Accuracy and reliability of measurements obtained with a noncontact tono-pachymeter for clinical use in mass screening.
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ABSTRACT:
SUBMITTER: Lee J
PROVIDER: S-EPMC8076298 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Tidal volume monitoring may help minimize lung injury during respiratory assistance. Surface imaging using time-of-flight camera is a new, non-invasive, non-contact, radiation-free, and easy-to-use technique that enables tidal volume and respiratory rate measurements. The objectives of the study were to determine the accuracy of Time-of-Flight volume (VTTOF) and respiratory rate (RRTOF) measurements at the bedside, and to validate its application for spontaneously breathing patients under high flow nasal canula. Data analysis was performed within the ReaSTOC data-warehousing project (ClinicalTrials.gov identifier NCT02893462). All data were recorded using standard monitoring devices, and the computerized medical file. Time-of-flight technique used a Kinect V2 (Microsoft, Redmond, WA, USA) to acquire the distance information, based on measuring the phase delay between the emitted light-wave and received backscattered signals. 44 patients (32 under mechanical ventilation; 12 under high-flow nasal canula) were recorded. High correlation (r = 0.84; p < 0.001), with low bias (-1.7 mL) and acceptable deviation (75 mL) was observed between VTTOF and VTREF under ventilation. Similar performance was observed for respiratory rate (r = 0.91; p < 0.001; bias < 1b/min; deviation ≤ 5b/min). Measurements were possible for all patients under high-flow nasal canula, detecting overdistension in 4 patients (tidal volume > 8 mL/kg) and low ventilation in 6 patients (tidal volume < 6 mL/kg). Tidal volume monitoring using time-of-flight camera (VTTOF) is correlated to reference values. Time-of-flight camera enables continuous and non-contact respiratory monitoring under high-flow nasal canula, and enables to detect tidal volume and respiratory rate changes, while modifying flow. It enables respiratory monitoring for spontaneously patients, especially while using high-flow nasal oxygenation.
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Project description:Background: To assess whether the linear measurements obtained from stitched cone beam computed tomography (CBCT) images were as accurate as the direct skull measurements. Methods: Nine dry human skulls were marked with gutta-percha at reference points to obtain Twenty-two linear measurements on each skull. Ten measurements in the cranio-caudal plane, two measurements in the antero-posterior plane, and ten measurements in the medio-lateral plane. CBCT linear measurements obtained using stitching software were measured and compared with direct skull measurements. Results: The absolute Dahlberg error between direct linear measurements and linear measurements on stitched CBCT images ranged from (0.07 mm to 0.41 mm). The relative Dahlberg error ranged from (0.2% to 1.8%). Moreover, Intra-class Correlation Coefficient (ICC) ranged from (0.97 to 1.0) indicating excellent agreement. Conclusion: Stitched CBCT linear measurements were highly comparable to the direct skull measurements using a digital caliper.
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Project description:Natural products chemistry is the discipline that lies at the heart of modern pharmacognosy. The field encompasses qualitative and quantitative analytical tools that range from spectroscopy and spectrometry to chromatography. Among other things, modern research on crude botanicals is engaged in the discovery of the phytochemical constituents necessary for therapeutic efficacy, including the synergistic effects of components of complex mixtures in the botanical matrix. In the phytomedicine field, these botanicals and their contained mixtures are considered the active pharmaceutical ingredient (API), and pharmacognosists are increasingly called upon to supplement their molecular discovery work by assisting in the development and utilization of analytical tools for assessing the quality and safety of these products. Unlike single-chemical entity APIs, botanical raw materials and their derived products are highly variable because their chemistry and morphology depend on the genotypic and phenotypic variation, geographical origin and weather exposure, harvesting practices, and processing conditions of the source material. Unless controlled, this inherent variability in the raw material stream can result in inconsistent finished products that are under-potent, over-potent, and/or contaminated. Over the decades, natural product chemists have routinely developed quantitative analytical methods for phytochemicals of interest. Quantitative methods for the determination of product quality bear the weight of regulatory scrutiny. These methods must be accurate, precise, and reproducible. Accordingly, this review discusses the principles of accuracy (relationship between experimental and true value), precision (distribution of data values), and reliability in the quantitation of phytochemicals in natural products.
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Project description:BACKGROUND:An apical shift in the position of the gingiva beyond the cemento-enamel junction leads to gingival recession. This study aimed to evaluate the reproducibility of digital measurements of gingival recession when compared to conventional measurements taken clinically using periodontal probes. METHODS:Gingival recession was measured at 97 sites in the oral cavity by four examiners using the following methods: CP, direct measurement of gingival recession using William's periodontal probe intraorally; CC, measurements on cast models using a caliper; DP, digital measurement on virtual models obtained by intraoral scanning, and DC, digital measurements on virtual models of dental casts. Intra-class and inter-rater correlations were analyzed. Bland Altman plots were drawn to visually determine the magnitude of differences in any given pair-wise measurements. RESULTS:In this study, good inter-methods reliability was observed for almost all the examiners ranging from 0.907 to 0.918, except for one examiner (0.837). The greatest disagreements between the raters were observed for methods; CP (0.631) followed by CC (0.85), while the best agreements were observed for methods DP (0.9) followed by DC (0.872). CONCLUSION:Variations in measurements between examiners can be reduced by using digital technologies when compared to conventional methods. Improved reproducibility of measurements obtained via intraoral scanning will increase the validity and reliability of future studies that compare different treatment modalities for root coverage.
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Project description:ObjectiveTo evaluate the accuracy and reliability of a simple, single-camera smartphone-based method, named the Reflex Tracker (RT) system, for measuring reflex threshold angles related to ankle clonus and quadriceps hyperreflexia.DesignA prospective comparison study using a high-fidelity reference standard was constructed employing a 2 × 2 × 2 factorial design, with factors of rater (tester) type (student and experienced physical therapist), joint (ankle and knee), and repetition (2 per condition).SettingThis multicenter study was conducted at 4 outpatient rehabilitation clinics.ParticipantsA convenience sample of 14 individuals with a neurologic condition presented with 20 lower limbs that exhibited ankle clonus and/or quadriceps hyperreflexia and were included in the study. Also participating in the study were 8 student and 8 experienced physical therapist raters (testers) (N=16).InterventionsNot applicable.Main outcome measuresThe plantar flexor reflex threshold angle (PFRTA) related to ankle clonus and the quadriceps reflex threshold angle (QRTA) related to quadriceps hyperreflexia were quantified.ResultsPFRTA and QRTA results were compared between the smartphone RT method and synchronous 3-dimensional inertial measurement unit (IMU) sensor motion capture. Mean difference (bias) was minimal between RT and IMU measurements for PFRTA (bias≤0.2°) and QRTA (bias≤1.2°). Intrarater reliability for PFRTA ranged from 0.85-0.90 using RT and from 0.85-0.87 using IMU; QRTA ranged from 0.97-0.98 using RT and from 0.96-0.99 using IMU. Intersensor reliability for PFRTA and QRTA was 0.97 and 0.99, respectively. Minimum detectable change for PFRTA ranged from 7.1°- 8.7° and for QRTA ranged from 6.1°-8.3°.ConclusionsRT performed comparable to IMU for accurate and reliable measurement of PFRTA and QRTA to quantify ankle clonus and quadriceps hyperreflexia in clinical settings.
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Project description:AimTo evaluate time, reliability and accuracy of craniofacial measurements with a 3D light scanner, considering prior demarcation of surface points on the face.Materials and methodsEleven facial measurements of 15 volunteers were obtained by a scanner (Artec Eva TM) and by a caliper directly on the face, with or without demarcation of facial reference points. Inter and intra-method comparison were examined by intraclass correlation coefficient and analysis of random error by the Dahlberg formula. Agreement between the methods was analyzed by the Bland-Altman. A Wilcoxon test was used to compare the time for each method, at p < 0.05.ResultsMarking points on the face improved accuracy for both methods. In the inter-methods analysis with landmarks, the scanner showed excellent reliability in all measures (ICC = 0.92-0.97, p < 0.0001). Measurements accuracy with scanner was around 2 mm when the points were not previously marked and about 1 mm when the points were marked. Measures taken with the scanner, however, took twice as long, compared with the direct method.ConclusionsCraniofacial measurements obtained with scanner showed excellent reliability and accuracy, which qualifies this method for clinical and scientific use. Accuracy is improved when the points were previously marked on face. However, the time needed to obtain measurements is greater than about 4 min for the direct method.
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Project description:PurposeTo evaluate the accuracy of the new Tono-Vera rebound tonometer (Reichert Inc, Buffalo, NY) compared to Goldmann Applanation Tonometry.MethodsThis prospective, observational, cross-sectional study was designed in accordance with ANSI Z80.10-2014 and ISO 8612-2009 guidelines for tonometer comparison. Intraocular Pressure (IOP) was measured by Goldmann Applanation and Tono-Vera on 160 eyes of 160 subjects. Corneal Astigmatism and Central Corneal Thickness were also measured. A single investigator (CN) conducted all measurements. The average of two measurements from each tonometer was used in the analysis. Bland-Altman plots, total least squares regression analysis, and simple linear regression were used to evaluate agreement between the tonometers.ResultsAverage IOP values from Goldmann Applanation and Tono-Vera were not significantly different (19.17 and 19.03 respectively, p=0.40, paired t-test). The total least squares regression analysis indicated strong agreement between the two tonometers (slope +0.97, offset +0.49 mmHg, standard deviation 2.11 mmHg). There were 2 IOP measurement pairs that exceeded the ± 5 mmHg limits of agreement required in ANSI Z80.10-2014 and ISO 8612-2009, which is within the range of acceptability specified in the standards.ConclusionWe evaluated IOP measurements by Tono-Vera Rebound Tonometer vs Goldmann Applanation Tonometry for eyes with a wide range of IOP values and found no statistically significant differences in the results. Tono-Vera meets the requirements of ANSI Z80.10-2014 and ISO 8612-2009, demonstrating accuracy comparable to Goldmann tonometry.
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Project description:BackgroundCurrent methods of assessing competence in acquiring point-of-care ultrasound images are inadequate. They rely upon cumbersome rating systems that do not depend on the actual outcome measured and lack evidence of validity. We describe a new method that uses a rigorous statistical model to assess performance of individual trainees based on the actual task, image acquisition. Measurements obtained from the images acquired (the actual desired outcome) are themselves used to validate effective training and competence acquiring ultrasound images. We enrolled a convenience sample of 21 spontaneously breathing adults from a general medicine ward. In random order, two trainees (A and B) and an instructor contemporaneously acquired point-of-care ultrasound images of the inferior vena cava and the right internal jugular vein from the same patients. Blinded diameter measurements from each ultrasound were analyzed quantitatively using a multilevel model. Consistent mean differences between each trainee's and the instructor's images were ascribed to systematic acquisition errors, indicative of poor measurement technique and a need for further training. Wider variances were attributed to sporadic errors, indicative of inconsistent application of measurement technique across patients. In addition, the instructor recorded qualitative observations of each trainee's performance during image acquisition.ResultsFor all four diameters, the means and variances of measurements from trainee A's images differed significantly from the instructor's, whereas those from trainee B's images were comparable. Techniques directly observed by the instructor supported these model-derived findings. For example, mean anteroposterior diameters of the internal jugular vein obtained from trainee A's images were 3.8 mm (90% CI 2.3-5.4) smaller than from the instructor's; this model-derived finding matched the instructor's observation that trainee A compressed the vein during acquisition. Instructor summative assessments agreed with model-derived findings, providing internal validation of the descriptive and quantitative assessments of competence acquiring ultrasound images.ConclusionsClinical measurements obtained from point-of-care ultrasound images acquired contemporaneously by trainees and an instructor can be used to quantitatively assess the image acquisition competence of specific trainees. This method may obviate resource-intensive qualitative rating systems that are based on ultrasound image quality and direct observation, while also helping instructors guide remediation.
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Project description:BackgroundDetermining the reliability and predictive validity of office blood pressure (OBP), ambulatory BP (ABP), and home BP (HBP) can inform which is best for diagnosing hypertension and estimating risk of cardiovascular disease.ObjectivesThis study aimed to assess the reliability of OBP, HBP, and ABP and evaluate their associations with left ventricular mass index (LVMI) in untreated persons.MethodsThe Improving the Detection of Hypertension (IDH) study, a community-based observational study, enrolled 408 participants who had OBP assessed at 3 visits, and completed 3 weeks of HBP, 2 24-h ABP recordings, and a 2-dimensional echocardiogram. Mean age was 41.2 ± 13.1 years, 59.5% were women, 25.5% African American, and 64.0% Hispanic.ResultsThe reliability of 1 week of HBP, 3 office visits with mercury sphygmomanometry, and 24-h ABP were 0.938, 0.894, and 0.846 for systolic and 0.918, 0.847, and 0.843 for diastolic BP, respectively. The correlations among OBP, HBP, and ABP, corrected for regression dilution bias, were 0.74 to 0.89. After multivariable adjustment including OBP and 24-h ABP, 10 mm Hg higher systolic and diastolic HBP were associated with 5.07 (standard error [SE]: 1.48) and 3.92 (SE: 2.14) g/m2 higher LVMI, respectively. After adjustment for HBP, neither systolic or diastolic OBP nor ABP was associated with LVMI.ConclusionsOBP, HBP, and ABP assess somewhat distinct parameters. Compared with OBP (3 visits) or 24-h ABP, systolic and diastolic HBP (1 week) were more reliable and more strongly associated with LVMI. These data suggest that 1 week of HBP monitoring may be the best approach for diagnosing hypertension.
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Project description:Quantifying hearing thresholds via mobile self-assessment audiometric applications has been demonstrated repeatedly with heterogenous results regarding the accuracy. One important limitation of several of these applications has been the lack of appropriate calibration of their core technical components (sound generator and headphones). The current study aimed at evaluating accuracy and reliability of a calibrated application (app) for pure-tone screening audiometry by self-assessment on a tablet computer: Audimatch app installed on Apple iPad 4 in combination with Sennheiser HDA-280 headphones. In a repeated-measures design audiometric thresholds collected by the app were compared to those obtained by standardized automated audiometry and additionally test-retest reliability was evaluated. Sixty-eight participants aged 19-65 years with normal hearing were tested in a sound-attenuating booth. An equivalence test revealed highly similar hearing thresholds for the app compared with standardized automated audiometry. A test-retest reliability analysis within each method showed a high correlation coefficient for the app (Spearman rank correlation: rho = 0.829) and for the automated audiometer (rho = 0.792). The results imply that the self-assessment of audiometric thresholds via a calibrated mobile device represents a valid and reliable alternative for stationary assessment of hearing loss thresholds, supporting the potential usability within the area of occupational health care.
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