden of disease or change thereof, and as such the only true 'outcome measure' in clinical research. However, outcome research is expensive in costs and time expenditure, and sometimes impossible. Therefore study results are often expressed in intermediate measures. These measures tell us something about the disease process and the pathophysiological consequences of the disease and should have a relation with outcome. If this relation is strong, the measure is called 'surrogate outcome'. Intermediate measures and surrogate outcomes have advantages and disadvantages. The reader of clinical trial results first has to decide whether the answer to the study question is relevant in his personal situation. If so, the applicability of a measure can be simply appraised by answering 3 questions: 'Is the measure truthful (relevant, unbiased)?'; 'Does it discriminate between situations that are of interest?'; 'Is the measure feasible in my setting?'

Clinical Trials as Topic↗