clinical tests

临床测试
  • 文章类型: Journal Article
    下腰痛(LBP)很常见。运动控制功能障碍(MCD)可能在LBP的发展中起重要作用。
    寻找可靠和有效的临床测试来识别LBP患者的MCD。
    PubMed和Medline图书馆数据库的搜索时间为10年,直到2019年11月。
    包括以英语或德语发表的检查MCD临床测试的研究。检查临床结果的研究,排除了基于设备的测试或急性疼痛。纳入/排除是根据规定的标准和两名审稿人之间的共识确定的。通过关键评估工具(Brink和Louw,2012).
    这些研究是根据目标进行评估的,人口和方法,并通过实施文献中的标准(Landies和Koch,1977年;波特尼和沃特金斯,2015).
    九项研究(376名患者,23项测试)符合纳入标准。22项测试检查了评估者间的可靠性,五个测量的评分者内部可靠性,五个评估了结构/判别效度。15个测试显示出良好/非常好的评分者间可靠性。评分者内部可靠性从中等到良好。两项研究评估了结构效度,结果良好,和一个结果不佳的判别效度。
    对于有效性测试,应考虑使用具有良好可靠性的测试。两种可推荐临床使用。所有其他测试应进一步评估或重新考虑。
    相关研究可能会被遗漏,因为他们年龄超过十岁,不包括在搜索的数据库中,以其他语言出版,或者没有被设定的标准所接受。
    Low back pain (LBP) is common. Motor-control-dysfunctions (MCD) might play an important role in the development of LBP.
    Find reliable and valid clinical tests to identify MCD in patients with LBP.
    PubMed and Medline Library databases were searched over a period of ten years till November 2019.
    Studies examining clinical tests for MCD published in English or German were included. Studies examining clinical outcome, apparatus-based tests or acute pain were excluded. The inclusion/exclusion was determined by stated criteria and consensus between two reviewers. The risk of bias was examined by the critical appraisal tool (Brink and Louw, 2012).
    The studies were assessed according to aim, population and methods and by implementing criteria from literature (Landies and Koch, 1977; Portney and Watkins, 2015).
    Nine studies (376 patients, 23 tests) met the inclusion criteria. 22 tests examined interrater reliability, five measured intra-rater-reliability, and five assessed the construct/discriminative validity. Fifteen tests showed good/very good interrater-reliability. The intra-rater-reliability ranged from moderate to good. Two studies evaluated construct validity with good results, and one discriminative validity with poor results.
    Tests with good reliability should be considered for validity testing DISCUSSION: Of all the tests reviewed, two can be recommended for clinical use. All the other tests should undergo further evaluation or be reconsidered.
    Relevant studies might be missed, since they were older than ten years, not included in the searched databases, be published in other languages, or were not picked up by the set criteria.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    背景:先前关于肩关节临床测试诊断准确性的系统评价和荟萃分析没有得出关于肩胛骨下撕裂的结论。
    目的:比较常用临床检查对肩胛骨下撕裂的诊断准确性。
    方法:系统评价;证据水平,3.
    方法:使用Medline进行电子文献检索,Embase,和科克伦图书馆/中央。合格标准是原始的临床研究,报告了临床测试的诊断准确性,以诊断涉及肩胛骨下的肩袖撕裂的存在。
    结果:电子文献检索返回2212条记录,其中13条符合资格。在系统评价中包含的8项测试中,最常报告的是剥离试验(12项研究).四项测试有资格进行荟萃分析:拥抱测试,腹部按压测试,内部旋转滞后信号(IRLS),和提离试验。熊抱试验的最高合并敏感性为0.55(95%CI,0.28-0.79),而最低的合并敏感性为0.32(95%CI,0.13-0.61),对于IRLS。在所有测试中,合并特异性>0.90.
    结论:在符合荟萃分析条件的4项临床试验中(熊抱试验,腹部按压测试,IRLS,和提离试验),所有患者的合并特异性>0.90,但合并敏感性<0.60.没有单一的临床测试足够可靠地诊断肩胛骨下撕裂。
    背景:PROSPERO(CRD42019137019)。
    BACKGROUND: Previous systematic reviews and meta-analyses on the diagnostic accuracy of shoulder clinical tests do not reach conclusions regarding subscapularis tears.
    OBJECTIVE: To compare the diagnostic accuracy of commonly used clinical tests for subscapularis tears.
    METHODS: Systematic review; Level of evidence, 3.
    METHODS: An electronic literature search was conducted using Medline, Embase, and the Cochrane Library/Central. Eligibility criteria were original clinical studies reporting the diagnostic accuracy of clinical tests to diagnose the presence of rotator cuff tears involving the subscapularis.
    RESULTS: The electronic literature search returned 2212 records, of which 13 articles were eligible. Among 8 tests included in the systematic review, the lift-off test was most frequently reported (12 studies). Four tests were eligible for meta-analysis: bear-hug test, belly-press test, internal rotation lag sign (IRLS), and lift-off test. The highest pooled sensitivity was 0.55 (95% CI, 0.28-0.79) for the bear-hug test, while the lowest pooled sensitivity was 0.32 (95% CI, 0.13-0.61), for the IRLS. In all tests, pooled specificity was >0.90.
    CONCLUSIONS: Among the 4 clinical tests eligible for meta-analysis (bear-hug test, belly-press test, IRLS, and lift-off test), all had pooled specificity >0.90 but pooled sensitivity <0.60. No single clinical test is sufficiently reliable to diagnose subscapularis tears.
    BACKGROUND: PROSPERO (CRD42019137019).
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    Multimodal imaging (MMI) allows a more granular grading of age-related macular degeneration (AMD) disease severity, with many novel risk factors having been recently identified. With this imaging information, we are better able to counsel our patients with more accurate and individualized progression scenarios. MMI also allows identification of anatomical features that increase our understanding of disease processes involved in progression to late AMD. Treatment protocols for neovascular AMD (nAMD) depend largely on the optical coherence tomography (OCT) appearance to determine disease activity, which allows us to individualize treatment. In geographic atrophy (GA), new intervention trials require the ability to define the extent of GA, so that GA growth rate can be determined. This is achieved through fundus autofluorescence (FAF) imaging, which allows greater accuracy of border identification, as well as revealing FAF patterns predictive of growth rates. As we strive to bring interventions earlier in the disease course, OCT imaging provides an ability to identify the first signs of atrophy, which may serve as novel surrogate biomarkers for GA, thereby facilitating trials. In the future, the use of artificial intelligence (AI) to automatically identify relevant features on MMI could further enhance our ability to determine disease severity, predict progression and assist in identifying disease activity parameters to support clinical decision making when treating nAMD. Newer developments may allow frequent, remote capturing of images, reducing clinic visits, detecting progression and monitoring neovascular activity in-between clinic visits. Being aware of these new imaging insights in AMD, greatly enhance our clinical management of AMD.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

  • 文章类型: Journal Article
    UNASSIGNED: To review the published scientific literature concerning clinical and material degradations of intraocular lenses after implantation in cataract surgery.
    UNASSIGNED: A search was undertaken using the following databases: CENTRAL (including Cochrane Eyes and Vision Trials Register; The Cochrane Library: Issue 2 of 12 February 2019), Ovid MEDLINE (R) without Revisions (1996 to February week 2, 2019), Ovid MEDLINE (R) (1946 to February week 2, 2019), Ovid MEDLINE (R) Daily Update 19 February 2019, MEDLINE and MEDLINE non-indexed items, Embase (1980-2019, week 7), Embase (1974-2019, 19 February), Ovid MEDLINE (R) and Epub Ahead of Print, in-Process & Other Non-Indexed Citations and Daily (1946 to 19 February 2019), Web of Science (all years), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrial.gov) and the WHO International Clinical Trials Registry Platform (www.who.int/ictrp/search/en). Only published articles in English were selected. Search terms/keywords included \'IOL\' or \'intraocular lens\', combined with \'opacification\', degradation, glistenings, nanoglistenings, whitening, transmittance, light scatter, discolouration/discoloration, performance, quality, material, biocompatibility, calcification, explantation and ultraviolet/UV radiation. Relevant in-article references not returned in our searches were also considered.
    UNASSIGNED: After review of the available articles, the authors included 122 publications in this review, based on the quality of their methodology and their originality. The studies included in this review were randomized controlled trials, cohort studies, case-controlled studies, case series, case reports, laboratory studies and review papers. Differing material degradations of intraocular lenses have been described and their associated pathophysiology studied. Reported anomalies include photochemical alterations, water vacuoles, internal and surface calcific deposits, surface coatings and discolouration. The nature of such changes has been shown to depend on the type of intraocular lenses material used and/or manufacturing processes and storage conditions employed. Changes in the intraocular lens can also be influenced by surgical technique, coexisting ocular pathologies and topical and systemic medications. The clinical significance of these degradations is variable, with some resulting in significant visual disturbance and the need for intraocular lens explantation and others producing only minimal visual impairments. Failure to recognize the precise nature of the problem may lead to unnecessary laser capsulotomy procedures.
    UNASSIGNED: Clinical degradations of intraocular lenses are uncommon but have been reported following the implantation of intraocular lenses made of differing biomaterials. Their correct identification and thorough investigation to determine the underlying cause is necessary for optimal patient management and the prevention of such problems. Choosing a lens made of a particular material may be important in patients with certain ocular conditions.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

  • 文章类型: Journal Article
    The purpose of this study was to conduct an evidence-based review to determine predictors of fitness to drive and return to driving in persons with traumatic brain injury (TBI). Relevant databases (MEDLINE/PubMed, CINAHL, Cochrane Library, and SCOPUS) were searched for primary articles published before June 2016 using MeSH search terms. Using the American Academy of Neurology\'s classification criteria, 24 articles were included after reviewing 1998 articles. Studies were rated by class (I⁻IV), with I being the highest level of evidence. Articles were classified according to TBI severity, as well as types of assessments (on-road, simulator and surveys). There were no Class I studies. Based on Class II studies, only Post-traumatic amnesia (PTA) duration was found to be probably predictive of on-road driving performance. There is limited evidence concerning predictors of return to driving. The findings suggest further evidence is needed to identify predictors of on-road driving performance in persons with TBI. Class I studies reporting Level A recommendations for definitive predictors of driving performance in drivers with TBI are needed by policy makers and clinicians to develop evidence-based guidelines.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

       PDF(Pubmed)

  • 文章类型: Journal Article
    BACKGROUND: Congenital colour vision deficiencies affect 8% of the male and 0.5% of the female population. The study of colour vision is a complex process due to several factors: the psychophysics of vision itself, the difficulty to establish mathematical models for its analysis, the vague correlation of results between different tests, and the influence of external factors such as lighting, the tests condition, or the experience of the examiner and the patient. In the present document, a simplified review was carried out on the main colour vision tests available in clinical practice.
    METHODS: Once a filtered preliminary review was made of the bibliography related to the study of colour vision using the PubMed search tool, the most used tests in clinical practice were selected according to their frequency of use and the purpose for which they were applied. A bibliographic study was then carried out on each particular test according to the design of the shown stimuli, its target population, and its sensitivity and specificity.
    RESULTS: From the 95 publications found using the PubMed search tool, in 41 of them, colour tests were used by researchers in their methodology. From the 64 colour tests used, 19 of them were different (with 4 of them being different tests adapted by research groups, and 2 of them carried out online). The most used tests were the following: Ishihara test (10.88%), Farnsworth-Munsell (7.04%), Farnsworth-Munsell 100 Hue (6.4%), Cambridge Colour Test (3.84%), Hardy-Rand-Rittler (3.2%), tests developed by the groups (2.56%), the Anomaloscope (1.28%), the online tests (1.28%) and, finally, Colour Assessment and Diagnosis (0.64%), Pflüger Trident Colour Plates (0.64%), Toothguide Training Box (0.64%), Lanthony Desaturated D-15 (0.64%), City University Test (0.64%), Universal Colour Discrimination Test (0.64%), and Rabin Cone Contrast Test (0.64%).
    CONCLUSIONS: The Anomaloscope is the \"gold standard\" in terms of colour vision testing, despite its incompatibility with daily clinical practice. It is fairly complex to use, difficult to understand for children, and its practice requires having the time available. Nevertheless, it is possible to reach an accurate approximation through the combination of some of the tests listed in this article. The above mentioned tests are a good alternative to determine the presence of dyschromatopsia in settings closer to daily clinical practice or in less controlled settings than a clinical study. The major drawback among the wide range of tests available for the study of colour vision is the difficulty to compare results between tests, since units of the reported data are usually different, and experience is required for its correct interpretation. Currently, there is no consensus on which colour test is the most complete. It is, therefore, advisable to use at least 2 tests in order to ensure diagnoses, and have more extensive information about the visual perception of patients.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

  • 文章类型: Journal Article
    Proprioception is a vital aspect of motor control and when degraded or lost can have a profound impact on function in diverse clinical populations. This systematic review aimed to identify clinically related tools to measure proprioceptive acuity, to classify the construct(s) underpinning the tools, and to report on the clinimetric properties of the tools. We searched key databases with the pertinent search terms, and from an initial list of 935 articles, we identified 57 of relevance. These articles described 32 different tools or methods to quantify proprioception. There was wide variation in methods, the joints able to be tested, and the populations sampled. The predominant construct was active or passive joint position detection, followed by passive motion detection and motion direction discrimination. The clinimetric properties were mostly poorly evaluated or reported. The Rivermead Assessment of Somatosensory Perception was generally considered to be a valid and reliable tool but with low precision; other tools with higher precision are potentially not clinically feasible. Clinicians and clinical researchers can use the summary tables to make more informed decisions about which tool to use to match their predominant requirements. Further discussion and research is needed to produce measures of proprioception that have improved validity and utility.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • DOI:
    文章类型: Journal Article
    BACKGROUND: The sacroiliac joint (SIJ) can be a source of low back pain. The complexity of the system involving the SIJ and the varied SIJ pain referral pattern makes it difficult to clinically assess SIJ dysfunction. Despite the emergence of detail of the SIJ complex, the basis of the clinical tests has not been thoroughly investigated.
    OBJECTIVE: To review the literature from the last decade dealing with the validity and reliability of clinical tests for SIJ dysfunction in order to determine which tests are reliable and valid.
    CONCLUSIONS: For clinical tests with multiple studies, there was agreement on reliability for Gaenslens, Thigh Thrust test, Finger Point test and SIJ Pain Mapping and agreement on validity for Thigh Thrust test. However, Gillets Test, Patrick\'s FABER and Sacral Thrust/Compression were considered invalid and unreliable, although these results may have been influenced by methodological shortcomings. Examination of the entire SIJ complex may mean that a series of tests are required.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

公众号