Dataset Information

Inter-tester reproducibility and inter-method agreement of two variations of the Beighton test for determining Generalised Joint Hypermobility in primary school children.

ABSTRACT: BACKGROUND: The assessment of Generalised Joint Hypermobility (GJH) is usually based on the Beighton tests, which consist of a series of nine tests. Possible methodological shortcomings can arise, as the tests do not include detailed descriptions of performance, interpretation nor classification of GJH. The purpose of this study was, among children aged 7-8 and 10-12 years, to evaluate: 1) the inter-tester reproducibility of the tests and criteria for classification of GJH for 2 variations of the Beighton test battery (Methods A and B) with a variation in starting positions and benchmarks between methods, and 2) the inter-method agreement for the two batteries. METHODS: A standardised three-phase protocol for clinical reproducibility studies was followed including a training phase, an overall agreement phase and a study phase. The number of participants in the three phases was 10, 70 and 39 respectively. For the inter-method study a total of 103 children participated. Two testers judged each test battery. A score of ? 5 was set as the cut-off level for GJH. Cohen's kappa statistics and McNemar's test were used to test for agreement and significant differences. RESULTS: Kappa values for GJH (? 5) were 0.64 (Method A, prevalence 0.42) and 0.59 (Method B, prevalence 0.46), with no difference between testers in Method A (p = 0.45) and B (p = 0.29). Prevalence of GJH in the inter-method study was 31% (A) and 35% (B) with no difference between methods (p = 0.54). CONCLUSIONS: Inter-tester reproducibility of Methods A and B was moderate to substantial, when following a standardised study protocol. Both test batteries can be used in the same children population, as there was no difference in prevalence of GJH at cut point 5, when applying method A and B. However, both methods need to be tested for their predictive validity at higher cut-off levels, e.g. ? 6 and ? 7.

SUBMITTER: Junge T

PROVIDER: S-EPMC3878084 | biostudies-other | 2013

REPOSITORIES: biostudies-other

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Inter-tester reproducibility and inter-method agreement of two variations of the Beighton test for determining Generalised Joint Hypermobility in primary school children.

Junge Tina T Jespersen Eva E Wedderkopp Niels N Juul-Kristensen Birgit B

BMC pediatrics 20131221

<h4>Background</h4>The assessment of Generalised Joint Hypermobility (GJH) is usually based on the Beighton tests, which consist of a series of nine tests. Possible methodological shortcomings can arise, as the tests do not include detailed descriptions of performance, interpretation nor classification of GJH. The purpose of this study was, among children aged 7-8 and 10-12 years, to evaluate: 1) the inter-tester reproducibility of the tests and criteria for classification of GJH for 2 variation ...[more]

PMID: 24358988

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Project description:IntroductionEhlers-Danlos syndromes (EDS)/generalised hypermobility spectrum disorders (G-HSD) affect the connective tissue of the body and present with a heterogeneous set of symptoms that pose a challenge for diagnosis. One of the main diagnostic criteria of EDS/G-HSD is generalised joint hypermobility, which is currently assessed by clinicians during a physical exam. However, the practice for measuring joint hypermobility is inconsistent between clinicians, leading to high inter-rater variability. Often patients are misdiagnosed with EDS/G-HSD based on an incorrect hypermobility assessment, leading to increased referral rates and resource utilisation at specialised EDS clinics that results in unnecessary emotional distress for patients. An objective, validated and scalable method for assessing hypermobility might mitigate these issues and result in improved EDS/G-HSD patient care.Methods and analysisThis study will examine the use of videos obtained using a smartphone camera to assess the range of motion (ROM) and hypermobility of the joints assessed in Beighton score and more (spine, shoulders, elbows, knees, ankles, thumbs and fifth fingers) in individuals with suspected EDS/G-HSD. Short videos of participants will be captured as they undergo a formal assessment of joint hypermobility at the GoodHope EDS Clinic at Toronto General Hospital. Clinicians will measure the ROM at each joint using a clinical-grade goniometer to establish ground truth measurements. Open-source human pose-estimation libraries will be used to extract the locations of key joints from the videos. Deterministic and machine learning systems will be developed and evaluated for estimating the ROM at each joint. Results will be analysed separately for each joint and human pose-estimation library.Ethics and disseminationThis study was approved by the Research Ethics Board of the University Health Network in Toronto on 26 April 2022. Participants will provide written informed consent. Findings from this study will be published in peer-reviewed journals and presented at conferences.Trial registration numberNCT05366114.

Project description:Objectives To explore agreement among healthcare professionals assessing eligibility for work disability benefits.Design Systematic review and narrative synthesis of reproducibility studies.Data sources Medline, Embase, and PsycINFO searched up to 16 March 2016, without language restrictions, and review of bibliographies of included studies.Eligibility criteria Observational studies investigating reproducibility among healthcare professionals performing disability evaluations using a global rating of working capacity and reporting inter-rater reliability by a statistical measure or descriptively. Studies could be conducted in insurance settings, where decisions on ability to work include normative judgments based on legal considerations, or in research settings, where decisions on ability to work disregard normative considerations. : Teams of paired reviewers identified eligible studies, appraised their methodological quality and generalisability, and abstracted results with pretested forms. As heterogeneity of research designs and findings impeded a quantitative analysis, a descriptive synthesis stratified by setting (insurance or research) was performed.Results From 4562 references, 101 full text articles were reviewed. Of these, 16 studies conducted in an insurance setting and seven in a research setting, performed in 12 countries, met the inclusion criteria. Studies in the insurance setting were conducted with medical experts assessing claimants who were actual disability claimants or played by actors, hypothetical cases, or short written scenarios. Conditions were mental (n=6, 38%), musculoskeletal (n=4, 25%), or mixed (n=6, 38%). Applicability of findings from studies conducted in an insurance setting to real life evaluations ranged from generalisable (n=7, 44%) and probably generalisable (n=3, 19%) to probably not generalisable (n=6, 37%). Median inter-rater reliability among experts was 0.45 (range intraclass correlation coefficient 0.86 to κ-0.10). Inter-rater reliability was poor in six studies (37%) and excellent in only two (13%). This contrasts with studies conducted in the research setting, where the median inter-rater reliability was 0.76 (range 0.91-0.53), and 71% (5/7) studies achieved excellent inter-rater reliability. Reliability between assessing professionals was higher when the evaluation was guided by a standardised instrument (23 studies, P=0.006). No such association was detected for subjective or chronic health conditions or the studies' generalisability to real world evaluation of disability (P=0.46, 0.45, and 0.65, respectively).Conclusions Despite their common use and far reaching consequences for workers claiming disabling injury or illness, research on the reliability of medical evaluations of disability for work is limited and indicates high variation in judgments among assessing professionals. Standardising the evaluation process could improve reliability. Development and testing of instruments and structured approaches to improve reliability in evaluation of disability are urgently needed.

Project description:BackgroundGeneralised joint hypermobility (GJH) has been associated with an increased risk of suffering an anterior cruciate ligament (ACL) injury. Patients with GJH exhibit lower muscle strength and poorer scores for patient-reported outcomes after ACL reconstruction, compared with patients without GJH. The aim of this study was to examine differences in the percentages of patients who return to sport (RTS) or pre-injury level of activity (RTP), muscle function and patient-reported outcomes at the time of RTS or RTP, as well as the time of RTS or RTP in patients with GJH compared with patients without GJH in the first two years after ACL reconstruction.MethodsThis prospective study used data from an ACL- and rehabilitation-specific register located in Gothenburg, Sweden. Patients aged between 16 and 50, who had a primary ACL injury treated with reconstruction, were included. Data up to two years after ACL reconstruction were used and consisted of achieving RTS and RTP, results from isokinetic muscle function tests for knee extension and flexion and patient-reported outcomes (Knee Self-Efficacy Scale, Knee injury and Osteoarthritis Outcome Score and ACL-Return to Sport after Injury scale) at the time of RTS, as well as the time of RTP. A Beighton Score of ≥ 5/9 was used to define GJH. A Tegner Activity Scale of ≥ 6 was used to define RTS, while a Tegner equal to or above pre-injury level was used to define RTP.ResultsA total of 1,198 patients (54.7% women) with a mean age of 28.5 ± 8.6 years were included. A smaller proportion of patients with GJH achieved RTS compared with patients without GJH (49.2% vs. 57.3%, Odds ratio: 0.720, p = 0.041). Furthermore, patients with GJH were marginally less symmetrical on the knee extension strength test, expressed as a Limb Symmetry Index, at the time of RTP compared with patients without GJH (87.3 ± 13.5 vs. 91.7 ± 14.3, Cohen's d = 0.142, p = 0.022). No further differences were found between groups regarding any muscle function tests or patient-reported outcomes.ConclusionA smaller proportion of patients with GJH achieved RTS compared with patients without GJH. Patients with GJH displayed less symmetrical knee extension strength at the time of RTP compared with patients without GJH.

Dataset Information

Inter-tester reproducibility and inter-method agreement of two variations of the Beighton test for determining Generalised Joint Hypermobility in primary school children.

Publications

Inter-tester reproducibility and inter-method agreement of two variations of the Beighton test for determining Generalised Joint Hypermobility in primary school children.

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