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PubMed2006

Validation study of the Siriraj Stroke score in African Nigerians and evaluation of the discriminant values of its parameters: a preliminary prospective CT scan study.

BACKGROUND AND PURPOSE: CT scanning is important to identify stroke pathology and exclude mimics. Its poor availability in our environment makes the search for simple, reliable clinical-score imperative. This study aims to validate the Siriraj Stroke score (SSS) and determine the discriminant values of its parameters in the black population of African-Nigerians. METHODS: A prospective multicenter study was carried out on patients that presented with stroke and had brain CT scan done within 14 days of onset. An interviewer structured questionnaire was administered and SSS computed. The stroke-type was classified and compared with CT diagnosis. Data were analyzed using Epi-info-2002. RESULTS: 1122 patients presented with clinical features of stroke, of which only 101 (9%) could afford the cost of CT scan. Of these, 90 had CT-scan features consistent with acute stroke, 5 had cortical atrophy and 1 was normal. Thus, 96 patients were analyzed, of which 68 (71%) had cerebral ischemia and 28 (29%) had intracerebral hemorrhage. The 6 patients with no visible infarct on CT were regarded as cerebral infarction. The correlation between SSS, headache, vomiting, loss-of-consciousness and CT diagnosis achieved statistical significance, whereas atheroma markers and diastolic blood pressure did not. The SSS has an overall predictive accuracy of 80%. CONCLUSIONS: This preliminary study has shown that only 9% of our hospital stroke population had benefit of CT scan. The limited number of patients studied and their potential lack of representativeness, represent a funding issue to properly establish the performance of clinical scoring systems and assist in descriptive epidemiology of hospital and community-based stroke studies in resource-poor settings. However, in this study, the SSS diagnosis correlates significantly with CT diagnosis.

Adult↗

PubMed2003

The compliance-questionnaire-rheumatology compared with electronic medication event monitoring: a validation study.

OBJECTIVE: To validate the 19-item Compliance-Questionnaire-Rheumatology (CQR) against the "gold standard" in compliance measurement, electronic medication event monitoring. METHODS: Among 127 consenting patients, 81 with rheumatoid arthritis taking nonsteroidal antiinflammatory drugs (13 diclofenac, 20 naproxen) or disease modifying antirheumatic drugs (25 sulfasalazine, 23 methotrexate), 17 patients with polymyalgia rheumatica taking prednisone, and 29 patients with gout taking daily prophylactic colchicine (n = 12) or the uric acid lowering drugs allopurinol (10) or benzbromaron (7), 104 used their medication from a regular medication bottle fitted with a special cap containing microelectronics capable of recording time and date of opening and closing, defined as a medication event. Data were processed for the following: (1) the percentage of prescribed medication events during the study period (taking compliance) and (2) the percentage of days with the prescribed number of medication events (i.e., correct dosing). Satisfactory compliance was defined as taking compliance or correct dosing > 80%, while unsatisfactory compliance was defined as taking compliance or correct dosing < or = 80%. All patients were informed about the monitoring, and were followed for 6 months (gout: 1 year). At baseline 85 patients completed a set of questionnaires including the 19-item CQR. RESULTS: A total of 85 patients who had complete questionnaire and electronic monitoring data were analyzed. Multiple linear regression analyses showed that the total, weighted CQR score significantly and adequately predicts taking compliance (p = 0.001, r2 = 0.46) and correct dosing (p = 0.004, r2 = 0.42). Discriminant analyses showed that specificity and sensitivity to detect good taking compliance were 95% and 62%, respectively, with a prevalence of good compliance of 52%. The predictive value to detect unsatisfactory taking compliance was 86%, and to detect good taking compliance was 83%. The likelihood ratio of the CQR-19 to detect low taking compliance was 11.6. Four items were especially predictive: fear of forgetting to take the drug, being able to function well, routines in daily life, and side effects (combined r2 = 0.35). CONCLUSION: These results support the validity of the Compliance Questionnaire Rheumatology.

Aged↗

PubMed2005

Multicentre validation study of sentinel node biopsy for staging in breast cancer.

BACKGROUND: The aim of this study was to validate sentinel node biopsy for axillary staging after the initial learning phase, and to analyse factors associated with false-negative biopsies. METHODS: Some 675 patients, who had standard sentinel node biopsy followed by level I and II axillary clearance in one of 20 hospitals in Sweden and were operated on by 36 different surgeons, were recruited prospectively. RESULTS: The overall detection rate was 94.5 per cent. It varied between surgeons but was not influenced by the number of operations per surgeon. Moreover, it was lower among older patients. The overall false-negative rate was 7.7 per cent. This rate was not affected by patient age, tumour histological type or Elston grade, but was increased in patients with multifocal tumours. Some 21 per cent of patients with a multifocal tumour diagnosed on postoperative histopathological analysis had a false-negative biopsy compared with 5.6 per cent of those with unifocal tumours (P = 0.004). CONCLUSION: Sentinel node biopsy was shown to be a reliable method for axillary staging of unifocal breast tumours.

Adult↗

PubMed2001

Simultaneous measurement of regional cerebral blood flow by perfusion CT and stable xenon CT: a validation study.

BACKGROUND AND PURPOSE: Knowledge of cerebral blood flow (CBF) alterations in cases of acute stroke could be valuable in the early management of these cases. Among imaging techniques affording evaluation of cerebral perfusion, perfusion CT studies involve sequential acquisition of cerebral CT sections obtained in an axial mode during the IV administration of iodinated contrast material. They are thus very easy to perform in emergency settings. Perfusion CT values of CBF have proved to be accurate in animals, and perfusion CT affords plausible values in humans. The purpose of this study was to validate perfusion CT studies of CBF by comparison with the results provided by stable xenon CT, which have been reported to be accurate, and to evaluate acquisition and processing modalities of CT data, notably the possible deconvolution methods and the selection of the reference artery. METHODS: Twelve stable xenon CT and perfusion CT cerebral examinations were performed within an interval of a few minutes in patients with various cerebrovascular diseases. CBF maps were obtained from perfusion CT data by deconvolution using singular value decomposition and least mean square methods. The CBF were compared with the stable xenon CT results in multiple regions of interest through linear regression analysis and bilateral t tests for matched variables. RESULTS: Linear regression analysis showed good correlation between perfusion CT and stable xenon CT CBF values (singular value decomposition method: R(2) = 0.79, slope = 0.87; least mean square method: R(2) = 0.67, slope = 0.83). Bilateral t tests for matched variables did not identify a significant difference between the two imaging methods (P >.1). Both deconvolution methods were equivalent (P >.1). The choice of the reference artery is a major concern and has a strong influence on the final perfusion CT CBF map. CONCLUSION: Perfusion CT studies of CBF achieved with adequate acquisition parameters and processing lead to accurate and reliable results.

Adult↗

PubMed2002

Investigating the validity of the Draw-A-Person: Screening Procedure for Emotional Disturbance: a measurement validation study with high-risk youth.

This validity study examined the extent to which the Draw-A-Person: Screening Procedure for Emotional Disturbance (DAP:SPED; J. A. Naglieri, T. J. McNeish, & A. N. Bardos, 1991) was a significant predictor of behavioral functioning within a clinical sample of 68 latency-age children (6-12 years old) receiving counseling services at outpatient and residential treatment facilities. Study results showed that the total DAP:SPED (man, woman, and self scores summed) was a significant predictor in explaining variation in internalizing behavioral disturbance. Specifically, the DAP:SPED remained a moderate strength predictor of internalizing behavioral disturbance after controlling for the Child and Adolescent Adjustment Profile parent-report behavioral measure. Findings lend preliminary support to the DAP:SPED's validity in providing assessment information about child behavioral functioning. Continued validation investigation along these lines is recommended.

Affective Symptoms↗

PubMed2003

[Validation study on the criteria for clinical classification of small for gestational age infants].

OBJECTIVE: To study the validity of criteria currently used in China for the classification of symmetric small for gestational age infants (SGA) as compared with its definition. METHODS: This study included 417 inpatients diagnosed as SGA in authors' hospital from January 1998 to June 2002. Symmetric SGA was diagnosed by the following three criteria: (1) the Ponderal Index (PI), (2) the crown-heel length-to-head circumference ratio (BL/HC) issued in Chin J Pediatr (1988;26:164 - 165), as well as (3) the SGA definition. The definition criterion was considered as the "gold standard". The sensitivity, specificity, false positive and negative values, positive and negative predictive values, exact agreement ratio, diagnosis index, and Cohen's Kappa value were used to evaluate the validity and agreement of the methods of PI and BL/HC. Receiver Operating Characteristic (ROC) analysis was used to evaluate the validity of the diagnosis. RESULTS: Of 417 SGA infants, 376 (90.17%), 376 (90.17%) and 187 (44.84%) subjects were diagnosed as symmetric type with PI, BL/HC and the definition criteria, respectively. (2) The agreement rate and Kappa value between PI and BL/HC was 80.82% and -0.093 (SEM 0.026), respectively. And the agreement rates between PI or BL/HC and the definition criterion were 49.88% and 50.84%, respectively. As compared with the definition criterion, the PI and BL/HC methods had sensitivities of 91.8% - 96.4%, specificities of 9.3% - 25.9%, positive predictive values of 45.8% - 51.1%, negative predictive values of 72.7% - 82.8%, diagnosis indices of 4.9% - 17.7% and Kappa values of 0.070 - 0.167. (3) The areas under the ROC curves in full-term and preterm infants by PI method were 0.635 (95% CI, 0.573 - 0.697) and 0.698 (95% CI, 0.622 - 0.725), respectively. PI cutoffs at 2.47 in full-term SGA, at 2.43 in preterm SGA, and BL/HC cutoff at 1.43 produced the maximum diagnosis indices that were 24.7%, 39.6% and 33.7%, respectively. When the PI at 2.50 (full-term), PI at 2.31 (preterm) and BL/HC values at 1.46, the sensitivity closed mostly to the specificity. The sensitivities and specificities in full-term and preterm infants were 59.4% and 59.3%, 65.3% and 65.5%, and 66.3% and 65.5%, respectively. CONCLUSION: In the classification of SGA, the results showed a poor agreement between PI or BL/HC and the definition criterion. The results suggested that the current cutoffs of PI and BL/HC might not be appropriate for the diagnosis of symmetric SGA. Low AUC suggested that PI and BL/HC could not give a valid diagnosis at any cutoffs.

Anthropometry↗

PubMed1998

Scoring the mouse formalin test: validation study.

The formalin test is a well-established model for assessing nociceptive processes and analgesic drug effects. Previous studies have provided statistical validation of optimal procedures for conducting and scoring the rat formalin test. In the mouse model, formalin concentration has been subjected to validation studies. The present research extended previous work by subjecting two additional parameters - the behaviors that should be scored and the optimal interval for second-phase formalin response - to empirical validation. Five behavioral (formalin-induced favoring, lifting, and biting/licking, rearing and locomotion) and two physiological measures (paw weight and paw thickness increases reflective of formalin-induced inflammation) were examined under four formalin concentrations (Exp. 1: 0.5, 1.0, 5.0, and 10.0%/25µl formalin) or under four morphine doses (Exp. 2: 0.0, 1.0, 5.0, and 10.0 mg/kg, s.c. with 5% formalin concentration). Multiple regression analyses defined the optimal second-phase formalin response in outbred, Swiss-Webster mice as 15-35 min post formalin injection, and revealed that the second-phase response is best characterized by the cumulative time spent biting/licking the injected paw. Finally, paw physiological measures provided convergent evidence of nociceptive and antinociceptive processes in the mouse formalin test. Copyright 1998European Federation of Chapters of the International Association for the Study of Pain.

Journal Article↗

PubMed2003

[Validation study of a polygraphic screening device (BREAS SC20) in the diagnosis of sleep apnea-hypopnea syndrome].

OBJECTIVE: To validate the BREAS SC20 (Breas Medical AB, Mölnlyke, Sweden) polygraphic screening device, comparing it with conventional polysomnography (PSG), in the diagnosis of sleep apnea-hypopnea syndrome. A validity study of the diagnostic test was carried out at the sleep clinic of a tertiary hospital. PATIENTS AND METHODS: Seventy patients clinically suspected of sleep apnea-hypopnea syndrome and treated at the sleep laboratory of the Hospital Txagorritxu, Vitoria, Spain, from November, 2001 until August, 2002 were consecutively enrolled in the study. Patient characteristics, comorbidities, and results on the Epworth sleepiness scale were recorded. The apneahypopnea index (AHI) per hour of sleep was determined by PSG; the respiratory events index (REI) per hour of screening was determined by the polygraphic screening device. RESULTS: Sixty studies were valid (77% were men; mean [SD] age: 51.6 [13.2]; body mass index: 30.3 [5]; AHI: 31.0 [27.6]). The intraclass correlation coefficient between the AHI by PSG and the manual REI was 0.92. The mean difference between the AHI and the manual REI was 2.92 (9.75). The area under the receiver operating characteristic curve was 0.924 for the cut point AHI >or =5. The optimal cut point for an AHI > or = 5 was 3.6 in the REI (98% sensitivity). The respiratory screening device correctly classified 90% to 95% of the patients. CONCLUSIONS: The BREAS SC20 is a valid system for identifying patients clinically suspected of sleep apnea-hypopnea syndrome.

Adult↗

PubMed2004

Validation study to evaluate the reproducibility of a candidate in vitro potency assay of newcastle disease vaccines and to establish the suitability of a candidate biological reference preparation.

A quantification assay for the Haemagglutinin-Neuraminidase (HN) protein of Newcastle Disease Virus (NDV) has been developed at CIDC-Lelystad as a candidate in vitro potency test for inactivated Newcastle disease (ND) vaccines. In studies performed at CIDC-Lelystad, a high correlation was demonstrated between the results of this candidate in vitro potency assay and the results of the serological potency assay (European Pharmacopoeia monograph 0870; test A). Furthermore, a high correlation between the serological data (Haemagglutination Inhibition-antibody titres) and clinical protection after challenge was demonstrated. Correlation between in vivo and in vitro potency assays was confirmed in a collaborative pre-validation study. In the pre-validation study three Official Medicines Control Laboratories (OMCLs) determined both the NDV-HN antigen content and the in vivo potency (vaccination-serology and vaccination-challenge) of 6 vaccine batches. The conclusion of the pre-validation study was that a large-scale collaborative study should be organised to validate the in vitro method and the suitability of the reference preparation. This report describes the outcome of this study. In brief, 14 laboratories (8 OMCLs and 6 vaccine manufacturers) determined the NDV-HN antigen content of 9 different vaccines in 3 independent tests. The vaccine batches were produced by 5 different manufacturers and represent a quantitative range of ND antigen content. One vaccine batch with insufficient potency and one poultry vaccine not containing NDV were included. Statistical evaluation of the results indicated that the antigen content could be determined with high precision. A good repeatability as well as reproducibility was found. Furthermore all laboratories found a similar ranking of the vaccines, based on the antigen content. Comparison of the antigen content and the in vivo potency of a series of vaccines with relatively low potencies indicated that a threshold relative antigen level of 7.0 antigen units per dose would discriminate between vaccine batches with sufficient and insufficient potency. An in vitro assay with this threshold level for antigen content did not result in any false positive results and only a limited number of false negative results in the BSP055 study. We conclude that the in vitro measurement of the antigen content of inactivated ND-vaccines with the proposed method is a reliable alternative potency assay that could be included as a new method in monograph 0870 on ND-vaccines.

Animals↗

PubMed1997

Validation study of a central venous pressure-based protocol for the management of neurosurgical patients with hyponatremia and natriuresis.

OBJECTIVE: We had previously suggested a protocol for the management of neurosurgical patients with hyponatremia and natriuresis that was based on their volume status as determined by actual blood volume measurements. All patients in that study were found to be hypovolemic or normovolemic and responded, within 72 hours, to salt and fluid replacement. In the present study, the validity of that protocol was tested using central venous pressure as the sole measure of volume status of patients with hyponatremia and natriuresis. METHOD: Twenty-five consecutive patients (26 cases) who fulfilled the inclusion criteria typically used to diagnose the syndrome of inappropriate secretion of antidiuretic hormone were included in the study. Central venous pressure was used to classify patients as hypovolemic (< 5 cm of water), normovolemic (6-10 cm of water), or hypervolemic (> 11 cm of water). Hypovolemic patients were given fluids (50 ml/kg/d) and salt (12 g/d). Normovolemic patients were given normal fluid with 12 g of salt per day. In addition, patients with anemia (hematocrit, < 27%) were administered whole blood. The end point was a serum sodium of more than or equal to 130 mEq/L measured in two consecutive samples 12 hours apart or 72 hours after entry into the study. If the serum sodium was less than 130 mEq/L at the end of 72 hours, the clinical condition of the patient determined further management. RESULTS: Nineteen of 25 patients (26 cases) were hypovolemic, the rest were normovolemic. No patient was hypervolemic. Nineteen of 25 patients (26 cases) attained normal serum sodium values within 72 hours, and an additional 3 responded within the next 36 hours (108 h after entry into the study). One patient who was discharged on request had normalized her serum sodium a week later. Among the three nonresponders, who were severely hypovolemic, as revealed by blood volume measurement, and responded to increased fluid and salt administration. One was normovolemic and responded to increased salt administration. There were no complications related to the therapy. CONCLUSION: Hyponatremia with natriuresis in the neurosurgical setting responds to salt and fluid replacement guided by the patients' volume status as determined by the central venous pressure. This study also offers further indirect evidence to suggest that the syndrome of hyponatremia with natriuresis is most often caused by "cerebral salt wasting" rather than by the syndrome of inappropriate secretion of antidiuretic hormone.

Adolescent↗

PubMed2005

Stages of change for osteoporosis preventive behaviors: a construct validation study.

OBJECTIVE: This article presents a construct validation study for osteoporosis preventive behaviors based on a survey completed by 113 older adults. METHODS: Participants were classified using stages of change for osteoporosis preventive behaviors according to an algorithm adapted from the Transtheoretical Model of health behavior change. RESULTS: One-way analyses of variance and a hierarchical regression model indicate that stage of change location is significantly related to one's level of knowledge about osteoporosis as well as age, gender, and educational attainment. These findings bring support to the validity of the instrument. DISCUSSION: Findings from this study indicate that elders' attitudes and knowledge about osteoporosis reflect public health messages heralding osteoporosis as the disease of the older White women. Significant health care expenditures in the nontargeted groups call for a revision in these messages. Further applications with more heterogeneous samples are necessary for thorough validation and reliability testing of the proposed instrument.

Age Factors↗

PubMed1997

Register of dietary assessment calibration-validation studies: a status report.

A register of dietary assessment calibration-validation studies was created to improve communication between investigators, avoid duplication of effort, and identify gaps in knowledge. Calibration-validation studies were defined as investigations in which the participants completed at least two different dietary measurements. A questionnaire soliciting descriptive information about such studies was widely distributed. Completed questionnaires were received from October 1993 through September 1994 and the data from them were entered into a computer database. Preliminary individual reports were mailed to all contributors in September 1994 for revision or updating. Responses received by the end of October 1994 were incorporated into the database. A status report was published in December 1994. The report includes descriptions of 84 studies, 15 summary tables, and 6 reference indexes. Of the 84 studies included, 44 (52%) were conducted in North America, 35 (42%) in Europe, 2 (2%) in South America, 2 (2%) in Asia, and 1 (1%) in Australia. Sixty-three of the 84 studies (75%) used food-frequency questionnaires, 52 (62%) used food records, 35 (42%) used one or more dietary recalls, 11 (13%) used biological measures, and 8 (10%) used diet histories. Plans for maintaining and updating the register are being developed.

Biomarkers↗

PubMedDate not supplied

[Operationalization of the "locus of control" concept: translation and first validation study of the Levenson control scale (IPC: the internal powerful others and chance scale)].

This work presents the study of validation of the French version of the Internal Powerful others and Chance Scale (IPC) of Levenson. A principal components analysis was carried out on a group of 134 healthy subjects. The Cronbach alpha coefficient and the correlation between the items and the total score of each sub-scale of the IPC were calculated. Our results were discussed in comparison with others studies.

Adolescent↗

PubMedDate not supplied

[Validation study of the Center for Epidemiological Studies-Depression of a Spanish population of patients with affective disorders].

The Center for Epidemiologic Studies-Depression (CES-D) is a short self-rating scale composed of 20 items, designed to detect depressive symptomatology. It has demonstrated its sensibility in psychiatric patients and general population. The CES-D was administered to 99 patients, 33 men and 66 women with mean age of 44.14 years. The patients had been diagnosed of: Major Depressive Disorder (74%), Bipolar Disorder (10%), Adaptive Disorder with depressive mood (10%) and other mood disorders (6%) according to DSM-IIIR criteria. In order to study the validity and reliability of the CES-D, we administered the Hamilton Rating Depression Scale, the Beck Depression Inventory and analogical scales to all the patients. In the reliability analysis we obtain 0.9 alpha. The factor analysis show 4 factors who explain the 58.8% of the variance: "depresses Affect/Somatic", "Positive Affect", "Irritability/Hopelessness", "Interpersonal/Social". The scale shows a 0.95 sensibility and 0.91 specificity to depressive symptomatology detection (according to scores equal or over 9 on HRSD) taking as cutoff scores equal or over 16 on CES-D. Our results show that the CES-D is a sensitive and specify tool for depressive symptomatology detection in psychiatric population. The CES-D is easy to be completed and evaluated, therefore may be useful in epidemiologic studies in general populations.

Adolescent↗

PubMed1999

The natural history of somatic morbidity in disintegrative psychosis and infantile autism: a validation study.

In order to study the validity of disintegrative psychosis (DP) as defined in ICD-9, we compared the natural history of somatic morbidity of 13 patients given this diagnosis in childhood with a control group of 39 patients with infantile autism (IA) matched for gender, age, IQ and social class. Average follow-up time was 22 and 23 (11-33) years, respectively. Significantly more DP patients (85 versus 41%) had been admitted to a non-psychiatric hospital during the follow-up period. They also had significantly more admissions (3.6 versus 1.0) and stayed longer in hospital (78 versus 4 days) than patients with IA. Three of the DP individuals had an associated medical disorder and made extensive use of somatic services during the follow-up period. Altogether the DP group had utilised the medical health care system more than patients with IA suggesting that they had more medical symptoms than the IA group. On the whole our findings suggest that individuals with DP and IA should be conceptualised as essentially distinct and should be studied separately as regards aetiology, pathophysiology, course and treatment.

Adult↗

PubMed1992

The Missouri Children's Behavior Checklist behavioral classification system: a construct validity study with nonreferred children.

This study provides validity information about the Missouri Children's Behavior Checklist (MCBC) classifications system with nonreferred children. MCBC behavior patterns of 41 children were related to DSM-III symptomatology ascertained through a structured clinical interview, the Child Assessment Schedule, conducted with the mother. The findings indicated that considering the Undifferentiated Disturbance pattern as an indicator of poor adjustment may be unwarranted with nonreferred children.

Child↗

PubMed2006

A validation study of a scoring system to estimate the risk of lymph node metastasis for patients with endometrial cancer for tailoring the indication of lymphadenectomy.

OBJECTIVE: The aim of this study was to verify whether a preoperative scoring system to estimate the risk of lymph node metastasis (LNM) in endometrial carcinoma is clinically useful for tailoring the indication of lymphadenectomy. STUDY DESIGN: LNM score was set up using volume index, serum CA125 level, and tumor grade/histology, which were found to be independent risk factors for LNM in a pilot study. Based on the LNM score before a validation study was started, the estimated rates of LNM (para-aortic LNM) were 3.4% (0.0%) in a low risk group, 7.7% (5.8%) in an intermediate group, 44.4% (30.6%) in a high risk group and 70.0% (50.0%) in an extremely high risk group. The validation study was carried out using data for 211 patients with endometrial carcinoma for whom three risk factors were preoperatively confirmed. Logistic regression analysis was used to determine whether these factors remain valid. The actual rate of LNM was investigated according to the LNM score. RESULTS: Volume index, serum CA125 level, and tumor grade/histology were found to be independent risk factors for LNM in the cohort of this study. The actual rates of LNM (para-aortic LNM) were 3.2% (1.0%) in the low risk group, 15.3% (11.9%) in the intermediate group, 30.2% (23.8%) in the high risk group and 78.6% (57.1%) in the extremely high risk group. CONCLUSION: The actual rate of LNM for each score was fairly consistent with the estimated rate of LNM. Para-aortic lymphadenectomy may not be necessary in cases of a low risk group. A large prospective multicenter clinical trial needs to be conducted to establish the clinical usefulness of our preoperative scoring system.

Adult↗

PubMed2003

Food and nutrient intakes assessed with dietary records for the validation study of a self-administered food frequency questionnaire in JPHC Study Cohort I.

We present here the survey methods and basic results of dietary records which were used as reference values in the present validation study of a self-administered food frequency questionnaire (FFQ) for the 5-year follow-up survey of the JPHC study. A semi-weighed dietary record was kept for four seven consecutive days in each of the four seasons in 3 areas, i.e., Iwate, Akita, and Nagano, and for seven consecutive days in both winter and summer in Okinawa. The mean intakes were significantly different between areas for some nutrients and food groups. A significant seasonal difference in the mean intakes was also observed in some nutrients such as carotene and vitamin C, and in some food groups such as potatoes, vegetables, and fruits in both sexes, and alcoholic beverages in men and milks in women (p<0.001).

Analysis of Variance↗