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Reproducibility of pixel values for two photostimulable phosphor plates in consecutive standardized scannings.

The objective of the present study was to determine the reproducibility of the pixel values obtained with the Digora system (Soredex, Finland). Exposures were standardized, with variation in exposure and scanning time of two photostimulable phosphor plates containing a stepwedge image. The smallest variation in pixel values ranged from 50 to 75%, with the widest variations being observed in less dense steps. A significant difference in pixel values was observed in terms of X-ray exposure and scanning times and between the two plates themselves (ANOVA, p < 0.01). Using the present methodology, the reproducibility of pixel values was not satisfactory for the tested white photostimulable plates. This wide variation in digitalization might be influenced by the amount of X-rays that sensitized the plates. It may be important to establish the reproducibility of the pixel values in quantitative studies using digital image.

Analysis of Variance↗

Reproducibility of the cortisol response to stimulation with a low dose of ACTH(1-24): the effect of basal cortisol levels and comparison of low-dose with high-dose secretory dynamics.

We compared the reproducibility and repeatability of the acute adrenal response to low doses (90 and 500 ng/1.73 m2) of Synacthen (ACTH(1-24)) with that of the standard dose (250 micrograms/1.73 m2). We also examined the effect of basal cortisol levels on peak values achieved after stimulation with a low dose. ACTH(1-24) was given to six male volunteers: 90 ng/1.73 m2 twice at 90-min intervals on day 1, and 90 and 500 ng/1.73 m2 once on day 2 and 250 micrograms/1.73 m2 once on day 3. The rise in serum cortisol concentration with repeated low doses of ACTH was not attenuated (161 +/- 49 (S.D.) nmol/l on initial vs 150 +/- 41 nmol/l on repeat stimulation; P = 0.5) and this was reproducible (161 +/- 49 nmol/l on day 1 vs 148 +/- 15 nmol/l on day 2; P = 0.6). A dose of 500 ng ACTH(1-24)/1.73 m2 produced a maximal adrenal response in that the rise in serum cortisol concentration at 20 min was identical with that produced at the same time by the standard dose of 250 micrograms/1.73 m2. There was a strong positive correlation between the basal cortisol level and peak cortisol concentration after low-dose ACTH stimulation (r = 0.93, P < 0.001) but not between the basal cortisol level and the incremental rise (r = -0.1, P = 0.69). These results suggest that the cortisol response to low-dose ACTH stimulation is reproducible and not attenuated by repeat stimulation at 90-min intervals.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Cortex↗

Measuring clinical attachment: reproducibility of relative measurements with an electronic probe.

During the past few years, improvements in detecting longitudinal changes in clinical attachment or alveolar bone density have been introduced. For example, constant-force electronic probes and computer-assisted subtraction analysis of longitudinal radiographs have been reported to be more sensitive and reproducible in detecting changes in clinical attachment or alveolar bone density, respectively. Use of these new technologies requires that sources of measurement error be identified and their contribution quantified. This study investigated the reproducibility of a constant-force electronic probe in a careful clinical setting. Measurements were performed from individually fabricated acrylic stents. Three groups of subjects were selected for the study: 10 adults without oral disease, 10 adults with gingivitis, and 10 adults with moderate periodontitis. Four probing designs were employed to investigate the reproducibility of the probe. In design A, the probe tip was left in the sulcus between successive probings. In design B, the probe tip was removed from the gingival margin between probings but the next probing followed immediately. In design C, successive whole-mouth probings were interrupted by a 5-minute interval and a mouth rinse. In design D there was a 4-week interval between each successive probing. Three measurements were taken at each site for each design. The main purpose of this study was to identify variance components in the attachment level variation. The maximum probing error standard deviation ranged from 0.2 to 0.3 mm depending on the periodontal health of the subject. This level of variation is considerably smaller than that found in most previous studies.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Image homogeneity and recording reproducibility with 2 techniques for serial intra-oral radiography.

The present study compared recording reproducibility and image homogeneity after applying two techniques for recording of serial intra-oral radiographs: 1) a technique previously described in 1990 based on mechanical fixation between the patient, the film holder, and the x-ray tube; and 2) a newly developed technique which operates with an optical alignment provided by a light beam. Twenty adults participated in the study. Two intra-oral radiographs were taken with a 30-minute time interval of the mandibular premolar/molar and the incisor region in each individual with either of the methods. All radiographs were scanned and digitized. Subtractions were performed between the two radiographs taken of the same individual and region with the same method. The standard deviation (SD) of the histogram defining the distribution of the grey shades in the subtraction image was used as the statistical test parameter. Subtractions were performed with an automated method and using a reference point-based program in order to test recording reproducibility and image homogeneity, respectively. Paired t-tests revealed that the average SDs obtained by the mechanical fixation method and the optical method were not statistically significantly different neither when applying the automated nor the reference point-based subtraction method (P > 0.05). The SDs increased significantly when the automated method was used compared to the reference point-based method (P = 0.001). In conclusion, the optical method and the mechanical method provided images of similar recording reproducibility and homogeneity.

Humans↗

Reliability and reproducibility of dens fracture classification with use of plain radiography and reformatted computer-aided tomography.

BACKGROUND: The classification system of dens fractures by Anderson and D'Alonzo has been widely used in clinical studies. Of the three types of fractures, Type II and Type III are of particular importance because the distinction between them may affect treatment decisions. The purposes of this study were to assess whether this classification is reliable and reproducible and to determine whether computed tomography can improve its reliability and reproducibility. METHODS: Plain radiographs and spiral computed tomography images of dens fractures in eleven patients were assessed, and the fractures were assigned a classification of Type II or Type III at two readings, separated by six months, by two spine surgeons and three neuroradiologists. Kappa coefficients of agreement between the raters as well as the reproducibility of the classifications made by the individual raters were calculated independently for the fracture classifications based on the plain radiographs and those based on the reformatted computed tomography scans. RESULTS: The kappa coefficient for classifications based on plain radiographs was 0.30 and 0.25 (fair agreement) at the first and second readings, respectively. For classifications based on computed tomography scans, the corresponding kappa coefficients were 0.46 (moderate agreement) and 0.67 (substantial agreement). The kappa coefficients for intrarater reliability among the five raters averaged 0.56 (moderate agreement) when computed tomography scans were used and 0.28 (fair agreement) when plain radiographs were used. CONCLUSIONS: Substantial variation with regard to the classification of dens fractures was found within our group of raters. Greater agreement occurred when reformatted computed tomography scans rather than plain radiographs were used as the basis for classification. When classifying dens fractures according to the system of Anderson and D'Alonzo, one should consider using reformatted computed tomography scans and reaching a consensus with multiple raters.

Adolescent↗

RNA amplification results in reproducible microarray data with slight ratio bias.

Microarray expression analysis demands large amounts of RNA that are often not available. RNA amplification techniques have been developed to overcome this prcblem, but limited data are available regarding the reproducibility and maintenance of original transcript ratios. We optimized and validated two amplification techniques: a modified in vitro transcription for the linear amplification of 3 microg total RNA and a SMART PCR-based technique for the exponential amplification of 50 ng total RNA. To determine bias between transcript ratios, we compared the expression profiles in mouse testis versus spleen between the two amplification methods and a standard labeling protocol, using microarrays containing 4596 cDNAs spotted in duplicate. With each method, replicate hybridizations were highly reproducible. However, when comparing the amplification methods to standard labeling, correlation coefficients were lower. Twelve genes that exhibited inconsistent or contradictory expression ratios among the three methods were verified by quantitative RT-PCR. The amplification methods showed slightly more discrepancies in the expression ratios when compared to quantitative RT-PCR results but were more sensitive in terms of detecting expressed genes. In conclusion, although amplification methods introduce slight changes in the transcript ratios compared to standard labeling, they are highly reproducible. For small sample size, in vitro transcription is the preferred method, but one should never combine different labeling strategies within a single study.

Blotting, Southern↗

Reproducibility of a semi-quantitative food frequency questionnaire in Japanese female dietitians.

OBJECTIVE: To examine reproducibility of assessed intake of foods and nutrients according to a semi-quantitative food frequency questionnaire (SQFFQ) in Japanese female dietitians. SUBJECTS AND METHODS: An SQFFQ was self-administered to 106 (21 male and 85 female) Japanese dietitians in Aichi prefecture in autumn 1996 and the same questionnaire was repeated in autumn 1997. Reproducibility was evaluated in terms of consumption of 15 foods and energy and 30 macro- and micro-nutrients based on the SQFFQ from 84 Japanese female dietitians. RESULTS: For intake of foods, Pearson's correlation coefficients (CCs) with log-transformation and energy adjustment (minimum-median-maximum) ranged from 0.35 (beverages)-0.61-0.71 (dairy products). ANOVA intraclass correlation coefficients (ICCs) with log-transformation and energy adjustment ranged from 0.49 (beverages)-0.74-0.82 (dairy products). Spearman's rank CCs with energy adjustment ranged from 0.43 (confectionery)-0.57-0.76 (dairy products). Weighted kappa statistics with energy adjustment ranged from 0.34 (confectionery)-0.49-0.71 (dairy products). For consumption of nutrients, Pearson's CCs with log-transformation and energy adjustment ranged from 0.23 (zinc)-0.55-0.74 (insoluble dietary fiber). ANOVA ICCs with log-transformation and energy adjustment ranged from 0.37 (zinc)-0.70-0.84 (insoluble dietary fiber). Spearman's rank CCs with energy adjustment ranged from 0.25 (zinc)-0.56-0.74 (magnesium). Weighted kappa statistics with energy adjustment ranged from 0.25 (zinc)-0.50-0.68 (insoluble dietary fiber). CONCLUSIONS: Substantially high reproducibility of consumption of foods and nutrients was attained from an SOFFQ self-administered to Japanese female dietitians.

Analysis of Variance↗

Validity and reproducibility of a self-administered food frequency questionnaire in the JPHC Study Cohort II: study design, participant profile and results in comparison with Cohort I.

The objective of this study was to evaluate the validity and reproducibility of a self-administered food frequency questionnaire (FFQ) to estimate nutrient and food intake in the subjects of the Japan Public Health Center-based prospective Study on Cancer and Cardiovascular Diseases (JPHC Study Cohort II). The FFQ was originally developed to estimate intake in the JPHC Study Cohort I. A total of 392 subjects were recruited from the entire cohort participants in the 6 areas of Cohort II on a voluntary basis. The subjects completed the FFQ used for the 5-year follow-up survey twice at approximately a 1-year interval. Seven-day dietary records (DR) and blood samples were collected 4 times at 3-month intervals over a year. Daily nutrient and food intakes from FFQ and DR were estimated. The Spearman correlation coefficients for estimated intakes were calculated between FFQ and DR for validity, and between 2 identical FFQs for reproducibility. Correlation coefficients for the validity ranged from 0.09 to 0.82 among various nutrients and food groups. The correlation coefficients for most of the nutrients and food groups were improved to a level comparable to that of Cohort I by energy-adjustment. Correlation coefficients for reproducibility ranged from 0.42 to 0.82, similar to those of Cohort I.

Diet Records↗

Reproducibility and validity of a simple checklist-type questionnaire for food intake and dietary behavior.

BACKGROUND: A simple, reliable, and valid food questionnaire is needed in clinical dietary assessments, community health education, and multi-purpose epidemiologic studies to obtain a crude measure of dietary intake. METHODS: To assess the validity and reproducibility of a simple 4-point scale food intake and behavior checklist, it was compared to two 3-day weighed dietary records. The FBC was administered to 47 students of a dietician course and their parents (n = 94) over a 9-month interval to assess the reproducibility. The mean intakes of selected food groups assessed by the two dietary records completed between food intake and behavior checklists were compared to the responses to the food intake and behavior checklist to assess its validity. RESULTS: The kappa statistics for reproducibility ranged from 0.25 for confectionaries to 0.63 for a preference for fatty foods (median, 0.39). There was a reasonable level of correlation between the dietary record and the food intake and behavior checklist in the intake of eggs, milk, and fruits (r = 0.53, 0.56, and 0.50, respectively). There was a weaker but still significant correlation in the intake of vegetables, and alcohol (r = 0.31 and 0.45, respectively). No significant correlation was observed in the intake of meat, fish, confectionaries, and soft drinks. However, those who reported consuming mainly fish rather than meat were found to eat significantly less meat and animal fat. Similarly, those who did not prefer fatty foods consumed significantly less meat, animal fat, and polyunsaturated fatty acids. CONCLUSIONS: This simple food checklist was useful in collecting data on egg, milk, and fruit consumption. Assessing intake frequency of vegetables, meat or fish with the FBC may be useful in screening high- or low-intake individuals.

Adult↗

A simple food frequency questionnaire for Japanese diet--Part II. Reproducibility and validity for nutrient intakes.

A self-administered 97-item simple food frequency questionnaire (FFQ), without portion size questions for most items, was completed twice at an one-year interval by 88 men and women in central Japan to evaluate its reproducibility. This FFQ was further validated by referring to four 4-day weighed dietary records (DRs) which were performed at 3-month intervals. Mean energy and 18 nutrient intakes measured by the first and the second FFQs were quite similar to those measured by the DRs. In our reproducibility study, Pearson and intraclass correlation coefficients, adjusted for energy intake, sex and age, ranged from 0.48 to 0.82 (median = 0.67). In the validation study, adjusted and de-attenuated correlation coefficients between the second FFQ and the DRs ranged from 0.42 for iron to 0.83 for calcium (median = 0.61). The proportion of subjects classified by the FFQ into the same or adjacent quintiles defined by the DRs was between 65.9% and 83.0% (median = 69.9%). These findings essentially suggested that our FFQ is well reproducible and sufficiently valid, and therefore, reasonably useful for nutritional epidemiological studies for Japanese diets, particularly for those of Tokai Area.

Adult↗

Quantitative assessment of tissue perfusion using MDCT: comparison of colorectal cancer and skeletal muscle measurement reproducibility.

OBJECTIVE: The purposes of this study were to determine the reproducibility of quantitative colorectal cancer perfusion measurements using dynamic contrast-enhanced MDCT, and to compare this with measurements from skeletal muscle. SUBJECTS AND METHODS: Ten patients (mean age, 67 years; six men, four women) with histologically proven colorectal cancer were examined prospectively using 4-MDCT. Perfusion studies (cine mode; 4 x 5 mm collimation; 1 acquisition/s; 65 seconds total) were performed through the tumor epicenter after IV bolus contrast administration (iopamidol 340, 100 mL; 5 mL/s) and repeated within 48 hours. Quantitative values for blood volume, blood flow, mean transit time, and permeability were determined using commercial software. Two regions of interest were studied on the axial image: one within the tumor and another within the left gluteal muscle. Measurement reproducibility was assessed using Bland-Altman statistics. RESULTS: For the tumor, the mean difference (95% limits of agreement) was -0.04 mL/100 g tissue (-2.50, 2.42); 8.80 (-50.5, 68.0) mL/100 g tissue/min; -0.99 (-8.19, 6.20) seconds; and 1.20 (-5.42, 7.83) mL/100 g tissue/min for blood volume, blood flow, mean transit time, and permeability, respectively. For muscle, the mean difference (95% limits of agreement) was 0.02 (-1.40, 1.43), 6.60 (-11.2, 24.3), -3.76 (-16.87, 9.35), and 1.30 (-4.68, 7.28), respectively. CONCLUSION: Quantitative perfusion measurements are reproducible. Measurements from tumor are less variable than from skeletal muscle.

Adenocarcinoma↗

Quantitative assessment of lung cancer perfusion using MDCT: does measurement reproducibility improve with greater tumor volume coverage?

OBJECTIVE: To date, quantitative assessment of tumor vascularity using perfusion CT has been limited to a single tumor level, with the potential for measurement error in heterogeneous tumors. We aimed to determine if greater z-axis tumor coverage improves the reproducibility of perfusion CT measurements in lung cancer. SUBJECTS AND METHODS: Paired perfusion studies were performed on 10 patients who had histologically confirmed advanced non-small cell lung cancer. Using 16-MDCT, multiple sequential volumetric acquisitions encompassing the entire tumor were acquired after infusion of i.v. contrast material. Using Patlak analysis, median values of tumor permeability (mL/100 mL/min) and blood volume (mL/100 mL) were measured for 10-mm z-axis coverage, and for 40-mm z-axis coverage in each of the paired perfusion studies. Measurement reproducibility was evaluated using Bland-Altman statistics. RESULTS: Mean difference (95% limits of agreement) for tumor permeability was 1.4 (-4.0 to 6.8) for 10-mm coverage and 0.8 (-3.6 to 5.2) for 40-mm coverage. Mean difference (95% limits of agreement) for blood volume was 1.9 (-5.1 to 8.9) for 10-mm coverage and 1.4 (-3.7 to 6.6) for 40-mm coverage. The coefficient of variation for permeability was 18.7% for 10-mm coverage, improving to 11.9% for 40-mm coverage. The coefficient of variation for blood volume was 41.7% for 10-mm coverage, improving to 32.6% for 40-mm coverage. CONCLUSION: Our results show that an improvement in tumor perfusion measurement reproducibility may be achieved with greater z-axis coverage.

Aged↗

Reproducibility of postprocessing of quantitative CT perfusion maps.

OBJECTIVE: The purpose of this study was to assess interobserver and intraobserver variability in evaluation of the reproducibility of quantitative data obtained in semiautomated postprocessing of CT perfusion data sets by observers of different levels of skill and experience and in fully automated postprocessing. MATERIALS AND METHODS: Twenty CT perfusion data sets were postprocessed by a neuroradiologist using an automated postprocessing program and by five observers (neuroradiology attending, neurology attending, radiology resident, senior and junior CT technologists) who received a brief training session in use of software for semiautomated postprocessing. For assessment of intraobserver variability, each observer repeated postprocessing of 10 CT perfusion data sets. Standard regions of interest were placed on identical locations for each observer's cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) maps of three brain regions: an ischemia-infarct region, normal cortical gray matter, and white matter. RESULTS: The variability in mean quantitative values of CBF, CBV, and MTT was 2.5-9.5% among all observers. Greater variability (20.4%) was introduced with the automated program. High correlation was found among all possible pairings of observers (r = 0.87-0.99). Low correlation was observed between automated postprocessing and postprocessing by all observers. Intraobserver variability in quantitative CT perfusion data ranged from 0.29% to 10.8%. High intraobserver correlation (r = 0.91-0.99) was found for the observers. CONCLUSION: Quantitative CBF, CBV, and MTT data obtained from postprocessing of CT perfusion data sets are reproducible among observers with varying levels of skill and experience. Observer interaction with the software is an important component for correct identification of user-defined parameters. Establishing a uniform and standard postprocessing technique is essential for maintaining good reproducibility.

Algorithms↗

In vivo reproducibility of three-dimensional cartilage volume and thickness measurements with MR imaging.

OBJECTIVE: Previous studies suggest that MR imaging is capable of providing accurate data on knee joint cartilage volume and thickness in vitro, but the reproducibility of these data in living subjects has not been analyzed rigorously. Our aim was therefore to determine the in vivo reproducibility of volume and thickness measurements from replicated data sets, applying three-dimensional (3D) postprocessing methods. SUBJECTS AND METHODS: Eight healthy volunteers were imaged six times at a resolution of 2 x 0.31 x 0.31 mm with a fat-suppressed fast low-angle shot 3D sequence, the knee being repositioned in between replicated examinations. Three-dimensional reconstructions of the articular cartilage surfaces were obtained from sagittal data sets, and the cartilage volumes were calculated. The thickness distribution was analyzed throughout the joint surfaces independent of the section orientation, using a previously validated 3D minimal-distance algorithm. RESULTS: In the volunteers, the coefficient of variation for replicated volume measurements ranged from 1.3% (patella) to 3.4% (lateral tibia), and the standard deviation of the individual cartilage volumes ranged from +/- 16% (lateral tibia) to +/- 22% (femur). The intraclass correlation coefficient ranged from .959 (lateral tibia) to .995 (patella). The interobserver evaluation was similar to the interscan reproducibility. The mean interscan deviation of the maximal cartilage thickness interval ranged from 0.1 to 0.3 cartilage thickness intervals (of 0.5 mm); only in rare cases did we record deviations greater than one thickness interval. CONCLUSION: MR imaging can be used to determine cartilage volume and thickness in the knee joints of living subjects with high precision, provided that a fat-suppressed gradient-echo sequence with adequate resolution and 3D digital image processing are used.

Adult↗

Reproducibility of hippocampal single-Voxel proton MR spectroscopy and chemical shift imaging.

OBJECTIVE: We investigated between- and within-acquisition reproducibility of hippocampal metabolite ratios obtained using automated proton MR spectroscopy. SUBJECTS AND METHODS: We examined 30 healthy adults with a 1.5-T scanner four times on 3 days using single-voxel spectroscopy over the left hippocampus, chemical shift imaging over the left hippocampus, and chemical shift imaging over the bilateral hippocampi. Metabolite ratios were derived from the integral values of three major peaks: N:-acetylaspartate (NAA), choline-containing compounds (Cho), and creatine plus phosphocreatine (Cr). The random-effects model of one-way analysis of variance was used to evaluate the reproducibility in terms of coefficient of variation; the mixed-effects model was used to compare the results of different hippocampal regions and spectroscopic techniques. RESULTS: Most coefficients of variation for the NAA/(Cho+Cr) ratio were less than 20%. All the coefficients of variation for the posterior hippocampus (15-25%) were less than those for the anterior hippocampus (20-44%). The posterior hippocampal NAA/(Cho+Cr) ratio of unilateral chemical shift imaging had the lowest coefficient of variation (<16%). Single-voxel spectroscopy and unilateral chemical shift imaging had similar coefficients of variation for the anterior hippocampal NAA/(Cho+Cr) ratios (17-20%). There was a significant difference in metabolite ratios measured in different hippocampal regions (p<0.01) and in those acquired with different spectroscopic techniques (p<0.001). CONCLUSION: The NAA/(Cho+Cr) ratio is the most reproducible parameter for hippocampal MR spectroscopy on a 1.5-T scanner. Regional variation and technical differences in metabolite ratios must be considered when interpreting proton spectra of the hippocampus.

Adolescent↗

Allergic contact dermatitis from corticosteroids: reproducibility of patch testing and correlation with intradermal testing.

BACKGROUND: Corticosteroid contact allergy is not uncommon. The diagnosis can be made with either patch testing or intradermal (ID) testing. In view of a few problems that have been encountered with patch testing, patch testing is considered inferior to ID testing. The reported reproducibility of positive patch-test results in the literature ranges from 47 to 98%. OBJECTIVES: This study was conducted to (1) determine the reproducibility of patch testing with topical steroid preparations and their clinical relevance, (2) correlate positive results with ID testing, (3) address the issue of cross-reactivity between different steroid groups, and (4) identify the percentage of positive reactions to preservatives and vehicles used in commercial topical steroids. METHODS: A total of 19 patients with positive patch-test reactions to steroids from 1995 to 2004 were identified. Atopic patients and patients with type I hypersensitivity were excluded. The patients were patch-tested with a steroid series, select commercial steroid products, and vehicles and preservatives used in these preparations. The same patients were subjected to ID testing with select steroids. Readings were done on days 2, 5, and 7. ID testing was also performed on 9 control patients. RESULTS: Tixocortol-21-pivalate is the most common steroid allergen (68%). The reproducibility of patch testing with topical steroid preparations ranged from 66 to 100%. Reactions to both ID testing and patch testing occurred in 16 patients (89%); 1 patient reacted to patch testing and 1 other reacted to ID testing. Formaldehyde and formaldehyde releasers accounted for the majority of reactions in the vehicles and preservatives group. CONCLUSION: Patch testing is sufficient in diagnosing allergic contact dermatitis from topical steroids. Testing with commercial products is not a good screen for steroid allergy. The most common cross-reactions were between group A (hydrocortisone-type) corticosteroids and group D2 corticosteroids (composed of labile esters, with a long-chain ester at C17 and possibly C21).

Administration, Cutaneous↗

Optimizing reproducibility for clinical studies involving patch testing and application of topical preparations.

BACKGROUND: The reproducibility and consistency of patch-test techniques can be problematic, making controlled clinical trials of patch testing difficult. OBJECTIVE: To measure the accuracy and reproducibility of applying controlled quantities of petrolatum onto Finn Chambers. METHODS: Four dermatology nurses applied a total of 240 samples of white petrolatum, using three syringe sizes and types. Three different amounts of white petrolatum (0.02 mL, 0.05 mL, and the "usual" amount) were expressed onto previously weighed Finn Chambers, using three different syringe sizes (5 mL, 1 mL, and 0.5 mL), five times each on two separate days. RESULTS: The average weights of 0.05 mL of petrolatum expressed with each type of syringe (5 mL: 0.04252 g; 1 mL: 0.04084 g; and 0.5 mL: 0.04139 g) were not significantly different from each other in pairwise comparisons (p > .36) or from the "gold standard" expected value (0.04138 g, p > .72). The average weights of 0.02 mL of petrolatum expressed with two types of syringes (5 mL: 0.02138 g; 0.5 mL: 0.01778 g) were significantly different from each other (p = .0012), but neither differed significantly from the expected value (0.01655 g, p > .08). The variance due to the effect modifications of nurse, day, and interaction of nurse and day was statistically significant for measurements made with the 5 mL syringe but not for measurements made with the 1 mL or 0.5 mL syringe. CONCLUSION: The average amounts of petrolatum extruded from smaller syringes (0.5 mL and 1 mL) were less variable and more reproducible than those extruded from a 5 mL syringe.

Administration, Cutaneous↗

Reproducibility of acoustic rhinometry and rhinomanometry in normal subjects.

The reproducibility of nasal patency measurements was assessed by acoustic rhinometry and active rhinomanometry using previously described Toronto methodologies. Six subjects with normal upper airways were tested with both procedures on six separate occasions within a 2-month period. Topical decongestant was applied to minimize the effects of mucosal variation on the nasal airway. The mean coefficients of variation (mean +/- s.d; %) over time of the measurements were 8.1 +/- 4.1 and 9.7 +/- 5.2 for minimal unilateral cross-sectional area and 4.8 +/- 1.8 and 5.5 +/- 3.5 for nasal volume (0-5 cm) of the right and left sides, respectively. For active rhinomanometry, the mean coefficients of variation (mean +/- s.d.; %) over time of the measurements were 15.9 +/- 7.3, 12.9 +/- 4.6, and 8.5 +/- 2.8 for right, left and combined nasal airflow resistance. The intraclass correlation coefficient was 0.76, 0.70, and 0.96 for right, left, and combined nasal resistance, 0.91 and 0.87 for right and left minimal cross sectional area, and 0.86 and 0.69 for right and left nasal volumes, respectively, also confirming a high level of reproducibility for both methods. In conclusion, performed by an experienced operator under controlled circumstances, the reproducibility of both methods of nasal patency assessment compared favorably with many widely accepted clinical tests.

Acoustics↗