The purposes of this study were to: 1) determine absolute intrarater reliability of using the cervical range of motion device (CROM) for measuring cervical movements in older adults, and 2) determine the intrarater reliability and concurrent validity of the Candrive protocol, which uses a universal goniometer to measure rotation. Forty older adults (75.7 + 4.7 years of age) were tested in two sessions, one week apart, by two raters. Intrarater reliability scores were good for the CROM protocol (coefficient of variation (CV) values were 5.5% and 6.2 % for cervical rotation). The Candrive protocol values were higher (CV = 7.9 and 9.4%). Concordance analyses suggested that the Candrive protocol was less than good in terms of its validity, particularly when order effects were taken into consideration. In conclusion, the CROM protocol demonstrated good reliability for either group or individual analyses, whereas the Candrive protocol was less reliable and its validity marginal.

Bakgrund: Rehabiliteringen efter en rotatorkuffrupturoperation är oftast lång och följer olika faser med hänsyn till senans inläkning. Behandlingsresultatet är multifaktoriellt och det rekommenderas att rehabiliteringen individanpassas. För att följa och utvärdera rehabiliteringsprocessen behövs funktionella axeltester. I dagsläget saknas reliabla och validerade funktionella axeltester under rehabiliteringens tidigare faser. Syfte: Syftet med denna studie är att undersöka reliabiliteten hos två standardiserade armlyft, Aktivt armlyft i flexion och Aktivt armlyft i skapulaplanet, med statiskt kvarhåll i 90° under 30 sekunder, för vuxna individer som genomgått enrotatorkuffrupturoperation för cirka tre månader sedan. Metod: Datainsamlingen utfördes i tre steg, först utfördes en videoinspelning av de standardiserade armlyften av två fysioterapeuter. Därefter utfördes två bedömningstillfällen av två andra fysioterapeuter. Videoinspelningarna, armlyften och bedömningarna utfördes enligt standardiserade protokoll. Inter- och intrareliabilitetsbedömningarna baserades på videoinspelningarna där de två bedömarna graderade patienternas förmåga att utföra de två standardiserade armlyften utifrån utfallsmåtten ”Klarar” eller ”Klarar ej”. Överensstämmelsen analyserades i IBM SPSS med Cohens Kappa. Resultat: Åtta manliga studiedeltagare i åldrarna 49–71 år (medelålder 59,4 år) deltog. Videoinspelningarna utfördes i genomsnitt 15,25 (±3,9) veckor efter operation. Den andra bedömningen genomfördes i genomsnitt 9 (±3,1) dagar efterförsta bedömningen. Resultatet visade att interbedömarreliabiliteten var ”God”(k=0,71) till ”Utmärkt” (k=1,00) och intrabedömareliabiliteten var ”Utmärkt”(k=1,00). Slutsats: Denna studie fann att inter- och intrabedömarreliabilitet var ”God” till”Utmärkt” gällande de två standardiserade armlyften. Resultatet bör tolkas med försiktighet på grund av det begränsade deltagarantalet och ingen säker slutsats kandras. Ytterligare forskning behövs för att fastställa klinisk betydelse. / Background: Rehabilitation after rotator cuff tear surgery is often long and follows different phases with consideration for tendon healing. The treatment result is multifactorial, and the rehabilitation is recommended to be individualized.vFunctional shoulder tests are of value and evaluate the rehabilitation process. Currently, reliable and validated functional shoulder tests are lacking during the earlier phases of rehabilitation. Purpose: The purpose of this study is to investigate the reliability of two standardized arm lifts, Active shoulder flexion and Active shoulder scaption, with astatic hold at 90° for 30 seconds, three months post-surgery. Method: Data collection was conducted in three steps. Starting with videorecordings of the standardized arm lifts by two physiotherapists. Followed by two assessment sessions with approximately one week apart, by two other physiotherapists. The video recordings, arm lifts, and assessments were performed according to standardized protocols. Inter- and intrarater reliability assessments were based on the video recordings. The examiners graded the patient’s ability to perform the two functional shoulder tests based on the outcomes "Approved" or "Non-approved". The agreement was calculated with IBM SPSS using Cohen's Kappa. Results: Eight men were included, 49-71 years (mean age 59,4 years). The videorecordings and the first evaluation were performed in mean 15,3 (±3,9) weeks postsurgery. The second evaluation was performed in mean 9,4 (±3,1) days after the first evaluation. The results showed that the interrater-reliability was “Good” (k=0,71) to“Excellent” (k=1,00), and the intrarater-reliability was “Excellent” (k=1,00). Conclusion: This study found that the inter- and intrarater reliability for the two standardized arm lifts were good to excellent. The limited number of participants requires caution with the interpretation of the results and no definitive conclusion can be drawn. Further research is needed to establish any clinical significance.

Background: The Swedish driving licence test is a criterion-referenced test resulting in a pass or fail. It currently consists of two parts - a theory test with 65 multiple-choice items and a practical driving test where at least 25 minutes are spent driving in traffic. It is a high-stakes test in the sense that the results are used to determine whether the test-taker should be allowed to drive a car without supervision. As the only other requirements for obtaining a licence is a few hours of hazard education (and a short introduction if you intend to drive with a lay instructor) it is important that the test result, in terms of pass or fail, is reliable and valid. If this is not the case it could have detrimental effects on traffic safety. Examining all relevant aspects is beyond the scope of this licentiate thesis so I have focused on reliability. Methods Reliability for both the theoretical and practical test results was examined. As these are very different types of tests the types of reliability examined also differed. In order to examine inter-rater reliability of the driving test 83 examiners were accompanied by one of five selected supervising examiners for a day of tests. All in all 535 tests were conducted with two examiners assessing the same performance. At the end of the day the examiners compared notes and tried to determine the reason for any inconsistencies. Both examiners and students also filled in questionnaires with questions about background and preparation. As for studying decision consistency and decision accuracy of the theory test, three test versions (a total of around 12,000 tests) were examined with the help of methods devised by Subkoviak (Subkoviak, 1976, 1988) and Hanson & Brennan (Brennan, 2004; Hanson & Brennan, 1990). Results The results from two research studies concerning reliability were presented. Study I focused on inter-rater reliability in the driving test and in 93 per cent of cases the examiners made the same assessment. For the tests where their opinions differed there was no correlation to any of the background variables or other variables examined except for three, which had logical explanations and did not constitute a problem. Although there were cases where the differences were due to different stances on matters of interpretation the most common suggested cause was the placement in the car (back seat vs. front seat). Although the supervising examiners gave both praise and criticism as to how the test was carried out the study does not answer the question whether the tests were equal in terms of composition and difficulty. In Study II the focus was on decision consistency and decision accuracy in the theory test. Three versions of the theory tests were examined and, on the whole, found to be fairly similar in terms of item difficulty and score distribution, but the mean was so close to the cut-score (i.e. the score required to pass) that the pass rate differed somewhat between versions. Agreement coefficients were around .80 for all test versions (between .79 and .82 depending on method). Classification accuracy indicated an .87 probability of a correct classification. Conclusion It is important to examine the reliability and validity of the driving licence test since a misclassification can have serious consequences in terms of traffic safety. In the studies included here the rate of agreement between examiners is deemed as satisfactory. It would be preferable if the classification consistency and classification accuracy, as estimated by the methods used, were higher for the theory test, given its importance. While reliability in terms of agreement between raters/examiners or consistency and accuracy of classification are routinely examined in other contexts, such as large-scale educational testing, this is not often done for the driving licence tests. At the same time, the methods used here can be transferred to contexts where such properties are generally not examined. Collecting information about test-takers and examiners, like in Study I, can provide evidence concerning possible bias. Examining to what extent decisions are consistent is one important aspect of collecting evidence that shows that test results can be used to draw conclusions about driver competence. Still, regardless of outcome, validation is a process that never ends. There is always reason to examine various aspects and make further improvements. There are also many other relevant aspects to examine. A prerequisite for the validity of the score interpretation of a criterion-referenced test like this one is that the cut-score is appropriate and the content relevant. This should therefore be the subject of further research as the validation process continues.

The purpose of this study was to investigate if early childhood educators could reliably score items using a new scoring system for the Assessment, Evaluation, and Programming System for Infants and Children (AEPS; Bricker, 2002). The participants were university students completing their certification in Interdisciplinary Early Childhood Education (IECE) at the University of Kentucky (UK). The six participants completed training on implementing the AEPS and administered the AEPS to measure child outcomes. The results of this study validated the new scoring system for the AEPS by illustrating that the participants could reliably score a curriculum based assessment.

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This thesis presents a draft of a diagnostic tool, intented to use to analyze mediated learning experience ("MLE") in the interactions of parents and school aged children. The first chapter deals with historical roots of MLE and theoretical concepts, which inspired Reuver Feuerstein, author of MLE. Next chapters of the thesis are giving insight to MLE parameters and connecting the parameters to the contemporary knowledge from psychological practice. The thesis is also focused on MISC approach, created by Pnina Klein, which hasn't been described yet in the czech psychological literature, even though it is based on MLE and it is commonly used in foreign research and interventional programmes. The thesis describes the structure of MLE and possibilities of it's uses. At the end of the theoretical part of the thesis, methods, based on MLE theory, used in the Czech republic, are described. Contemporary methods of analyzing interactions of parents and children are also mentioned. Research project of the thesis was focused on designing a draft of a specific form of a diagnostic tool Observed Interactions of Mediated Learning Experience (Pozorované Interakce Zkušenosti Zprostředkovaného Učení - "PIZZU"). It's contents and graphic form was created in cooperation with pedagogues and psychologists. Creating PIZZU...

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Fragestellung und Zielsetzung: Ausgehend von dem Ziel, kommunikative Fähigkeiten von Studierenden der Humanmedizin objektiv zu messen, sollte in dieser Studie untersucht werden, ob eine ins Deutsche übersetzte Kurzversion des „Calgary-Cambridge Observation Guide for the Medical Interview“ (CCOG) von Kurtz und Silverman (1996) valide und reliabel ist und sich damit die Kommunikationsfähigkeit von Studierenden der Medizin bewerten lässt. Methode: Eine Auswahl von Ärzten, wissenschaftlichen Mitarbeitern und Studierenden des klinischen Studienabschnittes evaluierten im Abstand von mindestens drei Monaten fünf Anamnese-Videos mittels der ins Deutsche übersetzten „CCOG-Kurzversion“. Die Videos bestanden aus je einem Gespräch zwischen einem Studierenden des ersten klinischen Semesters in der Rolle des Arztes bzw. einer approbierten Ärztin und einem Schauspielpatienten – in unterschiedlicher Kommunikationsqualität. Die Auswertung erfolgte deskriptiv nach folgenden Kriterien: Bewertungszeitpunkt, Geschlecht bzw. Gruppe der Rater, Qualität der Videogespräche. Darüberhinaus wurden eine explorative und eine konfirmatorische Faktorenanalyse berechnet und die Retest-Reliabilität (Intra-Rater-Reliabilität) sowie die Intra-Class-Correlation (Inter-Rater-Reliabilität) bestimmt. Ergebnisse: 30 Rater beteiligten sich an der Studie, davon drei als sog. „Goldstan-dard“. Die Gesamtbewertung aller fünf Anamnese-Videos zeigte eine geringfügige Verbesserung in der Notenvergabe beim zweiten Bewertungszeitpunkt. In der Benotung waren professionelle Rater generell etwas strenger als Laien, Ärzte etwas strenger als Studierende und weibliche Rater etwas strenger als männliche. „Gold-standard“ und übrige Rater unterschieden sich bei einzelnen Items bis zu 1,6 Notenpunkten (z.B. beim Item „verbale/nonverbale Unterstützung des Patienten“). In der Originalversion enthält der CCOG 28 Items, die in sechs Skalen (mit jeweils 3 bis 7 Items) zusammengefasst sind. Diese Struktur ließ sich in der hier gerechneten Faktorenanalyse nur bedingt abbilden. Gemäß Eigenvalue > 1 genügten 5 Faktoren zur Abbildung bzw. Aufteilung der Items. Darüber hinaus zeigte sich eine andere Skalenzuordnung als im Original und über die Hälfte der Items (15/28) lud auf demselben Faktor. Auch die Inter-Rater-Übereinstimmung in der Beantwortung einzelner Items war nicht optimal (ICC-Range: 0,05 bis 0,57). Schlussfolgerungen: Die CCOG-Kurzversion zeigte relativ gute Übereinstimmun-gen bei der Retest-Reliabilität. Schwierigkeiten zeigten sich bei der Benotung einiger Items im Vergleich zwischen dem „Goldstandard“ und den übrigen Ratern. Die Skalen-Struktur der Items und die Inter-Rater-Reliabilität sind nur bedingt akzeptabel. Vielleicht hätte eine dreistufige Bewertungsskala oder eine homogene Rater-Gruppe oder auch eine bessere Schulung das Ergebnis der ICC verbessert. Es sollten einige Items gestrichen, sprachlich trennschärfer formuliert oder anders zusammengefasst, neue Items hinzugefügt und Skalen neu strukturiert werden.

INTRODUCTION Les anévrismes cérébraux représentent une condition potentiellement mortelle. Ils sont traités par voie chirurgicale (« clipping ») ou endovasculaire (dont le « coiling »), et plusieurs essais cliniques randomisés comparant ces traitements utilisent les résultats angiographiques comme mesure du succès du traitement. Le développement d'une classification standardisée et applicable aux deux traitements et aux trois modalités angiographiques (conventionnelle, angioscan et angio-IRM) est nécessaire. Nos objectifs furent de revoir systématiquement les classifications existantes, d’évaluer la fiabilité inter/intra-observateur d’une nouvelle classification angiographique commune, et d’en vérifier la pertinence clinique. MÉTHODES Deux revues systématiques furent effectuées dans 5 bases de données pour recenser les classifications (et leur fiabilité, lorsque rapportée) pour chaque traitement. Les résultats d’angiographie conventionnelle post-clipping (n=30) ou coiling (n=30) de 60 patients furent évalués de manière indépendante, à l’aide d’une nouvelle classification à 3 catégories, par 19 cliniciens ayant diverses pratiques et expériences. Les observateurs devaient également indiquer la prise en charge clinique appropriée pour chaque cas: un suivi espacé, étroit, ou un retraitement. Quinze lecteurs ont procédé à une 2e évaluation des cas (présentée selon un ordre permuté) à 1 mois d’écart. Le même travail fut reconduit, dans un deuxième temps, par 24 observateurs avec 60 cas évalués par angioscan (n=30) ou angio-IRM (n=30). Les accords inter/intra-observateurs furent estimés avec la statistique Alpha de Krippendorff (aK); la corrélation entre le choix de classe et la prise en charge fut calculée avec un test V de Cramer. RÉSULTATS Soixante-dix classifications (44 post-clipping, 26 post-coiling) furent recensées dans la littérature. La fiabilité variait de 0.12 à 1.00, avec une hétérogénéité significative en termes d’observateurs et de patients. L’accord inter-observateur pour la classification retenue était substantiel pour les résultats d’angiographie conventionnelle (aK=0.76; 0.67–0.83) et des autres modalités (aK=0.63; 0.55–0.70); peu importe le traitement, la spécialité ou l’expérience des évaluateurs. La classe est fortement corrélée à la prise en charge (V de Cramer de 0,77 à 0,80 selon la modalité angiographique; p<0,001). CONCLUSION La classification proposée est fiable et pertinente cliniquement. Elle servira d’outil valide pour évaluer les résultats angiographiques d’anévrismes dans les futurs essais cliniques comparant les deux traitements, peu importe la modalité d’imagerie utilisée. / INTRODUCTION Intracranial aneurysms are a medical condition associated with serious morbidity and mortality when ruptured. They are mainly treated with surgical clipping or endovascular coiling, and randomized clinical trials comparing both treatments often use angiographic results as a surrogate outcome of treatment success. The development of a standardized, reliable method to report angiographic results, applicable to both treatments using any angiographic modality (Conventional [CA], Computed tomography [CTA], or magnetic resonance [MRA] angiography) is needed. We sought to systematically review existing methods of classifying treated aneurysms and to assess the inter-/intra-rater reliability of a new angiographic grading scale, as well as its clinical relevance. METHODS We conducted two separate systematic reviews in 5 databases to collect post-clipping and post-coiling grading scales, along with their reliability when reported. The CA of 60 cases of clipped (n=30) and coiled (n=30) aneurysms were independently evaluated by 19 raters of various backgrounds and experiences using a new 3-grade scale. Raters were also asked how they would manage each case (delayed, close follow-up, or retreatment). Fifteen raters performed a 2nd evaluation of the same cases (in a permuted order) at least one month apart. The same methodology was used to study the reliability of the scale when 60 noninvasive angiography cases of clipped (30 CTA) or coiled (30 MRA) aneurysms were evaluated by 24 raters. Inter and intra-rater agreements were assessed using Krippendorff’s Alpha statistics (aK), and the relationship between occlusion grade and clinical management using Cramer’s V test. RESULTS The systematic reviews found 70 grading scales (44 post-clipping, 26 post-coiling) with significant heterogeneity in terms of reliability (kappa values from 0.12 to 1.00), raters, and patients. Overall inter-rater agreement for the grading scale was substantial for CA results (aK=0.76; 0.67–0.83) as well as for noninvasive results (aK=0.63; 0.55–0.70); regardless of background, experience, or treatment used. A strong relationship was found between angiographic grades and management decisions (V=0.80±0.12 for CA; V=0.77±0.14 for CTA/MRA [p<0.001]). CONCLUSION A standardized 3-grade scale was found to be a reliable and clinically meaningful tool to compare the results of clipping and coiling of aneurysms using any angiographic modality. It could be used as a valid tool to adjudicate results of comparative randomized trials, and to standardize the reporting of aneurysm treatments.