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At least 163 records · Page 9Linked to original sources

PubMed2000

Application of a disease-specific, quality-of-life measure (QoL-AGHDA) in growth hormone-deficient adults and a random population sample in Sweden: validation of the measure by rasch analysis.

OBJECTIVE: Growth hormone deficiency (GHD) in adults has been associated with impaired health status and quality of life (QoL) in several studies using generic measures, and in a few studies using recently developed disease-specific measures. Theoretically, disease-specific measures may be more sensitive and succinct than generic measures, and hence prove convenient for general use in clinical practice. The present study sought to validate the scaling properties of the disease-specific QoL-AGHDA measure through the implementation of Rasch analysis. The study also sought to compare, by using the QoL-AGHDA, the QoL of a relatively large Swedish cohort of adults with untreated GHD with that of a reference population also from Sweden. PATIENTS: The QoL of 111 adults with untreated GHD from Stockholm and Göteborg was compared with that of 1448 adult subjects randomly selected from the population of Göteborg. MEASUREMENTS: The scaling properties of the QoL-AGHDA were assessed by investigating its fit to a dichotomous Rasch model. Rasch-transformed QoL scores from the QoL-AGHDA questionnaire were stratified by age and gender, and 95% confidence intervals were calculated. RESULTS: Rasch analysis of the QoL-AGHDA indicated the measure to be robust in terms of its unidimensionality and ordering properties, and lack of differential item functioning. The raw scores produced by the QoL-AGHDA are at the ordinal level. Non-overlapping 95% confidence intervals of Rasch-transformed interval scores in most age categories indicated that men and women with GHD had significantly lower QoL than the reference population. CONCLUSION: The Swedish QoL-AGHDA has good scaling properties, and hence can be considered a robust measure. It is suitable for assessing quality of life in adults with GH deficiency, and for making comparisons with adults who are not growth hormone deficient. Adult GH deficiency is associated with a significant impairment in QoL.

Adult↗

PubMed2002

Measuring outcomes with tools of proven feasibility and utility: the example of a patient-focused asthma measure.

Best quality care is clearly desirable and instituting quality assurance should be logical and simple. However, the practicality of setting standards for a product or service, and designing systems to measure against the standards, is more difficult. In the health service it is only likely to be feasible if data can be generated from efficient and reliable information systems. The ideal measure of quality is an outcome measure that evaluates whether or not the quality of care has achieved the desired standard of outcome. Direct measures of outcome are not easy to construct and the information systems required to provide data are not widely available. The National Centre for Health Outcomes Development (NCHOD) has produced a series of indicators in 10 areas of health care, where an indicator is a pointer to, rather than a direct measure of, a desired outcome. Feasibility studies measuring their sensitivity and reliability have drawn attention to their possible utility within different health care settings. This paper reports on an investigation into a patient-focused outcome indicator for asthma. There is broad agreement about the need to measure the outcome of disease. However, when outcome indicators are defined there are major obstacles to their successful uptake. A key challenge for outcomes measurement is to ensure that the cost of collecting the data and ensuring completeness, accuracy and standardization are justified by the benefits derived. Health outcome indicators should not be treated as a panacea, but as a part of the clinical and health care tool kit.

Algorithms↗

PubMed2003

Threshold measurements: ten rules for good measuring practice.

The following rules for professionally measuring thresholds are derived and discussed: RULE 1: Thresholds should be expressed as voltage averaged over pulse duration to get reproducible and comparable results! RULE 2: Pacing threshold measurements with exponentially decaying pulses should not be extended beyond 1.4 ms as that portion of the pulse below rheobase does not contribute to the stimulation effect! RULE 3: Threshold measurements are best carried out with fixed pulse duration and variable voltage! RULE 4: If threshold measurements are carried out in discrete steps, the steps should be chosen such that the relative step size is as equal as possible! RULE 5: Accuracy of threshold measurements is highly increased if the arithmetically averaged value of the last effective and the first ineffective pulse is defined as threshold! RULE 6: To determine strength-duration-curves, a linear regression of the quantity versus pulse duration should be calculated which yields simply the numerical values of the chronaxie and rheobase! RULE 7: To reach representative strength-duration-curves, measurements with at least four pairs of values must be carried out! RULE 8: Measuring defibrillation thresholds, the relative voltage step size should be chosen equally to have equal accuracy for all steps. RULE 9: If the result of a defibrillation threshold investigation does not reach significance, a too large voltage step size could be an explanation! RULE 10: Comparing intraindividually the threshold of two different defibrillation systems or parameter settings, the threshold ratios should be formed and averaged! Obeying these rules guaranties professional threshold measurements expressed as "rheobase" and "chronaxie" even with devices with discrete steps in parameter programming.

Cardiac Pacing, Artificial↗

PubMedDate not supplied

A comparison of 4 common methods of hand-measured techniques with a computerized technique to measure the first intermetatarsal angle.

Measurement of the intermetatarsal (IM) angle on plain dorsoplantar radiographs is considered a standard in the surgical evaluation of hallux valgus. The angle formed in this measurement helps determine the selection of surgical procedure. A study was performed to determine the most consistent method to radiographically measure the first IM angle. The IM angle was measured manually with a tractograph by using 4 different techniques on 50 preoperative dorsoplantar radiographs. The techniques used were 1) bisecting the shaft of the first and second metatarsals, 2) bisecting the head and base of the first and second metatarsals (center-of-head method), 3) measuring the angle from the tangent of the medial aspect of the first and the second metatarsal shaft, and 4) measuring the angle formed by the tangent of the lateral aspects of the first and second metatarsal shafts. In addition, the same 50 radiographs were evaluated by a Java software program designed by 1 of the authors to specifically measure the IM angle by bisecting the areas of the first and second metatarsals. A statistical analysis was applied to determine which IM angle of the 4 methods measured by hand was most consistent with the computer-generated IM angle. The median absolute deviation error test was applied to interpret the results. The results showed that the bisection of the shaft of the first and second metatarsals had the smallest mean absolute value of 2.8 degrees (22.37% error), with the other techniques ranging from 3.0 degrees to 3.8 degrees. It appears that the method of bisection of the shafts of the first and second metatarsals provides the most accurate technique compared with the computer-determined technique.

Computer Simulation↗

PubMed2005

Quantum dynamics driven by continuous laser fields under measurements: towards measurement-assisted quantum dynamics control.

We study quantum system dynamics driven by continuous laser fields under the measurement process. In order to take into account the system transition due to the measurement, we define the superoperator which eliminates the coherence relevant to the measured quantum states. We clarify that the dynamics of the measured states is frozen in the frequent measurement limit, while the space spanned by unmeasured states is isolated from the original system. We also derive the effective Liouvillian which governs incoherent population dynamics under the condition, in which measurements are frequently applied. We apply the formulation to two-level and Lambda-type three-level systems and clarify how the quantum measurements hinder the coherent population dynamics driven by the continuous laser fields in practical examples. Analysis on the laser field amplitude dependency of the final distribution in the t-->infinity limit suggests the possibility of the measurement-assisted quantum control.

Journal Article↗

PubMed2000

Measuring quality of life in people referred for specialist care of acne: comparing generic and disease-specific measures.

OBJECTIVE: Our purpose was to compare 3 approaches to the measurement of quality of life in patients referred for specialist care of acne. METHODS: A questionnaire was sent to 130 patients referred for management of their acne. Follow-up questionnaires were sent 4 and 12 months after treatment began. The questionnaire contained a generic index measure (EuroQol EQ-5D), a generic profile measure (Short Form 36), and a disease-specific measure (Dermatology Life Quality Index). Pretreatment results for the EQ-5D were compared with normative data. The responsiveness of the EQ-5D was compared with that of the other measures. RESULTS: Before treatment, the sample reported substantially more pain/discomfort and anxiety/depression on the EQ-5D compared with a population sample. The disease-specific measure was more responsive to change compared with both generic measures. CONCLUSION: Our study highlights the importance of combining information from generic measures with information from instruments designed specifically for use in people with skin disease.

Acne Vulgaris↗

PubMed1998

Importance of measuring CO2-production rate when using 13C-breath tests to measure fat digestion.

Stable isotope breath tests offer a safe, repeatable non-invasive method of measuring fat digestion. They involve the ingestion of a substrate labelled with 13C followed by serial measurements of the 13C:12C ratio in expired CO2, from which the percentage of the 13C dose recovered (PDR) can be calculated. However PDR depends on the CO2-production rate. Our aim was to compare results obtained using directly measured CO2-production rates with those calculated from two predicted values. Twelve normal healthy children and twenty-four children with cystic fibrosis (CF) (without or with the normal dose of enzyme supplementation) were studied with 1,3-distearyl, 2[carboxyl-13C] octanoyl glycerol. The volume of CO2 produced (litres/min) was measured at rest for 30 min approximately 3 h after substrate ingestion, and the results were converted to mmol/min. For each subject the expected BMR was calculated from the equation of Schofield (1985), based on sex, age, weight and height, and from these values, CO2-production rate was derived. Surface area was calculated and an estimated value of 5 mmol/m2 per min (Shreeve et al. 1970) was used. Using these three CO2-production rates, three different PDR were calculated and compared. In healthy children there was a close concordance between measured and predicted CO2-production rates, but children with CF had a mean measured CO2-production rate 39% higher than normal children. This use of normal data for predicted CO2-production rates in children with CF underestimates cumulative PDR. If direct measurements of CO2-production rate are not available or impossible to perform the VCO2 obtained from the BMR calculated using the equations of Schofield (1985) or Shreeve et al. (1970) can be used in normal children. However, if accurate results for PDR are to be obtained, CO2-production rates should be measured when performing breath tests in conditions where energy expenditure and/or CO2-production rate are not expected to be normal.

Breath Tests↗

PubMed1997

Biochemical markers as additional measurements in studies of the accuracy of dietary questionnaire measurements: conceptual issues.

Studies of the accuracy of questionnaire measurements of habitual dietary intakes of individuals are generally based on a comparison with replicate weighed-food consumption records or 24-h recalls used as reference measurements. The correlation between the questionnaire measurements (Q) and the subjects' true long-term intake (T) of foods or nutrients (rho QT) is then estimated from the observed correlation with mean reference measurements, with correction for attenuating effects due to random errors in the reference measurements themselves. For this approach to be valid, it is crucial that these random errors are uncorrelated between questionnaire and reference measurements and between replicate reference measurements. In practice, however, these two criteria are not always fulfilled and rho QT may be systematically overestimated or underestimated. The advantage of using biochemical markers in dietary assessments is that there is often little reason to doubt that their random errors are truly independent of those of both questionnaire measurements and food-consumption records. Thus, the inclusion of such markers in dietary validity studies can make it more likely that the criteria of independent errors, crucial in validity studies, are met.

Biomarkers↗

PubMed1987

Blood flow velocity and systolic time intervals measured by pulsed Doppler ultrasound: reproducibility of measurements.

The reproducibility of measurements of blood flow velocity in the aorta and systolic time intervals using pulsed ultrasound Doppler was determined in 10 subjects. Measurements were made in both the ascending aorta and the aortic arch, and instant maximum as well as instant mean velocities were measured. The smallest variation was found when the maximum velocity was measured in the ascending aorta. The coefficient of variation in measurements was between 6.9% and 13.1%, when determined at intervals of 10-15 min. Again the smallest variation was when the maximum velocity was measured in the ascending aorta. The intraobserver variation was smaller than the interobserver variation (6.9% compared with 10.6%) in the ascending aorta. Both the intraobserver and interobserver variations in systolic time intervals were very small. The mean coefficients of variation were 1.7% for the pre-ejection period (PEP), 1.7% for left ventricular ejection time (LVET), 1.4% for electromechanical systole (QS2), and 2.9% for the PEP:LVET ratio. The mean values of pre-ejection period and left ventricular ejection time were 154 ms and 377 ms, which are a little longer and shorter respectively than measurements made by phonocardiography and pulse pressure monitoring, whereas QS2 was the same (531 ms). The interobserver variations were 2.6%, 2.0%, 1.4%, and 3.9% respectively. It is concluded that pulsed Doppler ultrasound is a reliable method of measuring blood flow velocity and systolic time intervals. Changes in blood flow velocity of 10-12% can be detected by this method.

Adult↗

PubMed1998

How best to measure implementation of school health curricula: a comparison of three measures.

The impact of school health education programs is often attenuated by inadequate teacher implementation. Using data from a school-based nutrition education program delivered in a sample of fifth graders, this study examines the discriminant and predictive validity of three measures of curriculum implementation: class-room observation of fidelity, and two measures of completeness, teacher self-report questionnaire and post-implementation interview. A fourth measure, obtained during teacher observations, that assessed student and teacher interaction and student receptivity to the curriculum (labeled Rapport) was also obtained. Predictive validity was determined by examining the association of implementation measures with three study outcomes; health knowledge, asking behaviors related to fruit and vegetables, and fruit and vegetable intake, assessed by 7-day diary. Of the 37 teachers observed, 21 were observed for two sessions and 16 were observed once. Implementation measures were moderately correlated, an indication of discriminant validity. Predictive validity analyses indicated that the observed fidelity, Rapport and interview measures were significantly correlated with post-test student knowledge. The association between health knowledge and observed fidelity (based on dual observation only), Rapport and interview measures remained significant after adjustment for pre-test knowledge values. None of the implementation variables were significantly associated with student fruit and vegetable intake or asking behaviors controlling for pre-test values. These results indicate that the teacher self-report questionnaire was not a valid measure of implementation completeness in this study. Post-implementation completeness interviews and dual observations of fidelity and Rapport appear to be more valid, and largely independent methods of implementation assessment.

Child↗

PubMed1993

Misclassification bias arising from random error in exposure measurement: implications for dual measurement strategies.

Despite the resulting loss of information, continuous exposure variables are often categorized in epidemiologic data analysis. It has been shown that nondifferential measurement error of exposure can lead to differential misclassification under these circumstances. This paper extends these findings to the misclassification bias that results from nondifferential measurement error if dual measurement strategies are employed with dichotomized exposures. Different scenarios of random measurement error are presented in the context of case-control studies. Although differences in the misclassification rates between cases and controls are generally small, the bias toward the null is usually much weaker than expected under truly nondifferential exposure misclassification even with single exposure measurements. In most cases, the bias is further reduced by the use of dual measurements. Caution is needed, however, if the analysis is restricted to individuals with concordant exposure classifications (both measurements above or both measurements below the cutpoint). In this case, the true exposure-disease association is often overestimated.

Bias↗

PubMed1989

A comparison of two methods to measure coronary flow reserve in the setting of coronary angioplasty: intracoronary blood flow velocity measurements with a Doppler catheter, and digital subtraction cineangiography.

Intracoronary blood flow velocity measurements with a Doppler balloon catheter and the radiographic assessment of myocardial perfusion with contrast media, before and after the intracoronary administration of papaverine, have previously been used to investigate regional coronary flow reserve. In the present study we applied both techniques in 21 patients to measure coronary flow reserve in the setting of coronary angioplasty. Pre-angioplasty (N = 14) and post-angioplasty (N = 19) measurements of coronary flow reserve were obtained by digital subtraction cineangiography in the myocardial region supplied by the dilated coronary artery, and with the Doppler probe in the proximal part of the dilated vessel. The reactive hyperaemia following the final balloon inflation was recorded with the Doppler balloon catheter still positioned across the stenotic lesion. Coronary stenosis geometry was quantified with the Cardiovascular Angiography Analysis System. When the epicardial stenosis was the only factor causing a reduction in coronary flow reserve, flow reserve measured with both digital subtraction cineangiography and with the Doppler probe correlated well with the cross-sectional area at the site of obstruction, r = 0.88, SEE = 0.36 and r = 0.77, SEE = 0.45 respectively. In contrast, when other factors decreasing coronary flow reserve were present (intimal dissection, left ventricular hypertrophy, previous myocardial infarction, collaterals) measurements obtained with both techniques correlated poorly with cross-sectional area (r = 0.55, SEE = 0.57, and r = 0.59, SEE = 0.50). Flow reserve measurements obtained with digital subtraction cineangiography correlated well with the measurements obtained with the Doppler probe (r = 0.85, SEE = 0.38, and r = 0.87, SEE = 0.34), although the two approaches have methodologically nothing in common and their respective regions of interest (myocardium for the radiographic technique and intracoronary lumen for the Doppler technique) are basically different. Furthermore, the reactive hyperaemia following the final balloon inflation was related to the flow reserve measured with both the angiographic technique (r = 0.85, SEE = 0.34) and the Doppler technique (r = 0.83, SEE = 0.32) using pharmacologically induced coronary vasodilation with intracoronary papaverine. This suggests that the same quantity of coronary flow reserve that can be recruited pharmacologically can be recruited by ischaemia following a transluminal occlusion.

Adult↗

PubMed1990

Validity of derived measurements of leg-length differences obtained by use of a tape measure.

Determining the difference in the length of an individual's legs is often an important component of a musculoskeletal examination. Although measurements are easily obtained with a tape measure, the validity of these measurements is not known. The purpose of this study was to examine the validity of determinations of leg-length differences (LLDs) obtained by use of a specified tape measure method (TMM). Leg-length differences using the TMM and a radiographic technique were determined for 10 subjects who were candidates for clinical leg-length measurements and for 9 healthy control subjects. Validity of the TMM measurements was determined by assessing the degree of agreement between TMM-obtained LLDs and those obtained by the radiographic method. Validity estimates as determined by intraclass correlation coefficients (ICCs) were .770 for patients, .359 for healthy subjects, and .683 for all subjects. When the means of the two values obtained by use of the TMM were compared with the radiographic measurements, the ICCs were .852 for the patient group, .637 for the healthy subjects, and .793 for all subjects. This study suggests that TMM-derived LLD measurements are valid indicators of leg-length inequality and that the estimates of validity are improved by using the average of two determinations rather than a single determination.

Adult↗

PubMed1997

Evaluation of index and profile measures of health status in a randomized controlled trial. Comparison of the Medical Outcomes Study 36-Item Short Form Health Survey, EuroQol, and disease specific measures.

OBJECTIVES: The authors compare two generic measures of health status with disease-specific measures in a randomized controlled trial of transurethral resection of the prostate with laser vaporization prostatectomy for benign prostatic hypertrophy. METHODS: Patients entered into the trial completed the following questionnaires prior to treatment and at follow-up at 3 months and 1 year. The Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) is a generic measure that produces an eight-dimension profile as well as two summary measures of health status (the physical component score and the mental component score). The EuroQol provides two single index measures of health status; one intended to convey the utility (or lack of) that an individual derives from his or her own health state compared with alternative states and a second simple visual analog scale "thermometer" of health status. The American Urological Association symptom score and the Bothersome index are disease-specific indices of health status for use specifically with benign prostatic hypertrophy patients. RESULTS: The EuroQol indicates no statistically significant improvements with time for either arm of the trial. The SF-36 physical and general health perceptions domains indicates statistically significant improvements for the transurethral resection of the prostate arm alone at 3 months and 1 year, as do the physical summary score at the 3-month follow-up visit. The effect sizes of these improvements, however, are small, using standard criteria. In contrast, statistically significant differences are found with time for both transurethral resection of the prostate and laser prostatectomy on both disease-specific measures, which also indicate statistically significant superior outcome for the transurethral resection of the prostate arm compared with the laser arm. CONCLUSIONS: The results indicate that the disease-specific measures are more sensitive to change than the generic measures of outcome. Possible explanations for this are discussed.

Follow-Up Studies↗

PubMed2002

Comparison of Portapres non-invasive blood pressure measurement in the finger with intra-aortic pressure measurement during incremental bicycle exercise.

BACKGROUND AND DESIGN: In order to evaluate the accuracy of continuous, non-invasive blood pressure measurements in the finger during stress, blood pressure was measured in six patients with a Portapres Model 2 during increasing levels of bicycle exercise, using simultaneously registered intra-aortic (aortic arch) pressure as a reference. METHODS: Blood pressure was measured continuously and non-invasively in the left middle finger using the Portapres Model 2 device, at the same time invasively using a pigtail catheter situated in the aortic arch at rest and during and after standardized bicycle exercise. At the end of each stress level, in accordance with the protocol of the Association for the Advancement of Medical Instrumentation, systolic and diastolic blood pressure and pulse values were determined from the non-invasive (Portapres Model 2) and invasive measurements for 15 s each, and the mean values and standard deviations were calculated. RESULTS: Compared with simultaneous invasive blood pressure measurement in the aortic arch, the difference in measured blood pressure value (the value determined by the device minus the value determined invasively) at rest fell within the authorized normal range for German and European blood pressure measurement devices: systolic +1.7 +/- 1.8 mmHg and diastolic -3.7 +/- 6.2 mmHg. The difference in measured value increased with the stress level. CONCLUSION: Blood pressure and pulse can be determined reliably and accurately using the Portapres Model 2, non-invasively, both at rest and at low-to-moderate levels of stress.

Adult↗

PubMed2003

Validation of the ROSSMAX blood pressure measuring monitor according to the European Society of Hypertension International Protocol for Validation of Blood Pressure Measuring Devices in Adults.

BACKGROUND: It is now accepted that blood pressure measuring devices should be subjected to an independent evaluation of their accuracy before they are marketed for clinical use. The results of validation of the ROSSMAX Blood Pressure Measuring Monitor for self-measurement according to the European Society of Hypertension International Protocol for Validation of Blood Pressure Measuring Devices in Adults are presented in this paper. POPULATION: Thirty-three subjects were recruited from among staff and patients at Beaumont Hospital, Dublin, Ireland. METHODS: The ROSSMAX monitor was connected to the Sphygmocorder, an audiovisual system for validation, which records blood pressure on tape and video for later analysis. Nine sequential same-arm measurements between the device and a standard mercury sphygmomanometer were recorded using the Sphygmocorder. RESULTS: In phase 1, the ROSSMAX monitor produced 21 measurements within 5 mmHg, 31 within 10 mmHg and 38 within 15 mmHg for systolic blood pressure (SBP), and 36 within 5 mmHg, 43 within 10 mmHg and 45 within 15 mmHg for diastolic blood pressure (DBP). The mean differences were -5.6 (10.2) [mean (SD)] mmHg for SBP and -0.5 (4.5) mmHg for DBP. The ROSSMAX monitor failed to meet any of the criteria for SBP but comfortably passed all of the criteria for DBP. In phase 2.1, the ROSSMAX monitor had 51 measurements within 5 mmHg, 73 within 10 mmHg and 86 within 15 mmHg for SBP, and 71 measurements within 5 mmHg, 93 within 10 mmHg and 98 within 15 mmHg for DBP. The mean differences were -4.5. (9.5) mmHg for SBP and -1.8 (5.0) mmHg for DBP. The ROSSMAX monitor failed to meet any of the criteria for SBP but comfortably passed all of the criteria for DBP. In phase 2.2, 16 subjects had at least two of the differences lying within 5 mmHg and 10 subjects had no differences within 5 mmHg for SBP; 26 subjects had at least two of the differences falling within 5 mmHg and three subjects no differences within 5 mmHg for DBP. The ROSSMAX monitor failed to meet the criteria for SBP but passed the criteria for DBP. CONCLUSIONS: The ROSSMAX monitor cannot be recommended for clinical use in an adult population because it records SBP inaccurately.

Adult↗

PubMed2005

Measurement of intraocular pressure using the NT-4000: a new non-contact tonometer equipped with pulse synchronous measurement function.

PURPOSE: NT-4000 (Nidek Co. Ltd., Gamagori, Japan) is a new non-contact tonometer (NCT) equipped with pulse synchronous measurement function that can measure intraocular pressure (IOP) synchronized with the ocular pulse. The purpose of this study was to evaluate the usefulness of NT-4000 in normal subjects and in patients with glaucoma and ocular hypertension. METHODS: This study included 175 eyes of 175 subjects. Firstly, the IOP was measured using NT-4000 without the pulse synchronous measurement function (NTn). Secondly, the IOP at peak, middle, and trough phases of the pulse signal were measured using NT-4000 with the pulse synchronous measurement function (NTp, NTm, NTt, respectively). Additionally, the IOP was measured with Goldmann applanation tonometer (GT). The coefficient of variation (CV) of three readings in the NCT measurements was used to evaluate the intra-session reproducibility. Statistical comparisons were performed using Wilcoxon signed rank test and one-way analysis of variance with Scheffe's test. Linear regression analysis was used to calculate correlation coefficients. P values less than 0.05 were accepted as statistically significant. RESULTS: The CV of NTn, NTp, NTm, and NTt were 6.4%, 5.5%, 4.9%, and 5.2%, respectively. The CV of NTp, NTm, and NTt were significantly smaller than that of NTn (P = 0.007, P < 0.001, P < 0.001, respectively). NTp was significantly higher than NTt (P = 0.038). GT was significantly correlated with NTn, NTp, NTm, and NTt (r = 0.898, P < 0.001; r = 0.912, P < 0.001; r = 0.908, P < 0.001; r = 0.900, P < 0.001, respectively). CONCLUSION: NT-4000 can detect the fluctuation of IOP associated with the ocular pulse.

Adult↗

PubMed2005

What's measured is not necessarily managed: cognitive contingencies of organizational measurement.

Organizational measurement is necessary for managing incremental improvements or change efforts. Some have argued that indicators of financial performance measure the past and should be joined by "lead" measures such as management development and customer relations, assumed to be drivers of performance. Approaches of "lead" measures have met criticism for not contributing to operational management. The present is an empirical case study where measures from a customer satisfaction survey and a management assessment instrument were analyzed and compared to actual measures of financial performance. The effects of measures obtained seem to depend on the interpretations and reflection taking place in the organization. The pursuit of "lead" indicators did not seem to drive results. Counter-intuitively, higher scores on these measures were related to poorer financial performance. The explication of and reflection on the underlying dynamic seemed to turn the development in a profitable direction.

Adult↗