Use of the Standard Error as a Reliability Index of Interest: An Applied Example Using Elbow Flexor Strength Data

Stratford, Paul W.; Goldsmith, Charlie H.

doi:10.1093/ptj/77.7.745

Cited by 362 publications

(239 citation statements)

References 12 publications

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“…16,39 The SEM quantifies the measurement error in the units of the original measurement, which provides a clinically meaningful value to be interpreted by the clinician. 32 Ninety-five percent confidence intervals (CIs) were calculated for all reliability coefficients.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of 3 Methodological Approaches to Defining Major Clinically Important Improvement of 4 Performance Measures in Patients With Hip Osteoarthritis

Wright¹,

Cook²,

Baxter³

et al. 2011

Journal of Orthopaedic & Sports Physical Therapy

309

246

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For rehabilitation professionals engaged in the treatment of osteoarthritis (OA), it is standard practice to perform objective assessments of physical function (using both physical performance and self-report measures) to obtain a picture of patient status. These assessments also serve as a baseline value for estimating changes (treatment effects) over time. While reliability and validity of some commonly used physical performance measures have been investigated in an OA population, most require further research regarding clinical utility and responsiveness. 14 Physical performance measures have often been criticized, as detailed testing of their measurement properties has not been extensively reported. 14,22,33 Measures of responsiveness have commonly been reported as statistically significant change scores, which are useful in establishing the threshold of change needed beyond measurement error. 10 Investigation of minimal clinically important differences (MCIDs) of physical performance measures is warranted, as these have become commonly used outcome measures in the treatment of OA. 8,12,17,[35][36][37] At present, the responsiveness (in terms of MCID) of the timed up-and-go (TUG) test, 40-meter self-paced walk test (40-m SPWT), 30-second chair stand (30 CST), and 20-cm step test has not been investigated in T T STUDY DESIGN: Prospective cohort study. T T OBJECTIVES:To establish the major clinically important improvement (MCII) of the timed upand-go test (TUG), 40-meter self-paced walk test (40-m SPWT), 30-second chair stand (30 CST), and a 20-cm step test in patients with hip osteoarthritis (OA) undergoing physiotherapy treatment. As a secondary aim, a comparison of methods was employed to evaluate the effect of method on the reported MCII. T T BACKGROUND: Minimal clinically importantdifference scores are commonly used by rehabilitation professionals to determine patient response following treatment. A gold standard for calculating MCII has yet to be determined, which has resulted in problems of interpretation due to varied results. T T METHODS:As part of a randomized controlled trial, 65 patients were randomized into a physiotherapy treatment group for hip OA, in which they completed 4 physical performance measures at baseline and 9 weeks. Upon completion of physiotherapy, patients assessed their response to treatment on a 15-point global rating of change scale (GRCS). MCII was estimated using 3 variations of an anchor-based method, based on the patient's opinion. T T RESULTS:A comparison of 3 methods resulted in the following change scores being best associated with our definition of MCII: a reduction equal to or greater than 0.8, 1.4, and 1.2 seconds for the TUG; an increase equal to or greater than 0.2, 0.3, and 0.2 m/s for the 40-m SPWT; an increase equal to or greater than 2.0, 2.6, and 2.1 repetitions for the 30 CST; an increase equal to or greater than 5.0, 12.8, and 16.4 steps for the 20-cm step test. T T CONCLUSION:The variation in methods provided very different results. This illustrates the impor...

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Section: Discussionmentioning

confidence: 99%

A Comparison of 3 Methodological Approaches to Defining Major Clinically Important Improvement of 4 Performance Measures in Patients With Hip Osteoarthritis

Wright¹,

Cook²,

Baxter³

et al. 2011

Journal of Orthopaedic & Sports Physical Therapy

309

246

View full text Add to dashboard Cite

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“…31 Standard error of measurement (SEM) was also calculated as SEM = SDdiff/√2 (under the assumption of similar variances where SDdiff = the standard deviation of the differences between test and retest observations). 32,33 ticipant correctly identified the test sensation on three trials, it was considered "normal"; when the participant identified the test sensation but not on all three trials in each region of the body, it was considered "impaired"; and, finally, when the participant did not identify the test sensation on any of the three trials, it was considered "absent." Each testing sense (light touch, pressure, pinprick, sharp and blunt, and proprioception) for each region of the body (upper limb: fingers, hand, forearm, and arm; lower limb: toes, foot, leg, and thigh) was analyzed separately.…”

Section: Discussionmentioning

confidence: 99%

Interrater Reliability of Four Sensory Measures in People with Multiple Sclerosis

Uszynski¹,

Purtill²,

Coote³

2016

International Journal of MS Care

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Background: Sensory disturbances are a major problem for people with multiple sclerosis (MS), and up to 80% of people with MS present with various sensory deficits. To date, only one study has investigated the reliability of sensory measures in people with MS. We sought to determine the interrater reliability of the verbal analogue scale (VAS), the Erasmus MC modifications to the revised Nottingham Sensory Assessment (EmNSA), Semmes-Weinstein monofilaments (SWMs), and the neurothesiometer (NT) in people with MS.

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“…However, research on reliability mostly employs ICC, which does not provide information about measurement errors. Therefore, the SEM should also be calculated, as a high ICC does not necessarily mean a small measurement error 30) . For instance, the ICCs for motor function and joint pain of the upper extremity were 0.972 and 0.830, respectively, and the SEMs were 3.25 and 2.23.…”

Section: Discussionmentioning

confidence: 99%

Reliability, Concurrent Validity, and Responsiveness of the Fugl-Meyer Assessment (FMA) for Hemiplegic Patients

Kim

Her

et al. 2012

J Phys Ther Sci

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Abstract.[Purpose] The purpose of this study was to determine the reliability, validity, and responsiveness of the Fugl-Meyer Assessment (FMA) for hemiplegic patients.[Subjects] For the reliability and validity study, 50 patients with stroke (26 males, 24 females) were recruited. For the responsiveness study, 16 hemiplegic patients (8 males, 8 females) participated.[Methods] Two physical therapists and one occupational therapist rated 50 video recordings of hemiplegic patients using the FMA to test the inter-rater reliability, and one physical therapist (rater A) rated each of the 50 video clips on two occasions, two weeks apart, to evaluate the test-retest reliability. Responsiveness was calculated three months after the baseline assessment. Reliability was calculated using the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and smallest real difference (SRD). Concurrent validity was examined using Pearson's correlation coefficient and responsiveness was calculated using the effect size (ES) and standardized response mean (SRM).[Results] Assessment using the FMA showed high relative reliability, and the absolute reliability was satisfactory for the inter-rater and test-retest reliabilities. The correlations between motor function of the FMA and the Jebsen-Taylor hand function, grip power, motor assessment scale (MAS), and the Berg balance scale (BBS) were moderate to good, and were highly significant (p<0.05), while responsiveness was moderate to large. [Conclusion] The results indicate that the FMA is a reasonable assessment of the function of the upper and lower extremities of patient with stroke.

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Use of the Standard Error as a Reliability Index of Interest: An Applied Example Using Elbow Flexor Strength Data

Cited by 362 publications

References 12 publications

A Comparison of 3 Methodological Approaches to Defining Major Clinically Important Improvement of 4 Performance Measures in Patients With Hip Osteoarthritis

A Comparison of 3 Methodological Approaches to Defining Major Clinically Important Improvement of 4 Performance Measures in Patients With Hip Osteoarthritis

Interrater Reliability of Four Sensory Measures in People with Multiple Sclerosis

Reliability, Concurrent Validity, and Responsiveness of the Fugl-Meyer Assessment (FMA) for Hemiplegic Patients

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