1
|
Blasco‐Peris C, Climent‐Paya V, Vetrovsky T, García‐Álvarez MI, Manresa‐Rocamora A, Beltrán‐Carrillo VJ, Sarabia JM. International Physical Activity Questionnaire Short Form and accelerometer-assessed physical activity: concurrent validity using six cut-points in HF patients. ESC Heart Fail 2024; 11:126-135. [PMID: 37842962 PMCID: PMC10804186 DOI: 10.1002/ehf2.14514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/21/2023] [Accepted: 08/21/2023] [Indexed: 10/17/2023] Open
Abstract
AIMS Physical activity (PA) is an important target for improving clinical outcomes in heart failure (HF) patients. Nonetheless, assessing the daily PA profile in this population is a challenging task, traditionally performed using self-report questionnaires such as the International PA Questionnaire Short Form (IPAQ-SF). This study aimed to evaluate the concurrent validity of the IPAQ-SF and accelerometer-assessed PA using six published cut-points in patients with HF and reduced or mildly reduced ejection fraction. METHODS AND RESULTS The concordance between the IPAQ-SF and a hip-worn accelerometer regarding daily time spent performing moderate to vigorous PA in bouts of at least 10 min was assessed in 53 participants for seven consecutive days using six different cut-points (Barnett, Dibben, Mark, Sanders, Troiano, and Vaha-Ypya). Spearman's correlation and Bland-Altman plots were used to evaluate concurrent validity between methods. Regressions were used to study the association between patient variables, wear protocol (waking hour or 24 h), and absolute bias. The kappa index was used to evaluate the concordance between IPAQ-SF and accelerometry for classifying patients as active or non-active. All analyses were re-run using non-bouted metrics to investigate the effect of bouted versus non-bouted analysis. The IPAQ-SF and accelerometry showed low to negligible correlation (ρ = 0.12 to 0.37), depending on the cut-point used. The regression analysis showed that the absolute bias was higher in participants following the waking-hour protocol at all cut-points except Dibben's (P ≤ 0.007). The concordance between the two methods to classify patients as active and non-active was low when using Mark (κ = 0.23) and Barnett (κ = 0.34) cut-points and poor for the remaining cut-points (κ = 0.03 to 0.18). The results of the sensitivity analysis showed negligible to low correlation using non-bouted metrics (ρ = 0.27 to 0.33). CONCLUSIONS Moderate to vigorous PA measures using IPAQ-SF and accelerometers are not equivalent, and we do not encourage researchers to use IPAQ-SF alone when assessing PA in HF patients. Moreover, applying personalized collection and processing criteria is important when assessing PA in HF patients. We recommend following the 24 h protocol and selecting cut-points calibrated in patients with cardiovascular diseases. Finally, it is necessary to develop a new tailored questionnaire that considers walking intensity and is adjusted to the current World Health Organisation recommendations, which use non-bouted metrics.
Collapse
Affiliation(s)
- Carles Blasco‐Peris
- Alicante Institute for Health and Biomedical Research (ISABIAL)AlicanteSpain
- Department of Physical Education and SportUniversity of ValenciaValenciaSpain
| | - Vicente Climent‐Paya
- Alicante Institute for Health and Biomedical Research (ISABIAL)AlicanteSpain
- Department of CardiologyDr Balmis General University Hospital (HGUA)AlicanteSpain
| | - Tomas Vetrovsky
- Faculty of Physical Education and SportCharles UniversityPragueCzech Republic
| | - María I. García‐Álvarez
- Alicante Institute for Health and Biomedical Research (ISABIAL)AlicanteSpain
- Department of CardiologyDr Balmis General University Hospital (HGUA)AlicanteSpain
| | - Agustín Manresa‐Rocamora
- Alicante Institute for Health and Biomedical Research (ISABIAL)AlicanteSpain
- Department of Sport Sciences, Sports Research CentreMiguel Hernández University of ElcheElcheSpain
| | | | - José Manuel Sarabia
- Alicante Institute for Health and Biomedical Research (ISABIAL)AlicanteSpain
- Department of Sport Sciences, Sports Research CentreMiguel Hernández University of ElcheElcheSpain
| |
Collapse
|
2
|
Arauz PG, Chavez G, Reinoso V, Ruiz P, Ortiz E, Cevallos C, Garcia G. Influence of a passive exoskeleton on kinematics, joint moments, and self-reported ratings during a lifting task. J Biomech 2024; 162:111886. [PMID: 38043494 DOI: 10.1016/j.jbiomech.2023.111886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 10/30/2023] [Accepted: 11/27/2023] [Indexed: 12/05/2023]
Abstract
It was found that the Auxivo LiftSuit reduced the load on the back and hip muscles when lifting heavy loads, but its effect on lower body kinematics, joint moments, and self-reported ratings was unclear. The purpose of this study was to assess the effect of this passive lift-exoskeleton design, on lower body kinematics, joint moments, and self-reported ratings during lifting of heavy loads. Twenty healthy subjects performed lifting of heavy loads with and without the exoskeleton under surveillance of a motion capture system. Medium and maximum level adjustments of the exoskeleton, as well as no exoskeleton use were analyzed. Our results indicate significant reduction (p <.01) in pelvis segment tilt and hip flexion ROM with the exoskeleton at maximum level adjustment in males during lifting. Lumbosacral flexion moment ranges were significantly decreased (p <.013) with the exoskeleton at maximum and medium level adjustment in males during lifting. The general user impressions were mostly positive, with participants reporting that it was easier to perform the task with the exoskeleton than without it (p <.0.001), and preferring and recommending the exoskeleton for the task. Although our findings may suggest negative effects of the Auxivo LiftSuit in males and females due to a ROM restriction and loose fit, respectively, it does not mean that the Auxivo LiftSuit is not useful for lifting tasks. Further design improvements are required to allow full range of motion of hips and pelvis, as well to provide better adjustment and level of support in female users.
Collapse
Affiliation(s)
- Paul G Arauz
- Departamento de Ingeniería Mecánica, Colegio de Ciencias e Ingenierías, Universidad San Francisco de Quito USFQ, Quito, Ecuador.
| | - Guillermo Chavez
- Departamento de Ingeniería Industrial, Colegio de Ciencias e Ingenierías, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Valentina Reinoso
- Departamento de Ingeniería Industrial, Colegio de Ciencias e Ingenierías, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Pablo Ruiz
- Laboratorio de Análisis de Movimiento, CELMOST Vivir, Quito, Ecuador
| | - Esteban Ortiz
- Department of Bioengineering, Rice University, Houston, United States
| | - Carlos Cevallos
- Faculté des Sciences de la Motricité, Université libre de Bruxelles, Bruxelles, Belgium
| | - Gabriela Garcia
- Departamento de Ingeniería Industrial, Colegio de Ciencias e Ingenierías, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| |
Collapse
|
3
|
Nudelman Y, Pincus T, Nicholas MK, Ben Ami N. Cross-cultural adaptation, reliability, and validity of the pain self-efficacy questionnaire - Hebrew version. Musculoskelet Sci Pract 2023; 64:102749. [PMID: 36965246 DOI: 10.1016/j.msksp.2023.102749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 03/08/2023] [Accepted: 03/14/2023] [Indexed: 03/27/2023]
Abstract
PURPOSE This study aims to translate, culturally adapt, and evaluate the psychometric properties of the Hebrew Pain Self-Efficacy Questionnaire (PSEQ). METHODS The study was designed according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) recommendations for patient-reported outcome measurement instruments. The PSEQ was initially translated into Hebrew and cross-culturally adapted. The Hebrew version of the PSEQ (PSEQ-H) was administered to participants suffering from chronic musculoskeletal pain, along with other self-report measures of pain (NPRS, FABQ, HADS, PCS, and SF-12). Eight hypotheses on expected correlations of the PSEQ-H with other instruments were formulated a priori to assess construct validity. Structural validity was assessed using confirmatory factor analysis. Floor and ceiling effects, test-retest, and internal consistency reliability were also assessed. RESULTS The translation process retained the unidimensional model of the PSEQ. The PSEQ-H demonstrates excellent internal consistency (Cronbach's α = 0.97) and test-retest reliability (ICC = 0.88), and no significant floor and ceiling effects were observed. Construct validity was found satisfactory as 75% (six) of the analyses between the PSEQ-H and the other self-reported measures met the hypotheses. Factor analysis confirmed the single-factor structure of the questionnaire. CONCLUSIONS The PSEQ-H version was found to have excellent reliability, good construct, and structural validity, and can be used with heterogeneous chronic musculoskeletal pain populations. Future studies should test the PSEQ-H's responsiveness and psychometric properties with specific pain populations.
Collapse
Affiliation(s)
- Yaniv Nudelman
- Department of Physiotherapy, Ariel University, Ariel, Israel; Maccabi Healthcare Services, Tel-aviv, Israel.
| | - Tamar Pincus
- University of Southampton, Southampton, United Kingdom
| | - Michael K Nicholas
- Pain Management Research Institute, Sydney Medical School, The University of Sydney, Royal North Shore, Australia
| | - Noa Ben Ami
- Department of Physiotherapy, Ariel University, Ariel, Israel
| |
Collapse
|
4
|
Verma D, Bach K, Mork PJ. External validation of prediction models for patient-reported outcome measurements collected using the selfBACK mobile app. Int J Med Inform 2023; 170:104936. [PMID: 36459835 DOI: 10.1016/j.ijmedinf.2022.104936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND External validation is essential in examining the disparities in the training and validation cohorts during the development of prediction models, especially when the application domain is healthcare-oriented. Currently, the use of prediction models in healthcare research aimed at utilising the under-explored potential of patient-reported outcome measurements (PROMs) is limited, and few are validated using external datasets. OBJECTIVE To validate the machine learning prediction models developed in our previous work [29] for predicting four pain-related patient-reported outcomes from the selfBACK clinical trial datasets. METHODS We evaluate the validity of three pre-trained prediction models based on three methods- Case-Based Reasoning, Support Vector Regression, and XGBoost Regression-using an external dataset that contains PROMs collected from patients with non-specific neck and or low back pain using the selfBACK mobile application. RESULTS Overall, the predictive power was low, except for prediction of one of the outcomes. The results indicate that while the predictions are far from immaculate in either case, the models show ability to generalise and predict outcomes for a new dataset. CONCLUSION External validation of the prediction models presents modest results and highlights the individual differences and need for external validation of prediction models in clinical settings. There is need for further development in this area of machine learning application and patient-centred care.
Collapse
Affiliation(s)
- Deepika Verma
- Department of Computer Science, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Kerstin Bach
- Department of Computer Science, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Paul Jarle Mork
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.
| |
Collapse
|
5
|
Verma D, Jansen D, Bach K, Poel M, Mork PJ, d’Hollosy WON. Exploratory application of machine learning methods on patient reported data in the development of supervised models for predicting outcomes. BMC Med Inform Decis Mak 2022; 22:227. [PMID: 36050726 PMCID: PMC9434943 DOI: 10.1186/s12911-022-01973-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 08/22/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Patient-reported outcome measurements (PROMs) are commonly used in clinical practice to support clinical decision making. However, few studies have investigated machine learning methods for predicting PROMs outcomes and thereby support clinical decision making. OBJECTIVE This study investigates to what extent different machine learning methods, applied to two different PROMs datasets, can predict outcomes among patients with non-specific neck and/or low back pain. METHODS Using two datasets consisting of PROMs from (1) care-seeking low back pain patients in primary care who participated in a randomized controlled trial, and (2) patients with neck and/or low back pain referred to multidisciplinary biopsychosocial rehabilitation, we present data science methods for data prepossessing and evaluate selected regression and classification methods for predicting patient outcomes. RESULTS The results show that there is a potential for machine learning to predict and classify PROMs. The prediction models based on baseline measurements perform well, and the number of predictors can be reduced, which is an advantage for implementation in decision support scenarios. The classification task shows that the dataset does not contain all necessary predictors for the care type classification. Overall, the work presents generalizable machine learning pipelines that can be adapted to other PROMs datasets. CONCLUSION This study demonstrates the potential of PROMs in predicting short-term patient outcomes. Our results indicate that machine learning methods can be used to exploit the predictive value of PROMs and thereby support clinical decision making, given that the PROMs hold enough predictive power.
Collapse
Affiliation(s)
- Deepika Verma
- grid.5947.f0000 0001 1516 2393Department of Computer Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Duncan Jansen
- grid.6214.10000 0004 0399 8953Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Twente, The Netherlands
| | - Kerstin Bach
- grid.5947.f0000 0001 1516 2393Department of Computer Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Mannes Poel
- grid.6214.10000 0004 0399 8953Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Twente, The Netherlands
| | - Paul Jarle Mork
- grid.5947.f0000 0001 1516 2393Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Wendy Oude Nijeweme d’Hollosy
- grid.6214.10000 0004 0399 8953Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Twente, The Netherlands ,grid.419315.beHealth Cluster, Roessingh Research and Development, Enschede, The Netherlands
| |
Collapse
|
6
|
Thorvaldsdottir KB, Halldorsdottir S, Johnson RM, Sigurdardottir S, Saint Arnault D. Adaptation of the barriers to help-seeking for trauma (BHS-TR) scale: a cross-cultural cognitive interview study with female intimate partner violence survivors in Iceland. J Patient Rep Outcomes 2021; 5:22. [PMID: 33638750 PMCID: PMC7914310 DOI: 10.1186/s41687-021-00295-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 02/11/2021] [Indexed: 11/25/2022] Open
Abstract
Background Even though traumatization is linked to substantially reduced health-related quality of life, help-seeking and service utilization among trauma survivors are very low. To date, there has not been available in Iceland a culturally attuned, self-reported measure on help-seeking barriers after trauma. This study aimed to translate and cross-culturally adapt the English version of Barriers to Help-Seeking for Trauma (BHS-TR) scale into the Icelandic language and context. Methods The BHS-TR was culturally adapted following well-established and rigorous guidelines, including forward-backward translation, expert committee review, and pretesting through cognitive interviews. Two rounds of interviews with 17 female survivors of intimate partner violence were conducted using a think-aloud technique and verbal probing. Data were analyzed using qualitative content analysis, a combination of deductive and inductive approaches. Results Issues with the BHS-TR that were uncovered in the study were classified into four categories related to general design, translation, cultural aspects, and post-trauma context. The trauma-specific issues emerged as a new category identified in this study and included concepts specific to trauma experiences. Therefore, modifications were of great importance—resulting in the scale becoming more trauma-informed. Revisions made to address identified issues improved the scale, and the process led to an Icelandic version, which appears to be semantically and conceptually equivalent to the original version; additionally, the results provided evidence of content validity. Conclusions As a cognitive interview study, it adds to the growing cognitive interviewing methodology literature. Furthermore, the results provide essential insights into the self-report response process of trauma survivors, highlighting the significance of making health-related research instruments trauma-informed.
Collapse
Affiliation(s)
| | | | - Rhonda M Johnson
- Department of Health Sciences, University of Alaska Anchorage, Anchorage, AK, USA
| | | | | |
Collapse
|
7
|
Paravlic AH, Pisot S, Mitic P, Pisot R. Validation of the Oxford Knee Score and Lower Extremity Functional Score questionnaires for use in Slovenia. Arch Orthop Trauma Surg 2020; 140:1515-22. [PMID: 32507946 DOI: 10.1007/s00402-020-03498-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 05/31/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND With the increasing prevalence of total knee replacement (TKR) due to knee osteoarthritis, the absence of patient-reported outcome measures in Slovenia must be addressed. QUESTIONS/PURPOSES (1) We cross-culturally adapted Oxford Knee Score (OKS) and Lower Extremity Functional Scale (LEFS) questionnaires to the Slovenian-speaking community. (2) We evaluated OKS and LEFS psychometric characteristics. PATIENTS AND METHODS In the first assessment (Time 1) Slovenian versions of both questionnaires (OKS-Slo and LEFS-Slo), knee pain, timed-up to go (TUG) and sit to stand (STS) tests were completed by 123 subjects (55% females), of which 78 were patients scheduled for TKR and 45 were healthy age-matched controls. The questionnaires were assessed one week apart (Time 2) to investigate the test-retest reliability, with 121 subjects (98.4%) completing second measurements. RESULTS Significant differences were observed between the two groups. Where patients had greater body mass index, they were slower in TUG, weaker in STS, had greater knee pain in both knees and scored lower on both questionnaires. Additionally, correlation analysis showed that OKS-Slo and LEFS-Slo correlated almost perfectly (correlation coefficient [CC] = .968, p < 0.001). Excellent negative correlations were observed with TUG (OKS-Slo/CC = - 0.679, p < 0.001; LEFS-Slo/CC = - 0.692, p < 0.001) and STS (OKS-Slo/CC = 0.790, p < 0.001; LEFS-Slo/CC = 0.815, p < 0.001) tests, while knee pain of affected leg correlated the most (OKS-Slo/CC = - 0.923, p < 0.001; LEFS-Slo/CC = - 0.915, p < 0.001). The Cronbach's alpha coefficient for both the OKS-Slo and LEFS-Slo ranged between 0.87 and 0.99, while the interclass correlation coefficient was excellent; i.e., 0.99. Finally, both questionnaires proved to be unidimensional measures. CONCLUSION The Slovenian version of both questionnaires is feasible, valid and reliable for use in clinical studies including the older adult population in Slovenia. LEVEL OF EVIDENCE Level III, Diagnostic-case-control study.
Collapse
|
8
|
Anthony H, Tabak R, Morshed AB, Schwarz C, Phad A, Haire-Joshu D. Awareness and accuracy of height and weight among mothers and their preschool-aged children. Public Health 2020; 182:151-154. [PMID: 32320905 PMCID: PMC7265393 DOI: 10.1016/j.puhe.2020.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 12/18/2019] [Accepted: 02/05/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES A constant challenge in addressing the issue of obesity is the validity and reliability of self-reported measurements to calculate body mass index, that assesses the prevalence of obesity in a population. The objective of this study is to analyze both awareness and accuracy of mothers who are overweight or obese, in reporting their own and their child's height and weight measurements. STUDY DESIGN cross-sectional study. METHODS In this study, mothers were asked over phone to self-report height and weight for them and their child. This was followed by objective measurement of maternal and child height and weight by study staff in a clinical setting. The descriptive and statistical analysis of the data obtained were carried out using SAS software. RESULTS 1) The mean weight of mothers who inaccurately self-reported their weight was 9.5 kg greater than the mean weight of those who reported accurately (P < 0.001). (2) Despite being aware of, and reporting their own measurements, 50% (n = 116) of mothers reported not knowing their child's height and 23% (n = 54) of them reported not knowing their child's weight. CONCLUSION Strategies to tackle both maternal awareness and accuracy of child's measurements can help with early identification of child's obesity risk and prevention of long-term consequences.
Collapse
Affiliation(s)
- H Anthony
- Center for Obesity Prevention and Policy Research, Brown School, Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO, 63130, USA; Department of Gastroenterology, Internal Medicine, Washington University in St. Louis, USA.
| | - R Tabak
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, MO, 63130, USA
| | - A B Morshed
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, MO, 63130, USA
| | - C Schwarz
- Center for Obesity Prevention and Policy Research, Brown School, Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO, 63130, USA
| | - A Phad
- Center for Diabetes Translation and Research, Brown School, Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO, 63110, USA
| | - D Haire-Joshu
- Center for Obesity Prevention and Policy Research, Brown School, Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO, 63130, USA; Department of Internal Medicine, Washington University School of Medicine, Washington University in St. Louis, USA
| |
Collapse
|
9
|
Santa Maria C, Sung CK, Baird BJ, Erickson-DiRenzo E. Vocal Hygiene in Collegiate Singers-Does Formal Training Relate to Practices? J Voice 2020; 35:859-868. [PMID: 32362576 DOI: 10.1016/j.jvoice.2020.03.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 03/13/2020] [Accepted: 03/18/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Vocal hygiene is vitally important for protecting vocal quality and promoting vocal longevity. It includes adequate hydration, avoidance of environmental irritants, and refraining from phonotraumatic behaviors such as screaming, excessive talking, and throat clearing. Formal singing training in addition to enhancing singing techniques, is also assumed to promote good vocal hygiene. Consequently, we investigated whether collegiate singers with formal training are more likely to practice good vocal hygiene habits than untrained collegiate singers. METHODS We completed a prospective cohort study, where collegiate singers at Stanford University were voluntarily enrolled in an annual vocal health clinic. Full laryngeal exams were performed and demographic information, formal vocal training status, and information on vocal hygiene habits were obtained through questionnaires. The results were then analyzed by grouping singers as "untrained" if less than 1 year of formal training, and "trained" if greater than a year. RESULTS A total of 82 singers were included for analysis, with 49 (59.8%) having greater than one year of formal training. Trained singers were more likely to employ a primary musical singing style of classical or operatic singing compared to untrained singers who were more likely to utilize "R&B" (P < 0.001). No significant differences were found between groups for hydration practices (P = 0.20), caffeine consumption (P = 0.73), warm up practices (P = 0.08), and phonotraumatic behaviors. Alcohol consumption, smoking tobacco, marijuana, e-cigarette usage was similar between groups. Overall, 11% of our sample reported intermittent less than daily marijuana use, with one singer reporting daily consumption. None of the singers in this sample used e-cigarettes. These rates are noticeably lower than the agematched United States population. Perceptions of cigarettes, marijuana, electronic cigarettes, alcohol, and caffeine were also the same between groups, with the vast majority of singers perceiving these agents as harmful to the voice (64%-100% depending on the agent). No laryngeal pathology was identified during laryngeal examination of any singers. CONCLUSIONS Vocal hygiene habits are similar between trained and untrained collegiate singers. This likely relates to a desire for vocal longevity irrespective of prior training. This may dispel the long-held assumption that formal training was necessary to develop good vocal habits. We do however, present a very homogenous, highly educated sample of collegiate singers from Stanford University, having significantly less at-risk behavior than their aged-matched counterparts in the general US population. A lack of laryngeal pathology despite extensive vocal demands may also be reflective of good vocal hygiene habits.
Collapse
Affiliation(s)
- Chloe Santa Maria
- Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, Stanford, California
| | - Chih-Kwang Sung
- Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, Stanford, California
| | - Brandon J Baird
- Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, Stanford, California; Department of Surgery - Section of Otolaryngology - Head and Neck Surgery, University of Chicago, Chicago, Illinois
| | - Elizabeth Erickson-DiRenzo
- Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, Stanford, California.
| |
Collapse
|
10
|
Guida J, Fukunaga A, Liu H. Biomarker validation of self-reported sex among middle-aged female sex workers in China. Ann Epidemiol 2017; 27:181-186.e1. [PMID: 28185717 DOI: 10.1016/j.annepidem.2017.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 12/05/2016] [Accepted: 01/08/2017] [Indexed: 10/20/2022]
Abstract
PURPOSE The objective of this study was to examine information bias arising from self-reported sexual activity and its association with syphilitic infections among female sex workers (FSWs) aged 35 years and older in China. METHODS A questionnaire was administered to 1245 middle-aged FSWs. Respondents self-reported sexual intercourse in the past 48 hours. The prostate-specific antigen test was used to verify self-reported sexual activity. FSWs were considered discordant if they indicated no sexual intercourse in the past 48 hours on the questionnaire and had a positive prostate-specific antigen test. Logistic regression was used to assess the associations between discordance and syphilis. RESULTS Three hundred twenty FSWs self-reported no engagement in sexual intercourse in the past 48 hours. One-fourth of respondents (25%) were discordant. Twenty-two percent and 35.8% of discordant FSWs tested positive for active and prevalent syphilis, respectively. After adjusting for confounders, discordant FSWs had 3.8 times the odds of active syphilis (95% confidence interval: 1.52-9.30) and 2.6 times the odds of prevalent syphilis (95% confidence interval: 1.37-5.02), compared with concordant FSWs. CONCLUSIONS FSWs who had active or prevalent syphilis were more likely to be discordant. Data collected via self-reported questionnaire may not be a valid tool to assess sexual behavior.
Collapse
Affiliation(s)
- Jennifer Guida
- School of Public Health, University of Maryland, College Park.
| | - Ami Fukunaga
- School of Public Health, University of Maryland, College Park
| | - Hongjie Liu
- School of Public Health, University of Maryland, College Park
| |
Collapse
|
11
|
Yachida W, Arima T, Castrillon EE, Baad-Hansen L, Ohata N, Svensson P. Diagnostic validity of self-reported measures of sleep bruxism using an ambulatory single-channel EMG device. J Prosthodont Res 2016; 60:250-257. [PMID: 26876908 DOI: 10.1016/j.jpor.2016.01.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 12/14/2015] [Accepted: 01/16/2016] [Indexed: 11/13/2022]
Abstract
PURPOSE Self-reported measures have been widely used to indicate the presence of possible and probable sleep bruxism (SB) in both research and clinical situations. However, few studies have attempted to assess the diagnostic validity of this approach. The aim of this study was to estimate the diagnostic validity of self-reported measures of SB using an ambulatory single-channel electromyographic (EMG) device. METHODS A total of 115 participants were enrolled and examined by standardized Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) including two questions related to SB: self-reported SB and morning-jaw symptoms. An ambulatory single-channel EMG device (GrindCare3™, Medotech A/S) was used for measuring jaw-muscle EMG activity during sleep for seven consecutive nights. Cut-off values for different measures of EMG activity (average, maximum and minimum) and the coefficient of variation (CV) were selected to divide participants into two groups, with higher or lower EMG activity or CV values. The sensitivity and specificity for each question and combination of them were calculated. RESULTS Self-reported SB had the highest sensitivity (compared with morning-jaw symptoms) for all measures of EMG activity and CV, although the values were low to modest (average: 76.0%, maximum: 76.9%, minimum: 77.3%, CV: 61.0%). The specificity was low for both the questions related to the different measures of EMG activity and CV (35.1-52.4%). CONCLUSIONS This study indicated that the diagnostic validity of self-reported measures of SB was low to modest using an ambulatory EMG device assessment as a reference. Using only self-reported measures for the assessment of SB may not have a high validity, which should be taken into consideration in the clinical evaluation of patients.
Collapse
Affiliation(s)
- Wataru Yachida
- Clinical Division of Crown and Bridge Prosthodontics Dentistry, Hokkaido University Hospital, Sapporo, Japan
| | - Taro Arima
- Division of International Affairs, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan.
| | - Eduardo E Castrillon
- Section of Orofacial Pain and Jaw Function, Department of Dentistry, Aarhus University, Aarhus, Denmark; Scandinavian Centre for Orofacial Neuroscience (SCON)
| | - Lene Baad-Hansen
- Section of Orofacial Pain and Jaw Function, Department of Dentistry, Aarhus University, Aarhus, Denmark; Scandinavian Centre for Orofacial Neuroscience (SCON)
| | - Noboru Ohata
- Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Peter Svensson
- Section of Orofacial Pain and Jaw Function, Department of Dentistry, Aarhus University, Aarhus, Denmark; Scandinavian Centre for Orofacial Neuroscience (SCON); Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| |
Collapse
|