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Scoring Methods (scoring + methods)
Selected AbstractsA new magnetic resonance imaging scoring method for assessment of haemophilic arthropathyHAEMOPHILIA, Issue 4 2004B. Lundin Summary., In a European multicentre study, 39 ankles in 28 haemophilic boys were investigated by magnetic resonance imaging (MRI). A new MRI score was developed in the format A(e:s:h) for evaluating haemophilic arthropathy. This scheme provides high resolution and allows separation of different pathological components. The factor A is calculated as the sum of scores for subchondral cysts (maximum value 6), irregularity/erosion of subchondral cortex (maximum 4) and chondral destruction (maximum 6); e, s and h, respectively, represent effusion/haemarthrosis, synovial hypertrophy and haemosiderin deposition, and they are separately evaluated on a scale of 0,4. Working independently, two radiologists scored the 39 ankles twice using both this new ,European' scoring method and a previously published ,Denver' scoring scheme. Final classification was achieved by consensus. The reproducibility of the readings was assessed, and for both scoring methods the results indicated good or moderate intraobserver agreement, and good, moderate or fair interobserver agreement. These findings suggest that MRI can be useful for semiquantitative evaluation of haemophilic arthropathy, providing the examination is performed according to an appropriate protocol, and the images are evaluated by specially trained radiologists. [source] Detection of Delirium by Bedside Nurses Using the Confusion Assessment MethodJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 4 2006Joke Lemiengre RN A prospective, descriptive study was used to assess the diagnostic validity of the Confusion Assessment Method (CAM) administered at the bedside by nurses in daily practice. Two different scoring methods of the CAM (the specific (SPEC) and sensitive (SENS) methods) were compared with a criterion standard (CAM completed by trained research nurses). During a 5-month period, all patients consecutively admitted to an acute geriatric ward of the University Hospitals of Leuven (Belgium) were enrolled in the study. The 258 elderly inpatients who were included underwent 641 paired but independent ratings of delirium by bedside and trained research nurses. Delirium was identified in 36 of the 258 patients (14%) or in 42 of the 641 paired observations (6.5%). The SENS method of the CAM algorithm as administered by bedside nurses had the greatest diagnostic accuracy, with 66.7% sensitivity and 90.7% specificity; the SPEC method had 23.8% sensitivity and 97.7% specificity. Bedside nurses had difficulties recognizing the features of acute onset, fluctuation, and altered level of consciousness. For both scoring methods, bedside nurses had difficulties with the identification of elderly patients with delirium but succeeded in diagnosing correctly those patients without delirium in more than 90% of observations. Given these results, additional education about delirium with special attention to guided training of bedside nurses in the use of an assessment strategy such as the CAM for the recognition of delirium symptoms is warranted. [source] Evaluation of the Mini-Mental State Examination's Internal Consistency in a Community-Based Sample of Mexican-American and European-American Elders: Results from the San Antonio Longitudinal Study of AgingJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2004David V. Espino MD This study examined the effect of scoring method, education, and language usage on internal consistency of the Folstein Mini-Mental State Examination (MMSE). Trained bilingual staff administered the MMSE in participants' homes as part of the San Antonio Longitudinal Study of Aging home-based assessment battery. Subjects included 833 community-dwelling Mexican-American (MA) and European-American (EA) elders, aged 65 and older, residing in three socioculturally distinct neighborhoods in San Antonio, Texas. Three methods of scoring the MMSE were examined: serial sevens only, spelling only, and serial sevens or spelling, whichever was higher. Mean MMSE scores±standard deviation ranged from 27.7±2.4 to 28.5±1.9 for EAs, from 25.6±3.2 to 27.2±2.9 for MAs interviewed in English, and from 22.5±4.5 to 25.5±3.5 for MAs interviewed in Spanish, depending on scoring method. Across the three ethnic-language subgroups, the lowest mean scores, largest coefficients of variation, and highest alpha coefficients were observed using serial sevens only. Stratification by educational level showed that alpha coefficients for all three scoring methods were consistently lower in high school graduates than in less-educated groups. Serial sevens only was the only scoring method that yielded acceptably high alpha coefficients across all ethnic, language, and education subgroups. Thus, clinicians should use the serial sevens,only method when administering the MMSE and be alert to the increased potential for false-negatives in more highly educated EA and MA elders, particularly in EAs and MAs proficient in English. [source] A new method for scoring additive multi-attribute value models using pairwise rankings of alternativesJOURNAL OF MULTI CRITERIA DECISION ANALYSIS, Issue 3-4 2008Paul Hansen Abstract We present a new method for determining the point values for additive multi-attribute value models with performance categories. The method, which we refer to as PAPRIKA (Potentially All Pairwise RanKings of all possible Alternatives), involves the decision-maker pairwise ranking potentially all undominated pairs of all possible alternatives represented by the value model. The number of pairs to be explicitly ranked is minimized by the method identifying all pairs implicitly ranked as corollaries of the explicitly ranked pairs. We report on simulations of the method's use and show that if the decision-maker explicitly ranks pairs defined on just two criteria at-a-time, the overall ranking of alternatives produced by the value model is very highly correlated with the true ranking. Therefore, for most practical purposes decision-makers are unlikely to need to rank pairs defined on more than two criteria, thereby reducing the elicitation burden. We also describe a successful real-world application involving the scoring of a value model for prioritizing patients for cardiac surgery in New Zealand. We conclude that although the new method entails more judgments than traditional scoring methods, the type of judgment (pairwise rankings of undominated pairs) is arguably simpler and might reasonably be expected to reflect the preferences of decision-makers more accurately. Copyright © 2009 John Wiley & Sons, Ltd. [source] Psychosocial Well-Being and Quality of Life Among Women Newly Diagnosed With Genital HerpesJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 3 2009Hayley Mark ABSTRACT Objective: To assess the psychosocial well-being and quality of life among women with a new genital herpes simplex virus diagnosis. Design: Data were collected by a cross-sectional survey. Participants: Eighty-three women diagnosed with genital herpes simplex virus by culture, visual exam and/or a description of symptoms within the last 3 months were recruited from primary health care clinics by their provider. Measures: Participants completed the Hospital Anxiety and Depression Scale and the Recurrent Genital Herpes Quality of Life scale. Results: Thirty-four percent of the women qualified as "clinical cases" for depression, and 64% were designated as "anxiety cases" based on Hospital Anxiety and Depression Scale scoring methods. A majority of participants reported feeling ashamed about having herpes and worried about having an outbreak or giving herpes to someone else. Conclusions: Despite substantial progress toward understanding genital herpes simplex virus epidemiology and transmission, a diagnosis of genital herpes continues to cause considerable psychosocial morbidity and to impact quality of life. There is a dearth of good evidence on how best to intervene to minimize the psychological impact of a diagnosis. Experts recommend addressing both the medical and psychological aspects of infection by providing antiviral therapy, written material, and resources. [source] Data fusion according to the principle of polyrepresentationJOURNAL OF THE AMERICAN SOCIETY FOR INFORMATION SCIENCE AND TECHNOLOGY, Issue 4 2009Birger Larsen We report data fusion experiments carried out on the four best-performing retrieval models from TREC 5. Three were conceptually/algorithmically very different from one another; one was algorithmically similar to one of the former. The objective of the test was to observe the performance of the 11 logical data fusion combinations compared to the performance of the four individual models and their intermediate fusions when following the principle of polyrepresentation. This principle is based on cognitive IR perspective (Ingwersen & Järvelin, 2005) and implies that each retrieval model is regarded as a representation of a unique interpretation of information retrieval (IR). It predicts that only fusions of very different, but equally good, IR models may outperform each constituent as well as their intermediate fusions. Two kinds of experiments were carried out. One tested restricted fusions, which entails that only the inner disjoint overlap documents between fused models are ranked. The second set of experiments was based on traditional data fusion methods. The experiments involved the 30 TREC 5 topics that contain more than 44 relevant documents. In all tests, the Borda and CombSUM scoring methods were used. Performance was measured by precision and recall, with document cutoff values (DCVs) at 100 and 15 documents, respectively. Results show that restricted fusions made of two, three, or four cognitively/algorithmically very different retrieval models perform significantly better than do the individual models at DCV100. At DCV15, however, the results of polyrepresentative fusion were less predictable. The traditional fusion method based on polyrepresentation principles demonstrates a clear picture of performance at both DCV levels and verifies the polyrepresentation predictions for data fusion in IR. Data fusion improves retrieval performance over their constituent IR models only if the models all are quite conceptually/algorithmically dissimilar and equally and well performing, in that order of importance. [source] Bacterial vaginosis , a laboratory and clinical diagnostics enigma,APMIS, Issue 3 2005Review article II Diagnosing bacterial vaginosis (BV) has long been based on the clinical criteria of Amsel et al., whereby three of four defined criteria must be satisfied. Though there are other criteria and scoring methods which function well in comparison (i.e. Nugent scoring), it is not certain that they will always identify the same category of patients. Point-of-care methods based on various combinations of microbial products, presence of RNA, or more complex laboratory instrumentations such as sensor arrays, have also been introduced for the diagnosis of BV. No method for diagnosing BV can at present be regarded as the best. It could be that , based partly on tacit knowledge on the part of the clinical investigators scoring in the clinic , various scoring systems have been chosen to fit a particular BV-related problem in a particular population. In this review we critically examine these pertinent issues influencing clinical scoring and laboratory diagnostics of BV. [source] Determination of the minimal clinically important difference in rheumatoid arthritis joint damage of the Sharp/van der Heijde and Larsen/Scott scoring methods by clinical experts and comparison with the smallest detectable differenceARTHRITIS & RHEUMATISM, Issue 4 2002Karin Bruynesteyn Objective To assess the minimal clinically important difference (MCID) in joint damage on hand and foot radiographs of patients with early rheumatoid arthritis (RA) as assessed with the Sharp/van der Heijde and Larsen/Scott methods, and to study how the smallest detectable difference (SDD) relates to the MCID for each method. Methods The judgments of an international panel of experts on the clinical relevance of progression of joint damage as seen on sets of radiographs obtained at 1-year intervals in 4 clinical settings (early versus late RA and mild versus high disease activity) were used as the external criterion, which was compared with the progression scores as determined by the 2 scoring methods. Progression scores with the highest combined sensitivity and specificity for detecting clinically relevant progression represented the MCID. Subsequently, the sensitivity and specificity of the scoring methods were determined when using the SDD as the threshold for relevant progression, and these were compared with the sensitivity and specificity of the MCID. Results The panel judged changes in joint damage around the level of the SDD (5.0) of the Sharp/van der Heijde method as minimal clinically important, resulting in satisfactory sensitivity (mean 79%) and specificity (mean 84%) for detecting clinically important progression in the 4 clinical settings when using the SDD as the threshold value. The MCID (mean 2.3) of the Larsen/Scott method was much smaller than its SDD (5.8), and the sensitivity for detecting clinically important progression by applying the SDD as threshold was consequently low (mean 51%), accompanied by high specificity (mean 99%). Conclusion This study suggests that the SDD of the Sharp/van der Heijde method can be used as the MCID, i.e., as the threshold level for individual response criteria. The SDD of the Larsen/Scott method, however, turned out to be too insensitive to use as the threshold for individual clinically relevant change. [source] Assessment of the upper limb in acute stroke: The validity of hierarchal scoring for the Motor Assessment ScaleAUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 3 2010Rebekah L. Pickering Background/aim:, Stroke is the greatest contributor to disability in Australian adults and much of this disability results from a stroke-affected upper limb. This study aimed to determine the validity of hierarchal scoring for the upper limb subscale of the Motor Assessment Scale (UL-MAS) in acute stroke using Rasch analysis. Method:, This study applied Rasch analysis to 40 UL-MAS assessment results across 25 subjects to determine the validity of the hierarchy of the three upper limb subsets: upper arm function (six), hand movements (seven) and advanced hand activities (eight). Rasch analysis examines the relationship between ,item difficulty' and ,person ability' and produces an output which represents the difficulty of each item in relation to each other. Results:, As hypothesised, the hierarchy was upheld within subset 6. In subset 7, the hierarchy was not upheld. Results indicated that item 3 was the least difficult, followed by items 1, 4, 2, 5 and 6 in order of increasing difficulty. In subset 8 the hierarchy was not upheld. Results indicated that item 1 was the least difficult, followed by item 6, then 2 and 5 of equal value and then 3 and 4 of equal value. Conclusions:, The hierarchal scoring is not supported for subsets 7 and 8 and future research is required to explore the validity of alternate scoring methods. At present, the authors recommend that the UL-MAS should be scored non-hierarchally, meaning that every item within the subsets should be scored regardless of its place within the hierarchy (UL-MAS-NH). [source] 3424: Posterior capsule opacification assessment and factors that influence visual quality after posterior capsulotomyACTA OPHTHALMOLOGICA, Issue 2010R MICHAEL Purpose To study the correlation between posterior capsule opacification (PCO) and intraocular straylight and visual acuity. Methods We measured visual acuity (VA) (logMAR) and intraocular straylight (C-Quant straylight parameter log[s]) under photopic conditions before and 2 weeks after YAG capsulotomy in 41 patients (53 eyes) from the Centro de Oftalmología Barraquer in Barcelona and the University Eye Clinic, Paracelsus Medical University in Salzburg. Photopic pupil diameter was also measured. To document the level of opacification, pupils were dilated, and photographs were taken with a slit lamp, using retroillumination and the reflected light of a wide slit beam at an angle of 45º. PCO was subjectively graded on a scale of 0 to 10 and using the POCOman system. A multiple regression analysis was performed to evaluate factors that influence straylight after capsulotomy. Results Straylight correlated well with retroillumination and reflected-light PCO scores, whereas VA only correlated with retroillumination. Both VA and straylight improved after capsulotomy. Straylight values varied widely after capsulotomy. Multiple regression analysis showed that older age, large ocular axial length, hydrophobic acrylic intraocular lenses (IOLs), and small capsulotomies are factors that increased intraocular straylight. Conclusion Intraocular straylight is a useful tool in the assessment of PCO. It correlates well with PCO severity scoring methods. When performing a posterior capsulotomy, factors such as age, IOL material, axial length, and capsulotomy size must be taken into consideration, as they influence intraocular straylight. [source] Image analysis and quantification in lung tissueCLINICAL & EXPERIMENTAL ALLERGY, Issue 3 2001W.I. De Boer On 9,10 September 1999, an international workshop on image analysis and quantification in lung tissue was held at the Leiden University Medical Center, Leiden, The Netherlands. Participants with expertise in pulmonary and/or pathology research discussed the validity and applicability of techniques used for quantitative examination of inflammatory cell patterns and gene expression in bronchial or parenchymal tissue in studies focusing on asthma and chronic obstructive pulmonary disease (COPD). Differences in techniques for tissue sampling and processing, immunohistochemistry, cell counting and densitometry are hampering the comparison of data between various laboratories. The main goals of the workshop were to make an inventory of the techniques that are currently available for each of these aspects, and in particular to address the validity and unresolved problems of using digital image analysis (DIA) as opposed to manual scoring methods for cell counting and assessment of gene and protein expression. Obviously, tissue sampling and handling, fixation and (immunohistochemical) staining, and microscope settings, are having a large impact on any quantitative analysis. In addition, careful choices will have to be made of the commercially available optical and recording systems as well as the application software in order to optimize quantitative DIA. Finally, it appears to be of equal importance to reach consensus on which histological areas are to be analysed. The current proceedings highlight recent advances and state of the art knowledge on digital image analysis for lung tissue, and summarize the established issues and remaining questions raised during the course of the workshop. [source] A qualitative study to assess the effectiveness of laser epilation using a quality-of-life scoring systemCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 6 2006F. J. Conroy Summary Background., Facial hirsutism has a negative effect on the quality of life (QOL) of female patients. Aim., To assess the efficacy of laser epilation on the quality of life in hirsute women. Methods., Over a 6-month period, we recruited 38 patients with severe pathological facial hirsutism. Each patient completed a pretreatment questionnaire consisting of a modified Dermatology Life Quality Index (DLQI), a visual analogue scoring system, and an ,out-of-10' scoring system. The patients were also scored independently by a doctor and a nurse. Each patient received a laser-epilation treatment programme and was reassessed in an identical fashion. Results., Following laser epilation, the mean patient DLQI score fell by 5 points. All three scoring groups scored lower across all scoring methods following laser treatment. There was also correlation in scoring between disciplines. Conclusion., DLQI provides a valid scoring system to assess the efficacy of laser epilation. The interdisciplinary scores in this study indicate that an objective grading system for facial hirsutism could be developed in the future., [source] | ||||||||||