Notice bibliographique
Résumé
Background: Vision tests are noninvasive tests increasingly suggested for concussion assessment. To know if a test result is abnormal after a concussion, one needs to compare the result to a value obtained before a concussion (baseline). The test results may be affected by physiological and psychological changes of the patient over time and variations in how the clinician conducts the examination. Therefore, one needs to know how much the results may vary even without a concussion in order to determine if the change with a concussion (signal) is more than the expected change due to normal variability (noise). However, only a limited number of studies have assessed the test-retest reliability of vision tests, and none have evaluated test-retest time intervals longer than about 57 days. Because concussions may occur months after a yearly baseline test, appropriate interpretation of results can only be made if we understand one-year test-retest reliability.Objective: Our objective was to determine the one-year test-retest reliability of ten vision tests in a cohort of healthy Canadian elite athletes, who did not suffer a concussion during one-year. These ten tests measured different aspects of visual function, including Positive Fusional Vergence at 30cm and 3m, Negative Fusional Vergence at 30cm and 3m, Phoria at 30cm and 3m, Near Point of Convergence and Near Point of Convergence break, Gross Stereoscopic Acuity, and Saccades.Methods: We studied elite Canadian athletes followed at the Institut National du Sport du Quebec (INSQ), evaluated by a single INSQ sports medicine physician who was responsible for all vision testing referrals. The vision test data was abstracted from the medical records of a single clinician trained in orthoptic testing (APEXK) performing the vision tests. The two data sets were linked, cleaned and harmonized according to a pre-determined set of rules. After data verification, we included athletes who completed two baseline evaluations within 365±30 days. We excluded athletes with any concussion, vision training in between the annual evaluations, or medical conditions/treatment that might affect the tests. We evaluated test-retest reliability using Intraclass Correlation Coefficient (ICC) and 95% limits of agreement (95% LoA). We considered ICC of ≤0.5 as poor, 0.51-0.74 as moderate, 0.75-0.89 as good, and ≥0.90 as excellent reliability.Results: There were 16 athletes, nine females and seven males, out of 199 who met our inclusion criteria, with a mean age of 22.7 (SD 4.5) years. Among the vision tests, we observed excellent test-retest reliability in Positive Fusional Vergence at 30cm (ICC=0.93, 95% LoA=±41.9%), but the ICC dropped to 0.53 (95% LoA= ±43.5%) when an outlier was excluded in a sensitivity analysis. There was good to moderate reliability in Negative Fusional Vergence at 30cm (ICC=0.78, 95% LoA=±41.2%), Phoria at 30cm (ICC=0.68, 95% LoA=±119.2%), Near Point of Convergence break (ICC=0.65, 95% LoA=±49.4%) and Saccades (ICC=0.61, 95% LoA=±24.3%). The ICC for Positive Fusional Vergence at 3m (ICC=0.56, 95% LoA=±60.2%) also decreased to 0.21 after removing one outlier. We found poor reliability in Near Point of Convergence (ICC=0.47, 95% LoA=±73.9%), Gross Stereoscopic Acuity (ICC=0.03, 95% LoA=±92.5%) and Negative Fusional Vergence at 3m (ICC=0.0, 95% LoA=±48.4%). ICC for Phoria at 3m was not appropriate because scores were identical in 14/16 athletes.Conclusions: Five vision tests had good to moderate one-year test-retest reliability after removing outliers, and the remaining tests had poor reliability in this healthy athlete population. These results represent the “noise” of the tests. Future research is needed to investigate if concussions produce a signal that is greater than the noise. If this is the case, these vision tests will be useful clinically regardless of the absolute ICCs and LoA values
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».