Psychometric and Comparative Study of an Argentine Version of the Morningness Composite and the Early/Late Preference Scales

This study examined the psychometric properties of an Argentine Version of the Morningness Composite (CS) and the Early/Late Preference (PS) Scales. During summer (long photoperiod in Argentina), 304 subjects (69.1% women; mean age=33.64 yrs, SD=14 yrs) completed the scales for the first time. In winter (short photoperiod), 100 of the same individuals (71% women; mean age=37.17 yrs, SD=14.63 yrs) were retested. The total scores ranged within the values reported by previous studies and were independent of gender. Older subjects showed higher morningness scores. The internal consistencies were good (CS=0.86, PS=0.82). Item 7 from the CS and items 7 and 9 from the PS showed low item‐scale correlation. Factor analysis produced a three‐factor solution for both scales. However, the inconsistency of the evening items suggests that the single‐solution may be more acceptable. Test‐retest correlations were satisfactory (CS=0.88, PS=0.78), but the two‐related‐sample test revealed significant differences between test and retest scores, suggesting relative temporal stabilities. Both scales presented similar and acceptable psychometric properties and good correlation, indicating construct validity.     

Season of birth and morningness: comparison between the northern and southern hemispheres

The present study explored the possible role of the photoperiod at birth on morningness by collecting data in the northern (Italy) and southern (Australia) hemispheres. To assess circadian typology, the Composite Scale of Morningness (CS) was administered to a sample of 1734 university students (977 Italian and 757 Australian; 1099 females and 635 males; age 24.79?±?7.45 yrs [mean?±?SD]). Consistent with the literature, females reported higher CS scores (morningness) than males, and Australian participants reported higher CS scores than Italian participants. Allowing for the fact the seasons are reversed between the hemispheres, the results are in line with previous studies. The authors found more evening types were born during the seasons associated with longer photoperiod (spring and summer), and more morning types were born during the seasons associated with shorter photoperiod (autumn and winter), indirectly supporting an imprinting-like phenomenon played by the photoperiod at birth.     

Season of Birth and Morningness: Comparison Between the Northern and Southern Hemispheres

The present study explored the possible role of the photoperiod at birth on morningness by collecting data in the northern (Italy) and southern (Australia) hemispheres. To assess circadian typology, the Composite Scale of Morningness (CS) was administered to a sample of 1734 university students (977 Italian and 757 Australian; 1099 females and 635 males; age 24.79?±?7.45 yrs [mean?±?SD]). Consistent with the literature, females reported higher CS scores (morningness) than males, and Australian participants reported higher CS scores than Italian participants. Allowing for the fact the seasons are reversed between the hemispheres, the results are in line with previous studies. The authors found more evening types were born during the seasons associated with longer photoperiod (spring and summer), and more morning types were born during the seasons associated with shorter photoperiod (autumn and winter), indirectly supporting an imprinting-like phenomenon played by the photoperiod at birth. (Author correspondence: vincenzo.natale@.unibo.it)     

Validation of a Chronotype Questionnaire Including an Amplitude Dimension

The aim of this paper was to validate a French version of the Chronotype Questionnaire (Ogińska, 2011, Pers. Individ. Dif. 50:1039–1043), which represents an interesting novelty in the psychometric assessment of chronotype, because it comprises not only an assessment of the morningness-eveningness (ME) dimension, but also a distinctness (DI) dimension (i.e., amplitude), which represents the range of diurnal variation. In study 1, we aimed to confirm the structure of the Chronotype Questionnaire, with two different samples, young adults (n?=?338, mean?±?SD?=?18.70?±?1.12?yrs, 244 men and 94 women) and old adults (n?=?477, mean?±?SD?=?55.92?±?11.9?yrs, 168 men and 310 women). The confirmatory factor analysis (CFA) indicated a poor fit in both samples as well as in the whole sample, which could be due to some inconsistencies in the original instrument, above all in the distinctness dimension. We therefore decided to revise the Chronotype Questionnaire, keeping the ME dimension, but refining the DI dimension. In study 2, with a new sample of 197 participants (mean?±?SD?=?22.71?±?2.23?yrs, 105 men and 92 women), we examined the factor structure of the revised scale containing 18 items. The resulting questionnaire contained 16 items (i.e., 8 items on each scale), with item factor loadings higher than .45. In study 3, we aimed to confirm the factor structure of the instrument developed in study 2 as well as to examine its convergent validity, with a new sample of 158 participants (mean?±?SD?=?55.92?±?11.9?yrs, 97 men and 61 women). Results of the CFA showed that a good fit of the model could be obtained with 16 items in the questionnaire. The new questionnaire derived from the original Chronotype Questionnaire was from now on called the Caen Chronotype Questionnaire (CCQ). Convergence validity was obtained with the Horne and Östberg questionnaire and the ME scale of the CCQ, showing a negative significant relationship (r?=??.82). The CCQ showed promising psychometric qualities, and further research should aim to combine it with physiological variables.     

Transcultural properties of the composite scale of morningness: the relevance of the "morning affect" factor

Morningness scales have been translated into several languages, but a lack of normative data and methodological differences make cross-cultural comparisons difficult. This study examines the psychometric properties and factor structure of the Composite Scale of Morningness (CSM) in samples from five countries: France (n=627), Italy (n=702), Spain (n=391), Thailand (n=503), and Australia (n=654). Strong national differences are identified. A quadratic relationship between age and CSM total score was apparent in the Australian data with a downward trend after age 35 yrs. There was no age effect in any sample in the range from 18 to 29 yrs. Factor analysis identified a three-factor solution in all groups for both men and women. Tucker's congruence coefficients indicate that: (1) this solution is highly congruent between sexes in each culture, and (2) a morning affect factor is highly congruent between cultures. These results indicate there are national differences in factorial structure and that cut-off scores used to categorize participants as morning- and evening-types should be established for different cultural and age groups.     

Transcultural Properties of the Composite Scale of Morningness: The Relevance of the “Morning Affect” Factor

Morningness scales have been translated into several languages, but a lack of normative data and methodological differences make cross‐cultural comparisons difficult. This study examines the psychometric properties and factor structure of the Composite Scale of Morningness (CSM) in samples from five countries: France (n=627), Italy (n=702), Spain (n=391), Thailand (n=503), and Australia (n=654). Strong national differences are identified. A quadratic relationship between age and CSM total score was apparent in the Australian data with a downward trend after age 35 yrs. There was no age effect in any sample in the range from 18 to 29 yrs. Factor analysis identified a three‐factor solution in all groups for both men and women. Tucker's congruence coefficients indicate that: (1) this solution is highly congruent between sexes in each culture, and (2) a morning affect factor is highly congruent between cultures. These results indicate there are national differences in factorial structure and that cut‐off scores used to categorize participants as morning‐ and evening‐types should be established for different cultural and age groups.     

Psychometric analysis of behavior pattern A in the Spanish population and its relationship with personality variables

As a first step in the epidemiological study for CHD prevention among the Spanish population, the authors have analyzed two of the instruments for the assessment of the behavior pattern A (JAS and Bortner questionnaires). From a student sample (n = 302), a factor analysis of items and scales was made, relating pattern A scores to Eysenck's personality variables (EPQ). The importance of an accurate psychometric study of pattern A was emphasized, in order to select A subjects as specifically as possible.     

The Kiddie-SADS allows a dimensional assessment of externalizing symptoms in ADHD children and adolescents

Objective of the study was the investigation of the psychometric properties of a scale derived from the Kiddie-SADS used for a dimensional assessment of externalizing symptoms in children and adolescents. The scale consists of 26 DSM-IV Kiddie-SADS items for attention deficit hyperactivity disorder (ADHD, 18 items) and oppositional defiant disorder (ODD, 8 items). Patients and their mothers were interviewed separately on the patients' symptoms during the last 2 weeks prior to interview. An ADHD-ODD sum score ranging between 0 and 26 was computed reflecting the number of fulfilled diagnostic criteria within the 2-week period under investigation. Interviews were videotaped and re-rated by an independent second rater. Additionally, mothers filled out two questionnaires on their children's symptoms (FBB-HKS, a German ADHD scale based on ICD-10 and DSM-IV criteria; strength and difficulties questionnaire, SDQ). We investigated 59 patients affected by AD(H)D according to DSM-IV recruited from our Department for Child and Adolescent Psychiatry (39 males, 20 females; mean age: M=9.66, SD=2.30). Inter-rater correlation regarding the ADHD-ODD scores was r=0.98 with no significant differences in mean sum scores between rater 1 and rater 2. Internal consistency of the ADHD-ODD scale was 0.85 (Cronbach's alpha). Item difficulties and discriminative power of the items also proved to be adequate. Convergent and discriminant validity were indicated by middle to high correlations with mother-ratings of the children's externalizing symptoms and a low correlation with ratings of internalizing symptoms. Factor analysis revealed a three-factor solution mainly covering inattentive, hyperactive and oppositional symptoms. In summary, ADHD and ODD sections of the Kiddie-SADS allow a reliable and valid dimensional assessment of externalizing symptoms in AD(H)D children and adolescents.     

Assessing Impact of Weight on Quality of Life

This paper is a preliminary report on the development of a new instrument, the Impact of Weight on Quality of Life (IWQOL) questionnaire, that assesses the effects of weight on various areas of life. We conducted two studies utilizing subjects in treatment for obesity at Duke University Diet and Fitness Center. The first study describes item development, assesses reliability, and compares pre- and post-treatment scores on the IWQOL. In the second study we examined the effects of body mass index (BMI), gender, and age on subjects' perceptions of impact of weight on quality of life. Results indicate adequate psychometric properties with test-retest reliabilities averaging .75 for single items, and .89 for scales. Scale internal consistency averaged .87. Post-treatment scores differed significantly from pre-treatment scores on all scales, indicating that treatment produced positive changes in impact of weight on quality of life. The results of the second study indicate that the impact of weight generally worsened as the patients' size increased. However for women there was no association between BMI and impact of weight on Self-Esteem and Sexual Life. Even at the lowest BMI tertile studied, women reported that weight had a substantial impact in these areas. There were also significant gender differences, with women showing greater impact of weight on Self-Esteem and Sexual Life compared with men. The impact of age was a bit surprising, with some areas showing positive changes and others showing no change.     

Serum insulin and serum lipid profiles of a selected group of Southern Ontario tannery workers with elevated serum and urine chromium concentrations

This study compares the serum insulin and lipid profiles of a group of Southern Ontario tannery workers, with elevated serum and urine Cr levels, with those of men not exposed to industrial chromium (III) oxide. Fasting blood samples were obtained from 72 male tannery workers (TW) (mean age±SD=36±12 y) and from 52 control subjects (CS) (mean age±SD=41±13 y), matched by age, sex, race, and socioeconomic group. There were no significant differences between the two groups for median serum insulin (TW=8 μM/mL vs CS=9 μM/mL), total cholesterol (TC) (TW=201 mg/dL vs CS 209 mg/dL), triglycerides (TG) (TW=131 mg/dL vs 114 mg/dL) and high density lipoprotein cholesterol (HDL-C) (TW=45 mg/dL vs CS=43 mg/dL), or, in the calculated median values for low density lipoprotein cholesterol (TW=117 mg/dL vs CS=134 mg/dL), percent HDL-C (TW=23% vs CS=22%), and the cholesterol atherogenic ratio (TC/HDL-C) (TW=4.3 vs CS=4.5). Results of this study, therefore, demonstrate that absorption of trivalent Cr compounds, arising from industrial exposure, has no significant effect on serum insulin and lipid profiles.     

Evaluation of the Psychometric Properties of the Functional Assessment of Cancer Therapy-Cervix Questionnaire in Brazil

Background

Although cervical cancer is ​​the second most common tumor among Brazilian women, studies that evaluate the quality of life of these women are still scarce. This situation is explained by the lack of specific and validated tools for this purpose in Portuguese (Brazil). The aim of this study was to evaluate the psychometric properties of the Portuguese version of the FACT-CX (Functional Assessment of Cancer Therapy-Cervix) questionnaire in a population of Brazilian women with cervical cancer.

Methods

The psychometric properties of the FACT-CX questionnaire were tested in a sample of 100 women diagnosed with cervical cancer who were previously treated in the Barretos Cancer Hospital. We analyzed the internal consistency (Cronbach''s alpha), reproducibility (intraclass correlation coefficient - ICC), confirmatory factor analysis, convergent validity (correlation with the SF-36 questionnaire), and discriminant validity by disease stage and two questions related to self-perception of health was also performed.

Results

The scales had Cronbach´s alpha coefficients ranging from 0.61 to 0.80. However, three scales did not have a statistically significant coefficient greater than 0.70. The ICC ranged from 0.68 to 0.82 and all considered satisfactory. Factor analysis did not generate consistent components. The FACT-G and FACT-CX total scores had good internal consistency and reproducibility, and also correlated well with the General Health and Vitality scales of the SF-36. However, only two FACT-CX scales had a significant correlation with SF-36. Discriminant analysis showed that FACT-CX failed to discriminate groups according to clinical stage but was able to divide the women according to the self-perception of health.

Conclusion

FATC-CX total score had good internal consistency, reproducibility and discriminant validity. In addition, it correlated well with General Health and Vitality scales of SF-36. However, three scales had questionable internal consistency and only two had significant correlation with SF-36.     

Periodontal disease status of pregnant women with diabetes mellitus

The aim of the present study was to evaluate the association between type I diabetes mellitus (DM) and periodontal disease in pregnant women. Fifty-two pregnant women aged 27.9 +/- 6.9 years with type I DM participated in the present study. Forty-two non-pregnant type I female diabetics (mean age: 27.9 +/- 6.1 years) and 121 healthy non-pregnant women (mean age: 29.1 +/- 5.7 years) without diabetes formed the control group. All subjects were given a clinical periodontal examination including probing pocket depth (PPD), probing attachment level (PAL), assessment of plaque and gingivitis scores (SBI). Blood parameters included levels of hemoglobin, glycosylated hemoglobin, total cholesterol, triglyceride and leukocytes. The pregnant diabetic subjects showed despite a good metabolic control significantly higher values for the SBI compared to the controls. Pregnant diabetic subjects displayed a significant correlation between the dose of insulin per day and PPD (p < or = 0.05) as well as the PAL (p < or = 0.05). In conclusion, the results of the study indicate that pregnant diabetics demonstrate a higher degree of periodontal inflammation and destruction compared to non-pregnant diabetics and healthy non-pregnant patients.     

Mokken scale analysis of the UPDRS: dimensionality of the Motor Section revisited

The dimensionality and reliability of the Motor Section of the Unified Parkinson Disease Rating Scale (UPDRS III) was studied with non-parametric Mokken scale analysis. UPDRS measures were obtained on 147 patients with PD (96 men, 51 women, mean age 61, range 35-80 yrs). Mokken scale analysis revealed a four-dimensional structure of the UPDRS III. Left-sided bradykinesia and rigidity appeared to co-occur with axial signs, gait disturbance, and speech/hypomimia, whereas right-sided bradykinesia and rigidity formed a second scale. Two further small scales were found consisting of right- and left-sided tremor. Results from the scale analysis reveal that all four subscales are strong. The reliability of the two tremor scales is low because they only contain three and four items, respectively.     

Morningness-eveningness and lifestyle regularity

The relation between morningness (M) - eveningness (E) and lifestyle regularity was studied in a convenience sample of 100 healthy subjects aged between 20 and 59 yrs (47 males and 53 females; mean age 33.6 yrs). Morningness-eveningness was measured by a single administration of the 13-item Composite Scale for Morningness (CSM). Lifestyle regularity was measured by requiring subjects to complete a five-item Social Rhythm Metric diary (SRM-5) each evening for two weeks. Each week of SRM-5 was analyzed separately and the two SRM scores averaged to yield the lifestyle regularity measure for the subject. Subjects were categorized by morningness into top and bottom quartiles of CSM score (denoted M-types and E-types, respectively), with the remaining 50% of subjects denoted as intermediate (I-types). Mean SRM scores significantly differed between the three morningness groups (p <0.001) in the order E-types (SRM = 3.6), then I-types (SRM=4.0), then M-types (SRM=4.9), with higher scores indicating greater daily lifestyle regularity. The effect size of the E-type versus M-type difference was approximately 1.3. The relationship between the CSM and SRM scores was also confirmed using a correlational analysis (rho = 0.428; p < 0.001). This correlational finding was substantially weaker when age was partialed out (r=0.186; p=0.065), although there was still a trend toward a significan relationship. Thus it appears that morning types appear to be more regular in their daily lifestyle than are evening types, suggesting a relationship between these two aspects of human circadian behavior.     

Derivation of normative data for the COPD assessment test (CAT)

Background

The tradition classification of the severity of COPD, based on spirometry, fails to encompass the heterogeneity of the disease. The COPD assessment test (CAT), a multi-dimensional, patient-filled questionnaire, assesses the overall health status of patients, and is recommended as part of the assessment of individuals with COPD. However, information regarding the range of values for the test in a non-COPD population (normative values) is limited, and consequently, knowledge regarding the optimal cut-off, and the minimum clinically important difference (MCID) for the test remain largely empirical.

Methods

CanCOLD is a population-based multi-center cohort study conducted across Canada, the methodology of which is based on the international BOLD initiative. The study includes subjects with COPD, at-risk individuals who smoke, and healthy control subjects. CAT questionnaires were administered at baseline to all subjects. Among non-COPD subjects, normative values for the CAT questionnaire, and psychometric properties of the test were characterized. Predictors of high CAT scores were identified using multivariable logistic regression.

Results

Of the 525 non-COPD subjects enrolled, 500 were included in the analysis. Mean FEV₁/FVC ratio among the 500 included subjects was 0.77 (SD 0.49); the mean predicted FEV₁ was 99.38% (SD 16.88%). The overall mean CAT score was 6 (SD 5.09); scores were higher among females (6.43, SD 5.59), and subjects over 80 years of age (mean 7.58, SD 6.82). Cronbach alpha for the CAT was 0.79, suggesting a high internal consistency for the test. A score of 16 was the 95th percentile for the population, and 27 subjects (5.4%) were found to have a CAT score > =16. Current smoking (aOR 3.41, 95% CI 1.05, 11.02), subject-reported physician-diagnosed asthma (aOR 7.59, 95% CI 2.71, 21.25) and musculoskeletal disease (aOR 4.09, 95% CI 1.72, 9.71) were found to be significantly associated with a score ≥16.

Conclusions

The characterization of CAT scores in the general population will be useful for norm-based comparisons. Longitudinal follow-up of these subjects will help in the optimization of cut-offs for the test.     

Human ears grow throughout the entire lifetime according to complicated and sexually dimorphic patterns--conclusions from a cross-sectional analysis

In most of its anatomical constituents, e.g. in the Helix, etc., the external human ear is homologous to that of all Primates and Scandentia (tree shrews). Thus, its genetic basis is largely older than 60 Mio yrs. Based upon the observation of lifelong growth of the ear (e.g. Montacer-Kuhssary 1959), we aimed to elucidate the growth of the human ear in a more detailed way throughout life and in both sexes. On standardized photographical material collected randomly in Berlin (Germany), we measured N = 1448 ears from neonate children to volunteers of 92 yrs in age. 10 longitudinal measurements and 5 further anatomical parameters yielded a data set of roughly 19,000 data in total. Based upon our cross-section analysis, we quantified several sexual dimorphisms. Furthermore, we deduced ontogenetic developments and, partially, corrected their proportions for secular acceleration and body height shrinking with age. At the time of birth, in proportion to the body, the external ear was even bigger than the large head and continued growing rather linearly throughout life, reaching the highest average lengths in the volunteers aged over 85 yrs. The large yearly increases during childhood began to diminish at as early an age as 8 or 10 yrs. In all parameters where post adult growth was observed, female ears showed a lesser increase than those of men. The greatest ear length in females was 52 mm (SD +/- 4.3 mm) at birth, 61 mm (SD +/- 3.9 mm) at around 20 yrs of age and 72 mm (SD +/- 4.6 mm) in women older than 70 yrs. For the male subjects, these three values were: 52 mm (SD +/- 4.1 mm), 65 mm (SD +/- 4.0 mm) and 78 mm (SD +/- 4.8 mm), respectively. In spite of extreme premature growth of the auricle and its further lifelong growth, three anatomical features of the ear did practically not grow at all after birth: the width of the Concha auriculae and of the Incisura intertragica, as well as the diameter of the helical brim of the auricle. The problems arising concerning the functions and selective values of all these very unusual proportions and growths are discussed. The ontogenetic development of one or more pretragal skin folds could be used as a contribution to age estimations in forensic anthropology.     

Internal desynchronization of circadian rhythms and tolerance to shift work

Intolerance to shift work may result from individual susceptibility to an internal desynchronization. Some shift workers (SW) who show desynchronization of their circadian rhythms (e.g., sleep-wake, body temperature, and grip strength of both hands) exhibit symptoms of SW intolerance, such as sleep alteration, persistent fatigue, sleep medication dependence, and mood disturbances, including depression. Existing time series data previously collected from 48 male Caucasian French SW were reanalyzed specifically to test the hypothesis that internal synchronization of circadian rhythms is associated with SW intolerance and symptoms. The entry of the subjects into the study was randomized. Three groups were formed thereafter: SW with good tolerance (n=14); SW with poor tolerance, as evident by medical complaints for at least one year (n=19); and former SW (n=15) with very poor tolerance and who had been discharged from night work for at 1.5 yr span but who were symptom-free at the time of the study. Individual and longitudinal time series of selected variables (self-recorded sleep-wake data using a sleep log, self-measured grip strength of both hands using a Colin Gentile dynamometer, and oral temperature using a clinical thermometer) were gathered for at least 15 days, including during one or two night shifts. Measurements were performed 4-5 times/24 h. Power spectra used to quantify the prominent period (tau) and t-test, chi square, and correlation coefficient were used as statistical tools. The mean (+/-SEM) age of SW with good tolerance was greater than that of SW with poor tolerance (44.9+/-2.1 yrs vs. 40.1+/-2.6 yrs, p<.001) and of former SW discharged from night work (very poor tolerance; 33.4+/-1.7, p<.001). The shift-work duration (yrs) was longer in SW with good than poor tolerance (19.9+/-2.2 yrs vs. 15.7+/-2.2; p<0.002) and former SW (10.7+/-1.2; p<.0001). The correlation between subject age and shift-work duration was stronger in tolerant SW (r=0.97, p<.0001) than in non-tolerant SW (r=0.80, p<0.001) and greater than that of former SW (r=0.72, p<.01). The mean sleep-wake rhythm tau was 24 h for all 48 subjects. The number of desynchronized circadian rhythms (tau differing from 24 h) was greater in non-tolerant than in tolerant SW (chi square=38.9, p<.0001). In Former SW (i.e., 15 individuals assessed in follow-up studies done 1.5 to 20 yrs after return to day work), both symptoms of intolerance and internal desynchronization were reduced or absent. The results suggest that non-tolerant SW are particularly sensitive to the internal desynchronization of their circadian time organization.     

Does religious affiliation influence glycaemic control in primary care patients with type 2 diabetes mellitus?

Background To determine the relationships between religiosity, religions and glycaemic control of type 2 diabetes mellitus (T2D).Methods This is a cross-sectional study conducted at an urban, university-based, teaching outpatient clinic. Religiosity was assessed with the Beliefs and Values Scale (BV), which contains 20 items each with a Likert scale of five possible responses. The range of scores is 0 to 80, with a higher score indicating stronger religious belief. Glycaemic control was taken as the mean value of the latest three fasting plasma glucose (FPG) levels and HbA1c readings documented in each patient's case records.Results A total of 212 patients participated (a response rate of 79%). Two-thirds were female, mean age was 62.7 (SD 10.8) years and mean duration of T2D was 11.7 (SD 6.7) years. The mean BV score was 57.4 (SD 10.97, CI 55.9, 59.0). Religiosity had a negative correlation with lower FPG (r = -0.15, p = 0.041) but no such correlation was found with HbA1c. Moslem religiosity had a significant negative correlation with HbA1c (r = -0.34, p = 0.007, n = 61) even after controlling for covariates. Christians and non-religious group had significantly lower mean rank HbA1c than other religions (p = 0.042).Conclusions Those with higher religiosity amongst the Moslem population had significantly better glycaemic control. Patients who had church-going religions had better glycaemic control compared with those of other religions.     

不同评分者急性生理和慢性健康评分的差异及其原因分析

目的:了解急性生理和慢性健康状况评分(APACHEII)的差异及其原因。方法:对2名医生做的32例重症患者的APACHEII评分进行前瞻性分析,讨论各项生理数值和评分的一致性,及导致不一致的原因。结果:两名医生APACHE II评分的一致性较差(Kapp=0.695),其中慢性健康评分(Kappa=0.75)和年龄评分(Kappa=0.956)的一致性较好,而急性生理评分(APS)的一致性差(Kappa=0.728)。APS的各项指标中,两名医生记录的原始数据共有160处不同,最终造成52处生理评分的不同。其比例最高有3项,第一为血清钾(8/11)第二为AaDO2(9/20),第三为平均动脉压(11/25)。造成评分差异的最主要原因为生理指标不同(85.2%),另有数据一致时评分不同的共9处,其中8处是由于评分者未遵循氧合评分标准,另1处为取值不同造成。结论:为了进一步提高评分的准确性,我们应该强化评分准则和积极做专业评分培训。