Reproducibility of regional pulse‐wave velocity in uremic subjects
Bibliographic record
Abstract
Despite the clinical importance of pulse-wave velocity (PWV), there are no standards for accurate carotid-radial pulse-wave measurement in uremic patients with respect to carotid-femoral measurement. We assessed the reproducibility of PWV values using the carotid-radial PWV measurement. We have measured the carotid-femoral PWV and carotid-radial PWV with an automated system (Pulse Pen, DiaTecne) using 2 different blind operators in 105 hemodialysis (HD) patients. The carotid-femoral waveforms were acquired by the first blind operator simultaneously with 2 pressure-sensitive transducers and the transit time of the pulse was calculated using the system software. Similarly, the second blind operator acquired the carotid-radial waveforms. The two operators performed 2 consecutive measurements from the same subject, in a random order. In fact, after the first operator had completed 2 consecutive measurements from 1 subject, all of the sensors were detached, and the second operator attached sensors again to the same subject. The measurements were performed during interval of a midweek dialysis-free day. To evaluate the reproducibility of the system, both within-observer and between-observer analyses were performed. We studied 105 dialysis patients (HD) and 20 controls. All HD patients had three dialysis sessions lasting at least 4 h/wk. A total of 28 patients (26.7%) had diabetic nephropathy. The mean age of HD was 64.6 ± 16.1 years, the body weight was 71.1 ± 15.1 kg, and the height was 164.6 ± 6.1 cm. All population studied is referral at a tertiary care from at least 6 months (mean 11.1 ± 2.1 months). A total of 45% of patients are smokers or ex-smokers. The PWV of carotid-femoral is 8.58 ± 3.99 and the PWV of carotid-radial is 8.70 ± 4.01 m/sec, respectively, by the first and the second operator; the difference of PWV (femoral-radial measure) is -0.037 ± 0.99 m/sec. The linear correlation of carotid-femoral vs. carotid-radial PWV measurements is the highest (R(2) =0.90). The results regarding reproducibility, including mean differences and standard deviations, standard errors, and correlation coefficients were analyzed for each regional PWV value for the between-observer and within-observer studies. All of the measurements showed significant correlation coefficients, ranging from 0.94 to 0.98. The reproducibility of regional PWV values for 2 consecutive measurements from the same subject was also analyzed using Bland-Altman plots, with the reproducibility expressed as the mean difference and 2 standard deviations between the measurements obtained by the 2 operators during carotid-femoral and carotid-radial measurements. Carotid-radial PWV measurement provides an accurate analysis with a high reproducibility with respect to carotid-femoral PWV measurement, and it can be used for arterial stiffness analysis in hemodialysis patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".