Study on the method of automatically determining maxillary complex landmarks based on non-rigid registration algorithms / 中华口腔医学杂志

Objective: To explore an automatic landmarking method for anatomical landmarks in the three-dimensional (3D) data of the maxillary complex and preliminarily evaluate its reproducibility and accuracy. Methods: From June 2021 to December 2022, spiral CT data of 31 patients with relatively normal craniofacial morphology were selected from those who visited the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology. The sample included 15 males and 16 females, with the age of (33.3±8.3) years. The maxillary complex was reconstructed in 3D using Mimics software, and the resulting 3D data of the maxillary complex was mesh-refined using Geomagic software. Two attending physicians and one associate chief physician manually landmarked the 31 maxillary complex datasets, determining 24 anatomical landmarks. The average values of the three expert landmarking results were used as the expert-defined landmarks. One case that conformed to the average 3D morphological characteristics of healthy individuals' craniofacial bones was selected as the template data, while the remaining 30 cases were used as target data. The open-source MeshMonk program (a non-rigid registration algorithm) was used to perform an initial alignment of the template and target data based on 4 landmarks (nasion, left and right zygomatic arch prominence, and anterior nasal spine). The template data was then deformed to the shape of the target data using a non-rigid registration algorithm, resulting in the deformed template data. Based on the unchanged index property of homonymous landmarks before and after deformation of the template data, the coordinates of each landmark in the deformed template data were automatically retrieved as the automatic landmarking coordinates of the homonymous landmarks in the target data, thus completing the automatic landmarking process. The automatic landmarking process for the 30 target data was repeated three times. The root-mean-square distance (RMSD) of the dense corresponding point pairs (approximately 25 000 pairs) between the deformed template data and the target data was calculated as the deformation error of the non-rigid registration algorithm, and the intra-class correlation coefficient (ICC) of the deformation error in the three repetitions was analyzed. The linear distances between the automatic landmarking results and the expert-defined landmarks for the 24 anatomical landmarks were calculated as the automatic landmarking errors, and the ICC values of the 3D coordinates in the three automatic landmarking repetitions were analyzed. Results: The average three-dimensional deviation (RMSD) between the deformed template data and the corresponding target data for the 30 cases was (0.70±0.09) mm, with an ICC value of 1.00 for the deformation error in the three repetitions of the non-rigid registration algorithm. The average automatic landmarking error for the 24 anatomical landmarks was (1.86±0.30) mm, with the smallest error at the anterior nasal spine (0.65±0.24) mm and the largest error at the left oribital (3.27±2.28) mm. The ICC values for the 3D coordinates in the three automatic landmarking repetitions were all 1.00. Conclusions: This study established an automatic landmarking method for three-dimensional data of the maxillary complex based on a non-rigid registration algorithm. The accuracy and repeatability of this method for landmarking normal maxillary complex 3D data were relatively good.

Confiabilidad de una escala de valoración de resúmenes para congresos

Introducción: En 2013, desarrollamos una escala, para evaluar resúmenes de congresos de la Sociedad de Cirujanos de Chile (SOCICH). Objetivo: Determinar consistencia interna y confiabilidad interobservador de una escala para evaluar resúmenes de congresos. Material y Método: Estudio de confiabilidad. Doce cirujanos fueron capacitados de forma virtual durante 8 horas, para aplicar la escala. Una vez finalizado el entrenamiento, se les envió un cuestionario para evaluar contenidos de la capacitación, y varios resúmenescasos para ser evaluados con la escala antes señalada. Se aplicó estadística descriptiva, luego se estimó el grado de acuerdo entre observadores para cada ítem de la escala. Posteriormente, se evaluó el coeficiente de correlación (CCI), utilizando un modelo de dos factores mixtos en el que los efectos de los evaluadores son aleatorios y los ítems fijos; utilizando una definición de acuerdo absoluto. Además, se evaluó la consistencia interna de los ítems utilizando alfa de Cronbach, considerando intérvalos de confianza del 95% (IC 95%). Resultados: Luego de analizar las mediciones de los 9 ítems por los 12 observadores, se verificó que el CCI fue de 0,871; con un IC 95% de 0,700; 0,965. El valor de la consistencia interna fue de 0,7 considerando los 9 ítems, no se recomienda eliminar ningún ítem. Conclusión: La escala tiene buena confiabilidad interobservador y los ítems son consistentes entre sí; por lo que puede ser considerada como un instrumento confiable para la valoración de resúmenes de congresos.

Background: In 2013, we developed a scale to evaluate the abstracts of the congresses of the Society of Surgeons of Chile (SOCICH). Objective: To determine internal consistency and interobserver reliability of a scale to evaluate conference abstracts. Material and Methods: Reliability study. Twelve surgeons were trained virtually for 8 hours, to apply the scale. Once the training was finished, they were sent a questionnaire to evaluate the contents of the training, and several summaries-cases to be evaluated with the aforementioned scale. Descriptive statistics were applied, then the degree of agreement between observers was estimated for each item of the scale. Subsequently, intraclass correlation coefficient (ICC) was evaluated, using a mixed two-factor model where the effects of the evaluators are random and the items are fixed, using a definition of absolute agreement. In addition, the internal consistency of the items was evaluated using Cronbach's alpha, considering 95% confidence intervals (95% CI). Results: After analyzing the measurements of the 9 items by the 12 observers, it was verified that the ICC was 0.871; with a 95% CI of 0.700; 0.965. The internal consistency value was 0.7 considering the 9 items, it is not recommended to delete any item. Conclusions: The scale has good internal consistency and interobserver reliability. Therefore, it can be considered as reliable instrument to be used in the evaluation of abstracts for congresses.

Free nipple graft: current indications and applications of a centenary breast surgery technique ­ an integrative review

Introduction: Free nipple graft is a mammaplasty technique first described about 100 years ago. Its indication, restricted to reduction mammoplasty earlier, has been expanding into areas in mastology intervention, such as transgender and oncological surgery. Aim: The aim of this study was to evaluate the efficacy and outcomes of the technique. Methods: Electronic literature search was conducted, using PubMed and LILACS databases. The search strategy consisted of the keywords, MeSH terms, and free text words and variants for the free nipple graft and its application in reduction and mammaplasty, transgender, and oncoplastic surgery. Results: A total of 397 articles were found and, after inclusion and exclusion criteria, 15 were selected. Their outcomes have been shown, despite lack of standardized scores, as well as clinical trials to postulate better scientific evidence on its use and indications, that the technique, analyzed in over 1290 patients, achieved high safety rates and reproducibility. Conclusion: Aesthetics and patients satisfaction were found positive, as recommended by the authors in different studies discussed in this article.

Utilização de sensores inerciais no teste timed up and go: uma revisão narrativa / Use of inertial sensors in the timed up and go test: a narrative review

O teste funcional Timed Up and Go (TUG) é amplamente utilizado para avaliar o risco de queda, através do equilíbrio e mobilidade, por ser de fácil aplicação e boa reprodutibilidade na prática clínica. Porém, o TUG ainda possui algumas limitações, pois se concentra no tempo total em que o teste é realizado. Uma proposta de avaliação é através da utilização de sensores inerciais, baseados na tecnologia de sistemas microeletromecânicos, e vem sendo muito utilizados para análise do movimento humano. Logo, o objetivo desse estudo foi realizar uma revisão narrativa sobre o uso dos sensores inerciais nas medidas temporais e cinemáticas do TUG e suas subfases. Metodologia: Essa revisão narrativa foi realizada nas bases de dados PubMed, CENTRAL, BVS e PEDro, por meio do vocabulário MeSH entre o período de maio a junho de 2020. Os critérios de inclusão foram estudos que utilizaram sensores inerciais para avaliação de medidas temporais e cinemáticas do TUG e suas subfases. Resultados: Foram incluídos 11 artigos de um total de 2305 achados. Desses, 5 utilizaram os sensores de smartphones. Não houve padronização em relação à quantidade utilizada, nem à fixação e posicionamento. Os sensores conseguiram mostrar diferenças no TUG e suas subfases nas medidas temporais e cinemáticas nos diferentes grupos avaliados. Considerações Finais: Sensores inerciais são capazes de avaliar medidas temporais e cinemáticas do TUG e de suas subfases, mostrando serem ferramentas confiáveis. Entretanto, mesmo obtendo resultados satisfatórios, necessita-se de mais estudos abrangendo uma população maior.

The Timed Up and Go (TUG) functional test is widely used to assess the risk of falling through balance and mobility since it is easy to apply and presents good reproducibility in clinical practice. However, the TUG test still has some limitations, as it focuses on the total time the test is performed. A proposal for evaluation is the use of inertial sensors, based on the microelectromechanical system technology, which has been widely used for the analysis of human movement. Therefore, the objective of this study was to carry out a narrative review on the use of inertial sensors in the temporal and kinematic measurements of TUG and its subphases. Methodology: This narrative review was carried out in the PubMed, CENTRAL, BVS, and PEDro databases using the MeSH vocabulary between the period of May to June 2020. The inclusion criteria were studies using inertial sensors to evaluate temporal and kinematic measurements of the TUG and its subphases. Results: A total of 11 articles were selected from 2305 hits. From these, five (5) used smartphone sensors. There was no standardization regarding the quantity used, nor their fixation and positioning. The sensors were able to show differences in the TUG and its subphases in the temporal and kinematic measurements in the different groups evaluated. Final Considerations: Inertial sensors are capable of evaluating temporal and kinematic measurements of the TUG and its subphases, showing that they are reliable tools. Nevertheless, although satisfactory results were obtained, further studies are needed covering a larger population.

Clinical questionnaires for chronic obstructive pulmonary disease diagnosis: A systematic review and meta-analysis / Cuestionarios clínicos para el diagnóstico de la enfermedad pulmonar obstructiva crónica. Revisión sistemática y metaanálisis

Abstract Introduction: The use of early screening questionnaires for chronic obstructive pulmonary disease (COPD) in primary health care could improve underdiagnosis. Several instruments are currently available, but there is scant information on their diagnostic performance. Objective: To determine the validity of different questionnaires for COPD diagnosis. Materials and methods: A systematic review and a meta-analysis of diagnostic test accuracy were carried out. A search of the literature published between July 1, 1997, and June 30, 2019 was performed in PubMed, EMBASE, and LILACS databases using MeSH and DeCS terms and the PICO strategy. Based on the inclusion and exclusion criteria, two reviewers selected the articles for complete analysis. Article quality was assessed using the QUADAS instrument. Results: 19 articles were included for analysis. Overall results were: sensitivity: 68.1% (95%CI: 66.7% -69.4%); specificity: 64.9% (95%CI: 64.3-65.5); positive likelihood ratio: 2.024 (95%CI: 1.7152.388); negative likelihood ratio: 0.407 (95%CI: 0.289-0.573); and receiver operating characteristic area under the curve (ROC AUC): 0.75. The COPD-PS questionnaire reported the highest performance with sensitivity of 0.673 (95%CI: 0.653-0.692), specificity of 0.663 (95%CI: 0.65.5- 0.651), and ROC AUC of 0.750. It was followed by LFQ with sensitivity of 0.840 (95%CI: 0.806-0.871), specificity of 0.312 (95%CI: 0.289-0.336), and ROC AUC of 0.730. Finally, CDQ had sensitivity of 0.798 (95%CI: 0.764-0.829), specificity of 0.517 (95%CI: 0.495-0.538), and ROC AUC of 0.727. Conclusion: Clinical prediction instruments for COPD diagnosis have an acceptable performance. The COPD-PS, LFQ and CDQ questionnaires show a similar performance.

Resumen Introducción. El uso de cuestionarios de predicción clínica para el diagnóstico de la enfermedad pulmonar obstructiva crónica (EPOC) en atención primaria en salud podría mejorar el subdiagnóstico de esta enfermedad. Hoy en día existen varios instrumentos de este tipo; sin embargo, hay poca información sobre su rendimiento diagnóstico. Objetivo. Determinar la validez del uso de los diferentes cuestionarios de predicción clínica para el diagnóstico de la EPOC. Materiales y métodos. Se realizó una revisión sistemática con metaanálisis de prueba diagnóstica en las bases de datos PubMed, EMBASE y LILACS a partir de la estrategia PICO y utilizando términos MeSH y DeCS. Se incluyeron los estudios publicados entre julio 1 de 1997 y junio 30 de 2019. Dos revisores seleccionaron los artículos para análisis completo con base en los criterios de inclusión y exclusión. La calidad de los artículos se evaluó con el instrumento QUADAS. Resultados. Se incluyeron 19 artículos para el análisis. En cuanto a la evaluación global de los cuestionarios se obtuvieron los siguientes datos: sensibilidad: 68.1% (IC95%: 66.7-69.4); especificidad: 64.9% (IC95%: 64.3-65.5); razón de verosimilitud positiva: 2.024 (IC95%: 1.715-2.388); razón de verosimilitud negativa: 0.407 (IC95%: 0.289-0.573) y el área bajo la curva de características del receptor (ACOR): 0.75. El cuestionario COPD-PS reportó el mayor rendimiento -sensibilidad: 0.673 (IC95%: 0.653-0.692), especificidad: 0.663 (IC95%: 0.655-0.671) y ACOR: 0.750-; seguido de LFQ -sensibilidad: 0.840 (IC95%: 0.806-0.871), especificidad: 0.312 (IC95%: 0.289-0.336) y ACOR: 0,730-, y CDQ -sensibilidad: 0.798 (IC95%: 0.764-0.829), especificidad: 0.517 (IC95%: 0.495-0.538) y ACOR: 0.727-. Conclusión. Los instrumentos de predicción clínica para el diagnóstico de EPOC tienen un rendimiento aceptable, pues los valores de sensibilidad obtenidos a través de estos son superiores a los de la evaluación individual de la sintomatología respiratoria que se puede hacer a través de la historia clínica habitual.

Systematic review and comparative analysis of pediatric nutrition screening tools validated in Europe and Canada / Revisión sistemática y análisis comparativo de las herramientas de tamizaje nutricional en pediatría validadas en Europa y Canadá

Abstract Introduction: Nutritional screening is a useful tool for determining the risk of hospital malnutrition; therefore, reviewing the guidelines on its use in the pediatric population is of great importance. Objective: To provide recommendations on the use of nutrition screening tools validated in Canada and Europe in the Colombian pediatric population. Materials and method: A systematic review was conducted using the PRISMA methodology. The quality of the evidence found in the review was assessed using the U.S. Preventive Services Task Force (USPSTF) tool, which was established by the Canadian Task Force on the Periodic Health Examination for assessing preventive actions. Results: Fifteen studies were included in the review as they met the inclusion criteria. In addition, 7 nutrition screening tools were identified (PYMS, iPYMS, PeDiSMART, PNR, STAMP, PMST and STRONGkids). According to guidelines of the European Society for Clinical Nutrition and Metabolism, the PYMS, iPYMS and STRONGkids tools simultaneously assess prognostic variables such as current nutritional status, stability, expected improvement or worsening of the condition, and the influence of the disease process in nutritional deterioration. Regarding concurrent validity, data analysis shows that PYMS, iPYMS and PMST have sensitivities >85%, and that PYMS has a specificity >85%. In terms of reproducibility, PEDISMART, STRONGkids, STAMP and PYMS have an acceptable interobserver agreement (k>0.41). Conclusion: Based on the evidence found, which was analyzed in terms of prognostic variables, concurrent validity and reproducibility, the use of the PYMS tool in the clinical practice is suggested. In contrast, hospitals must assess the applicability of the STAMP and iPYMS tools.

Resumen Introducción. El tamizaje nutricional es una herramienta efectiva que permite establecer el riesgo de desnutrición hospitalaria, por consiguiente es importante revisar las directrices respecto a su uso en pediatría. Objetivo. Ofrecer recomendaciones sobre el uso de las herramientas de tamizaje nutricional validadas en Canadá y Europa en población colombiana. Materiales y métodos. Se realizó una revisión sistemática siguiendo la metodología PRISMA. Para la evaluación de la calidad de la evidencia se utilizó la herramienta U.S Preventive Services Task Force, formulada para medir acciones preventivas por la Canadian Task Force on the Periodic Health Examination. Resultados. Se incluyeron 15 estudios que cumplían los criterios de selección y se identificaron 7 herramientas (PYMS, iPYMS, PeDiSMART, PNR, STAMP, PMST y STRONGkids). Según los lineamientos de la Sociedad Europea de Nutrición Clínica y Metabolismo, la PYMS, la iPYMS y la STRONGkids evalúan simultáneamente variables pronósticas como estado nutricional actual, estabilidad, progresión esperada e influencia de la enfermedad. En cuanto a validez concurrente, el análisis de datos muestra que la PYMS, la iPYMS y la PMST tienen sensibilidades >85% y que la PYMS tiene especificidad >85%. Respecto a reproducibilidad, la PEDISMART, la STRONGkids, la STAMP y la PYMS tienen una concordancia inter-observadores aceptable (k>0.41). Conclusión. Según la evidencia analizada en términos de variables pronósticas, validez concurrente y reproducibilidad, se sugiere el empleo en la práctica clínica de la herramienta PYMS, mientras que para el uso de la STAMP y la iPYMS las instituciones deben evaluar su aplicabilidad.

Standardization and ten essential steps in the lateral robotic extended totally extraperitoneal (eTEP) repair of ventral hernias / Hérnias ventrais por acesso lateral totalmente extraperitoneal robótico (eTEP): dez etapas essenciais na padronização técnica

ABSTRACT Objectives: described by Dr. Jorge Daes, principles of the enhanced view totally extraperitoneal (eTEP) has been widely used in the armamentarium of ventral hernia repair recently. Robotic assisted eTEP technique feasibility has been proved, however, a complete understanding of retromuscular abdominal wall planes and its landmarks still uncertain in a majority of general surgeons. The aim of this report is to propose a technical standardization and its anatomic concepts in the robotic-assisted eTEP ventral hernia repair. Methods: our group describes 10 key steps in a structured step-by-step approach for a safe and reproducible repair based on well defined anatomic landmarks, identification of zones of dissection and correct restoration of the linea alba. Results: the standardization has been developed 2 years ago and applied to all patients. A robotic-assisted surgery with 3 robotic arms is performed in a lateral docking setup. Feasibility is established and reproducibility is high among general surgeons. Conclusion: we present a standardized side docking robotic assisted eTEP approach for ventral hernia repairs with 10 key steps. We believe understanding the landmarks and a step-by-step guidance based on the concepts of retromuscular abdominal wall anatomy foment a safe learning of minimally invasive restoration of the abdominal wall integrity regarding non-expert surgeons.

RESUMO Objetivo: descritos pelo Dr. Jorge Daes, os princípios da visão aprimorada totalmente extraperitoneal (eTEP) têm mais recentemente sido utilizados no arsenal de reparos de hérnias ventrais. A realização da técnica de reparo totalmente extraperitoneal com o uso da robótica mostrou-se viável. No entanto, o verdadeiro conhecimento dos planos da parede abdominal retromuscular e os referenciais ainda são incertos para a maioria dos cirurgiões gerais. O objetivo deste artigo é propor padronização técnica e conceitos anatômicos no reparo de hérnia ventral robótico totalmente extraperitoneal (eTEP VHR). Métodos: nosso artigo descreve 10 etapas essenciais em abordagem estruturada passo a passo para procedimento seguro e reprodutível com base em referenciais anatômicos bem definidos, identificação de zonas de dissecção e restauração correta e completa da linha alba. Resultados: a padronização foi desenvolvida há 2 anos e aplicada a todos os pacientes. A cirurgia robótica é realizada com três braços da plataforma e por docking lateral. Conforme descrita, a reprodutibilidade e segurança são altas entre os cirurgiões gerais. Conclusão: apresentamos abordagem padronizada da técnica robótica de reparo de hérnia ventral totalmente extraperitoneal (eTEP VHR) em docking lateral por meio de 10 etapas essenciais. Acreditamos que a compreensão dos referenciais anatômicos e orientação passo a passo com base nos conceitos da anatomia do espaço retromuscular fomentam o aprendizado seguro, na atuação de cirurgiões não experientes durante a restauração minimamente invasiva da integridade da parede abdominal.

Workplace violence in the health sector: validez y adaptación del instrumento al idioma español, en el contexto ecuatoriano para tipos de violencia / Workplace violence in the health sector: adaptation and validation of the questionnaire for types of violence in the ecuadorian context

Uno de los objetivos de la encuesta "Workplace Violence in the Health Sector" es investigar los factores que pueden contribuir a la violencia en el lugar de trabajo en el sector de salud en varios países del mundo para la toma de políticas públicas apropiadas. A pesar de que el inglés sea un idioma universal, en la práctica genera limitaciones para aplicarlo sobre todo en los países de América Latina. Esta investigación tiene como propósito validar el contenido, y constructo para que la encuesta se pueda aplicar en los países cuya lengua oficial es el español. Se emplearon las técnicas cualitativas y cuantitativas para validar el instrumento, con la revisión de expertos se validó la semántica e idioma. A través del el Alpha de Cronbach de 0,96 se puede aseverar la confiabilidad de este para medir la violencia de trabajo en el sector de la salud de los países de habla hispana.

The purpose of the survey "Violence in the workplace in the health sector" is to obtain information on the factors that could contribute to the workplace violence in the health sector within different countries of the world. Collecting data on the problem is therefore important of the appropriate public policy making. Despite of English is considered widely the universal language, in practice it generates limitations to apply especially in Latin American countries. This research aims to validate the content, and construction for the survey to the application in countries where Spanish is an official language. Qualitative and quantitative techniques were used to validate the questionnaire; experts review validated the semantics and language construction. The global inventory (Cronbach's alpha = 0.96) indicated good reliability to measure the workplace violence in the health sector for Spanish-speaking countries.

Remembering a name: Neuropsychological validity studies and a computer proposal for detection of anomia / Lembrando um nome: estudos de validade neuropsicológica e uma proposta computadorizada para detecção de anomia

ABSTRACT There are contradictory results or lack of validity studies concerning the naming function and brain laterality. Although anomia is a frequent symptom of memory impairment, and the most relevant symptom of aphasia, few studies have been conducted to evaluate its validity for detecting patients with left-hemisphere damage (LD), as per the MeSH definition. Objective: To validate a paper-and-pencil confrontation naming test (CNT) according to side of brain injury; to select a valid and reliable abbreviated CNT wherein the effect of demographic variables is minimized; and to use the selected CNT to develop a computer-aided confrontation-naming evaluation (CACNE). Methods: Control data were obtained from 213 healthy participants (HP) aged 15 to 89 years. A subsample of 106 HP was demographically matched to 39 patients with LD and 40 patients with right-hemisphere damage (RD). Anomia definition and CNT cues were considered for the CACNE. Results: Test-retest and inter-rater reliability, internal consistency, and validity for detecting LD were demonstrated. A significant age effect was observed in HP. The CACNE was developed to detect anomia in interaction with environmental interventions. Conclusion: The inconsistencies observed in the CNT studies were probably due to the presence of anomia in almost 50% of the RD patients.

RESUMO Existem resultados contraditórios ou falta de estudos de validade relativos à função de nomeação e lateralidade cerebral. Embora a anomia seja um sintoma frequente de comprometimento da memória e o sintoma mais relevante da afasia, poucos estudos foram realizados para avaliar sua validade na detecção de pacientes com lesão no hemisfério esquerdo (LHE) conforme definição do MeSH. Objetivo: Validar um teste de nomeação por confrontação (TNC) do tipo papel-e-lápis de acordo com o lado da lesão cerebral. Selecionar um TNC abreviada válida e confiável, na qual o efeito de variáveis ​​demográficas seja minimizado. Usar o TNC selecionado para desenvolver uma avaliação de nomeação por confrontação auxiliada por computador (CACNE). Métodos: Os dados de controle foram obtidos de 213 participantes saudáveis ​​(PS) com idades entre 15 e 89 anos. Uma subamostra de 106 PS foi demograficamente pareada com 39 LHE e 40 pacientes com lesão no hemisfério direito (LHD). A definição de anomia e as pistas do TNC foram consideradas para a CACNE. Resultados: A confiabilidade teste-reteste e interexaminador, consistência interna e validade para a detecção de LHE foram demonstradas. Um efeito significativo da idade foi observado na PS. CACNE foi desenvolvida para detectar anomia em interação com intervenções ambientais. Conclusão: As inconsistências observadas nos estudos do TNC devem-se provavelmente à presença de anomia em quase 50% dos pacientes com LHD.

Lecciones aprendidas en un estudio de reproducibilidad y validez de cuestionarios para estimar la ingesta dietética en Colombia. 2010-2017 / Lessons learned in a study of reproducibility and validity of questionnaires to estimate dietary intake in Colombia, 2010-2017

Resumen Introducción. La dieta es una exposición compleja de medir que se asocia al desarrollo de enfermedad crónica, por lo cual es necesario desarrollar y validar instrumentos simplificados para su medición. Objetivo. Establecer la reproducibilidad en la clasificación y la validez contra recordatorios de la ingesta dietética en las últimas 24 horas (R24H) de cuestionarios de frecuencia de consumo (CFC) desarrollados en Colombia. Materiales y métodos. Estudio de tecnología diagnóstica desarrollado durante 2010-2017. Se aplicaron dos R24H y dos CFC a 523 sujetos: 109 en Bogotá D.C., 107 en Medellín, 106 en Cali, 102 en Barranquilla y 99 en Bucaramanga y su área metropolitana. Los estudios de reproducibilidad y validez se realizaron con coeficientes de correlación r de Pearson crudos y ajustados por el método de energía residual. Resultados. La reproducibilidad de los recordatorios fue pobre-moderada (mínimo -0.00, máximo 0.72), al igual que la de los cuestionarios (mínimo -0.01, máximo 0.72). La validez de los cuestionarios fue pobre (mínimo -0.01, máximo, -0.59). Conclusión. Los CFC no son útiles en la investigación epidemiológica, lo que se explica en la alta variabilidad debida a pocas repeticiones en la estimación dietética al diseñar los cuestionarios y a fallas en la recolección de los datos.

Abstract Introduction: Dietary exposure is complex to measure and is associated with the development of chronic diseases; therefore, it is necessary to develop and validate simplified instruments for measurement. Objective: To establish the classification and validity reproducibility of the 24-hour dietary recall method (24hDR) in food frequency questionnaires (FFQ) developed in Colombia. Materials and methods: Diagnostic technology study developed during 2010-2017. Two 24hDR and two FFQs were applied to 523 subjects: 109 in Bogotá D.C., 107 in Medellín, 106 in Cali, 102 in Barranquilla and 99 in Bucaramanga and its metropolitan area. Reproducibility and validity studies were performed using crude Pearson's r coefficients adjusted by residual energy method. Results: The reproducibility of 24hDR was poor-moderate (minimum -0.00, maximum 0.72), as was the reproducibility of the questionnaires (minimum -0.01, maximum 0.72). The validity of the questionnaires was poor (minimum -0.01, maximum -0.59). Conclusion: FFQs are not useful for epidemiological research, which is explained by the high variability caused by few 24hR recalls in dietary estimation when designing questionnaires, and failures in data collection.

Adaptación transcultural para Colombia de la Escala KidsLife para personas con discapacidad intelectual y múltiple / Cross-Cultural adaptation for Colombia of the KidsLife Scale for people with intellectual and multiple disabilities

Resumen Introducción. La calidad de vida, como constructo multidimensional, considera aspectos físicos, sociales y culturales de las personas con discapacidad intelectual; por ello, se hace necesario contar con instrumentos adaptados y validados que permitan reconocer las necesidades específicas de esta población. Objetivo. Adaptar transculturalmente para Colombia la Escala KidsLife para personas con discapacidad intelectual. Materiales y métodos. Estudio instrumental hecho por fases: se hizo una revisión preliminar de la escala por parte de los investigadores; se comprobó la validez de contenido por juicio de siete expertos, quienes valoraron importancia, influencia, observancia y adecuación gramatical, y se realizó un estudio piloto con 30 personas para determinar confiabilidad y poder discriminativo. Resultados. En cuanto a la validez de contenido, los coeficientes de concordancia ponderados para concordancia entre jueces y concordancia de las dimensiones resultaron buenos. Respecto a la confiabilidad y poder discriminativo, se halló consistencia interna muy buena piara la escala total (alfa de Cronbach 0.95) y 52 ítems bajo poder discriminativo (p>0.1). Conclusiones. La adaptación y validez para Colombia de la Escala KidsLife permitirá fortalecer procesos de atención desde las diferentes dimensiones de calidad de vida centrados en las necesidades de la persona con discapacidad intelectual y múltiple, las familias y los profesionales de apoyo.

Abstract Introduction: Quality of life, as a multidimensional construct, comprises physical, social and cultural aspects of people with intellectual disabilities; therefore, it is necessary to have adapted and validated instruments to recognize the specific needs of this population. Objective: To make a cross-cultural adaptation for Colombia of the KidsLife Scale for people with intellectual disabilities. Materials and methods: Instrumental study done in phases. First, a preliminary review of the scale was made by the researchers; then, the validity of the content was verified by seven experts who assessed relevance, impact, compliance and grammatical adequacy; finally, a pilot study was carried out with 30 people to determine reliability and discriminative power. Results: In terms of content validity, the weighted concordance coefficients for agreement among judges and dimensional concordance were good. Regarding reliability and discriminative power, very good internal consistency was found for the whole scale (Cronbach's alpha of 0.95) and 52 items under discriminative power (p>0.1). Conclusions: The adapted and validated KidsLife Scale for Colombia will strengthen the care processes from different dimensions of quality of life, focused on the needs of the person with intellectual and multiple disabilities, families and support professionals.

Optimization of Water Extraction Technology of Saikosaponin a and Saikosaponin d from Bupleurum chinense by Electroma- gnetic Cracking / 中国药房

OBJECTIVE： To establish the method for simultaneous determination of saikosaponin a and saikosaponin d in Bupleurum chinense water extract， and to optimize its water extraction technology for electromagnetic cracking. METHODS： HPLC method was used. The determination was performed on SB-C18 column with mobile phase consisted of acetonitrile-water （gradient elution） at the flow rate of 1.0 mL/min. The column temperature was 40 ℃. The detection wavelength was set at 210 nm， and  the sample size was 10 μL. Based on single factor experiment， using extraction time， particle size， solide-liquid ratio as factors， total extraction rate of saikosaponin a to saikosaponin d as indexes， the extraction technology was optimized by using Box-Behnken response surface methdology， and compared with the results of ultrasound method and decoction method. RESULTS： The linear range of saikosaponin a and saikosaponin d were 50.70-202.80 μg/mL （r＝0.999 9） and 50.50-202.00 μg/mL （r＝0.999 9）， respectively. The quantitation limits were 0.16 and 0.13 μg/mL， respectively. The detection limits were 0.05 and 0.04 μg/mL，respectively. RSDs of precision， stability and reproducibility tests were all lower than 2％. The average recoveries were 98.23-102.47％ （RSD＝1.80％， n＝6） and 98.84％-102.06％ （RSD＝1.60％， n＝6）. The optimal extraction technology was as follows： the extraction time of 2.50 min； the particle size of 80 mesh， solid-liquid ratio of 1 ∶ 28 （g/mL）. Results of 3 times of validation tests showed that the optimal technology included the average total extraction rates of saikosaponin a and saikosaponin d were 8.42 mg/g， which was higher than that of ultrasonic method （8.34 mg/g） and decoction method （8.06 mg/g）， and the extration time was shorter. CONCLUSIONS： Established method is simple and accurate， and can be used for simultaneous determination of saikosaponin a and saikosaponin d in B. chinense water extract. The optimized water extraction technology for electromagnetic cracking is stable and feasible.

Adjustable sling for the treatment of post-prostatectomy urinary incontinence: systematic review and meta-analysis / Implante de sling ajustável no tratamento da incontinência urinária pós-prostatectomia: revisão sistemática e meta-análise

ABSTRACT Urinary incontinence after prostatectomy has a significant negative impact on the quality of life of the patient. The surgical treatment includes several models of male slings, such as adjustable slings. The objective of this study was to evaluate the effectiveness and safety of adjustable sling in the treatment of post-prostatectomy urinary incontinence. This is a systematic review of literature. The following electronic databases were searched until January 2018: PubMed®, Embase, CENTRAL and LILACS. The keywords used in the search strategies were: "prostatectomy" [Mesh], "urinary incontinence" [Mesh] and "suburethral slings" [Mesh]. Randomized clinical trials and observational studies, with or without Control Group, and follow-up of more than 12 months were included. Only one randomized study with high risk of bias was included and it concluded the effectiveness equivalence between adjustable and non-adjustable slings. All other studies were cases series with patients of varying levels of incontinence intensity and history of pelvic radiation therapy and previous surgeries. The meta-analysis for 0 pad in 24 hours demonstrated an effectiveness of 53%. For the 0 to 1 pad test in 24 hours, the meta-analysis resulted in an effectiveness of 69%. Risk factors for surgery failure include prior radiation, severity of post-prostatectomy urinary incontinence, and previous surgeries. The meta-analysis of the extrusion rate was 9.8% and the most commonly reported adverse effects were pain and local infection. Evidence of low quality indicates that adjustable slings are effective for treating post-prostatectomy urinary incontinence, with frequency of adverse events similar to the surgical option considered gold standard (the artificial urinary sphincter implant).

RESUMO A incontinência urinária pós-prostatectomia tem importante impacto negativo na qualidade de vida do portador. O tratamento cirúrgico inclui slings masculinos e, entre os diversos modelos, os slings ajustáveis. O objetivo deste estudo foi avaliar a efetividade e a segurança do sling ajustável no tratamento da incontinência urinária pós-prostatectomia. Trata-se de revisão sistemática de literatura. Foram pesquisadas as seguintes bases de dados eletrônicas até janeiro de 2018: PubMed®, Embase, CENTRAL e LILACS. As palavras-chaves utilizadas nas estratégias de busca foram: "prostatectomy" [Mesh], "urinary incontinence" [Mesh] e "suburethral slings" [Mesh]. Foram incluídos ensaios clínicos randomizados e estudos observacionais controlados ou não com seguimento maior que 12 meses. Apenas um estudo randomizado com alto risco de viés foi localizado e concluiu a equivalência de efetividade de slings ajustáveis e não ajustáveis. Todos os outros estudos foram série de casos com pacientes de variados níveis de intensidade da incontinência e histórico de radioterapia pélvica e cirurgias prévias. A metanálise para 0 pad em 24 horas demonstrou efetividade de 53%. Para o desfecho 0 a 1 pad em 24 horas, a metanálise resultou em efetividade de 69%. Os fatores de risco para insucesso da cirurgia incluem radiação prévia, gravidade da incontinência urinária pós-prostatectomia e cirurgias anteriores. A metanálise da taxa de extrusão foi de 9,8%, e os efeitos adversos mais relatados foram dor e infecção local. Evidências de baixa qualidade indicam que os slings ajustáveis são efetivos para o tratamento da incontinência urinária pós-prostatectomia, com frequência de eventos adversos semelhantes à opção cirúrgica considerada padrão-ouro (o implante de esfíncter urinário artificial).

Uso da estereofotogrametria para mensuração do volume da anatomia externa da face: revisão sistemática / Use of stereophotogrammetry for measuring the volume of external facial anatomy: a systematic review

Introdução: O registro fotográfico tem sido importante para diversas especialidades médicas como a Cirurgia Plástica. A fotografia em duas dimensões apresenta limitações para capturar profundidade e volume de estruturas outros instrumentos para avaliar essa alteração. Diversas tecnologias foram desenvolvidas para analisar objeto em três dimensões, sendo a estereofotogrametria uma tecnologia que utiliza a análise computadorizada de duas ou mais fotografias simultâneas do objeto para produzir um modelo geométrico em três dimensões. As vantagens da estereofotogrametria incluem menor custo, portabilidade, ausência de radiação e rapidez da captura das imagens. O objetivo deste trabalho foi realizar uma revisão bibliográfica avaliando o uso e a acurácia da estereofotogrametria para mensuração de volume de estruturas na face. Métodos: Foi realizada pesquisa nos bancos de dados Cochrane Library e Medline até maio de 2018 utilizando uma combinação de descritores Mesh e termos livres. Resultados: Foram obtidos inicialmente 2213 estudos observando a estratégia de busca. Seguindo os critérios de elegibilidade, foram selecionados 27 artigos, sendo 21 relatos de casos não randomizados e 6 ensaios clínicos randomizados. A qualidade metodológica dos estudos variou de 50 a 67%, segundo uma pontuação que vai de 0 a 100%. Conclusões: A estereofotogrametria é uma tecnologia promissora e tem sido cada vez mais utilizada para verificar variações de volume na face com alta acurácia e reprodutibilidade. Faltam estudos com melhor qualidade metodológica avaliando a acurácia e o uso da estereofotogrametria na avaliação de volume facial.

Introduction: Photographic documentation is important in several medical specialties, such as plastic surgery. Two-dimensional photography has limitations in capturing structure depth and volume, requiring other instruments to evaluate these changes. Several technologies have been developed for three-dimensional analysis of objects, of which stereophotogrammetry uses computerized analysis of two or more simultaneous photographs of the object to produce a three-dimensional geometric model. The advantages of stereophotogrammetry include lower cost, portability, absence of radiation, and speed of image capture. The aim of the present study was to perform a bibliographic review evaluating the use and accuracy of stereophotogrammetry for measuring the volume of facial structures. Methods: Using a combination of MeSH keywords and free terms, a search was performed in the Cochrane Library and MEDLINE databases. The search included all articles published on or before May 2018. Results: 2,213 studies were initially retrieved using this search strategy. Of these, 27 studies were selected based on the eligibility criteria, of which 21 were non-randomized case studies and 6 were randomized clinical trials. The methodological quality of the studies varied between 50 and 67%, on a grading scale from 0 to 100%. Conclusions: Stereophotogrammetry is a promising technology that is increasingly being used to check for facial volume variations with high accuracy and reproducibility. More studies with higher methodological quality are needed for evaluating the accuracy and use of stereophotogrammetry for facial volume evaluations.

Pro - inflammatory cytokines and metalloproteinase activation in polypropylene mesh implant in rat subcutaneous tissue

ABSTRACT Aims and Objectives: Polypropylene meshes have been increasingly adopted for correction of pelvic organ prolapse due to its lower recurrence rate when compared to surgeries without meshes. The study of the interaction of these materials with the host tissue may contribute to the development of materials with best biocompatibility and, consequently, less complication rates. Materials and Methods: The present study compares the inflammatory reaction of standard-weight (SW) and lightweight (LW) meshes (72 g/m216g/m2 respectively), implanted in the abdomen of 20 adult rats, which were euthanized in four or 30 days. Quantification of pro-inflammatory markers, IL-1 and TNF-α, and of metalloproteinases, MMP2 and MMP3, were carried out through immunohistochemistry with AxioVision® software. Results: There were no significant differences in the quantification of IL-1 and TNF-α in LW versus SW meshes. However, IL-1 quantification increased along time (30 days >4 days, p=0.0269). Also, MMP-2 quantification was similar to SW and LW and both presented a significant increase along time (30 days >4 days, p <0.0001). MMP-3 quantification also showed no difference between the SW and LW groups, but increased along time (30 days >4 days, p=0.02). Conclusions: Mesh's density did not influence the quantification of pro-inflammatory cytokines IL-1 and TNF-α and metalloproteinases 2 and 3. The increased expression of IL-1, MMP-2 and MMP-3 over time could represent a longstanding inflammatory response after PP mesh implantation. Possibly, the occurrence of adverse events following PP prosthetic implants can be influenced by other factors, not solely related to the amount of implanted material.

Functional outcomes and quality of life after transobturatory slings: hand - made vs. commercial slings

ABSTRACT Surgical correction is the most efficient treatment for stress urinary incontinence (SUI), and transobturator sling (TO) has optimal results. The high cost of commercially available sling kits makes it difficult the access in most Brazilian public health services. Hand-made polypropylene slings, on the other hand, have been previously reported. The aim of the present study was to compare the effectiveness and safety of commercial vs. hand-made polypropylene mesh slings. Data from 57 women who underwent consecutive TO sling surgery to treat SUI were pros- pectively collected between 2012 and 2014, and divided in two groups for further compa- rison. In Group-1, 31 women underwent surgery with commercial slings. In Group-2, 26 women underwent hand-made polypropylene slings. Women were compared according to epidemiological data, perioperative evaluation, quality of life, urodynamic study, cure and complication rates. Results were objectively (stress test with Valsalva maneuver, with at least 200mL vesical repletion) and subjectively evaluated by the Patient Global Impression of Improvement(PGI-I), Visual Analog Scale (VAS) and ICIQ-SF. Success was defined as PGI-I, VAS and negative stress test. Group-1 (n=31) and Group-2 (n=26) had a mean age of 60 vs. 58years (p=0.386). All de- mographic data were similar. The mean VLPP was 75.6cmH2O vs. 76.6cmH2O (p=0.88). The mean follow-up was 24.3 vs. 21.5months (p=0.96). Success rates were 74.2% vs. 80.2% (p=0.556), with ICIQ-SF variation of 12.6 vs.15.5 (p=0.139) and PGI-I of 71% vs. 80% (p=0.225). There was only one major complication (urethrovaginal fistula in Group-1). In conclusion, handmade and commercial slings have similar effectiveness and safety. The manufacture technique has important key-points stated in the present manuscript.

Initial validation of a scale to measure methodological quality in prognosis studies: the MInCir proposal / Validación inicial de una escala para medir calidad metodológica en estudios de pronóstico: la propuesta de MInCir

Research in methodological quality (MQ) of prognosis studies (PS) is relevant in view of the important number of studies developed in this scenario. However, currently there are no instruments designed to measure MQ in PS, thus the aim of this study was to validate a scale to determine the MQ in PS. Scale validation study. Two independent researchers applied the scale (10 items/4 domains) in 119 articles found in 13 Journals of high, medium and low impact factor. Criterion validity was determined by contrasting MQ scores with Oxford Centre for Evidence-Based Medicine levels of evidence. Construct validity of extreme groups and high and low impact factors were estimated. Intraclass correlation coefficient was used to determine interobserver reliability, and the cut-off point was calculated using a ROC curve. The best cut-off point was 33, with an under curve area of 82.6 %. Criterion and construct validity were statistically significant with (p<0.001). Interobserver reliability was 0.91 and a scale to measure the MQ in PS was validated.

El objetivo de este estudio fue validar una escala para determinar calidad metodológica (CM) de estudios de pronóstico (EP). Se realizó un estudio de validación de escalas. La escala, compuesta por 10 ítems y 4 dominios; se aplicó a 119 artículos de 13 revistas, de factores de impacto alto, medio y bajo; por dos investigadores independientes. La validez del criterio se determinó al contrastar las puntuaciones de CM de cada artículo con los niveles de evidencia del Centro de Medicina Basada en la Evidencia de Oxford de la revista en la cual fueron publicados. Se estimó la validez de constructo de grupos extremos (factores de impacto alto y bajo). Se utilizó el coeficiente de correlación intraclase para determinar la confiabilidad interobservador, y el punto de corte se calculó construyendo curvas ROC. El mejor punto de corte fue 33 puntos (área bajo la curva de 82,6 %). La validez de criterio y de constructo fueron estadísticamente significativas (p<0,001). La confiabilidad interobservador fue 0,91. Se validó una escala para medir CM en EP.

Effectiveness of nursing intervention to control fear in patients scheduled for surgery / Eficacia de una intervención de enfermería para control del temor en pacientes programados para cirugía

Abstract Introduction: Fear before surgery has multiple consequences that can be handled by means of nursing interventions. Objective: To determine the effectiveness of two nursing interventions to control fear in patients scheduled for surgery. Materials and methods: Controlled clinical trial carried out in Bucaramanga on 45 people, 15 in the intervention group (preoperative teaching and reduction of anxiety) and 30 in the control group (usual management). Sample size considered power of 0.90, alpha error of 0.05 and intervention ratio of 1:2 in the control group. Block-randomized double-blind clinical trial. Internal consistency of the evaluation format of both result labels of the Nursing Outcomes Classification (NOC) was measured using Chronbach's alpha. The reproducibility of the formats was determined using Bland-Altman plots. The effects of nursing interventions on fear were established through covariance analysis (ANCOVA). Results: The intervention group presented a coefficient of changes in the "fear control" label, controlled by initial NOC, age and sex of 1.09 (p=0.000). The coefficient of changes in the "knowledge on therapeutic scheme" label was 1.33 (p=0.000). Conclusion: People who received nursing interventions showed a significant decrease in fear compared to those who received usual care (control group).

Resumen Introducción. El temor prequirúrgico tiene múltiples consecuencias. Este se puede controlar mediante intervenciones de enfermería. Objetivo. Determinar la eficacia de dos intervenciones de enfermería en el control del temor en pacientes programados para cirugía. Materiales y métodos. Ensayo clínico controlado. Grupo intervención de 15 participantes y grupo control de 30. Se consideró un poder de 0.90, un error alfa de 0.05 y una razón de intervenido a control de 1:2. La asignación aleatoria utilizó el sistema de bloques. Se usó enmascaramiento tipo doble ciego. Se midió la consistencia interna del formato de evaluación de las dos etiquetas de resultados de la Clasificación de resultados de enfermería (NOC) mediante el alfa de Chronbach. Se determinó la reproducibilidad de los formatos usando los límites de acuerdo de Bland y Altman. Los efectos de las intervenciones de enfermería en el temor fueron establecidos mediante análisis de covarianza (ANCOVA). Resultados. El grupo intervención tuvo un coeficiente de cambios en la etiqueta "Control del temor", controlado por NOC inicial, edad y género de 1.09 (p=0.000) y su coeficiente de cambios en la etiqueta "Conocimientos: régimen terapéutico" fue de 1.33 (p=0.000). Conclusión. Las personas que recibieron las intervenciones de enfermería presentaron una disminución significativa del temor respecto a las que recibieron la atención usual.

Influence of ceramic material, thickness of restoration and cement layer on stress distribution of occlusal veneers

Abstract The aim of this study was to evaluate stress distribution in an occlusal veneer according to the restorative material, restoration thickness, and cement layer thickness. A tridimensional model of a human maxillary first molar with an occlusal veneer preparation was constructed using a modeling software of finite element analysis. The model was replicated 9 times to evaluate the factors: restoration thickness (0.6, 1.2, and 1.8 mm) and cement layer thickness (100, 200, and 300 μm). Then, each model received different restorative materials (High Translucency Zirconia - [YZHT], Lithium Disilicate - [LD], Zirconia Reinforced Lithium Silicate - [ZLS], Feldspathic - [F], and Hybrid Ceramic - [HC]), totaling forty-five groups. An axial load (600 N) was applied on the occlusal face for static structural analysis. Solids were considered isotropic, homogeneous, and linearly elastic. Contacts were considered perfectly bonded. Fixation occurred in the dental root and a mechanical static structural analysis was performed. Descriptive statistical analysis and one-way ANOVA (α =10%) were performed for tensile stress peak values in the restoration and cement layer. The difference between groups was compared using the Tukey's test with 10% significance to match the percentage of the mesh convergence test. According to the results, the cement layer thickness did not influence stress distribution in the restoration (p ≥ 0.10). The thicker the restoration, the higher the tensile stress concentration in the restoration. The graphs showed higher stress concentration in the YZHT, followed by LD, F, ZLS, and HC. Also, the restorative material influenced stress concentration on the cement layer, which decreased according to the sequence HC>YZHT>ZLS>LD>F. HC stood out for causing the least stress concentration in the restoration. Cement layer thickness did not interfere in the mechanical performance of the restorations.

Confiabilidad, precisión o reproducibilidad de las mediciones. Métodos de valoración, utilidad y aplicaciones en la práctica clínica / Reliability, precision or reproducibility of the measurements. Methods of assessment, utility and applications in clinical practice

Resumen En investigación, la confiabilidad (precisión, consistencia y reproducibilidad), corresponde a una propiedad psicométrica que dice relación con la ausencia de error de la medición; o del grado de consistencia y estabilidad de las puntuaciones obtenidas a lo largo de sucesivos procesos de medición con un mismo instrumento. Por ello, es esperable que, a mayor variabilidad de resultados, menor sea la precisión del instrumento de medición utilizado, concepto que aplica desde el laboratorio a la práctica clínica. La reproducibilidad se determina aplicando el coeficiente de confiabilidad, que es la correlación entre las puntuaciones obtenidas por los sujetos, en dos formas paralelas de una prueba (porque se supone que miden lo mismo). Por ello, asumiendo que midan lo mismo, las puntuaciones de los sujetos en estudio deberían ser iguales en ambas aplicaciones. De este modo, cuando la correlación es 1, la confiabilidad, precisión o reproducibilidad es máxima; y mientras más cercana a 0 es peor. La precisión en las mediciones está influenciada por el que mide (observador), por aquello con lo que se mide (instrumento de medición), y por lo que es medido (lo observado). Por ende, se ha de tomar en cuenta la variabilidad de cada uno de estos componentes al momento de planificar la medición de la variable en estudio; de tal modo de reducir al máximo los sesgos de medición. Así, las formas más comunes de determinar confiabilidad son: modelos de formas paralelas, test-retest y de dos mitades. Este manuscrito se centra en los conceptos de medición y las diversas técnicas estadísticas utilizadas para ello, como paso previo a la aplicación en la clínica. Por ello, el objetivo de este manuscrito es generar un documento de estudio y consulta relacionado con la confiabilidad, reproducibilidad o precisión del proceso de medición.

Reliability (accuracy, consistency and reproducibility) is a psychometric property, which is related to the absence of measurement error, or, to the degree of consistency and stability of the scores obtained through successive measurement processes with the same instrument. Thus a greater variability of results will lower the accuracy or reliability of instrument used, fact that is transverse from the laboratory to the clinical practice. It is determined by applying the reliability coefficient, which is the correlation between the scores obtained by the subjects in two parallel forms of a test. Assuming that the two forms of the test are parallel (measure the same), the scores of the subjects under study should be the same in both applications. In this way, when the correlation is 1, the reliability or precision is maximum. On the other hand, reliability could be influenced by the observer (the one that measures), the measuring instrument (by that with which it is measured), and by the observed (by what is measured). Therefore, the variability of each of these components must be taken into account when planning the measurement of the variable under study, in such a way to reduce measurement biases as much as possible. The most common ways to determine reliability are the models of parallel forms, test-retest and two halves. This manuscript focuses on the concepts of measurement and the various statistical techniques used for this, as a step prior to application in the clinic. Therefore, the aim of this manuscript is to generate a consultation document related to the reliability or reproducibility of the measurement process.