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Kappa Statistics (kappa + statistics)
Selected AbstractsEffectiveness of limited cone-beam computed tomography in the detection of horizontal root fractureDENTAL TRAUMATOLOGY, Issue 3 2009vanē Kamburo Root fractures were created in the horizontal plane in 18 teeth by a mechanical force and fragments were relocated. Another 18 intact teeth with no horizontal root fracture served as a control group. Thirty-six teeth were placed in the respective empty maxillary anterior sockets of a human dry skull in groups three by three. Intraoral radiographs were obtained in three different vertical views by utilizing Eastman Kodak E-speed film, CCD sensor, RVG 5.0 Trophy and a PSP sensor Digora, Optime. Cone beam CT images were taken with a unit (3D Accuitomo; J Morita MFG. Corp, Kyoto, Japan). Three dental radiologists separately examined the intraoral film, PSP, CCD and cone beam CT images for the presence of horizontal root fracture. Specificity and sensitivity for each radiographic technique were calculated. Kappa statistics was used for assessing the agreement between observers. Chi-square statistics was used to determine whether there were differences between the systems. Results were considered significant at P < 0.05. Cone beam CT images revealed significantly higher sensitivities (P < 0.05) than the intraoral systems between which no significant differences were found. Specificities did not show any statistically significant differences between any of the four systems. The kappa values for inter-observer agreement between observers (four pairs) ranged between 0.82,0.90 for the 3DX evaluations and between 0.63,0.71 for the different types of intraoral images. Limited cone beam CT, outperformed the two-dimensional intraoral, conventional as well as digital, radiographic methods in detecting simulated horizontal root fracture. [source] Interobserver Reliability of Video Recording in the Diagnosis of Nocturnal Frontal Lobe SeizuresEPILEPSIA, Issue 8 2007Luca Vignatelli Summary:,Background: Nocturnal frontal lobe seizures (NFLS) show one or all of the following semeiological patterns: (1) paroxysmal arousals (PA: brief and sudden recurrent motor paroxysmal behavior); (2) hyperkinetic seizures (HS: motor attacks with complex dyskinetic features); (3) asymmetric bilateral tonic seizures (ATS: motor attacks with dystonic features); (4) epileptic nocturnal wanderings (ENW: stereotyped, prolonged ambulatory behavior). Objective: To estimate the interobserver reliability (IR) of video-recording diagnosis in patients with suspected NFLS among sleep medicine experts, epileptologists, and trainees in sleep medicine. Methods: Sixty-six patients with suspected NFLS were included. All underwent nocturnal video-polysomnographic recording. Six doctors (three experts and three trainees) independently classified each case as "NFLS ascertained" (according to the above specified subtypes: PA, HS, ATS, ENW) or "NFLS excluded". IR was calculated by means of Kappa statistics, and interpreted according to the standard classification (0.0,0.20 = slight agreement; 0.21,0.40 = fair; 0.41,0.60 = moderate; 0.61,0.80 = substantial; 0.81,1.00 = almost perfect). Results: The observed raw agreement ranged from 63% to 79% between each pair of raters; the IR ranged from "moderate" (kappa = 0.50) to "substantial" (kappa = 0.72). A major source of variance was the disagreement in distinguishing between PA and nonepileptic arousals, without differences in the level of agreement between experts and trainees. Conclusions: Among sleep experts and trainees, IR of diagnosis of NFLS, based on videotaped observation of sleep phenomena, is not satisfactory. Explicit video-polysomnographic criteria for the classification of paroxysmal sleep motor phenomena are needed. [source] A new method of vegetation,climate classification in ChinaINTERNATIONAL JOURNAL OF CLIMATOLOGY, Issue 9 2008Sun Yanling Abstract Coefficient C is a synthetic index from the third correlative equation, which represents the state of moisture in a region and may be used for assigning vegetation zonality. The third correlative equation is a new equation concerning heat and water balance from knowledge of evaporation on land. In this article, coefficient C and accumulated temperature over 5 °C (AT5) are combined to predict the distribution of vegetation zones in China. Predictions of vegetation distribution are made using observational climate data interpolated into a 25 × 25 km grid. The overall impression from examining the resulting vegetation map is that the location and distribution of vegetation zones in China are predicted fairly well. Comparison between the predicted vegetation map and the vegetation regionalization map are based on Kappa statistics and indicate very good agreement for the cold,temperate coniferous forest zone, the subtropical evergreen broadleaved forest zone, and the temperate mixed coniferous,broadleaved forest zone. Agreement is good for the warm,temperate deciduous broadleaved forest zone, the temperate steppe zone, the temperate desert zone, and the Tibetan high-cold plateau zone. Agreement between the regionalization map and the produced map is fair for the tropical rainforest and monsoon forest zone. Compared with those produced by the Holdridge, Thornthwaite, Penman, and the Kira models, as well as the Budyko method, the Kappa statistics in this article are all better except for the cold,temperate (boreal) coniferous forest zone and the temperate desert zone. The results are particularly superior for the Tibetan high-cold plateau zone. Coefficient C provides important information for predicting the distribution of vegetation zones in China, and this article attempts to study vegetation,climate classification on a large scale using coefficient C and AT5. Copyright © 2007 Royal Meteorological Society [source] Agreement Between Self-Report of Disease Diagnoses and Medical Record Validation in Disabled Older Women: Factors That Modify AgreementJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2004Crystal F. Simpson MD Objectives: To determine the agreement between self-report of chronic disease and validated evidence of disease using multiple ascertainment methods and to assess effects of cognition, education, age, and comorbidity. Design: Cross-sectional analysis. Setting: Community Baltimore, Maryland. Participants: One thousand two community-dwelling disabled women aged 65 and older. Measurements: Kappa statistics were calculated to determine the relationship between self-report of 14 diseases and standardized algorithms. Analyses were stratified using Mini-Mental State Examination score, education, number of chronic diseases, and age. Results: Kappa was excellent for hip fracture (HF), Parkinson's disease (PD), diabetes mellitus (DM), cancer, stroke, and disc disease (DD); fair to good for angina pectoris, congestive heart failure, and myocardial infarction; and poor for peripheral arterial disease, spinal stenosis, osteoporosis, arthritis, and lung disease. Overall, kappa decreased with decreasing cognition and education, increasing age, and four or more diseases. Conclusion: In disabled older women, self-report of physician diagnosis of HF, PD, DM, cancer, stroke, and DD appears valid. In general, increasing comorbidity and age and decreasing cognition and education do not reduce validity for diseases where agreement was excellent overall. [source] Care dependency of children in EgyptJOURNAL OF CLINICAL NURSING, Issue 3 2008Hanan Tork RN Aims., This study aimed to modify the Care Dependency Scale so that it could be used for children, to apply its Arabic version to Egyptian children to test the reliability and validity of the modified scale and to compare the care dependency of disabled and non-disabled Egyptian children. Background., A higher dependence of children in their daily tasks undoubtedly places a greater burden on their caregivers. To estimate the extent of the problem of care dependency, data from different countries and proper standard instruments are required. Method., The Care Dependency Scale was modified for children by Delphi technique. This study assessed the care dependency of non-disabled children compared with children with physical and mental disabilities using the modified version of the Care Dependency Scale for paediatrics. The total sample included 260 Egyptian school-age children (50·8% of whom were disabled and 49·2% were non-disabled). Results., Reliability was examined in terms of internal consistency using Cronbach's alpha (0·91). Inter-rater reliability revealed moderate to very good Kappa statistics between 0·57,0·89. Content validity and criterion validity were evaluated. Differences regarding care dependency were found between disabled and non-disabled children. Conclusion., The psychometric properties of the Care Dependency Scale for paediatrics support its usefulness in measuring the care dependency of children in Egypt. This study provides an Arabic version of the Care Dependency Scale for paediatrics that is easy to administer and may be useful to measure the care dependency in various Arabic countries. Relevance to clinical practice., The findings raise concerns regarding the extent to which disabled and also non-disabled school-age children are care dependent leading to an increased burden of care on nurses or on caregivers in general. The Care Dependency Scale for Paediatrics can help nurses conduct an appropriate assessment of children's care dependency so that any nursing care can be planned according to the children's needs. [source] Ascertaining Health-Related Information on Adults With Intellectual Disabilities: Development and Field Testing of the Rochester Health Status SurveyJOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 1 2008Philip W. Davidson Abstract, There is a growing need for researchers and service providers to ascertain and track health status and health care utilization among adults with intellectual disabilities as they pass through the lifespan. This paper reports the development and field testing of the Rochester Health Status Survey (RHSS), a survey instrument that identifies incidence, lifetime prevalence, and point prevalence of diseases common in adults, as well as functional abilities and medication usage. The instrument also provides information about health system access and utilization. The survey is designed to be completed from chart review. An initial version of the survey was developed in 1998, revised in 2003, and then validated on a cohort of adults ages 21 to 73 years living in supervised community residences in the U.S. The RHSS includes 51 questions and requires about 45 min to complete. In the present study, data were collected on each subject by 3 different respondents (a service coordinator, a nurse, and when available, a family member). Their responses were compared item by item with the responses of the second author, a developmental disabilities geriatrician, who also completed the survey on each subject. Correlations and Kappa statistics confirmed that the highest agreement scores occurred between nurses and the geriatrician. [source] Reliability of the assessment of preventable adverse drug events in daily clinical practice,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 7 2008Jasperien E. van Doormaal PharmD Abstract Purpose To determine the reliability of the assessment of preventable adverse drug events (ADEs) in daily practice and to explore the impact of the assessors' professional background and the case characteristics on reliability. Methods We used a combination of the simplified Yale algorithm and the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) scheme to assess on the one hand the causal relationship between medication errors (MEs) and adverse events in hospitalised patients and on the other hand the severity of the clinical consequence of MEs. Five pharmacists and five physicians applied this algorithm to 30 potential MEs. After individual assessment, the pharmacists reached consensus and so did the physicians. Outcome was both MEs' severity (ordinal scale, NCC MERP categories A,I) and the occurrence of preventable harm (binary outcome, NCC MERP categories A,D vs. E,I). Kappa statistics was used to assess agreement. Results The overall agreement on MEs' severity was fair for the pharmacists (,,=,0.34) as well as for the physicians (,,=,0.25). Overall agreement for the 10 raters was fair (,,=,0.25) as well as the agreement between both consensus outcomes (,,=,0.30). Agreement on the occurrence of preventable harm was higher, ranging from ,,=,0.36 for the physicians through ,,=,0.49 for the pharmacists. Overall agreement for the 10 raters was fair (,,=,0.36). The agreement between both consensus outcomes was moderate (,,=,0.47). None of the included case characteristics had a significant impact on agreement. Conclusions Individual assessment of preventable ADEs in real patients is difficult, possibly because of the difficult assessment of contextual information. Best approach seems to be a consensus method including both pharmacists and physicians. Copyright © 2008 John Wiley & Sons, Ltd. [source] Global angiographic scoring system for inflammatory diseasesACTA OPHTHALMOLOGICA, Issue 2009M KHAIRALLAH Purpose Fundus fluorescein and indocyanine green angiography are essential imaging techniques in the appraisal of posterior segment inflammation. A combined fluorescein and indocyanine green angiographic scoring system has been developed in order to provide semi-quantitative data for follow-up of disease progression, monitoring response to treatment, and comparison between clinical studies. We tested interobserver variations in the semi-quantitative scoring of dual fluorescein/indocyanine green angiograms. Methods Four observers scored 32 dual fluorescein and indocyanine green angiograms. Spearman rank correlation was used to analyze correlation between scores assigned to each angiographic sign. We used the Kappa statistics to test agreement between pairs of observers in comparative total fluorescein and indocyanine green angiographic scores. Results We found a significant correlation between pairs of observers in scores assigned to each fluorescein angiographic sign and the total score of fluorescein angiograms. A significant correlation was found only between 2 separate pairs of observers in scores assigned to early stromal vessel hyperfluoresence on indocyanine green angiography. However, a significant correlation was found in other indocyanine green angiographic signs and the total score of indocyanine green angiograms. There was a good agreement between observers in comparative fluorescein , indocyanine green angiographic total scores. Conclusion Further experience with the scoring system, especially with the indocyanine green angiographic scoring, may improve its reproducibility. [source] A PCA-based modelling technique for predicting environmental suitability for organisms from presence recordsDIVERSITY AND DISTRIBUTIONS, Issue 1-2 2001M. P. Robertson We present a correlative modelling technique that uses locality records (associated with species presence) and a set of predictor variables to produce a statistically justifiable probability response surface for a target species. The probability response surface indicates the suitability of each grid cell in a map for the target species in terms of the suite of predictor variables. The technique constructs a hyperspace for the target species using principal component axes derived from a principal components analysis performed on a training dataset. The training dataset comprises the values of the predictor variables associated with the localities where the species has been recorded as present. The origin of this hyperspace is taken to characterize the centre of the niche of the organism. All the localities (grid-cells) in the map region are then fitted into this hyperspace using the values of the predictor variables at these localities (the prediction dataset). The Euclidean distance from any locality to the origin of the hyperspace gives a measure of the ,centrality' of that locality in the hyperspace. These distances are used to derive probability values for each grid cell in the map region. The modelling technique was applied to bioclimatic data to predict bioclimatic suitability for three alien invasive plant species (Lantana camara L., Ricinus communis L. and Solanum mauritianum Scop.) in South Africa, Lesotho and Swaziland. The models were tested against independent test records by calculating area under the curve (AUC) values of receiver operator characteristic (ROC) curves and kappa statistics. There was good agreement between the models and the independent test records. The pre-processing of climatic variable data to reduce the deleterious effects of multicollinearity, and the use of stopping rules to prevent overfitting of the models are important aspects of the modelling process. [source] Severity of cerebral white matter lesions and infarcts in patients with transient or moderately disabling cerebral ischaemia: reproducibility of grading by neurologistsEUROPEAN JOURNAL OF NEUROLOGY, Issue 8 2006E. L. L. M. De Schryver Diffuse or multifocal ischaemic white matter lesions increase the risk of intracranial haemorrhage in patients using oral anticoagulants for secondary prevention after cerebral ischaemia of arterial origin. We studied whether neurologists could reliably assess the presence of these white matter abnormalities. As part of the European/Australian Stroke Prevention in Reversible Ischaemia Trial (ESPRIT), the severity of white matter lesions and presence of ischaemic lesions were twice assessed in a consensus meeting of three neurologists (from a pool of nine) as absent, moderate or severe, in a sample of 126 randomly selected CT or MRI scans. The neurologists were not aware of the duplicate grading. The degree of agreement between the first and second observation was calculated with kappa statistics. The kappa value for agreement between the first and second assessment of white matter lesions was 0.58 (95% CI 0.40,0.76). The kappa value for the presence of clinically relevant and/or irrelevant ischaemic lesions was 0.68 (95% CI 0.58,0.78). Clinicians can assess the presence of white matter lesions with sufficient reliability. Such assessment may prevent unnecessary risk with oral anticoagulation in secondary prevention after cerebral ischaemia of arterial origin, of which the efficacy is currently being assessed in ESPRIT. [source] Model-based uncertainty in species range predictionJOURNAL OF BIOGEOGRAPHY, Issue 10 2006Richard G. Pearson Abstract Aim, Many attempts to predict the potential range of species rely on environmental niche (or ,bioclimate envelope') modelling, yet the effects of using different niche-based methodologies require further investigation. Here we investigate the impact that the choice of model can have on predictions, identify key reasons why model output may differ and discuss the implications that model uncertainty has for policy-guiding applications. Location, The Western Cape of South Africa. Methods, We applied nine of the most widely used modelling techniques to model potential distributions under current and predicted future climate for four species (including two subspecies) of Proteaceae. Each model was built using an identical set of five input variables and distribution data for 3996 sampled sites. We compare model predictions by testing agreement between observed and simulated distributions for the present day (using the area under the receiver operating characteristic curve (AUC) and kappa statistics) and by assessing consistency in predictions of range size changes under future climate (using cluster analysis). Results, Our analyses show significant differences between predictions from different models, with predicted changes in range size by 2030 differing in both magnitude and direction (e.g. from 92% loss to 322% gain). We explain differences with reference to two characteristics of the modelling techniques: data input requirements (presence/absence vs. presence-only approaches) and assumptions made by each algorithm when extrapolating beyond the range of data used to build the model. The effects of these factors should be carefully considered when using this modelling approach to predict species ranges. Main conclusions, We highlight an important source of uncertainty in assessments of the impacts of climate change on biodiversity and emphasize that model predictions should be interpreted in policy-guiding applications along with a full appreciation of uncertainty. [source] Observer variability in the sonographic evaluation of thyroid nodulesJOURNAL OF CLINICAL ULTRASOUND, Issue 6 2010Chang Suk Park MD Abstract Objective. Inter- and intraobserver variabilities in the description and diagnostic categorization of sonographic (US) features of thyroid nodules were evaluated. Methods. The current study was conducted on 72 malignant nodules and 61 benign nodules. The US findings for each thyroid nodule were analyzed twice at a 6-week interval by five radiologists. The analyses were in accordance with the guidelines proposed bythe Thyroid Study Group of the Korean Society of Neuroradiology and Head and Neck Radiology (TSGKSNRHNR). Inter- and intraobserver variabilities were calculated using Cohen's kappa statistics. The sensitivity, specificity, positive-predictive value, and negative-predictive value in the assessment of the diagnostic accuracy using these guidelines were calculated. Result. The interobserver agreement was fair to substantial for US features and categorization. Of the US features of the thyroid nodules, internal content (solid versus cystic) showed substantial agreement (k= 0.64). There was moderate agreement with regard to shape, echogenicity, calcification, and diagnostic categories (k = 0.42, 0.57, 0.55, and 0.55, respectively). There was fair agreement for margin, echotexture, and capsule invasion (k = 0.34, 0.26, and 0.32, respectively). With regard to intraobserver agreement, there was moderate to substantial agreement for all US features except for echotexture and capsule invasion, which showed fair agreement. In particular, there was moderate to almost perfect agreement for the diagnostic category. The sensitivity, specificity, positive-predictive value, and negative-predictive value were 65.3%,81.9%, 60.7%,68.9%, 69.7%,73.8%, and 66.6%,75.5%, respectively. Conclusion. There were high degrees of inter- and intraobserver agreement using the "Guidelines for diagnostic thyroid ultrasonography," of the TSGKSNRHNR in the description and categorization of thyroid nodules. © 2010 Wiley Periodicals, Inc. J Clin Ultrasound, 2010 [source] Development, standardization, and testing of a lexicon for reporting contrast-enhanced breast magnetic resonance imaging studiesJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 6 2001Debra M. Ikeda MD Abstract The purpose of this study was to develop, standardize, and test reproducibility of a lexicon for reporting contrast-enhanced breast magnetic resonance imaging (MRI) examinations. To standardize breast MRI lesion description and reporting, seven radiologists with extensive breast MRI experience developed consensus on technical detail, clinical history, and terminology reporting to describe kinetic and architectural features of lesions detected on contrast-enhanced breast MR images. This lexicon adapted American College of Radiology Breast Imaging and Data Reporting System terminology for breast MRI reporting, including recommendations for reporting clinical history, technical parameters for breast MRI, descriptions for general breast composition, morphologic and kinetic characteristics of mass lesions or regions of abnormal enhancement, and overall impression and management recommendations. To test morphology reproducibility, seven radiologists assessed morphology characteristics of 85 contrast-enhanced breast MRI studies. Data from each independent reader were used to compute weighted and unweighted kappa (,) statistics for interobserver agreement among readers. The MR lexicon differentiates two lesion types, mass and non-mass-like enhancement based on morphology and geographical distribution, with descriptors of shape, margin, and internal enhancement. Lexicon testing showed substantial agreement for breast density (, = 0.63) and moderate agreement for lesion type (, = 0.57), mass margins (, = 0.55), and mass shape (, = 0.42). Agreement was fair for internal enhancement characteristics. Unweighted kappa statistics showed highest agreement for the terms dense in the breast composition category, mass in lesion type, spiculated and smooth in mass margins, irregular in mass shape, and both dark septations and rim enhancement for internal enhancement characteristics within a mass. The newly developed breast MR lexicon demonstrated moderate interobserver agreement. While breast density and lesion type appear reproducible, other terms require further refinement and testing to lead to a uniform standard language and reporting system for breast MRI. J. Magn. Reson. Imaging 2001;13:889,895. © 2001 Wiley-Liss, Inc. [source] The Danish Prostatic Symptom Score (DAN-PSS-1) questionnaire is reliable in stroke patients,NEUROUROLOGY AND URODYNAMICS, Issue 4 2006Sigrid Tibaek Abstract Aims To investigate the test,retest reliability of Danish Prostatic Symptom Score (DAN-PSS-1) questionnaire in a sample of stroke patients. Methods A prospective study design was used in which the stroke patients were invited to complete a postal self-administrated DAN-PSS-1 questionnaire twice. The questionnaire consists of 12 questions related to lower urinary tract symptoms (LUTS). The participants were asked to state the frequency and severity of their symptoms (symptom score) and its impact on their daily life (bother score). Seventy-one stroke patients were included and 59 (83%) answered the questionnaire twice. The reliability test was done in two aspects: (a) detecting the frequency of each symptom and its bother factor, the scores were reduced to a two-category scale (=0, >0) and simple kappa statistics was used; (b) detecting the severity of each symptom and its bother factor, the total scale (0,3) and weighted kappa statistics was used. Results The proportion of agreement for the frequency symptom scores ranged from 76% to 97% and the simple kappa coefficient ranged from poor (,,=,0.00) to excellent (,,=,0.91). The proportion of agreement for the corresponding bother scores ranged from 76% to 95% and the simple kappa coefficient ranged from good (,,=,0.61) to excellent (,,=,0.84). The weighted kappa coefficient for the severity symptom scores ranged from moderate (,w,=,0.43) to good (,w,=,0.75) and the corresponding bother scores ranged from moderate (,w,=,0.48) to good (,w,=,0.68). Conclusions The DAN-PSS-1 questionnaire had acceptable test,retest reliability and may be suitable for measuring the frequency and severity of LUTS and its bother factor in stroke patients. Neurourol. Urodynam. © 2006 Wiley-Liss, Inc. [source] The FLACC behavioral scale for procedural pain assessment in children aged 5,16 yearsPEDIATRIC ANESTHESIA, Issue 8 2008STEFAN NILSSON MSN RN Summary Objectives:, To evaluate the concurrent and construct validity and the interrater reliability of the Face, Legs, Activity, Cry and Consolability (FLACC) scale during procedural pain in children aged 5,16 years. Background:, Self-reporting of pain is considered to be the primary source of information on pain intensity for older children but a validated observational tool will provide augment information to self-reports during painful procedures. Methods:, Eighty children scheduled for peripheral venous cannulation or percutaneous puncture of a venous port were included. In 40 cases two nurses simultaneously and independently assessed pain by using the FLACC scale and in 40 cases one of these nurses assessed the child. All children scored the intensity of pain by using the Coloured Analogue Scale (CAS) and distress by the Facial Affective Scale (FAS). Results:, Concurrent validity was supported by the correlation between FLACC scores and the children's self-reported CAS scores during the procedure (r = 0.59, P < 0.05). A weaker correlation was found between the FLACC scores and children's self-reported FAS (r = 0.35, P < 0.05). Construct validity was demonstrated by the increase in median FLACC score to 1 during the procedure compared with 0 before and after the procedure (P < 0.001). Interrater reliability during the procedure was supported by adequate kappa statistics for all items and for the total FLACC scores (, = 0.85, P < 0.001). Conclusions:, The findings of this study support the use of FLACC as a valid and reliable tool for assessing procedural pain in children aged 5,16 years. [source] Lack of Awareness of Partner STD Risk Among Heterosexual CouplesPERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH, Issue 1 2010Susan S. Witte CONTEXT: Individuals' accurate assessment of their exposure to the risk of HIV and other STDs requires awareness of their sexual partners' risk behaviors and disease status. METHODS: In a sample of 217 couples enrolled in a risk intervention trial in 1997,2002, both partners reported on their own risk behaviors and their perceptions of their partner's behavior; concordance of partners' reports was examined using kappa statistics. Individual and relationship characteristics predicting lack of awareness of a partner's risk behavior were explored using multivariate logistic regression. RESULTS: Three percent of women and 14% of men were unaware that their partner had recently had a concurrent partner. Eleven percent and 12%, respectively, were unaware that their partner had ever injected drugs; 10% and 12% were unaware that their partner had recently received an STD diagnosis; and 2% and 4% were unaware that their partner was HIV-positive. Women's lack of awareness of partner risk was associated with increasing age (odds ratio, 1.1), being of a race or ethnicity other than black or Latina (15.8) and having a Latino partner (3.7); it was positively associated with a man's report that he was married (4.4) and with relationship satisfaction as reported by both the woman and her partner (1.2 for each). Among men, lack of awareness was positively associated with partner's age (1.1) and with having a partner who was formerly married (8.2). CONCLUSIONS: Couple-based interventions that assess each partner's awareness of the other's risk behavior may help programs better target couples' STD prevention needs. [source] How well do patients report noncompliance with antihypertensive medications?: a comparison of self-report versus filled prescriptionsPHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 1 2004Philip S. Wang MD Abstract Purpose To address poor patient compliance with antihypertensives, clinicians and researchers need accurate measures of adherence with prescribed regimens. Although self-reports are often the only means available in routine practice, their accuracy and agreement with other data sources remain questionable. Methods A telephone survey was conducted on 200 hypertensive patients treated with a single antihypertensive agent in a large health maintenance organization (HMO) or a Veterans Affairs medical center (VAMC) to obtain self-reports of the frequency of missing antihypertensive therapy. We then analyzed records of all filled prescriptions to calculate the number of days that patients actually had antihypertensive medications available for use. Agreement between the two data sources was measured with correlation coefficients and kappa statistics. Logistic regression models were used to identify demographic, clinical and psychosocial correlates of overstating compliance. Results There was very poor agreement between self-reported compliance and days actually covered by filled prescriptions (Spearman correlation coefficient,=,0.15; 95%CI: 0.01, 0.28). Very poor agreement was also observed between a categorical measure of self-reported compliance (ever vs. never missing a dose) and categories of actual compliance defined by filled prescriptions (<,80% vs >,80% of days covered; kappa,=,0.12, 95%CI: ,0.02, 0.26). Surprisingly, few factors were associated with inaccurate self-reporting in either crude or adjusted analyses; fewer visits to health care providers was significantly associated with overstating compliance. Conclusions Compliance was markedly overstated in this sample of patients and few characteristics identified those who reported more versus less accurately. Clinicians and researchers who rely on self-reports should be aware of these limits and should take steps to enhance their accuracy. Copyright © 2003 John Wiley & Sons, Ltd. [source] How well does a telephone questionnaire measure drinking water intake?AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 6 2000Brent Robertson Background:Few studies have assessed the validity or reliability of drinking water intake estimations. In studies investigating potential waterborne disease, this is very important. Methods:We carried out a validity and reliability study to evaluate water intake estimations. The validity part of the study compared a telephone questionnaire to a diary. The reliability part of the study compared two telephone questionnaires. Results:253 participants were recruited. The most commonly consumed water intake categories were plain and boiled tap water. For persons aged less than 12 years, the median volume of plain water consumption was 2.9 glasses/day according to the diary. For persons aged 12 years and over, the median volume of plain water consumption was 3.0 glasses/day and for boiled water 3.0 glasses/day according to the diary. There was negligible systematic over or under reporting by participants for the telephone questionnaire in comparison to the diary and for the comparison of both telephone questionnaires. Water intake estimates were converted to categorical variables and the per cent agreement and weighted kappa statistics were calculated. For both the validity and reliability parts of the study the per cent agreement was 57,78% and the weighted kappa was 0.57,0.81. Conclusion:Water intake estimates show only moderate levels of validity and reliability when using a telephone questionnaire in comparison to a diary. Implications:Investigators of potential waterborne disease or nutritional research should exercise some caution in drawing conclusions from minor differences in drinking water intake that are obtained from a telephone questionnaire. [source] | ||||||||||||||||||||||