Pelvic Floor Muscle Electromyography as a Guiding Tool During Lead Placement and (Re)Programming in Sacral Neuromodulation Patients: Validity, Reliability, and Feasibility of the Technique
Donald VaganéeSigrid Van de BornePetra Voorham‐van der ZalmJeroen VoorhamErik FransénStefan De Wachter
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Keywords:
Repeatability
Concurrent validity
Neuromodulation
Lead (geology)
Pelvic Floor Muscle
Sensory threshold
Objective To study the repeatability and consistency of normal female pelvic floor structure using transperineal real-time three-dimensional ultrasound.Methods Forty-two cases of normal adult female were evaluated by two different experience operator, using the real-time three-dimensional ultrasound diagnostic apparatus. The bladder neck movement degrees and the levator hiatus area were observed after Valsalva condition. Differences between the groups were compared. Intraclass correlation coefficient （ICC）, the coefficient of variation （CV） and Bland-Ahman analysis of consistency were evaluated. Results The bladder neck movement degrees and the levator hiatus area measured by the experienced operator （operator 1） and less experienced operator（operator 2） were （18.48 ± 5.84）cm and （17.79 ± 5.48） cm, （17.53± 3.95）cm^2 and （17.31 ± 4.32）cm^2 , respectively.There was no significant difference between the two operators （P 〉 0.05）. The intra-ICC were 0.89 and 0.90, CV were 7.26M and 3.03%. Experienced operator repeatability （ICC = 0.99,0.94） was slightly higher than the less experienced researchers （ICC 0.92,0.81）.The analysis results of Bland-Ahman image showed good consistency between two different operators.Conclusions The current study proves real-time three-dimensional ultrasound is a reproducible method for female pelvic floor structure assessment, and the reproducibility is very well. The detection performance of experienced operator slightly better than the one with less experience, strengthen the training of junior doctors may further improve the accuracy of measurement.
Key words:
Uhrasonography, three-dimensional; Pelvic floor ; Reproducibility of results
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Valsalva maneuver
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Accurate and repeatable measurements of the retinal nerve fibre layer (RNFL) thickness are important in the diagnosis and management of glaucoma and other disorders.To assess the repeatability and reproducibility of the iVue-100 optical coherence tomographer (OCT).The thickness of the RNFL was measured for 50 healthy participants using the iVue-100 OCT. Although both eyes per participant were measured, only right eyes were analysed here. Repeatability and reproducibility of the iVue-100 OCT were assessed using the intraclass correlation coefficient (ICC), coefficient of variation (CoV), paired t-tests and Bland-Altman analysis.Good intra-observer repeatability was obtained as indicated by the ICC of observer 1 (range: 0.941 - 0.976) and observer 2 (range: 0.829 - 0.953) as well by the CoV of observer 1 (range: 0.098 - 0.137) and observer 2 (0.091 - 0.132). In terms of inter-observer reproducibility, significant differences (p< 0.05) in mean measurements between the observers were noted for the average RNFL readings and in the superior and inferior quadrants as assessed with paired t-tests. Even though significant inter-session differences were found for the average RNFL thickness and the superior quadrant (p = 0.003 and p = 0.013, respectively), excellent ICCs were obtained for inter-session reproducibility (range: 0.914 - 0.979).The iVue-100 OCT demonstrated good repeatability and reproducibility for RNFL thickness measurements.
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To determine repeatability and reproducibility of A-scan biometry quantitative findings in order to uniformly evaluate lenticular cataract changes.Seventeen eyes from seventeen cataract patients were examined by three (trainee ophthalmologists). Results (ratio of mean internal lens spikes height/lens anterior surface spike height) were compared using coefficient of variation (CV), repeatability coefficient (CR), and intraclass correlation coefficients (ICC).Intra-observer consistency was CV = 0.36, CR = 0.49, and ICC = 0.778 for the first operator; CV = 0.33, CR = 0.52, and ICC = 0.642 for the second operator; and CV = 0.32, CR = 0.53, and ICC = 0.567 for the third operator. Concerning inter-observer agreement: CV (in 6 of 7 eyes) was > 8%, CR was > 0.21, and intraclass correlation coefficient for all eyes was < 0.81.Regarding repeatability and reproducibility, although there is a tendency for statistical significance, variability of the results does not allow the use of the method as a complementary clinical tool for comparing results. Standardization of this procedure, in order to achieve higher test reliability, might be the aim of relevant future studies, although there are a number of points that have to be addressed.
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Trunk-flexor muscle strength plays a fundamental role in athletic performance, but objective measurements are usually obtained using expensive and nonportable equipment, such as isokinetic dynamometers. The aim of this study was to assess the concurrent validity of a portable, one-dimensional, trunk-flexor muscle strength measurement system (Measurement System) that uses calibrated barbells and the reliability of the measurements obtained using the Measurement System, by conducting test-retests. As a complementary assessment, the measurements obtained during a maximum contraction test performed by a group of 15 subjects were also recorded. Four conditions were assessed: repeatability, time reproducibility, position reproducibility, and subject reproducibility. The results demonstrate that both the concurrent validity and the measured reliability (intraclass correlation coefficient > .98) of the Measurement System are acceptable. The Measurement System provides valid and reliable measures of trunk-flexor muscle strength.
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Abstract Tono-Pen and TonoVet have been used in rabbits to measure intraocular pressure (IOP) and investigate the effect of IOP lowering therapies. Therefore, their reliability and accuracy are very important and deserve careful evaluation. Our results showed that the with-subject deviation ( S w ) and intraclass correlation coefficient (ICC) of the TonoVet and Tono-Pen were 0.61 mmHg/0.83 mmHg and 0.97/0.94, respectively for intrasession repeatability. For intersession reproducibility, the Sw and ICC of TonoVet and Tono-Pen were 1.42 mmHg/1.66 mmHg and 0.73/0.67, respectively. For interoperator reproducibility, the S w and ICC of the TonoVet and Tono-Pen were 0.72 mmHg/1.11 mmHg and 0.91/0.82 respectively. Both TonoVet and Tono-Pen underestimated the IOP measured by manometry. The regression function was: y = 0.8249x + 0.1011 and y =0.6881x + 2.2290 for TonoVet and Tono-Pen, respectively. Our study suggests that both TonoVet and Tono-Pen had excellent intrasession repeatability and inter-operator reproducibility, but good intersession reproducibility. Both TonoVet and Tono-Pen correlated well with manometry, but underestimated the manometric IOP with presence of fixed and proportional biases. These factors should be considered when measuring IOP with Tono-Pen or TonoVet in rabbit eyes.
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The aim of this study was to evaluate repeatability and reproducibility of newly calculated biomechanical parameters of the cornea, developed by our research group.One eye from each of the 23 healthy subjects was measured three times consecutively, three times at different daytimes and on three different days. The within-subject standard deviation and coefficient of variation, as well as the intraclass correlation coefficient, were calculated for every parameter in each group.Excellent repeatability and reproducibility (coefficient of variation < 5%, intraclass correlation coefficient > 0.75) was found for corrected values measured at A1, HC, and A2 time points (2nd A2 Time, 2nd A1 Time, 2nd HC Time, 2nd HC Def Amp and 2nd A1 Def Amp). Corneal-specific stiffness parameters, which showed good repeatability and reliability, were DA_cor (coefficient of variation = 4.02%, intraclass correlation coefficient = 0.919), KcLinear (coefficient of variation = 4.03%, intraclass correlation coefficient = 0.895), areaForceCornea (coefficient of variation = 3.34%, intraclass correlation coefficient = 0.853) and E2 (coefficient of variation = 4.1%, intraclass correlation coefficient = 0.78). Overall, most parameters fell into the category of good reliability (high intraclass correlation coefficient) and poor reproducibility (low coefficient of variation), including all the parameters describing extraocular deformation (DA_ext, AEPvED, AUC EDef, areaForceExtra, Kg and μg). Comparing the coefficient of variation values for intrasession, intersession and daytime measurements, there were no indices for diurnal changes.Most parameters showed good repeatability and reliability. The extraocular stiffness parameters showed poor reproducibility. KcLinear can serve as a very reliable and repeatable indicator of corneal stiffness.
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Few studies assess repeatability and reproducibility in registers of resonance frequency analysis (a value of dental implant stability).Few studies assess repeatability and reproducibility in resonance frequency analyses (implant stability evaluation). This study is aimed at assessing reliability (repeatabilty and reproducibility) in the Osstell Mentor® system using the intraclass correlation coefficient (ICC) as the statistical method.ISQ measurements of RFA were carried out by means of the Osstell Mentor® instrument in 58 implants in 19 patients. Six measurements were performed on each implant by means of two different Smart-Pegs (I and II). Three consecutive measurements were registered with each transducer.Average ISQ varied from 72.43 to 72.60 and 73.26 in the first, second and third measurements, respectively with the SamrtPeg I and from 72.98 to 73.26 and 73.74 in the first, second and third measurements, respectively with the SamrtPeg II . Exactly equal values were observed in 10.43 and 12.1% of the cases with Smart-Pegs I and II, respectively. The intraclass correlation coefficient was 0.96 and 0.96 for Smart Pegs I and II, respectively. Repeatability and reproducibility was 0.97 for both Smart-Pegs I and II.The RFA system contributed by Osstell Mentor® renders almost perfect reproducibility and repeatability, as proven by statistical analysis carried out by means of ICC with 95% confidence level. This instrument contributes highly reliable RFA measurements in dental implants.
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To evaluate the intraobserver repeatability and interobserver reproducibility of Strip Meniscometry Tube (SMTube) and determine the correlations among the SMTube measurements and other ocular examinations in dry eye disease (DED) patients.The study recruited 73 eyes of 49 DED patients. Every subject was subjected to the following five measurements sequentially: the Ocular Surface Disease Index (OSDI) questionnaire, Tear Meniscus Height (TMH) assessment, SMTube measurements, tear film breakup time (BUT) examination, and Schirmer I test (SIT). The repeatability and reproducibility of the measurements were assessed by the intraclass correlation coefficient (ICC) and the Bland-Altman analysis, and the correlations were evaluated by the Spearman rank-order correlation.The repeatability and reproducibility of the SMTube measurements were good in DED patients. The ICCs between the repeatability and reproducibility of the SMTube measurements were 0.789 and 0.741, respectively, and the Bland-Altman 95% limits of the repeatability and the reproducibility were -1.726 to 1.658 and -0.967 to 1.474, respectively (all P < 0.01). The SMTube measurements had correlations with TMH, BUT, and SIT. The Spearman rank correlation coefficients between SMTube and TMH; SMTube and Schirmer I test; and SMTube and BUT were 0.632, 0.617, and 0.653, respectively (all P < 0.01).The measurements of the SMTube may provide a novel, swift, noninvasive, and convenient approach to screen and diagnose DED with acceptable repeatability and reproducibility and specific correlations with TMH, BUT, and SIT.
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Abstract To identify robust and reproducible methods of cerebellar morphometry that can be used in future large-scale structural MRI studies, we investigated the replicability, repeatability, and longterm reproducibility of three fully-automated software tools: FreeSurfer, CERES, and ACAPULCO. Replicability was defined as computational replicability, determined by comparing two analyses of the same high-resolution MRI data set performed with identical analysis software and computer hardware. Repeatability was determined by comparing the analyses of two MRI scans of the same participant taken during two independent MRI sessions on the same day for the Kirby-21 study. Long-term reproducibility was assessed by analyzing two MRI scans of the same participant in the longitudinal OASIS-2 study. We determined percent difference, the image intraclass correlation coefficient, the coefficient of variation, and the intraclass correlation coefficient between two analyses. Our results show that CERES and ACAPULCO use stochastic algorithms that result in surprisingly high differences between identical analyses for ACAPULCO and small differences for CERES. Changes between two consecutive scans from the Kirby-21 study were less than ±5% in most cases for FreeSurfer and CERES (i.e., demonstrating high repeatability). As expected, long-term reproducibility was lower than repeatability for all software tools. In summary, CERES is an accurate, as demonstrated before, and reproducible tool for fully-automated segmentation and parcellation of the cerebellum. We conclude with recommendations for the assessment of replicability, repeatability, and longterm reproducibility in future studies on cerebellar structure.
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