Reliability of cushion construction for a low-cost pressure-reducing wheelchair cushion for less-resourced settings
Bibliographic record
Abstract
In less-resourced settings, 80% of people with spinal cord injuries die from pressure ulcer complications within two years. Appropriately constructed wheelchair cushions are effective in reducing incidence and severity of pressure ulcers. The Tuball is an inexpensive wheelchair cushion designed for users in less-resourced settings, which can be reproduced by local clinicians using locally sourced materials. This paper aimed to assess whether different individuals with limited knowledge of cushion construction could reliably construct the Tuball cushion. A convenience sample of eleven occupational therapy students were randomly assigned to one of two groups. Six participants constructed a Tuball and completed a subjective workload assessment. Five different participants sat on each cushion while pressure distributions were mapped. Intraclass correlation coefficients (ICC) with 95% confidence intervals were calculated for reliability of construction of each cushion using data from a range of pressure indices: dispersion index (primary outcome), peak pressure index, contact area, and seat pressure index (secondary outcomes) across all six cushions. The ICC across all cushions was 0.745 (95% CI 0.103-0.970) for dispersion index. ICCs across cushions for secondary outcomes ranged from 0.879 to 0.951. Good-moderate reliability was found for the reliability in cushion construction as measured by the dispersion index. Excellent reliability in cushion construction was found as measured by peak pressure index, contact area, and seat pressure index. Data indicates individuals can reliably construct the Tuball given equivalent materials and instructions.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 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 teacher head, 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".