Tehran University Medical Journal

Background and Aim: Spasticity is a velocity-dependent increase in tonic stretch reflexes (muscle tone) with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex. The measurement of spasticity is necessary to determine the effect of treatments. The Modified Ashworth Scale is the most widely used method for assessing muscle spasticity in clinical practice and research. The purpose of this study was to investigate the interrater reliability of Modified Ashworth Scale in hemiplegic patients.

Materials and Methods: Thirty subjects (16 males, 14 females) with a mean age of 59.40 (SD =14.013) recruited. Shoulder adductor , elbow flexor , wrist dorsiflexor , hip adductor , knee extensor and ankle plantarflexor on the hemiplegic side were tested by two physiotherapists.

Results: In the upper limb, the interrater reliability for shoulder adductor and elbow flexor muscles was fair (0.372 and 0.369, respectively). The reliability for the wrist flexors was good (0.612). The difference in Kappa value for the proximal muscle (shoulder adductor 0.372) and the distal muscle (wrist flexor 0.612) was significant (²X=33.87, df=1, p<0.05). In the lower limb, the reliability for the hip adductor was fair (0.350), but for the knee extensor and ankle plantar flexor was moderate (0.518 and 0.542, respectively). The Kappa value for the proximal muscle (hip adductor: 0.350) and distal muscle (ankle plantar flexor0.542) had no significant difference (²X =1.35, df=1, p >0.05). The mean value for the upper limb (0.505) and the lower limb (0,.516) was not significantly different (²X=0.1407, df=1, p>0.05).

Conclusion: The interrater reliability of Modified Ashworth Scale was not good . The limb, upper or lower, had no significant effect on the reliability. In the upper limb, the reliability for the proximal and distal muscle was significantly different. However. The difference in the lower limb was not significant.When using the scale, one should consider it&aposs limitation.

Background: Intra-rater agreement in observing and decision making in diagnosis of any disease is of great importance.This investigation is to observe and read ultrasound pictures of ovarian cysts and distinguish its category for any radiologist. Distinguishability is one of the related entities in this matter and radiologists&apos ability in correct diagnosis is of great concern. In this study, we evaluated radiologist’s distinguishability of ordered categories of ovarian cyst diseases (benign, borderline and malignant) in ultrasonography. To do this, we measured intra-rater agreement of radiologists by Weighted Kappa coefficient, and then by the help of “square scores association model” and “agreement plus square scores association model” we evaluated their distinguishability in diagnosis of the severity of the ovarian cyst’s diseases.

Methods: In this analytical cross-sectional study, two radiologists and three radiology residents assessed ultrasounds of 40 patients separately and independently in two periods (with the interval of one week). Patients selected from those who were referred to Mirza Koochak Khan Hospital in January 2005. Ultrasounds were performed by an expert radiologist and by a single apparatus.

Result: Data from radiologists was evaluated by “square scores association model” due to their superior results of distinguishability. Mean of Weighted Kappa coefficient was 0.81 and intra-rater agreement was 0.99 for our radiologists, but due to weaker results of our residents, we used “agreement plus square scores association model” for analyzing and mean of Weighted Kappa coefficient was 0.65 and intra-rater agreement was 0.97 for them.

Conclusion: Although radiologists had a better function than their residents, all of them showed appropriate distinguishability and intra-rater agreement in diagnosis and categorizing of the ovarian cyst’s disease. To distinguish benign category from borderline was more difficult than to distinguish malignant category from borderline and radiologists showed better results in this than their residents did.

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Iranian researchers and scientists in the fields of psychiatry and psychology undoubtedly need to spend more time and make considerable efforts to prepare and validate Persian versions of measurements. The present study was designed to validate HADS in Iranian clinically anxious and depressed patients compared to normal population.
Methods: 261 anxious and depressed patients referred to the inpatient clinic of Rouzbeh Psychiatric Hospital, Tehran, and 261 healthy volunteers (matched for their sex) were tested using HADS, and two additional clinical tools, ie., BDI & BAI. Then the patients were interviewed by a psychiatrist or a psychologist (using DSM IV checklist) and rated for their anxiety and depression severity levels based on a 10-point scale from 1 to 10. BDI and BAI were regarded as objective device providing other external criteria to examine validity further. Moreover, to assess reliability 10% of the patients (n= 27) were randomly selected and re-tested after three days.
Results: Findings showed that all measures and their subscales proved to be valid and reliable with good internal consistencies in Iranian depressed and anxious patients. This study provides clinicians and researchers with Iranian cut-off points for HADS, BDI and BAI, to be used in their settings, to categorize the patients with different levels of psychopathology.
Conclusion: The results support the use of all the measures and subscales examined in this study in clinical and research settings. The cut-off points obtained in this study are somehow different from those presented by original authors which will be discussed from cultural point of view in this report.

Background: The sino- nasal outcome test 20 (SNOT-20) is a self- report measure for the assessment of patients with rhinosinusitis. The aim of the present study was to translate the SNOT-20 into Persian, and to evaluate the reliability and validity of the Persian SNOT-20.
Methods: The SNOT-20 was translated from English into Persian. Thirty patients with chronic rhinosinusitis completed the Persian SNOT-20 two times with an interval of 1-2 weeks. Thirty healthy volunteers completed the Persian SNOT-20 for the evaluation of discriminant validity.
Results: Cronbach's alpha coefficient values were high with 0.88 for test and 0.90 for retest. ICC for test-retest reliability was 0.95. The scores of patients were significantly higher than those of the healthy subjects. There were no floor and ceiling effects.
Conclusion: The Persian SNOT-20 is a reliable and valid measure for the assessment of Persian speaking patients with rhinosinusitis.