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PubMed1992

Maintenance of wakefulness test and multiple sleep latency test. Measurement of different abilities in patients with sleep disorders.

The multiple sleep latency test and the maintenance of wakefulness test were administered on the same day to 258 consecutive patients whose clinical presentation required evaluation for excessive sleepiness. While the MSLT is the standard test for assessing excessive daytime sleepiness, the MWT may have some clinical advantage over the MSLT when the assessment of daytime alertness is the primary goal. To explore further the relationship between alertness and sleepiness, we have conducted a thorough analysis of the similarities, differences, and correlations between MWT and MSLT. The results of this study show that the coefficient of correlation between MSLT and MWT (r = 0.41), although statistically significant, accounts for less than 17 percent of the variability between the two tests. Factor analysis suggests that two factors, alertness and sleepiness, account for 91 percent of all variance. Our data demonstrate that patients with diagnosable disorders of excessive somnolence may be discordant on the two tests (eg, having low sleep latency on MSLT but high sleep latency on MWT). Specifically, we found that some patients with abnormally low MSLT scores were able to stay awake when asked to do so on the MWT, and conversely, some patients who failed to stay awake when asked to do so on the MWT were unable to fall asleep quickly on the MSLT. We conclude that the MWT and MSLT measure different abilities and that the MWT may be a useful adjuvant daytime test in many clinical situations.

Adult↗
PubMedDate not supplied

[Method for calculating the distribution of randomly expected scores in a false-true-do not know-type of test].

Multiple choice tests have been used widely in the evaluation of knowledge. The lowest passing limit is generally chosen arbitrarily. Better and more objective criteria may arise from analyzing the distribution of correct and incorrect answers as expected by chance. In order to calculate the distribution of correct answers and the difference between correct and incorrect answers (core) we propose the use of a method based on a gaussian distribution. The distribution of scores expected by chance is approximated by a gaussian distribution with a mean of zero and a standard deviation SD = square root of n(pA + pE), and the distribution of the total number of correct answers has a mean of npA and SD = square root of npApE, where n is the total number of questions, and pA and pE are the probabilities of having a correct and an incorrect answer, respectively. The formulae are applicable to questions type false/true/do not know and to the more common type of one correct in five options. Once the chance distribution is known, it can be compared with the distribution of scores or correct answers obtained, which can then be used to separate people in two groups: those that answer the test as expected or worse than expected by chance, and those that answer the test better than expected by chance. The first group should not be passed. The passing of individuals in the second group can be decided by additional criteria.

Educational Measurement↗
PubMed1992

Writing a multiple-choice test question.

Multiple-choice test questions are the most widely used and highly regarded of the presently available objective or selective test items. They can be used to test all levels of learning and are applicable to the measurement of most important educational outcomes. Although it is difficult to construct these questions well, they are versatile and can be used in settings involving large numbers of students.

Education, Medical, Graduate↗
PubMed1986

Changes in non-specific immune responses induced by repeated delayed-type hypersensitivity skin testing with multiple antigens.

Delayed-type hypersensitivity (DTH) responses following in vivo multiple-antigen skin testing in healthy individuals have been well described as indicators of immune responsiveness. In contrast, little information is available about how repeated in vivo multiple antigen skin testing could effect major non-specific parameters of immune responses. In a prospective study of 22 healthy adult volunteers, DTH skin tests were performed 6 times at 4-week intervals over a 28-week course. Prior to each skin test, blood specimens were collected and evaluated by in vitro assays of non-specific parameters related to humoral and cell-mediated immune (CMI) responses. Sustained effects of repeated skin tests in the volunteers included decreased numbers of circulating polymorphonuclear leukocytes (PMNLs), increased serum IgM levels and decreased DTH responses in those individuals originally designated as high DTH responders. Increased lymphocyte transformation with PHA was transiently observed in the study group at 4-12 weeks into the study. In contrast, numbers of T, B and total lymphocytes, levels of IgG, IgA, and circulating immune complexes, and serum blocking activity did not change. This study suggests that few alterations in non-specific immune parameters may be expected to occur in normal, adult individuals as a result of repeated multiple-antigen skin tests.

Adolescent↗
PubMed1978

[Application of the multiple vocabulary test to assessing mental disorders].

The multiple vocabulary test has been used to investigate approaches to objectifying general mental deterioration. Compared to methods used to determine the actual level of intelligence, the premorbid levels of intelligence which were determined with the use of the multiple vocabulary test were roughly the same for patients with brain injuries that cannot be detected by means of specialized instruments. In the case of patients where brain injuries were detectable through the use of instruments, the premorbid level of intelligence was significantly higher than the actual intelligence level. Patients with general mental deterioration showed highly significant differences between premorbid and actual levels of intelligence. The results obtained indicate that the multiple vocabulary test is a useful means of diagnosing general mental deterioration due to organic or psychological factors. Also discussed by the authors in their present paper are hitherto unsolved problems that stand in the way of an objective diagnosis of dementia and loss of intelligence.

Humans↗
PubMed1976

Utilisation of multiple biochemical tests in a large general hospital.

This report gives an account of the patterns of requesting of multiple biochemical tests in a large general hospital and the frequency of abnormal test results in different hospital departments. There are appreciable differences between some areas in the frequency of requests for multiple testing and in the proportions of abnormal results. If it is assumed that clinicians should be aware of abnormal values and their progress, facilities for multiple testing are desirable and economically justifiable.

Chemistry, Clinical↗
PubMed1992

The Multiple Sleep Latency Test: a paradoxical test?

The Multiple Sleep Latency Test (MSLT) has gradually gained acceptance as an objective equivalent of the complaint of sleepiness. The history of this test and questions considering the validity of the MSLT in different situations are discussed.

Arousal↗
PubMed1990

More powerful procedures for multiple significance testing.

The problem of multiple comparisons is discussed in the context of medical research. The need for more powerful procedures than classical multiple comparison procedures is indicated. To this end some new, general and simple procedures are discussed and demonstrated by two examples from the medical literature: the neuropsychologic effects of unidentified childhood exposure to lead, and the sleep patterns of sober chronic alcoholics.

Alcoholism↗
PubMed1976

The linoleic acid depression (LAD) test for multiple sclerosis using the macrophage electrophoretic mobility (MEM) test.

With the macrophage electrophoretic mobility (MEM) test of Field & Caspary, lymphocyte sensitization to thyroid antigen (F1-fraction) is demonstrable in all subjects--multiple sclerosis (MS) patients, those with other (destructive) neurological diseases (OND) and normals. The MEM-LAD test enables a further differentiation to be made in neurological patients compared ot normals: Linoleic acid inhibits the positive result by about 95 per cent in the case of MS, 58 per cent in normals and 45 per cent in OND. The high reduction appears to be a characteristic of MS. It is seen at all stages and in all forms of the disease and is not materially influenced by moderate immunosuppressive therapy. The mothers of MS patients show an intermediate result of about 78 per cent, suggesting a familial (genetic) background to the metabolic phenomenon described here; there is, however, evidence of an added exogenic factor for the development of the disease. The theoretical basis of the LAD test suggests further therapeutic trials of linoleic acid in treatment of MS.

Adolescent↗
PubMed1977

[The advantages of multiple choice tests in undergraduate teaching of pharmacology (author's transl)].

Multiple-choice tests in pharmacology were carried out with students who had no previous experience in this kind of examination. The curriculum in pharmacology was divided into four parts. Each part was followed by a test consisting of 90 questions. A special arrangement was made for those students who voluntarily participated in all four tests during academic year. Pass marks in all four completed tests were considered equivalent to a successful outcome in the one oral examination which is, at present, obligatory. In order to encourage a high level of participation amongst the students, failure in one or more of the tests had no adverse consequences. As a result, a markedly increased attendance at lectures, as well as a positive feed back of information for the faculty, were ascertained and assessment of the efficiency of the teaching methods facilitated. Application of multiple choice tests to the teaching of Pharmacology to undergraduate students proved to be recommendable, both as a test procedure and of advantage in the actual learning process.

Austria↗
PubMed1987

Isomorphic patient management problems: a method of creating equivalent problem-solving tests.

Multiple choice format pre- and post-tests have a high likelihood of being equivalent (i.e. parallel) if well-known guidelines are followed. In the absence of such guidelines for pre- and post-tests of problem-solving, the authors devised a simple method of creating problems that are likely to be equivalent. The method was employed with patient management problems (PMPs) and focuses on maintaining the same form or structure of the problems while making the problems appear different to the examinee. Such problems are 'isomorphic'. The equivalence or parallelism of 10 PMPs with their isomorphic counterparts was demonstrated. The method for creating isomorphic PMPs appears to be applicable for creating equivalent pre- and post-tests composed of problems other than PMPs.

Education, Medical↗
PubMed1990

Assessing the effect of multiple linkage tests in complex diseases.

The significance of a lod score value of 3 is very difficult to assess in linkage studies between a genetic marker and a complex disease. One reason is that multiple tests may have been performed, voluntarily or otherwise. For the same disease, linkage may be tested by different laboratories with several markers under various genetic models and diagnostic schemes for the disease. In such a case, we show that the probability of getting a lod score value of 3 under independent transmission of the disease and the marker may be not negligible.

Female↗