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[Reproducibility of the radiographic analysis of dysplasia of the femoral trochlea. Intra- and interobserver analysis of 68 knees].

PURPOSE OF THE STUDY: The relation between patello-femoral instability and trochlear dysplasia was identified by Dejour. Trochlear dysplasia, diagnosed on knee lateral Xray when the trochlear groove crosses both femoral condyles (the so-called "crossing sign"), must be corrected to improve patello-femoral stability. However surgery should be related to the severity and the shape of trochlear dysplasia, underlining the importance of a reproducible classification. The aim of this study was to establish intra and inter-observer reliability of Dejour's radiographic criteria. MATERIAL: 68 preoperative exact knee profile radiographs were harvested from clinical records of 64 patients who underwent trochleoplasty because of patello-femoral instability and trochlear dysplasia. On these 68 views, the crossing sign was identified by the senior surgeon (F.G.) who performed or supervised surgery. METHOD: The 68 radiographs were examined independently by 7 observers (2 juniors, 5 seniors) in order to assess interobserver agreement. Two juniors repeated the observation to test intraobserver agreement. Reproducibility for categorical data (7 shapes of trochlea according to Dejour (3 for dysplasia)) was evaluated by Kappa statistics, and for numerical data (depth and anterior projection of the trochlear groove with respect to anterior femoral cortex) we used the interclass correlation analysis. RESULTS: Two out of the 7 observers rated all the 68 trochleas as dysplastics. The 5 others rated as normal 1 to 6 trochleas out of the 68. None of the 68 trochleas were recognized with the same shape by the 7 examiners. At best, 6 observers agreed on the same shape and for only 12 trochleas. Disagreement was mostly related to mistakes between type I and type II of dysplasia. For trochlear morphology interobserver agreement was slight (Kappa = 0.17) and intraobserver agreement was fair (Kappa = 0.3). The mean prominence of the trochlea was 3 +/- 2.1 mm [-6 to 10], and the mean trochlea depth was 1 +/- 1.9 mm [0 to 11]. These measurements were more reliable since the interclass correlation coefficients were respectively 0.62 and 0.38. The level of experience of the observers had no influence for categorical or numerical data. DISCUSSION: Our results indicated a low interobserver agreement for trochlear shape identification according to Dejour. The most reliable criteria was measurement of the trochlear prominence which was mostly pathological in our series. The "crossing sign" was reliable to diagnose dysplasia since the probability to rate as normal a true dysplastic trochlea was only 3.1 per cent. However, once the dysplasia diagnosed, this classification gave inconsistent results to select the trochlear shape, particularly for type II. To improve reproducibility we propose to diagnose a type II only when 5 millimeters separate the crossings between the medial and lateral condyles. CONCLUSION: We recommend to use anterior projection of the trochlear groove to rate trochlear dysplasia and to determine the adequate type of trochleoplasty: elevating of the lateral facet if non prominent or deepening of the groove when prominent.

Adolescent↗

The reproducibility of cephalometric landmarks: an experimental study on skulls.

Few previous cephalometric studies have used dry skulls in order to eliminate the effects of the facial soft tissues. The aim of this study were to quantify the intra-examiner reproducibility of the commonly used cephalometric landmarks, angles and distances, using dry skulls and to compare these errors with previous error data obtained from normal cephalograms of living patients. Thirty skulls were mounted in a purpose-designed holder and repeat cephalograms of each skull were recorded and digitised. All measurements were made relative to an X-Y coordinate reference grid. Scattergrams were produced to show the characteristic distribution of the intra-examiner reproducibility errors for the landmarks, and the reproducibility of the angles and distances were tabulated. This data was compared with a related study that included the soft tissue profile. The standard deviations of the skeletal and dental angles and distances were greater in the presence of the soft tissues. These differences were up to four times larger for measurements including the location of Nasion (e.g. SNA, SNB and SNPg), which was the landmark location most affected by the presence of soft tissues, and for the distance: Incisal tip of Lower Incisor to Pogonion. Anterior Nasal Spine, in the horizontal plane, was also greatly affected by the presence of the soft tissues. By using dry skulls, the errors observed in this study may serve as standards for the rational interpretation of clinical cephalometric values.

Adult↗

Measuring reproducibility of regional brain metabolic responses to lorazepam using statistical parametric maps.

UNLABELLED: Statistical parametric mapping (SPM) is a method for localizing differences in brain activation patterns without the need for anatomic predefined constraints. The purpose of this study was to assess the reproducibility of the patterns of activation obtained with SPM for baseline measures and for metabolic changes in response to lorazepam on a test-retest design. The results were compared with those we previously published using region-of-interest (ROI) methods. METHODS: Sixteen healthy right-handed men were scanned twice with PET and [18F]fluorodeoxyglucose (FDG): before placebo and before lorazepam (30 microg/kg). The same double FDG procedure was repeated 6-8 wk later to assess test-retest reproducibility. Image datasets were analyzed by using SPM95 software. Difference images between baseline and lorazepam were compared for the first and second evaluations, both for relative decreases as well as increases in metabolism. Significance level was systematically varied to P < 0.001, P < 0.01 and P < 0.05. RESULTS: There were no differences in the baseline SPM maps obtained for the first and second evaluations. SPM showed similar, although not identical, differences in response to lorazepam between the two evaluations. Both evaluations showed significant decreases in occipital cortex (9.7% and 10%) and significant relative increases in left temporal pole (6.8% and 10.4%). However, the second evaluation showed a decrease in the left frontal cortex (areas 6 and 8), which was not present in the first evaluation. The results were very similar to those we had obtained with ROI methods, except for the activation in the left temporal pole, which we had not observed with ROI analyses. CONCLUSION: Although the overall pattern of lorazepam-induced activation depicted by SPM was reproducible in pattern and magnitude, there were some differences that included a left frontal area of deactivation during the second but not the first evaluation. Results with SPM are similar to those with the ROI method, and, because it systematically analyses the whole brain, SPM can uncover patterns not seen with the ROI method.

Adult↗

Reproducibility of short echo time proton magnetic resonance spectroscopy using point-resolved spatially localized spectroscopy sequence in normal human brains.

The reproducibility of short echo time proton MR spectroscopy (1H-MRS) in normal human brains was examined. Thirteen healthy volunteers were studied, and each underwent three MRS examinations. Second and third measurements were done on the same day, about two months after the first measurement, and interday and intraday reproducibility were evaluated. MRS was performed with proton brain examination/single voxel (PROBE/SV) and point-resolved spatially localized spectroscopy (PRESS) (repetition time = 2000 ms, echo time = 30 ms). Five metabolite ratios were computed; N-acetyl-aspartate (NAA)/creatine (Cr), choline (Cho)/Cr, myo-inositol (mI)/Cr, NAA/(NAA + Cr + Cho), and NAA/Cho. Their normal range and reproducibility were measured. For each metabolite ratio, there was no significant difference between interday difference and intraday difference, suggesting that the interval of two months has minimal effect on MRS measurements. MRS may be utilized for the observation of central nervous system diseases.

Adult↗

Home blood pressure measurement: reproducibility and relationship with left ventricular mass.

OBJECTIVE: To evaluate the reproducibility and relationship with left ventricular mass index of home blood pressure in comparison with ambulatory and office blood pressures. METHODS: We measured home, ambulatory and office blood pressures of 84 previously untreated hypertensive patients, aged 60-74 years, from primary care, at baseline and after 12 weeks, without active intervention in between. Left ventricular mass index was determined echocardiographically during week 12. RESULTS: Decreases in systolic and diastolic blood pressures were found after 12 weeks for mean home and office blood pressures (P<0.05), but not for mean ambulatory blood pressure. The coefficients of reproducibility for systolic and diastolic ambulatory blood pressures were 26.4 and 16.0, respectively. Correlation coefficients for correlation of left ventricular mass index to ambulatory blood pressure (0.51 and 0.36) were higher than the correlation coefficients for home (0.31 and 0. 16) and office (0.32 and 0.21) blood pressures, for systolic and diastolic values, respectively. However, we could find no statistically significant difference among the correlation coefficients for all three types of measurements. CONCLUSIONS: Home blood pressure was considerably less reproducible than ambulatory blood pressure and no different from office blood pressure in this respect. The relationship with left ventricular mass index appeared to be stronger for ambulatory than it was for home and office blood pressures, although not statistically significant so.

Aged↗

Reproducibility of repeated measures of endogenous dopamine competition with [11C]raclopride in the human brain in response to methylphenidate.

UNLABELLED: The measure of changes in synaptic dopamine (DA) concentration in response to the psychostimulant drug methylphenidate (MP) has been used as an indicator of responsiveness of the DA system. The purpose of this study was to assess the reproducibility of these measures. METHODS: Seven healthy subjects were scanned with PET and [11C]raclopride twice in the same day: 7 min after placebo or methylphenidate (0.5 mg/kg) administration. In parallel we also measured the physiologic and behavioral responses to placebo and to methylphenidate. The same procedures were repeated 1-2 wk later to assess test-retest reproducibility. RESULTS: Measures of plasma to brain transfer constant (K1), striatal distribution volume (DVstr) and DA D2 receptor availability (Bmax/Kd), for the placebo condition were similar for the first (E1) and second (E2) evaluations (Bmax/Kd, E1: 2.77+/-0.44; E2: 2.97+/-0.44). MP administration did not change K1, but it significantly decreased DVstr (E1: -25.9%+/-8.7%, P < or = 0.0002; E2: -20.7%+/-11.7%, P < or = 0.007) and Bmax/Kd (E1: -18.4%+/-8.7%, P < or = 0.002; E2: -13.4%+/-9.2%, P < or = 0.008), and the magnitude of these changes, though lower for E2, did not differ significantly. MP increased pulse rate (E1: +64%+/-43%, P < or = 0.002; E2: +69%+/-33%, P < or = 0.001), systolic pressure (E1: +37%+/-19%, P < or = 0.0006; E2: +29%+/-15%, P < or = 0.0009), self reports for drug effects (0: nothing to 10: extreme) of "rush" (E1: +8+/-3, P < or = 0.0004; E2: +6+/-4, P < or = 0.01) and "high" (E1: +8+/-3, P < or = 0.0001, E2: +8+/-3, P < or = 0.0003), anxiety (E1: +5+/-4, P < or = 0.02; E2: +4+/-4, P = 0.1) and restlessness (E1: +4+/-4, P < or = 0.04; E2: +4+/-5, P = 0.1). The magnitude of the cardiovascular and behavioral effects did not differ between E1 and E2. CONCLUSION: MP-induced changes in striatal DV and in Bmax/Kd, as well as the behavioral and cardiovascular effects, were reproducible with repeated administration.

Adult↗

Reproducibility and variability of the arginine test in normal adults. Comparison between sexes.

The biochemical diagnosis of growth hormone deficiency in adults (AGHD) remains controversial, mainly as regards stimulation tests and suggested cut-off lines. The insulin tolerance test proved to be the most effective growth hormone (GH) secretagogue in normal males, but a poor intra-individual reproducibility has been reported. Given the safety of the arginine test (AST), we decided to evaluate the incidence of false negatives (non responder normal subjects), its reproducibility and variability. Twenty five healthy non-obese volunteers (16 males, 9 females) with a chronological age range between 19 and 40 years, (mean: 29.8) were evaluated. AST was performed (0.5 g/kg i.v. infusion for 30 min), measuring GH (IRMA) at baseline (B), 30, 60 and 90 minutes, and it was repeated in the same subject 7 to 30 days later; in females both tests were performed in the early follicular phase. Results (median and range) were: 1st test B: 0.61 (0.35-22.60) micrograms/L; maximal response (Mx Resp) 10.00 (0.48-48.80) micrograms/L. 2nd test B: 0.50 (0.38-27.0) micrograms/L; Mx Resp 11.00 (0.50-47.70) micrograms/L. The statistical evaluation (Wilcoxon signed rank test) showed no differences between B vs. B and Mx Resp vs Mx Resp. Separated by sex, males showed: 1st test: B 0.45 (0.35-4.30) micrograms/L; Mx Resp 6.30 (0.48-48.80) micrograms/L. 2nd test B 0.46 (0.38-8.80) micrograms/L; Mx Resp 10.90 (0.50-47.70) micrograms/L, while females showed 1st test: B 5.20 (0.50-22.60) micrograms/L; mx Resp 14.00 (3.50-36.70) micrograms/L. 2nd test B 3.60 (0.75-27.00) micrograms/L; Mx Resp 13.00 (3.70-28.10) micrograms/L. The statistical comparison (Mann Whitney test) showed significant differences between both sexes in basal values of the first and second test (p < 0.001), and in the maximal response of the first test (p < 0.03). The statistical analysis did not show significant differences in delta increases between males and females, neither in the first AST nor in the second one. Considering GH values > or = 3 micrograms/L as a positive response, 4 males exhibited insufficient responses in both tests and other 2 males showed discordant results between tests 1 and 2. All females evaluated produced responses above 3 micrograms/L in both tests. The results of the present study demonstrate that, particularly in men, AST has no clear limit of normality while it shows good intra-individual reproducibility. In conclusion, at present the biochemical diagnosis of AGHD requires a clear and precise standardization which includes all variables that can modify the GH response to the stimulus used.

Adult↗

Relative 99mTc-MAG3 renal uptake: reproducibility and accuracy.

UNLABELLED: The aim of this study was to estimate the reproducibility and accuracy of 99mTc-mercaptoacetyltriglycine (MAG3) relative percentage uptake. METHODS: Reproducibility was evaluated on healthy volunteers who were submitted twice to a 99mTc-MAG3 renographic study, which used different uptake algorithms, different background corrections and different time intervals. Accuracy was evaluated in a group of patients with symmetrical or asymmetrical relative renal function, who underwent both 99mTc-dimercaptosuccinic acid (DMSA) and 99mTc-MAG3 studies, using the DMSA relative percentage uptake as a reference. RESULTS AND CONCLUSION: The methods that combined the best reproducibility and accuracy for estimating 99mTc-MAG3 left-to-right uptake ratio were the integral method, with subrenal or perirenal background correction, and the Patlak-Rutland plot. The use of the integral method without background correction introduced a systematic bias, whereas the slope method resulted in high variability. Therefore these methods cannot be recommended.

Adult↗

Reproducibility of methods for assessing baroreflex sensitivity in normal controls and in patients with chronic heart failure.

Baroreflex sensitivity (BRS) conveys useful prognostic information in patients with heart disease, yet methods for its quantification suffer from poor reproducibility and test failure in some patients with heart failure. We set out to compare the short-term reproducibility and success rate of four different methods of assessing BRS in normal subjects and patients with chronic heart failure (CHF). A total of 31 patients with CHF and 18 normal controls underwent BRS testing using four techniques: (1) bolus phenylephrine (BRS(Phe)), (2) alpha-index in both low- and high-frequency bands (BRS(alphaLF) and BRS(alphaHF) respectively), (3) the sequence method (BRS(Seq)), and (4) a new 0.1 Hz controlled-breathing, time-domain analysis method (BRS(Cbr)). Each subject underwent two test episodes with each method on the same day. The average values for BRS in patients and controls respectively were: BRS(Phe), 4.4 (+/-4.4) ms/mmHg and 19.8 (+/-11.5) ms/mmHg; BRS(alphaLF), 5.6 (+/-4.1) ms/mmHg and 15.4 (+/-5.0) ms/mmHg; BRS(alphaHF), 7.1 (+/-7.0) ms/mmHg and 25.1 (+/-8.3) ms/mmHg; BRS(Seq), 7.7 (+/-6.3) ms/mmHg and 22.5 (+/-8.4) ms/mmHg; BRS(Cbr), 6.6 (+/-5.9) ms/mmHg and 22.8 (+/-10.8) ms/mmHg. The coefficients of variation (S.D. of the difference in repeated values divided by mean) in patients and controls respectively were: BRS(Phe), 85.6% and 52.2%; BRS(alphaLF), 65.9% and 33.7%; BRS(alphaHF), 99.7% and 52. 1%; BRS(Seq), 30.7% and 40.4%; BRS(Cbr), 30.7% and 19.6%. The numbers of test failures in patients were: BRS(Phen), 15; BRS(alphaLF), 7; BRS(alphaHF), 5; BRS(Seq), 14; BRS(Cbr), 1. Of the four techniques assessed for measuring BRS, the controlled breathing time-domain method yielded the best reproducibility and lowest failure rate in controls and in patients with CHF.

Adult↗

Reproducibility and validity of maternal recall of pregnancy-related events.

We assessed the reproducibility and validity of a questionnaire that asks mothers to recall pregnancy-related events from thirty or more years ago. Among 146 women who completed the questionnaire twice, responses were highly reproducible for pre-pregnancy height and weight (r = 0.95), pregnancy complications (r = 0.74), substance use (r = 0.80), preterm delivery (r = 0.82), birthweight (r = 0.94), and breastfeeding (r = 0.89). Among 154 women whose questionnaire responses were compared to data collected during their pregnancies, recall was highly accurate for height (r = 0.90), pre-pregnancy weight (r = 0.86), birthweight (r = 0.91), and smoking (sensitivity = 0.86, specificity = 0.94). These findings suggest that long-term maternal recall is both reproducible and accurate for many factors related to pregnancy and delivery.

Aged↗

Reproducibility of the oxygen uptake efficiency slope in normal healthy subjects.

BACKGROUND: To elucidate the intertest agreement of the oxygen uptake efficiency slope (OUES) in comparison with those of the maximal oxygen uptake (VO2max) and the ventilatory anaerobic threshold (VAT). METHODS EXPERIMENTAL DESIGN: A comparative study. SETTING: Institutional practice. A total of 19 healthy volunteers underwent two sessions of maximal exercise testing with an interval of no more than 7 days. The testing was conducted on a cycle ergometer with the work rate increased by either 20, 30, or 40 Watts (W)/min so that the subject would reach exhaustion within 9 to 12 min of exercise. VAT was defined as the level of oxygen uptake (VO2) at which either an increase in the ventilatory equivalent for oxygen without a concomitant increase in the ventilatory equivalent for carbon dioxide or a change in the slope of the linear relationship between carbon-dioxide production (VCO2) and VO2 occurred. OUES was determined by the following equation: VO2 = a log VE + b, where VE was minute ventilation and "a" was the OUES. Intertest reproducibility was assessed by coefficient of repeatability (COR). RESULTS: The intertest reproducibility of VO2max and OUES were excellent (COR = 570 ml/min [16%] and 740 [20%], respectively). VAT showed poor agreement between the two tests (COR = 650 ml/min [31%]). CONCLUSIONS: Results show that OUES is reproducible and reliable, supporting the clinical usefulness of this index.

Adult↗

[Reliability of the KT-1000 arthrometer in measuring anterior laxity of the knee: comparative analysis with Telos of 48 reconstructions of the anterior cruciate ligament and intra- and interobserver reproducibility].

PURPOSE OF THE STUDY: The goal of this study was to compare KT-1000 and Telos measurements after anterior cruciate ligament reconstruction (ACLR). MATERIAL AND METHOD: Forty eight patients with asymptomatic ACLR (4 failures with positive pivot shift and 12 knees with positive (+) Lachman test) were assessed (mean 2.5 years after surgery) by the same examiner by means of: 1) Lachman radiographic with Telos at 150 N, 2) MEDmetric KT-1000 at 69 N, 89 N and maxi-manuel (MM). The examiner tested more than 200 patients each year. Measurements were performed for KT-1000 according to the manufacturers' recommendations and for Telos according to Staübli. Only side to side differences in millimeters are reported. Reproducibility of KT-1000 measurements were also evaluated: interobserver reproducibility was assessed by 16 examiners on a healthy patient, and the experienced examiner tested 20 times a healthy patient. RESULTS: An Interobserver error of 4 mm range (+/- 2 mm related to 0) was observed by 12 to 44 p. 100 of the examiners, respectively at 69 N to MM. An intraobserver error of 4 mm range (+/- 2 mm related to 0) was observed in 10 p. 100 at MM and in 20 p. 100 at 89 N. Mean side to side laxity with KT-1000 was 0.93 mm +/- 1.1 [-1 to 5] at 69 N, 1.3 mm +/- 1.6 [-2 to 6] at 89 N, and 1.41 +/- 1.8 [-2 to 6] at MM. With Telos the mean side to side laxity was 3.95 mm +/- 3.84 [0 to 15]. Significant differences (p = 0.0001) were found between measurements obtained by the two methods. No statistical correlation could be detected between values observed by Telos and KT-1000 (R < 0.1). If we consider a 3 mm side to side difference 23 knees (48 p. 100) had abnormal anterior laxity with Telos and with KT-1000 only 3 (6.2 p. 100) at 89 N and 6 (12.5 p. 100) at MM (1 (2 p. 100) at 69 N). With a 5 mm side to side difference, 12 knees (25 p. 100) had abnormal anterior laxity with Telos and with KT-1000 only 1 (2 p. 100) at 89 N and 1 (2 p. 100) at MM (0 at 69 N). Only Telos measurements were correlated to positive pivot shift (p = 0.007) and positive Lachman test (p = 0.01). CONCLUSION: Interobserver reproducibility of KT-1000 measurements was low, but improved for intraobserver agreement. However, even for a unique KT-1000 experienced examiner, reliability of KT-1000 was poor when comparing Telos and KT-1000 predicitive value to diagnose ACLR failure. Telos results were much more pejorative but the only ones corelated with ACLR failures. We recommand Telos instead of KT-1000 to assess laxity after ACLR.

Adolescent↗

Intraobserver reproducibility and interobserver reliability of cervical spine measurements.

Lateral flexion-extension radiographs of 72 patients with Down syndrome were used to assess the interobserver reliability and intraobserver reproducibility of the atlanto-dens interval, Wiesel-Rothman measurement, occiput atlas angle, and Power's ratio in flexion and extension. The radiographs were reviewed by three blinded observers on three different occasions with at least a 1-month interval between assessments. The intraclass correlation coefficient was used to measure the reproducibility of the measurements from a given observer and the reliability between different observers. With the exception of observer one, the atlanto-dens interval had a statistically significant intraobserver agreement compared with any of the other measurements (p < 0.05). The atlanto-dens interval and the Wiesel-Rothman measurements tended to have better correlation between observers, although there was only fair agreement. The agreement, however, was statistically significant (p < 0.05) compared with Power's ratio. The degree of intraobserver reproducibility and interobserver reliability may make it difficult to base treatment protocols on these measurements.

Adolescent↗

[Reproducibility of the walking test in patients with cystic fibrosis].

OBJECTIVE: The walking test is a useful and objective method for evaluating the tolerance for exercise in patients with chronic bronchopulmonary diseases. Our objective was to check the reproducibility of this test and evaluate whether there are differences between tests of varying duration (2 and 6 minutes) in a group of patients with cystic fibrosis. PATIENTS AND METHODS: We utilized the walking test on 29 patients who were in a stable phase and under care in the Cystic Fibrosis Unit of our hospital. Two tests were carried out, one of 2 minutes and the other of 6 minutes duration, both of which were repeated after a 15-minute interval. RESULTS: The reproducibility of the walking test in this type of patient was very good and we found an excellent correlation between the two-minute test and the six-minute test. We did not observe a training effect when the test was repeated. CONCLUSIONS: The two minute walking test has a high reproducibility and we propose this test, because it is shorter and more comfortable for pediatric patients with cystic fibrosis, in order to evaluate the evolution, progressive deterioration of the of the patient and the response to different types of treatments.

Adolescent↗

A new ELISA kit for measuring urinary 2-hydroxyestrone, 16alpha-hydroxyestrone, and their ratio: reproducibility, validity, and assay performance after freeze-thaw cycling and preservation by boric acid.

There is considerable controversy regarding the role of estrogen metabolites in breast cancer risk, fueled in part by the development of a rapid ELISA that is suitable for large scale investigations. An earlier version of the ELISA could detect values of the 2-hydroxyestrone (2-OHE1) and 16alpha-hydroxyestrone (16alpha-OHE1) metabolites as low as 2 ng/ml and produce consistent results in premenopausal urines. However, reproducibility was problematic in postmenopausal urines where concentrations of these compounds are much lower. In response to our concern, a new ELISA was developed with a sensitivity of 0.625 ng/ml, which we evaluated using the same pre- and postmenopausal urine samples analyzed in the earlier ELISA. In this report, we present findings on the new kit with regard to reproducibility of the 2-OHE1 and 16alpha-OHE1 measurements, comparability of results with gas chromatography-mass spectroscopy values, and with regard to the stability of the metabolites after repeated freeze-thaw cycles and after preservation by boric acid. For the most part, we found the new ELISA to be reproducible, with assay coefficients of variation ranging from 10 to 20%, and intraclass correlation coefficients (ICCs) ranging from 80 to 95% in both the pre- and postmenopausal urines. ELISA results for 16alpha-OHE1 differed from 1 day (i.e., batch) to the next, and the absolute values of the metabolites obtained by the ELISA were consistently lower than but well correlated with those obtained by gas chromatography-mass spectroscopy. Values of the 2-OHE1:16alpha-OHE1 ratio also differed between the methods, but because the range of values was not large, the magnitude of these differences was not as great. For the ratio, the correlation between methods was excellent, and the ICCs were high for both groups of women. After preservation by boric acid, values of the ratio varied according to acid concentration but not in a linear fashion. Ratio values were similar in urine samples exposed to four different freeze-thaw cycle treatments, although values for all treatments were consistently lower in one batch. Because batch-to-batch variability was not negligible, it is advisable that matched cases and controls be analyzed in the same batch. Provided this is done, the relatively low assay coefficient of variation and high ICC demonstrate that the new ELISA kit can reliably measure the 2-OHE1:16alpha-OHE1 ratio and detect small case-control differences in large population-based studies, where rapid and relatively easy laboratory methods are critical.

Boric Acids↗

[Reproducibility of cytologic diagnosis: study of CRISAP Ile-de-France].

The cervical Pap smear is the method of choice for early detection of precancerous cervical lesions. However, the sensitivity of the Pap smear is not perfect, nor is the specificity, in particular for minor atypia; quality control is the best method to improve the efficiency of the test. The "Centre de regroupement informatique et statistique des données en anatomie pathologique" (CRISAP) Ile-de-France has initiated an external quality control with a protocol aimed at assessing diagnosis reproducibility among observers. Thirteen pathologists agreed to participate on a voluntary basis fur this protocol, which consisted of the rereading of 650 slides chosen at random. Each participant reread 50 cases and sent 50 cases to be reread anonymously. The diagnosis was given according to the Bethesda classification. The reproducibility was assessed using the percentage of agreement and kappa statistics. The percentage of agreement for the whole group was 65% and the weighted kappa 0.66. When normal and unsatisfactory cases were combined as negative and atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LGSIL) and high-grade squamous intraepithelial lesion (HGSIL) as positive, the percentage of agreement was 83% and Kappa 0.66. When normal, unsatisfactory and ASCUS were combined as negative and LGSIL and HGSIL as positive, the percentage agreement raised to 90% and kappa to 0.76. This attempt at assessing the reproducibility of cytologic diagnosis using an informal method had led to good participation among participants. A fairly good agreement for overall cytologic diagnosis was found, though some variability remained concerning the diagnosis of unsatisfactory and those labelled as ASCUS. These results should lead the participants to reflect upon and eventually reassess their criteria on these specific cases.

Female↗

Quantitative ultrasound of the proximal phalanges: reproducibility in erosive and nodal osteoarthritis of the hands.

The aims of the study were to evaluate the reproducibility of quantitative ultrasound (QUS) densitometry of the hands and to verify whether this method is sensitive to phalangeal bone changes occurring in osteoarthritis patients and in erosive osteoarthritis patients. We studied 60 postmenopausal women (aged 63.8 +/- 3.2): 20 had osteoarthritis, 20 had erosive osteoarthritis, 20 were postmenopausal without local pathology of the hand and eight were premenopausal (aged 23.5 +/- 3.4). The patients were evaluated by means of a DBM Sonic 1200 which is able to evaluate ultrasound transmission velocity (amplitude-dependent speed of sound). The results indicated good intra- and interoperator reproducibility (coefficient of variation = 0.99% and 1.04%) in the premenopausal group. The ultrasound device was able to discriminate between the different groups and detected differences between the QUS values of erosive osteoarthritis patients, osteoarthritis patients and control subjects. QUS densitometry is reproducible and sensitive to bone changes occurring in patients with osteoarthritis and as well as in those with erosive osteoarthritis.

Absorptiometry, Photon↗

[Validity and reproducibility of a semi-quantitative food frequency questionnaire for nutritional education of patients of diabetes mellitus (FFQW65)].

BACKGROUND: A self-administered semi-quantitative food frequency questionnaire with 65 food lists (FFQW65) was developed for the nutritional education of patients of diabetes mellitus. METHODS: Relative validity and reproducibility of nutrient intakes as assessed by FFQW65 were investigated in volunteers of 71 males. To assess the relative validity, a one-week diet record was used as a reference. The FFQW65 was administered twice at an interval of 10 month in order to assess the reproducibility. Log transformed data was used to obtain Pearson correlation coefficients. RESULTS: As for the validity, Pearson correlation coefficient of total energy intake of breakfast was 0.74 and the relative difference between predicted value and diet record was relatively small (the difference was -5 kcal and relative difference rate was 1.1%). Compared with breakfast, those for lunch, supper and one-day total energy intakes were relatively lower (0.52, 0.66 and 0.64, respectively) and the relative differences were around 10%, respectively. The one-day intakes of sixteen nutrients (except for potassium and niacin) ranged from 0.28 to 0.64. Energy adjusted correlation coefficients for protein, iron and cholesterol were low (0.16, 0.14 and 0.19, respectively). Those for the other thirteen nutrients ranged from 0.26 to 0.65. As for the reproducibility, the second survey using FFQW65 was administered to 64 males. Pearson correlation coefficient of one-day total energy intake was 0.76 and those for the other nutrients ranged from 0.54 (vitamin D) to 0.81 (calcium). CONCLUSION: The results suggest that FFQW65 can be used for the evaluation of energy intake by usual meals for nutrition education of patients of diabetes mellitus.

Diabetes Mellitus↗