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At least 37 records · Page 2Linked to original sources

PubMed2004

[Design and testing of a novel measuring system for use in dental biomechanics--principles and examples of measurements with the hexapod measuring system].

A novel measuring set-up based on a hexapod system for use in dental biomechanics is described. It was specially developed to measure force/deflection characteristics of different dental materials and devices. The functionability and suitability of the system for use in experimental biomechanics were investigated in two different studies. In a first study the micro mobility of prosthetic telescopic crowns prior to and after simulated wear was determined to investigate the influence of wear processes on the stability of the anchorage elements and thus of prostheses. This study investigated the ability of the setup to load a specimen with high forces or torques of up to 100 Newton. The second study looked at the force/deflection characteristics of orthodontic anchorage pins used in orthodontics to additionally stabilize the anchorage unit, for example during molar movement. In this study specimens were loaded with small forces of less than 10 Newton, as are typically used in orthodontics. Using the setup, the deflection behaviour of these devices under high and low loading was measured at a resolution of approximately one micrometer or one angular second.

Biomechanical Phenomena↗

PubMed1998

[Home blood pressure measurement and ambulatory blood pressure measurement versus office blood pressure measurement].

PURPOSE: To compare both home blood pressure measurement (HBPM) and ambulatory blood pressure monitoring (ABPM) with office blood pressure measurement (OBP); and also to compare the correlation between HBPM and OBP with LVMI (left ventricular mass index). METHODS: Protocol 1--68 hypertensive patients (58 +/- 12 years, 37 females): a) self recorded blood pressure at home in the 7 days; b) recorded the ABPM during 24 hours; and c) the physician recorded blood pressure in the office. Protocol 2-41 hypertensive patients underwent the HBPM, OBP, and BI-dimensional echocardiogram. RESULTS: Protocol 1--OBP (153 +/- 24/96 +/- 13 mmHg) was higher (p < 0.05) than HBPM (133 +/- 18/84 +/- 12 mmHg) and ABPM (137 +/- 17/87 +/- 12 mmHg); Protocol 2--LVMI correlated better with HBPM (r = 0.39/0.49, p < 0.05, systolic and diastolic, respectively) than OBP (r = 0.02/ 0.22, p > 0.05, systolic and diastolic, respectively). CONCLUSION: This study showed that HBPM has a better correlation with LVMI than OBP.

Adult↗

PubMedDate not supplied

Comparison of pulmonary artery and central venous pressure waveform measurements via digital and graphic measurement methods.

BACKGROUND: Techniques to measure pulmonary artery (PA) pressure waveforms include digital measurement, graphic measurement, and freeze-cursor measurement. Previous studies reported the inaccuracy of digital and freeze-cursor measurements. However, many of the previous studies were small and did not thoroughly examine the circumstances of when digital measurements might be inaccurate. OBJECTIVES: To compare digital measurements and graphic measurements of PA and central venous pressure (CVP) waveforms in patients with a variety of respiratory patterns, and to compare digital measurements and graphic measurements of CVPs in patients with abnormal or right ventricular waveforms. METHODS: A total of 928 patients were enrolled in this study. Waveforms from the PA and CVP were collected from each patient. The monitor pressure value (digital measurement) printed on the recorded waveform was compared with the pressure value obtained by a graphic strip recording and measured by one of the primary investigators (graphic measurement). RESULTS: Digital measurements were found to be inaccurate in measuring waveforms in all respiratory categories and in measuring right ventricular waveforms. PA diastolic values and CVP values were the most inaccurately measured waveforms. Digital errors of more than 4 mm Hg were common. CONCLUSION: There were instances in which the monitor's digital measurement was substantially different from the graphically measured value. This difference has the potential to mislead interpretation of clinical situations. The monitor's ability to occasionally give digital measurement values similar to the graphic measurements may lead to a false sense of security in clinicians. Because the accuracy of the monitor is inconsistent, the bedside clinician should interpret waveforms through use of a graphic recording rather than rely on the digital measurement on the monitor.

Blood Pressure Determination↗

PubMedDate not supplied

Fundal height measurement. Part 5--The effect of clinician bias on fundal height measurements.

The purpose of this study was to determine whether clinicians' fundal height measurements were influenced by their ability to see the numeric markings on the tape measure during the measurement procedure, and by their knowledge of gestational weeks. Ten certified nurse-midwives and four student nurse-midwives each obtained measurements from 24 women. Each clinician obtained two fundal height measurements with unmarked paper tape measures and two fundal height measurements with marked paper tape measures. The fundal height measurement obtained and recorded on the prenatal chart by the clinician responsible for the woman's routine prenatal visit at the time of data collection was also recorded by the researchers. Comparison of the differences between the clinician's two marked and two unmarked tape measurements demonstrated that the differences between the two marked tape measurements were smaller (mean absolute difference = 0.61 cm) than the differences between the two unmarked tape measurements (mean absolute difference = 0.97 cm). When the gestational weeks were compared with the unmarked and marked tape measurements and with the fundal height measurements recorded on the prenatal record, the smallest differences were between the fundal height measurements recorded on the prenatal record and gestational weeks (mean absolute difference = 1.51 cm); the next smallest differences were between the marked tape measurements and gestational weeks (mean absolute difference = 1.89 cm); and the largest differences were between the unmarked tape measurements and gestational weeks (mean absolute difference = 2.15 cm). These findings demonstrate that clinicians' fundal height measurements are biased by their ability to see the numeric markings on the tape measure and by their knowledge of gestational weeks. These findings suggest that clinicians should blind themselves to their own fundal height measurements and to the number of gestational weeks to avoid the effects of clinician bias on their fundal height measurements.

Anthropometry↗

PubMed2004

Inter- and intra-measurer error in the measurement of Reimers' hip migration percentage.

Reimers' hip migration percentage is commonly used to document the extent of subluxation of the hip in children with spasticity. In this study, two measurers, with six months paediatric orthopaedic experience, measured the migration percentage on 44 pelvic radiographs of children with cerebral palsy, aged between two and eight years. Unknown to the measurers, each radiograph was duplicated, giving 22 non-identical radiographs (44 hips) which were measured twice at time 0 and twice six weeks later. The intra-measurer, intra-sessional absolute differences between the first and second measurements ranged from 0% to 23%, with median values of 2.5% to 3.6%. The intra-sessional median absolute differences were not statistically different between the two measurers and measuring sessions (p = 0.42, Kruskal-Wallis test). The inter-sessional absolute differences for measurements made by the same measurers ranged from 0% to 18% with a median absolute difference of 1.7% to 3.2%. Overall, only 5% of the intra-measurer measurement differences, within and between sessions, were above 13%. Repeated measurements by one measurer over time must, therefore, vary by more than 13% in order to be 95% confident of a true change. The inter-measurer error was higher with median absolute differences between the two measurers' measurements of the same hip of 3.25% to 5% (0% to 26%) and a 95th upper confidence interval of 21% to 23%. Averaging the four separate measurements over the two sessions reduced the inter-measurer error to a median absolute difference of 2.8%, but did not improve the 95th upper confidence interval, which measured 22.4%. Such inter-measurer errors may be clinically unacceptable.

Acetabulum↗

PubMed2005

The vexatious vital: neither clinical measurements by nurses nor an electronic monitor provides accurate measurements of respiratory rate in triage.

STUDY OBJECTIVE: Of all the vital signs, only respiratory rate is still measured clinically in most US triage systems. Previous studies have demonstrated the inaccuracy, poor interobserver agreement, and low variability of routine measurements of respiratory rate. We assess the variability and accuracy of triage nurses' measurements of respiratory rate against a criterion standard. Also, we assess electronic measurement of respiratory rate against the same criterion standard. METHODS: Consecutive patients presenting to an urban teaching emergency department (ED) were enrolled in this prospective study. Electronic measurement of respiratory rate was recorded throughout the triage encounter when nurses were recording measurements of respiratory rate. Electronic respiratory rate was measured using transthoracic impedance plethysmography. Immediately after each triage evaluation, criterion standard measurements of respiratory rate were made by research assistants using the World Health Organization recommendation of auscultation or observation for 60 seconds. RESULTS: We enrolled 159 patients. Variability was low for triage nurses' measurements of respiratory rate (SD 3.3) and electronic measurement of respiratory rate (SD 4.1) compared with criterion standard measurements of respiratory rate (SD 4.8; P <.05). Triage nurses' measurements of respiratory rate and electronic measurement of respiratory rate showed low sensitivity in detecting bradypnea and tachypnea. In a Bland-Altman analysis, triage nurses' measurements of respiratory rate and electronic measurement of respiratory rate showed poor agreement with criterion standard measurements of respiratory rate. Subgroup analysis of patients presenting with cardiac and respiratory symptoms yielded similar results. CONCLUSION: Neither triage nurses nor an electronic monitor provides accurate measurements of respiratory rate in the ED. Emergency physicians should search for new electronic modalities for measuring respiratory rate to bring respiratory rate into line with other vital signs. Emergency physicians should also consider new clinical strategies for measuring respiratory rate.

Adolescent↗

PubMedDate not supplied

Measurement of adherence in pharmacy administrative databases: a proposal for standard definitions and preferred measures.

BACKGROUND: A variety of measures have been developed to calculate refill adherence from administrative data such as pharmacy claims databases. These measures have focused on improving the accuracy of adherence measures or clarifying the evaluation time frame. As a result, there are many measures used to assess adherence that may or may not be comparable or accurate. OBJECTIVE: To compare available refill adherence measures. METHODS: A systematic literature review was conducted to identify current or recently used measures of calculating adherence from administrative data. A MEDLINE search (January 1990-March 2006) was undertaken using the search terms adherence or compliance in the title combined with administrative, pharmacy, or records in any field, including subheadings medical, nursing, and hospital records. Non-English articles were excluded. Seven hundred fifteen articles were available for review. Review articles and letters were excluded from measure selection, but were included in the search terms and used to identify additional research articles. Adherence measures were excluded if they were incompletely described, produced non-numeric values, or were duplicates. Eleven refill adherence measures were identified and compared using data from the LOSE Weight (Long-term Outcomes of Sibutramine Effectiveness on Weight) study. Measures compared include Continuous Measure of Medication Acquisition (CMA); Continuous Multiple Interval Measure of Oversupply (CMOS); Medication Possession Ratio (MPR); Medication Refill Adherence (MRA); Continuous Measure of Medication Gaps (CMG); Continuous, Single Interval Measure of Medication Aquisition (CSA); Proportion of Days Covered (PDC); Refill Compliance Rate (RCR); Medication Possession Ratio, modified (MPRm); Dates Between Fills Adherence Rate (DBR); and Compliance Rate (CR). RESULTS: The results suggest that the CMA, CMOS, MPR, and MRA are identical in terms of measuring adherence to prescription refills throughout the study period, each with a value of 63.5%; CMG and PDC are slightly lower (63.0%) and are equivalent to MRA when oversupply is truncated. CR, MPRm, RCR, and CSA result in higher adherence values of 84.4%, 86.6%, 104.8%, and 109.7%, respectively. CONCLUSIONS: Five measures produce equivalent results for measuring prescription refill adherence over the evaluation period. Of these, MRA has the fewest calculations, is easily truncated if one desires to exclude surplus medication issues, and requires the least amount of data. MRA is therefore recommended as the preferred measure of adherence using administrative data.

Appetite Depressants↗

PubMed2000

User procedure for self-measurement of blood pressure. First International Consensus Conference on Self Blood Pressure Measurement.

OBJECTIVE: To review the medical literature regarding the methodology of self-measurement of blood pressure and to provide some practical recommendations regarding protocol and procedure for measurement, documentation and analysis of data, choice and provision of devices and education of patients and physicians. PROCEDURE AND PROTOCOL FOR MEASUREMENTS: Technical recommendations regarding measurement of blood pressure do not differ from usual guidelines. Frequency of measurement remains a matter of discussion. At the beginning of the self-measurements of blood pressure and during the titration phase, there should be a 7-day measurement period with two measurement of blood pressure each morning and two measurements in the evening at pre-stipulated times. For long-term observation, a minimum measurement period of 1 week per quarter is required. The minimum number of measurements performed during each period should be a total of 12 readings recorded within seven working days. Depending on individual needs (e.g. poor compliance) or for pharmacologic studies, a higher frequency of readings could be used. DOCUMENTATION AND ANALYSIS OF DATA: Owing to the lack of reliability of patients' diaries, the use of printer-equipped or memory-equipped devices is advocated. All the recorded data, except those obtained on the first day, must be used for analysis. CHOICE AND PROVISION OF DEVICES: Self-measurement of blood pressure should be performed with validated fully automated devices using a brachial cuff. The preference should be given to apparatus offering the possibility of storing and transmitting measurements. Wrist apparatus should be used with caution due to the risk of measurement errors if it is used inappropriately. A manual device should be considered for patients suffering from irregular cardiac rhythms and patients with large or small arm circumferences, since automated devices have not been validated for use in these situations. Reimbursement of hypertensive patients using validated devices should be considered, so long as they are adequately trained and supervised. EDUCATION OF PATIENTS: In a therapeutic perspective, self-measurement of blood pressure should be performed by trained patients under the supervision of their practitioner. Teaching must be performed by skilled staff in hypertension centers and ultimately in general practice. Self-measurement of blood pressure is to be recommended for any hypertensive patient who is sufficiently motivated to participate in the treatment of his own hypertension. Patients with physical problems or mental disabilities that make them unable to perform or to understand the measuring technique represent the limits of the method. Education of patients must encompass information about hypertension and cardiovascular risk, blood-pressure-measurement procedures, advice on items of equipment and their proper use, protocols, and interpretation of data. A patient's proficiency must be checked before he or she should be considered competent at performing the procedure. Annual reevaluation is required.

Blood Pressure Determination↗

PubMed2001

Accuracy and reproducibility of simple cross-sectional linear and area measurements of brain structures and their comparison with volume measurements.

Volumetric measurement of brain structure on brain images is regarded as a gold standard, yet is very time consuming. We wondered whether simple linear and area measurements might be as accurate and reproducible. Two observers independently measured the cross-sectional area of the corpus callosum, lentiform and caudate nuclei, thalamus, amygdalas, hippocampi, lateral and third ventricles, and the width of the sylvian and frontal interhemispheric fissures and brain stem on brain MRI of 55 patients using a program written in-house; one observer also measured the volumes of the basal ganglia, amygdalo-hippocampal complex and ventricular system using Analyze, and performed qualitative assessment of four regions (lateral and third ventricles, cortex, and medial temporal lobe) using the Lieberman score. All measures were performed blinded to all other information. Test objects of known size were also imaged with MRI and measured by the two observers using the in-house program. The true sizes of the test objects were measured using engineering calipers by two observers blind to the MRI results. Differences between the two observers using the same measurement method, and one observer using different methods, were calculated. The simple linear and cross-sectional area measurements were rapid (20 min versus 5 h for volumetric); were highly accurate for test-object measurement versus true size; had excellent intraobserver reliability; and, for most brain structures, the simple measures correlated highly significantly with volumetric measures. The simple measures were in general highly reproducible, the difference (as a percentage of the area or width of a region) between the two raters being around 10%, range 0.1%-14.1%, (similar to inter-rater variability in previous studies of volume measurements). The simple linear and area measures are reproducible and correlate well with the measured volumes, and there is a considerable time saving with the former. In circumstances where a large volume of work precludes detailed volume measurement, simple methods are reliable and can be used instead.

Brain↗

PubMed2003

[Measurement of the AT and the CCD angle of macerated cadaver femora: a comparative study between CT and MRI measurements].

PURPOSE: To compare measurements of the real AT (femoral antetorsion) and CCD (caput-collum-diaphysis) angle by computed tomography (CT) and magnetic resonance imaging (MRI) of hip specimen using direct measurements as reference standard, and to show that measurement by MRI can replace CT measurements and may help avoiding X-ray exposition. MATERIALS AND METHODS: CT and MRI measurements were obtained on 25 in water-arrested macerated human femora. Postprocessing was done by 4 independent readers on a workstation using a dedicated 3D-software. Direct measurements of the real AT and the CCD angle were used as reference standard. The analysis included Student's t test for paired values, interobserver variability using intra-class correlation coefficients (ICC), maximum and middle divergence of the angles, and Bland-Altman plots. RESULTS: For determining AT and the CCD angle with CT and MRI, good correlation was found between the 4 readers and with measurements using the reference standard. ICCs were 0.97 and 0.90 for measuring AT and CCD angle with CT, and 0.95 and 0.71 for measurements with MRI, respectively. Mean divergence between CT measurements and those of the reference standard was 0.8 degrees for AT and 0.7 degrees for the CCD-angle. Mean divergence between MRI measurements and those of the reference standard was 0.3 degrees for AT and -0.4 degrees for the CCD-angle. Mean divergences between CT and MRI measurements of AT and CCD-angle were 0.5 degrees. Neither systematic errors nor dependences on the qualitative size of the reference data were evident in the divergences of measurements. CONCLUSION: Measurements of the real AT and CCD angle by CT and MR imaging revealed a good correlation with direct measurements of the femoral specimen and consequently can be recommended for clinical use. MRI measurements can replace CT measurements, avoiding X-ray exposure especially in young patients undergoing preoperative evaluation for hip dysplasia.

Bone Malalignment↗

PubMed1993

The American College of Rheumatology preliminary core set of disease activity measures for rheumatoid arthritis clinical trials. The Committee on Outcome Measures in Rheumatoid Arthritis Clinical Trials.

OBJECTIVE: To develop a set of disease activity measures for use in rheumatoid arthritis (RA) clinical trials, as well as to recommend specific methods for assessing each outcome measure. This is not intended to be a restrictive list, but rather, a core set of measures that should be included in all trials. METHODS: We evaluated disease activity measures commonly used in RA trials, to determine which measures best met each of 5 types of validity: construct, face, content, criterion, and discriminant. The evaluation consisted of an initial structured review of the literature on the validity of measures, with an analysis of data obtained from clinical trials to fill in gaps in this literature. A committee of experts in clinical trials, health services research, and biostatistics reviewed the validity data. A nominal group process method was used to reach consensus on a core set of disease activity measures. This set was then reviewed and finalized at an international conference on outcome measures for RA clinical trials. The committee also selected specific ways to assess each outcome. RESULTS: The core set of disease activity measures consists of a tender joint count, swollen joint count, patient's assessment of pain, patient's and physician's global assessments of disease activity, patient's assessment of physical function, and laboratory evaluation of 1 acute-phase reactant. Together, these measures sample the broad range of improvement in RA (have content validity), and all are at least moderately sensitive to change (have discriminant validity). Many of them predict other important long-term outcomes in RA, including physical disability, radiographic damage, and death. Other disease activity measures frequently used in clinical trials were not chosen for any one of several reasons, including insensitivity to change or duplication of information provided by one of the core measures (e.g., tender joint score and tender joint count). The committee also proposes specific ways of measuring each outcome. CONCLUSION: We propose a core set of outcome measures for RA clinical trials. We hope this will decrease the number of outcomes assessed and standardize outcomes assessments. Further, we hope that these measures will be found useful in long-term studies.

Arthritis, Rheumatoid↗

PubMed1996

Home self blood pressure measurement in general practice. The SMART study. Self-measurement for the Assessment of the Response to Trandolapril.

The SMART study (Self-Measurement for the Assessment of the Response to Trandolapril) was performed in general practice and enrolled 1710 patients in order to assess on a large scale the feasibility and informative value of self-measurement of blood pressure at home (SMBP), define home blood pressure (BP) levels in comparison to office readings, and determine the number of home measurements necessary to provide an accurate and precise BP value. After a 2-week washout period, patients with office diastolic blood pressure within the range 95 to 119 mm Hg received 2 mg trandolapril once daily in the morning for 4 weeks. Four days of SMBP were performed both at the end of the washout period and the end of the treatment period, with an automatic printer-equipped oscillometric device (A&D UA751). The first day values were not analyzed. Thus, the maximum number of BP measurements obtained per patient and per period was 18. Four hundred and twenty-four patients (25%) did not perform any measurements. One thousand one hundred and nine patients (65%) performed at least 4 measurements. Among them, 619 (36%) correctly performed all 18 measurements. A preference for digits 0 and 5 was detected in physicians' measurements (three consecutive values, during a single office visit). This digit preference was not found with the semiautomatic device. When the number of measurements selected for analysis was increased from 1 to 18, in the 604 patients who provided all recordings and fullfilled all protocol criteria, the standard deviation of the mean BP of the cohort was reduced by 17% for SBP and by 23% for DBP. Eighty-five percent of this reduction was already achieved by six home measurements taken at random. BP was significantly lower at home than at the office by 13 +/- 15 mm Hg for systolic BP (SBP), and 8 +/- 10 mm Hg for diastolic BP (DBP). This difference was independent of age, more marked in women (P < .001 for SBP and P < .05 for DBP), and had a Gaussian distribution. Under treatment, office SBP/DBP decreased from 166.4 +/- 14.8/101.4 +/- 5.7 mm Hg to 144.7 +/- 14.2/86.1 +/- 8.3 mm Hg, while SMBP decreased from 153.2 +/- 17.8/93.8 +/- 10.1 mm Hg to 139.4 +/- 16.4/85.1 +/- 9.5 mm Hg (all P < .0001). A major aim in research studies and individual care is to reduce BP measurements variability. This study demonstrates the ability to evaluate baseline SMBP level in two-thirds of patients previously unfamiliar with the method, the ability to evaluate treatment effect in about one-half of the patients, the improvement in the measurement precision obtained with the repetition of measures (at least six home measurements), and the absence of bias of SMBP as compared to office measurements.

Adolescent↗

PubMed2006

Measuring Friedreich ataxia: complementary features of examination and performance measures.

OBJECTIVE: To examine the potential validity of performance measures and examination-based scales in Friedreich ataxia (FA) by examining their correlation with disease characteristics. METHODS: The authors assessed the properties of a candidate clinical outcome measure, the Friedreich Ataxia Rating Scale (FARS), and simple performance measures (9-hole peg test, the timed 25-foot walk, PATA test, and low-contrast letter acuity) in 155 patients with FA from six institutions, and correlated the scores with disease duration, functional disability, activity of daily living scores, age, and shorter GAA repeat length to assess whether these measures capture the severity of neurologic dysfunction in FA. RESULTS: Scores for the FARS and performance measures correlated significantly with functional disability, activities of daily living scores, and disease duration, showing that these measures meet essential criteria for construct validity for measuring the progressive nature of FA. In addition, the FARS and transformed performance measures scores were predicted by age and shorter GAA repeat length in linear regression models accounting for sex and testing site. Correlations between performance measures were moderate in magnitude, suggesting that each test captures separate yet related dimensions of neurologic function in FA and that a composite measure might better predict disease status. Composite measures created using cohort means and standard deviations predicted disease status better than or equal to single performance measures or examination-based measures. CONCLUSIONS: The Friedreich Ataxia Rating Scale, performance measures, and performance measure composites provide valid assessments of disease progression in Friedreich ataxia.

Adolescent↗

PubMed2003

Use of an inclinometer to measure flexibility of the iliotibial band using the Ober test and the modified Ober test: differences in magnitude and reliability of measurements.

STUDY DESIGN: Test-retest design to evaluate the reliability of the measurement of iliotibial (IT) band flexibility using an inclinometer to measure the hip adduction angle. OBJECTIVES: The primary objective was to determine the intrarater reliability of the Ober test and the modified Ober test for the assessment of IT band flexibility using an inclinometer to measure the hip adduction angle. A secondary objective was to determine if a difference existed between the measurements of IT band flexibility between the Ober and modified Ober test. BACKGROUND: The Ober test and the modified Ober test are frequently used for the measurement of IT band flexibility. To date, data documenting the objective measurement of flexibility of the IT band is scarce in the literature. METHODS AND MEASURES: Sixty-one subjects, with a mean age of 24.2 (SD = 4.3) years, were measured during 2 measurement sessions over 2 consecutive days. During each measurement session, subjects were positioned on their left side and, with an inclinometer at the lateral epicondyle of the femur, hip adduction was measured during the Ober test (knee at 90 degrees of flexion) and the modified Ober test (knee extended). If the limb was horizontal, it was considered to be at 0 degrees, if below horizontal (adducted), it was recorded as a positive number, and if above horizontal (abducted), it was recorded as a negative number. RESULTS: The ICC values calculated for the intrarater reliability of the repeated measurement were 0.90 for the Ober test and 0.91 for the modified Ober test. Results of the dependent t test indicated a significantly greater range of motion of the hip in adduction using the modified Ober test as compared to the Ober test. DISCUSSION AND CONCLUSION: The use of an inclinometer to measure hip adduction using both the Ober test and the modified Ober test appears to be a reliable method for the measurement of IT band flexibility, and the technique is quite easy to use. However, given that the modified Ober test allows significantly greater hip adduction range of motion than the Ober test, the 2 examination procedures should not be used interchangeably for the measurement of the flexibility of the IT band.

Adult↗

PubMed2003

Measurement error in grip and pinch force measurements in patients with hand injuries.

BACKGROUND AND PURPOSE: There is limited documentation of measurement error of grip and pinch force evaluation methods. The purposes of this study were (1) to determine indexes of measurement error for intraexaminer and interexaminer measurements of grip and pinch force in patients with hand injuries and (2) to investigate whether the measurement error differs between measurements of the injured and noninjured hands and between experienced and inexperienced examiners. SUBJECTS: The subjects were a consecutive sample of 33 patients with hand injuries who were seen in the Department of Rehabilitation Medicine of Erasmus MC-University Medical Center Rotterdam in the Netherlands. METHODS: Repeated measurements were taken of grip and pinch force, with a short break of 2 to 3 minutes between sessions. For the grip force in 2 handle positions (distance between handles of 4.6 and 7.2 cm, respectively), tip pinch (with the index finger on top and the thumb below, with the other fingers flexed) and key pinch force (with the thumb on top and the radial side of the index finger below) data were obtained on both hands of the subjects by an experienced examiner and an inexperienced examiner. Intraclass correlation coefficients (ICCs), standard errors of measurement (SEMs), and associated smallest detectable differences (SDDs) were calculated and compared with data from previous studies. RESULTS: The reliability of the measurements was expressed by ICCs between .82 and .97. For grip force measurements (in the second handle position) by the experienced examiner, an SDD of 61 N was found. For tip pinch and key pinch, these values were 12 N and 11 N, respectively. For measurements by the inexperienced examiner, SDDs of 56 N for grip force and 13 N and 18 N for tip pinch and key pinch were found. DISCUSSION AND CONCLUSION: Based on the SEMs and SDDs, in individual patients only relatively large differences in grip and pinch force measurements can be adequately detected between consecutive measurements. Measurement error did not differ between injured and noninjured hands or between experienced and inexperienced examiners. Criteria for judging whether the measurement error does allow application of the measurements in individual patients are discussed.

Adolescent↗

PubMed2005

Alternative dental measurements: proposals and relationships with other measurements.

Most archaeological and fossil teeth are heavily worn, and this greatly limits the usefulness of tooth crown diameter measurements, as they are usually defined at the widest points of the crown. There are alternatives, particularly measurements at the cervix of the tooth, where the crown joints the root, and measurements along a diagonal axis in molars, that are much less affected by wear. These would allow a wider range of specimens to be included, e.g., in the study of dental reduction in Upper Palaeolithic and Mesolithic Homo sapiens. In addition, they would allow the little-worn teeth of children to be compared directly with well-worn teeth in adults. These alternatives, however, have been little used, and as yet there have not been any studies of the repeatability with which they can be measured, or of the extent to which they are related to the more usual crown diameters. The present study is based on a group of unworn teeth, where direct comparisons could be made between the alternative measurements, which are not much affected by wear, with the usual crown diameters, which are very much affected. In an interobserver-error study of this material, cervical and diagonal measurements could be recorded as reliably as the usual crown diameters. The buccolingual cervical measurement was strongly correlated with the normal bucclingual crown diameter in all teeth, whereas the mesiodistal cervical measurement was highly correlated with the normal mesiodistal crown diameter in incisors and canines, but less so in premolars and molars. The molar diagonal measurements showed high correlations with all other measurements. Crown areas (robustness index) calculated from the usual diameters were strongly correlated with crown areas calculated from cervical measurements, and crown areas calculated from molar diagonals were strongly correlated with both other areas. Despite the long usage of the more usual maximum crown diameters, the alternative dental measurements could be measured just as reliably, could record similar information about tooth crown size, and would be better measures for the worn dentitions seen in archaeological and fossil material.

Fossils↗

PubMed1995

Noninvasive continuous blood pressure measurement during anaesthesia: a clinical evaluation of a method commonly used in measuring devices.

The objective of the study was assess the utility during anaesthesia of noninvasive continuous blood pressure measurement techniques which use intermittent oscillometric blood pressure measurement for their calibration. The assessment was performed by comparing noninvasive blood pressure with intra-arterial blood pressure. The noninvasive blood pressure measurement device used for evaluation was the NCAT N-500 which uses tonometry for its continuous measurements. Fifteen patients were studied. In 10 patients the intra-arterial blood pressure curve (IBP) was recorded from the radial artery (radial artery group), and in 5 patients it was recorded from the brachial artery (brachial artery group). In all patients the oscillometrically calibrated tonometric blood pressure (OTBP) was recorded from the other arm. To discriminate between calibration dependent measurement error and tonometric measurement error, the OTBP signal was recalibrated against the IBP signal to get the intra-arterial calibrated tonometric pressure curve (ITBP). OTBP-IBP reflected the overall measurement error, ITBP-IBP the error of the tonometric measurement, and OTBP-ITBP the calibration dependent measurement error. According to criteria formulated in the discussion the accuracy and agreement of the ITBP-IBP measurements were clinical acceptable. Accuracy and agreement of OTBP-IBP and of OTBP-ITBP were not clinical acceptable. Correlation of dynamic behavior was lower for OTBP than for ITBP. A significant effect of site difference between calibration measurements and continuous measurements was not found. It is concluded that the approach of continuous noninvasive blood pressure measurement based on the combination of two different measurement methods, in which the continuous method is calibrated by the oscillometric method, lead to clinical unacceptable accuracy and agreement in the patient group studied.

Adolescent↗

PubMedDate not supplied

Fundal height measurement. Part 1--Techniques for measuring fundal height.

Several techniques of measuring fundal height have been described in the literature. Differences between the measurement techniques include the following: whether a tape measure or caliper is used to obtain the measurement; whether the uppermost border of the uterine fundus or the fetal pole in the fundus should be used as the superior landmark; which point on the symphysis pubis should be used as the inferior landmark; whether the tape measure should be held in contact with the skin of the maternal abdomen throughout the length of the measurement; and whether the measurement is obtained in the midline of the maternal abdomen or at the highest point of the uterine fundus or fetal pole. Preliminary studies indicate that the various measurement techniques yield different results. However, the differences between the measurement techniques have not been studied adequately and the superiority of one measurement technique has not been demonstrated. Because the various measurement techniques yield different results, it is important that clinicians be consistent in their measurement technique. Future studies should evaluate and compare the various measurement techniques to determine if one technique yields measurements that are more reliable and valid than other techniques.

Anthropometry↗