Angoff standard setting and a reformed curriculum: were the standards credible and responsive?

Determine the quality of eleven knowledge based multiple-choice examinations [A-J] and compare pass-fail rates before and after standard setting as a criterion of credibility; intra-class correlation coefficients [ICC] for inter-rater reliability and correlations between mean test scores and standards set for all individual items as a measure of validity. Determine the effect of standard setting an exam 121 days after it had been previously standard set and two options removed using item analysis. Design: Cohort study. In-course examinations delivered to 85-111 medical and dental students in one medical school. Intervention: Modified method of Angoff standard setting multiple-choice examinations. KR-20 coefficients of reliability, mean test scores, point biserial coefficients, standards set and item score correlation, intra-class correlations and pass-fail rates. All the examinations were of high quality according to the criteria used. The pass-fail rates of exams A and B not standard set were 56.4% and 51.8% which then fell to a range 6% - 29% [C-J] after standard setting. The ICC was 0.69 + 0.12, indicating good inter-rater reliability while the MTS - item Diff correlations were low. The theoretical exam confirmed an acceptable standard set in terms of a statistically insignificant change in pass-fail rates. These results support the use of standard setting as being credible and responsive, but only a moderate level of validity was achieved

Recurrence of Primary spontaneous pneumothorax: rate and risk factors

To study the recurrence rate of primary spontaneous pneumothorax [PSP] in our practice and to identify the factors that influence it Retrospective data analysis Chest Diseases Hospital, Kuwait Two hundred and eight patients with PSP Observation or tube thoracostomy Recurrence of PSP with reference to the following factors: age, sex, height, BMI, smoking status, and type of primary treatment Recurrence of PSP occurred in 72 patients with a recurrence rate of 34.6 percent. The majority of recurrences occurred in the first year - 45 out of 72 [62.5%]. PSP was eleven times more common in men than in women. Female sex was associated with higher recurrence rate. Ten out of 17 [58.8%] females had recurrence whereas 62 out of 191 [32.5%] males had recurrence [p = 0.02]. The recurrence rate in patients who continued to smoke and those who stopped smoking was 53/144 [36.8%] and 2/18 [11%] respectively [p = 0.03]. However, no association could be demonstrated between recurrence rate and age, height, BMI and type of treatment. Female sex and smoking behavior are significant prognostic factors for future recurrences of PSP