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Case Scores (case + score)
Selected AbstractsHigh score on the Relative Stress Scale, a marker of possible psychiatric disorder in family carers of patients with dementiaINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 3 2007Ingun Ulstein Abstract Objective To compare the scores on the Relative Stress Scale (RSS) with those on the General Health Questionnaire (GHQ) and the Geriatric Depression Scale (GDS), and to establish a cut-off score for RSS in order to distinguish carers with symptoms of psychiatric disorders from those without. Methods One hundred and ninety-four carers of 194 patients suffering from dementia according to ICD-10 were included in the study. Burden of care was assessed by the 15-items RSS, and psychiatric symptoms by means of the GHQ-30 and the 30-items GDS. A case score above 5 on GHQ and above 13 on GDS were used to define carers with probable psychiatric morbidity. Sensitivity (SS), specificity (SP), accuracy and likelihood ratio for a positive test (LR+) were calculated for different cut-points of the RSS. Results Fifty-six percent of the carers had a GHQ score above 5, and 22% had a GDS score above 13. A two-step cluster analysis using 192 of the 194 carers, identified three groups of carers; a low risk group for psychiatric morbidity (LRG), 82 carers with GHQ,,,5 and GDS,,,13; a medium risk group (MRG), 69 carers with GHQ,>,5 and GDS,,,13; and a high-risk group (HRG), 40 carers with GHQ,>,5 and GDS,>,13. The optimal RSS cut-off to distinguish between the LRG and the others was,>,23 (SS 0.72, SP 0.82, accuracy 0.76, LR,+,4.0), whereas the optimal cut-off to separate the HRG from the others was,>30 (SS 0.74, SP 0.87, accuracy 0.84, LR,+,5.7). Conclusion The RSS is a useful instrument to stratify carers according to their risk of psychiatric morbidity. Copyright © 2006 John Wiley & Sons, Ltd. [source] Variations of Apgar score of very low birth weight infants in different neonatal intensive care unitsACTA PAEDIATRICA, Issue 9 2009Mario Rüdiger Abstract Objective:, The Apgar score should be an objective method to assess the state of newborns; however, its applicability in preterm infants is hampered by large variations among different observers. The study tested whether physicians that give low scores to written case descriptions also apply lower scores to preterm infants. Patients and Methods:, Descriptions (BMJ 2004; 329: 143,4) were sent to 14 neonatal units. Physicians were asked to evaluate the Apgar (case score). From seven units Apgar scores of all very low birth weight infants (VLBW) born between January 2004 and December 2006 were obtained from charts (clinical score). Results:, In total, 121 physicians from 14 institutions (median 9, range 3,15) replied: 24 residents with <6-month and 28 with >6-month neonatal experience, and 69 consultants. The assessment of the case scores was very heterogeneous with large variations in respiration, muscle tone and reflexes. Clinical scores were obtained from 1000 VLBW infants. The score depended on the gestational age, with a median of 4 at 24 and 7 at 27 weeks. With one exception, centres that assigned low case scores had also low clinical scores. Conclusion:, There is considerable variation in assigning Apgar scores. Definitions are required to apply the Apgar score to infants under clinical conditions such as preterm delivery, resuscitation or artificial ventilation. [source] The reliability of summative judgements based on objective structured clinical examination cases distributed across the clinical yearMEDICAL EDUCATION, Issue 7 2007George R Bergus Context, Objective structured clinical examinations (OSCEs) can be used for formative and summative evaluation. We sought to determine the generalisability of students' summary scores aggregated from formative OSCE cases distributed across 5 clerkships during Year 3 of medical school. Methods, Five major clerkships held OSCEs with 2,4 cases each during their rotations. All cases used 15-minute student,standardised patient encounters and performance was assessed using clinical and communication skills checklists. As not all students completed every clerkship or OSCE case, the generalisability (G) study was an unbalanced student × (case : clerkship) design. After completion of the G study, a decision (D) study was undertaken and phi (,) values for different cut-points were calculated. Results, The data for this report were collected over 2 academic years involving 262 Year 3 students. The G study found that 9.7% of the score variance originated from the student, 3.1% from the student,clerkship interaction, and 87.2% from the student,case nested within clerkship effect. Using the variance components from the G study, the D study suggested that if students completed 3 OSCE cases in each of the 5 different clerkships, the reliability of the aggregated scores would be 0.63. The ,, calculated at a cut-point 1 standard deviation below the mean, would be approximately 0.85. Conclusions, Aggregating case scores from low stakes OSCEs within clerkships results in a score set that allows for very reliable decisions about which students are performing poorly. Medical schools can use OSCE case scores collected over a clinical year for summative evaluation. [source] Variations of Apgar score of very low birth weight infants in different neonatal intensive care unitsACTA PAEDIATRICA, Issue 9 2009Mario Rüdiger Abstract Objective:, The Apgar score should be an objective method to assess the state of newborns; however, its applicability in preterm infants is hampered by large variations among different observers. The study tested whether physicians that give low scores to written case descriptions also apply lower scores to preterm infants. Patients and Methods:, Descriptions (BMJ 2004; 329: 143,4) were sent to 14 neonatal units. Physicians were asked to evaluate the Apgar (case score). From seven units Apgar scores of all very low birth weight infants (VLBW) born between January 2004 and December 2006 were obtained from charts (clinical score). Results:, In total, 121 physicians from 14 institutions (median 9, range 3,15) replied: 24 residents with <6-month and 28 with >6-month neonatal experience, and 69 consultants. The assessment of the case scores was very heterogeneous with large variations in respiration, muscle tone and reflexes. Clinical scores were obtained from 1000 VLBW infants. The score depended on the gestational age, with a median of 4 at 24 and 7 at 27 weeks. With one exception, centres that assigned low case scores had also low clinical scores. Conclusion:, There is considerable variation in assigning Apgar scores. Definitions are required to apply the Apgar score to infants under clinical conditions such as preterm delivery, resuscitation or artificial ventilation. [source] | ||||||||||