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Autonomic surface potential analysis: assessment of reproducibility and sensitivity.

There has been recent interest in measuring sympathetic sudomotor function by autonomic surface potential analysis. The purpose of the present study was to assess factors affecting the reproducibility of the test. We determined the within-day and between-day reproducibility in 24 healthy volunteers. We used an increasing rather than a constant electrical stimulus to minimize habituation. The amplitudes were still highly variable (an average within-day coefficient of variation in the soles of 35%). Habituation did not, however, affect the latencies of the responses, which were much more reproducible (an average within-day coefficient of variation in the soles of 8%). Studies of between-day reproducibility revealed that the mean amplitudes were lower on day 2 vs. day 1 (0.706 +/- 0.10 vs. 0.85 +/- 0.10 mV in the soles, P less than 0.01) but the mean latencies were similar on the different testing days (2.09 +/- .04 seconds for the soles on day 1 vs. 2.16 +/- .05 seconds on day 2). We also assessed the sensitivity of surface potential analysis and report the results of testing 35 patients with far advanced autonomic neuropathy.

Aged

Reproducibility of programmed electrical stimulation responses in patients with ventricular tachycardia or fibrillation associated with coronary artery disease.

Invasive electrophysiologic studies were performed in 102 patients with sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) using an aggressive programmed electrical stimulation (PES) protocol. The study was repeated after 2.0 +/- 2.9 days in all patients with no intercurrent changes in antiarrhythmic therapy. Patients with coronary artery disease (n = 72) were identified and PES results of these patients were analyzed and compared with results of patients without coronary artery disease. Multiple clinical and electrophysiologic factors were analyzed to determine any association with concordance of PES responses. No significant difference in concordance of PES responses was found in the 2 groups of patients. PES responses were groups into 3 categories: (1) noninducible, (2) nonsustained VT, and (3) sustained VT. Kappa values of PES responses of noninducible and sustained VT in both groups were higher and therefore the PES responses were more reproducible than nonsustained VT. The induction of sustained monomorphic VT was more reproducible than a PES response of nonsustained or sustained polymorphic VT. Inducible sustained VT with a rate of greater than or equal to 250 beats/min was less reproducible than induction of sustained VT with a rate less than 250 beats/min. Induction of VT by 3 extrastimuli was less reproducible than with any other mode. This short-term variability may account for false negatives associated with PES-directed antiarrhythmic therapy. Because of these findings, it is recommended that nonsustained VT and sustained polymorphic or rapid polymorphic VT should not be used as PES end points to guide antiarrhythmic therapy.

Anti-Arrhythmia Agents

Reproducibility of stress redistribution thallium-201 SPECT quantitative indexes of hypoperfused myocardium secondary to coronary artery disease.

To determine the reproducibility of quantitative indexes of hypoperfused myocardium by exercise thallium-201 single-photon emission computed tomography, duplicate studies were performed in 16 stable patients within 1 month. Twenty-three other patients, with intervals up to 13 months between studies, were retrospectively identified from medical records. Symptoms, weight, heart rate achieved and peak systolic blood pressure during the 2 studies were similar. Maximal counts circumferential profiles' polar maps were generated and divided into 3 vascular territories. The hypoperfused myocardium was defined as the percent stress profile points below the normal level. The observed values were compared between the 2 studies for each patient. Defect size ranged from 0 to 73%. The concordance correlation coefficient (a measure of the closeness of the data points to the line of identity) and mean absolute deviation were 0.94 and 4.5%, respectively, when all patients were considered together, 0.93 and 3.2%, respectively in the reproducibility group, and 0.94 and 5.1%, respectively, in the retrospective group. Inter- and intraobserver reproducibility were also very high. For individual vessels, the concordance correlation coefficients were all > or = 0.89 and the mean absolute deviations between 3.7 and 9%. Thus, in stable patients with repeat thallium studies within a year, the percent hypoperfused myocardium is highly reproducible.

Adult

Reproducibility of transcranial Dopplersonography: a validation study.

Transcranial Doppler-sonography (TCD) is a useful noninvasive technique for the measurement of intracranial arterial blood flow velocity. The present study evaluated the reproducibility of this method for repeated measurements of flow velocity in the anterior, middle and posterior cerebral, and basilar arteries. Thirty-six patients (23 males and 13 females) were studied. Three measurements were made by the same examiner on each patient with a time interval of 1 h between the first and the second examination, and about 24 h between the first and the third examination. The statistical evaluation for the reproducibility was performed by calculating the correlation coefficient (r). The results showed good reproducibility of TCD for all arteries both between the first and second and between the first and third measurements (r = 0.78-0.97; p less than 0.001), but when the middle cerebral artery mean velocity is low the posterior cerebral artery reproducibility is poorest (r = 0.42-0.54).

Blood Flow Velocity

Comparison of the accuracy and reproducibility of the keratometer and the EyeSys Corneal Analysis System Model I.

The EyeSys Corneal Analysis System Model I measures corneal topography using digital image analysis of placido rings reflected off the cornea. With three observers, we compared the accuracy and reproducibility (precision) of the Marco Keratometer Model 1 and EyeSys Corneal Analysis System Model I using four poly(methyl methacrylate) spheres (37.50, 42.51, 47.54, and 55.06 diopters [D]), three steel spheres (40.50, 42.50, and 44.75 D), and 20 normal human eyes (41.50 to 46.00 D). For the spheres, the standard deviations of intra-observer and overall reproducibility for both devices were less than 0.12 D; the absolute mean differences between the measurements of the seven spheres and the known values were 0.25 D or more for two spheres as measured by the keratometer and none as measured by the EyeSys. For the normal corneas, the standard deviations of intra-observer and overall reproducibility for dioptric measurements were 0.07 D and 0.14 D for the keratometer and 0.13 D and 0.19 D for the EyeSys. The EyeSys Corneal Analysis System Model I exceeds keratometer accuracy in reading calibrated spheres and approaches keratometer reproducibility in measuring the 3-mm zone of normal human corneas.

Cornea

Assessing reproducibility of Hi-C chromatin interactions using stratum-adjusted irreproducible discovery rate.

MOTIVATION: Hi-C is a powerful technology for mapping chromatin interactions genome-wide. However, interaction loops identified from Hi-C contact maps often vary across replicate experiments due to experimental noise, making reproducibility assessment essential. A major challenge lies in the genomic distance dependence of interaction strength, which systematically affects reproducibility but is overlooked by existing methods for reproducibility assessment. RESULTS: We introduce Stratum-Adjusted Irreproducible Discovery Rate (SIDR), a novel statistical model that integrates distance stratification into the widely-used Irreproducible Discovery Rate (IDR) framework. SIDR explicitly models the confounding effect of genomic distance, enabling global control of irreproducibility across interaction ranges. Through simulations and real Hi-C datasets, we demonstrate that SIDR improves discriminative power and recovers more biologically meaningful interactions than existing approaches, making it a valuable tool for robust and reproducible Hi-C analysis. AVAILABILITY: The R package SIDR is freely available on GitHub https://github.com/qunhualilab/SIDR.

Chromatin

Dietary assessment of older Iowa women with a food frequency questionnaire: nutrient intake, reproducibility, and comparison with 24-hour dietary recall interviews.

The authors report the results of a dietary survey of 38,121 Iowa women, 55-69 years of age in 1986, based on a semiquantitative food frequency questionnaire previously tested among Boston-area women aged 34-59 years. The Iowa women, compared with the younger Boston-area women, consumed a similar amount of calories (1,767 vs. 1,844 kcal) and a similar amount of total calories from fat (35 vs. 37%) but had markedly greater intake of the following micronutrients after including supplement use: iron (+18%), calcium (+33%), vitamin A (+43%), riboflavin (+46%), thiamine (+50%), and pyridoxine (+122%). The reproducibility of the questionnaire was examined in two more administrations to 44 of the Iowa women in January and June of 1988. Reproducibility was highest for alcohol (Pearson's r = 0.99), caffeine (r = 0.95), and vitamin E (r = 0.90) and lowest for sucrose (r = 0.53), polyunsaturated fat (r = 0.56), and iron (r = 0.59). Micronutrient intakes were generally more reproducible than macronutrient intakes. The agreement between the June 1988 questionnaire and the average of five 24-hour dietary recalls was also assessed in the 44 subjects. The median correlations of energy-adjusted intake were as follows: for macronutrients, r = 0.45; for micronutrients without supplements, r = 0.33; and for micronutrients with supplements, r = 0.64. This food frequency questionnaire appears to be reasonably reproducible and accurate, so that its use may be extended to epidemiologic studies of older women with a broad range of socioeconomic backgrounds.

Energy Intake

Limited reproducibility of hourly blood pressure values obtained by ambulatory blood pressure monitoring: implications for studies on antihypertensive drugs.

OBJECTIVE: To assess the reproducibility of average hourly blood pressure values obtained by 24-h non-invasive ambulatory monitoring. PATIENTS: Fifteen outpatients with essential hypertension. In all subjects antihypertensive treatment was withdrawn for 4 weeks before and during the 4 weeks of the study. METHODS: The 24-h blood pressure was monitored by a SpaceLabs 5300 device (four readings per hour during the day and three readings per hour during the night) twice, at a 4-week interval. Systolic (SBP) and diastolic blood pressure (DBP) were averaged for each hour and for the whole 24-h period, and hourly and 24-h reproducibility was quantified by the standard deviation of the mean difference (SDD) between the values obtained in the two recordings. RESULTS: The SDD of hourly SBP and DBP was much greater than that of the 24-h values and ranged widely between the hours of recording. The SDD of hourly SBP and DBP were also variably greater than the SDD of the 24-h value in another 14 untreated essential hypertensives in whom 24-h ambulatory blood pressure was monitored intra-arterially twice at a 4-week interval to calculate hourly average blood pressure on thousands rather than on three or four values per hour. CONCLUSION: Reproducibility is less for hourly than for 24-h average blood pressure. This feature (which probably depends on behavioural differences between two recordings) suggests that ambulatory blood pressure measurement partly loses its advantages for reproducibility and reduction in trial size if the results are analysed over hourly periods.

Adolescent

Reproducibility of childhood respiratory symptom questions.

The reproducibility of answers to childhood respiratory symptom questions was investigated by administering two childhood respiratory symptom questionnaires twice, with a one month interval, to the same population of Dutch school children. The questionnaires were completed by the parents of 410 children from 6-12 yrs old. One questionnaire was developed by the World Health Organization (WHO). The other questionnaire was developed for use by school health services and was based mainly on the American Thoracic Society (ATS) questionnaire for respiratory symptoms in childhood. It was called the Child Health Care (CHC) Questionnaire. Half of the parents received a questionnaire in which the WHO questions came first on both occasions, the other half a questionnaire in which the CHC questionnaire came first on both occasions. The reproducibility of the answers was assessed by calculating Cohen's Kappa, a chance-corrected measure of association. Questions about "wheeze", "asthma", "bronchitis", "cough and phlegm", and "pneumonia" were found to give good to excellent reproducibility, with Kappa values ranging from 0.60-0.96. Questions about "phlegm", "cough", "chest congestion" and "runny/congested nose" were less satisfactory in this respect, with Kappa values generally well below 0.60. The reproducibility of the answers did not depend on the order in which the questionnaires were administered, on the gender or age of the child, or on the smoking habits or educational level of the parents.

Child

The reproducibility of pantographic tracings on medicated and nonmedicated subjects.

Tracings were made on three patients using a modified pantographic device. The tracings were made on glass flags with wax, etched, and superimposed. The effects of body position and modification were investigated. From this research project the following can be concluded: 1. A precise method has been developed which permits superimposition of pantographic tracings for analysis. 2. There is a significant difference in reproducibility between medicated and nonmedicated subjects. 3. The percentage coincidence of border tracings increases significantly when the patient is pantographed while under the influence of medication (Valium). 4. The angulation of the body does not appear to be significant for reproducing border tracings. 5. There appears to be no significant difference in the reproducibility of the border tracings relative to time (1, 1 1/2, 2, and 2 1/2 hours) after medication. 6. The lateral side shift of the jaw cannot always be reproduced accurately. 7. The neuromusculature appears to be the overriding factor governing border movements.

Adolescent

The reproducibility of colour-coded duplex scanning in measuring arterial wall dimensions.

Intimal hyperplasia continues to be a major problem following vascular surgery but experimental evidence suggests that it can be reduced pharmacologically. For clinical studies an accurate, reproducible and non-invasive image of the intima and lumen is required. We have assessed the value of the Acuson 128 Colour Duplex for such studies. Ten patients had their common femoral arteries scanned at a fixed point by two experienced observers on two separate occasions. External vessel diameter, luminal diameter and internal diameter (i.e. the diameter within the internal elastic lamina) were measured in both longitudinal and cross-sectional views. Cross-sectional area and degree of stenosis were all measured and all parameters expressed as limits of agreement. The mean external diameter of the common femoral arteries was 10.5 +/- 1.6 mm. Measurements in the longitudinal view were highly reproducible with limits of agreement ranging from -0.67 - +0.25 mm (internal diameter) to -1.49 - +1.31 mm (luminal diameter). In order to detect a meaningful change in longitudinal external diameter a real difference of 0.86 mm is required representing a change of less than 10%. Cross-sectional diameter measurements were similarly reproducible (-0.73 - +0.47 mm to -1.97 - +1.79 mm). However, cross-sectional area measurements had a wide variation so that the error in degree of stenosis was -25.4 - +30.2%. Thus, duplex ultrasound reproducibly images the layers of the arterial wall. Prospective studies of intimal hyperplasia are feasible but must be based on longitudinal and cross-sectional diameters rather than cross-sectional areas.

Aged

Reproducibility and comparative analysis of repeated intravenous and oral glucose tolerance tests.

We have developed a methodology for measuring the reproducibility of the oral glucose tolerance test (OGTT) and the intravenous glucose tolerance test (IVGTT) in normal subjects and in offspring of conjugal diabetic parents. Both groups of subjects revealed more striking correlations of several parameters of blood glucose and insulin secretion between two IVGTTs than between two OGTTs. Employing arbitrary criteria, we calculated a "reproducibility index" as a quantitative measure of blood glucose variability in each subject. No significant difference was found in the reproducibility of OGTT versus IVGTT, nor in normals versus the offspring. Only about 50 per cent of the tests in normals and in the offspring could be considered to be "reproducible." The offspring revealed greater correlations of several parameters, particularly insulin secretion, between the two IVGTTs and between the two OGTTs as compared with the normal group. However, the blood glucose variations tended to be considerably greater in the offspring from one to the other test.

Administration, Oral

Reproducibility of regional cerebral blood flow measurements in acute severe head injury.

In order to evaluate the reproducibility of regional cerebral blood flow (rCBF) measurements in pathological brain tissue, serial measurements were carried out in 13 determinations performed in patients who were comatose after severe head injuries within the first 2 weeks after the head trauma. The xenon-133 intra-arterial method was used for the flow measurements, and the flow was studied separately in 16 areas of the brain, producing 197 regional double determinations. The patients were maintained in a steady state during and between the measurements, and only differences of less than 2 mm Hg in the arterial CO2 pressure and less than 5 mm Hg in the perfusion pressure were tolerated. The reproducibility was found to be reasonably good as regards initial slope-flow indices and height/area flow indices and height/area flow values, whereas that of the compartmentally calculated flow parameters was poorer. On dividing the series into severely and moderately pathological areas, it could be shown that the reproducibility of the flor values in the moderately pathological brain areas was acceptable and similar to the results reported by others, whereas the reproducibility in the most severely pathological areas of the brain was rather poor, as regards the flow in the fast compartments. The correlation between the various flow parameters was found to be fairly good.

Brain Injuries

Inter-examiner and intra-examiner reproducibility in clinical and radiographic diagnosis.

The first technical report to be published by the FDI considered the principal requirements for controlled clinical trials of caries preventive agents and procedures. This document advocated the use of a simple reproducibility ratio as a measure of variability in caries diagnosis. In accordance with the FDI recommendations available figures from published work on duplicated examinations are presented in terms of this reproducibility ratio. The data refers to intra- and inter-examiner variability with respect to both clinical and radiographic examinations. Reproducibility studies carried out as a pre-calibration investigation and during the baseline examinations of a current clinical trial are also included. Considerable diversity is apparent, the intra- and inter-examiner variation for clinical examinations ranging from 0-13 to 0-61, and for radio-graphic assessments from 0-06 to 0-60. If an acceptable range of reproducibility ratios is to be formulated then this wide variation will have to be taken into account. Ultimately, if examiner variability cannot be maintained within reasonable limits, then the choice of an examiner could be just as important as the choice of the test substance.

Child

[The role of the lateral and medial hypothalamus in reproducing a motor reaction as the signal during the acquisition of classical conditioned reflexes].

In experiments on three dogs there was shown that testing electrostimulation of the lateral hypothalamus reproduced the motor reaction which is a signal stimulus at elaboration of classic alimentary conditioned reflexes (CRs) and did not reproduce it at elaboration of classic defensive CR. Testing electrostimulation of medial parts of the hypothalamus reproduced, as LH electrostimulation the "signal" motor reaction, but in less percentage of cases, during elaboration of classic alimentary CRs and did not reproduce it at elaboration of classic defensive CRs. The reproduction of the signal motor reaction at LH electrostimulation is connected with activation of backward conditioned connection from motivation structures of the hypothalamus to representation of the signal stimulus in the motor cortex.

Animals

[The reproducibility of occlusal contacts in the Dentatus and Stuart articulators].

The reproducibility of occlusal contacts of 30 subjects was tested in the Dentatus and Stuart articulators. Primary contacts in the terminal hinge axis position were reliably reproducible in both articulators. Contacts in habitual intercuspidation were reproduced only approximately by both devices. Contacts in eccentric occlusion were satisfactorily reproduced in the Stuart articulator only. The findings show that doubts are indicated about the simulating capacity of semi-adjustable articulators which is frequently rated too high.

Dental Articulators

Accuracy and reproducibility of visual coronary stenosis estimates using information from multiple observers.

The reliability of visual estimation of severity of coronary artery stenosis may be improved using data from multiple independent observers. Data were collected from the results of a video format examination used on an experimental basis in 1987 by the American Board of Internal Medicine to test 61 candidates for certification in cardiovascular diseases. Twenty arteriographic cases were presented in a standardized format. Each artery was viewed in multiple projections including angled views. Each view was shown in both real time and slow motion, and each case was seen twice in its entirety. The observers rated stenosis severity on a four-point scale ranging from 1-4. A two-way repeated measures analysis of variance was performed on the tabulated results, yielding variance components for the arteriographic data (signal), the differences among observers, and the observer by case interaction (both considered noise). These components then allowed calculation of 68 and 95% confidence intervals, the signal-to-noise ratio, and the reproducibility coefficient for any number of observers. When a single observer was considered, reproducibility was low, with 95% confidence intervals of +/- 0.9 points, corresponding to approximately +/- 22% diameter stenosis. However, when data of three observers were averaged, the 95% confidence interval decreased to +/- 0.52 points (13% stenosis), signal-to-noise ratio rose to 12.2, and reproducibility coefficient was 0.92. Relatively small increments in these values were noted when data from a fourth or fifth observer were added. In comparison to a computer-assisted quantitative method, 86% accuracy was found for the results of averaged subjective determinations of stenosis severity.(ABSTRACT TRUNCATED AT 250 WORDS)

Constriction, Pathologic

Reproducibility of a symptomatic response to upright tilt in young patients with unexplained syncope.

Serial upright tilt testing has been advocated as a possible therapeutic end point in treating patients with recurrent syncope, but the reproducibility of such testing has not been well-established in the absence of therapy. In 21 patients with recurrent syncope and a symptomatic response to upright tilt testing, tilt was repeated following a 25- to 30-minute recovery. Syncope or presyncope was reproduced in 14 of 21 patients on repeat tilt; 4 of 21 patients experienced milder symptoms, and 3 of 21 patients remained entirely asymptomatic on repeat tilt. The pattern of physiologic response was different during initial and repeat tilt in 7 of the 21 patients. Blood pressure and heart rate (before and during symptoms) were similar for the group on initial and repeat tilt. The abnormal physiologic response and associated symptoms elicited during upright tilt testing for unexplained syncope can be reproduced on immediate repeat tilt testing in most patients. However, the frequently attenuated response during repeat testing may limit its use as a therapeutic end point in individual patients.

Adolescent