The reliability of three devices used for measuring vertical jump height

The purpose of this investigation was to assess the intrasession and intersession reliability of the Vertec, Just Jump System, and Myotest for measuring countermovement vertical jump (CMJ) height. Forty male and 39 female university students completed 3 maximal-effort CMJs during 2 testing sessions, which were separated by 24-48 hours. The height of the CMJ was measured from all 3 devices simultaneously. Systematic error, relative reliability, absolute reliability, and heteroscedasticity were assessed for each device. Systematic error across the 3 CMJ trials was observed within both sessions for males and females, and this was most frequently observed when the CMJ height was measured by the Vertec. No systematic error was discovered across the 2 testing sessions when the maximum CMJ heights from the 2 sessions were compared. In males, the Myotest demonstrated the best intrasession reliability (intraclass correlation coefficient [ICC] = 0.95; SEM = 1.5 cm; coefficient of variation [CV] = 3.3%) and intersession reliability (ICC = 0.88; SEM = 2.4 cm; CV = 5.3%; limits of agreement = -0.08 ± 4.06 cm). Similarly, in females, the Myotest demonstrated the best intrasession reliability (ICC = 0.91; SEM = 1.4 cm; CV = 4.5%) and intersession reliability (ICC = 0.92; SEM = 1.3 cm; CV = 4.1%; limits of agreement = 0.33 ± 3.53 cm). Additional analysis revealed that heteroscedasticity was present in the CMJ when measured from all 3 devices, indicating that better jumpers demonstrate greater fluctuations in CMJ scores across testing sessions. To attain reliable CMJ height measurements, practitioners are encouraged to familiarize athletes with the CMJ technique and then allow the athletes to complete numerous repetitions until performance plateaus, particularly if the Vertec is being used.     

Evaluation of the reliability of soccer-specific field tests

The soccer-specific field tests are popular among coaches due to their simplicity, validity, and minimal use of equipment. Nevertheless, there is a general lack of data about their reliability, particularly regarding the tests of anaerobic performance. Twenty professional male soccer players performed 3 consecutive trials of the tests of throwing-in and standing-kick performance (the distance measured) as well as on timed 10-m sprint, flying 20-m sprint, running 10 x 5 m, zigzag running with and without the ball, and the skill index (i.e., the ratio of the zigzag running without and with the ball). With the exception of the throwing-in and standing kick, the evaluated tests revealed high intraclass correlation coefficients (i.e., >0.80), small within-individual variations (coefficient of variation, <4%), and sample sizes for detecting a 2% change in the tested performance that are either close to or below the standard size of a professional soccer squad. In addition to simplicity and face validity, most of the evaluated tests revealed high reliability. Therefore, the evaluated tests are recommended for sport-specific profiling and early selection of young athletes as well as for routine testing procedures that could detect effects of various intervention procedures. Regarding the throwing-in and standing-kick tests, direct measurement of the ball velocity (e.g., with a standard radar gun) is recommended.     

Reliability of bulky DNA adducts measurement by the nuclease P1 32P-post-labelling technique.

The aim was to assess the reliability of bulky DNA adducts measurement by means of the 32P-post-labelling assay. The research design consisted of an intramethod reliability study. Buffy coats from 41 subjects were used to obtain two aliquots of 1-5 microg DNA for each subject; bulky DNA adducts were measured using the nuclease P1 32P-post-labelling technique. The reliability of the measurement was assessed by means of the intraclass correlation coefficient (ICC), the distribution of the differences between the two measurements and the limits of agreement. The estimated ICC was 0.977, with a 95% confidence interval between 0.921 and 0.977. The limits of agreement were +/- 0.44 (DNA adducts per 10(8) nucleotides). Only three subjects had differences lying out of such limits. Bulky DNA adduct levels measured by the 32P-post-labelling technique showed good reliability. Only one measurement is needed to use DNA adducts as a biomarker of exposure and, possibly, cancer risk. Besides, as a validation analysis, 32P-post-labelling measurements can be repeated in only 20-30% of samples.     

Evaluation of a composite test of kicking performance

The aim of this study was to evaluate the reliability and sensitivity of variables for the direct assessment of kicking performance in young soccer players. One hundred and six elite young soccer players were divided into 4 age groups (12-15 years). Absolute error (AE), variable error (VE), and constant error (CE) were evaluated as the variables of kicking accuracy, whereas the kicking velocity variables involved the maximum ball velocity (BVmax) and the ball velocity during accurate kicks (BVacc). Results suggested low-to-moderate reliability of the kicking accuracy (intraclass correlation coefficient [ICC] = 0.00-0.67) and high reliability of the kicking velocity variables (ICC = 0.87-0.94). Regarding the sensitivity, most of the variables detected the differences both between the dominant and nondominant legs and among the age groups. Because the evaluated variables should have a property of face validity, the findings obtained generally suggest that AE (and perhaps VE, as the measures of kicking accuracy) and both BVmax and BVacc (as the measures of kicking velocity) could be used within a routine composite test of kicking performance in young elite soccer players. Further development of the evaluated composite test of kicking performance could be based on the involvement of other kicking techniques and on testing the athletes of different ages, levels of skill, or sport specialization.     

Test-retest reliability of 4 single-leg horizontal hop tests

The purpose of this study was to determine the test-retest reliability of 4 single-leg horizontal hop tests (i.e., single hop for distance, triple hop for distance, crossover hop for distance, and 6-m hop for time), with a time interval of approximately 4 weeks separating the 2 testing sessions. Eighteen healthy, young, adult men, all cadets enrolled at the U.S. Air Force Academy, Colorado, performed the single hop for distance, the triple hop for distance, the crossover hop for distance, and the 6-m hop for time during 2 testing sessions separated by 31.2 +/- 0.4 days. Reliability data for each of the single-leg hop tests were studied through a repeated measures analysis of variance, intraclass correlation coefficients (ICCs), and standard errors of measurement (SEMs). The ICCs ranged from 0.92 to 0.97 for the 4 single-leg hop tests. The SEMs for the single-leg hop tests that assessed the distance hopped ranged from 4.61 to 17.74 cm. The SEM for the 6-m hop for time test was 0.06 seconds. No significant differences were noted when the mean scores of the 2 test trials were compared by a repeated measures analysis of variance for any of the single-leg hop tests. These results indicate that the single-leg hop tests examined in this study offer strength and conditioning professionals a reliable method to assess the single-leg horizontal hopping capabilities of healthy, young, adult men, with intervals of approximately 4 weeks between testing sessions.     

Effects of 12-week medicine ball training on muscle strength and power in young female handball players

The purpose of this study was to examine the effects of medicine ball training on the strength and power in young female handball athletes. Twenty-one young female handball players (age, 16.9 ± 1.2 years) were randomly assigned to experimental and control groups. Experimental group (n = 11) participated in a 12-week medicine ball training program incorporated into the regular training session, whereas controls (n = 10) participated only in the regular training. Performance in the medicine ball throws in standing and sitting positions, 1 repetition maximum (1RM) bench and shoulder press, and power test at 2 different loads (30 and 50% of 1RM) on bench and shoulder press were assessed at pre- and posttraining testing. The athletes participating in the medicine ball training program made significantly greater gains in all medicine ball throw tests compared with the controls (p < 0.01). Also, the experimental group made significantly greater gains in bench and shoulder press power than control group (p < 0.05). Both training groups (E) and (C) significantly (p < 0.05) increased 1RM bench and shoulder strength, with no differences observed between the groups. Additionally, medicine ball throw tests showed stronger correlation with power tests, than with 1RM tests. These data suggest that 12-week medicine ball training, when incorporated into a regular training session, can provide greater sport-specific training improvements in the upper body for young female handball players.     

Reliability of bulky DNA adducts measurement by the nuclease P1 32P-post-labelling technique

The aim was to assess the reliability of bulky DNA adducts measurement by means of the ³²P-post-labelling assay. The research design consisted of an intramethod reliability study. Buffy coats from 41 subjects were used to obtain two aliquots of 1–5 μg DNA for each subject; bulky DNA adducts were measured using the nuclease P1 ³²P-post-labelling technique. The reliability of the measurement was assessed by means of the intraclass correlation coefficient (ICC), the distribution of the differences between the two measurements and the limits of agreement. The estimated ICC was 0.977, with a 95% confidence interval between 0.921 and 0.977. The limits of agreement were ±0.44 (DNA adducts per 10⁸ nucleotides). Only three subjects had differences lying out of such limits. Bulky DNA adduct levels measured by the ³²P-post-labelling technique showed good reliability. Only one measurement is needed to use DNA adducts as a biomarker of exposure and, possibly, cancer risk. Besides, as a validation analysis, ³²P-post-labelling measurements can be repeated in only 20–30% of samples.     

Reproducibility and concurrent validity of hip joint angle test for estimating hamstring flexibility in recreationally active young men

The purposes of this study were twofold: (a) to examine the test-retest reproducibility and concurrent validity of the horizontal hip joint angle test (H-HJA) and vertical hip joint angle test (V-HJA) for estimating hamstring flexibility measured with an inclinometer during the passive straight-leg raise test (PSLR) and (b) to determine whether the H-HJA cutoff scores may be used for V-HJA for the detection of short hamstring flexibility in active recreationally young adults. Fifty young men underwent the H-HJA, V-HJA, and PSLR on the right and left legs 3 times in a randomized order with a 4-week interval between trials under a controlled laboratory environment. Reproducibility was examined using coefficient of variation (CV) and intraclass correlation coefficient (ICC3,1) and their respective confidence limits. Regression and kappa correlation analyses were performed to examine the association of H-HJA and V-HJA with the PSLR test, and the 95% limits of agreement between H-HJA and V-HJA were calculated to check if there were differences in the raising scores. The results demonstrated acceptable reproducibility measures for the H-HJA (4.12% CV; 0.93 ICC), V-HJA (4.99% CV; 0.92 ICC), and PSLR (4.83% CV; 0.88 ICC). The H-HJA (R = 0.62) and V-HJA (R = 0.63) results were significantly associated with those of the PSLR. The 95% limits of agreement between the H-HJA and V-HJA reported systematic bias (+7.12 cm) and a wide 95% random error ( ±13.72 cm). This study concluded that the test-retest reproducibility of the H-HJA, V-HJA, and PSLR is acceptable and that the validity of H-HJA and V-HJA is moderate. Furthermore, the H-HJA cutoff scores should not be used for V-HJA for the detection of short hamstring muscles in young adults.     

Measuring core stability

In this study, a 4-item battery of core stability (CS) tests modeled on core stabilization activities used in training and rehabilitation research was developed, and a measurement schedule was established to maximize internal consistency and stability reliabilities. Specifically, we found that 4 test administrations on each of 4 days produced intraclass correlation coefficients that in most instances exceeded 0.90 and stability reliability coefficients on the third and fourth days of testing that exceeded 0.90 for 2 of the tests and 0.80 for the other 2. Thus, it is recommended that in future research, examiners administer the battery for at least 3 days and consider the data collected on day 3 as the best estimate of participant CS.     

Upper quarter y balance test: reliability and performance comparison between genders in active adults

ABSTRACT: Gorman, PP, Butler, RJ, Plisky, PJ, and Kiesel, KB. Upper Quarter Y Balance Test: Reliability and Performance Comparison Between Genders in Active Adults. J Strength Cond Res 26(11): 3043-3048, 2012-The inclusion of movement tests before performance training and sport participation is gaining popularity as part of musculoskeletal screening for injury. The identification of an athlete's asymmetries and poor performance in the preseason allows coaches and sports medicine clinicians the opportunity to proactively address these deficits to reduce the potential for injury. Currently, there are no tests reported in the literature that simultaneously require shoulder and core stability while taking the subjects through a large range of motion at the end range of their stability. Thus, the purpose of this article was to describe the Upper Quarter Y Balance Test and report the gender differences in the performance of the test. Upper extremity reach distances were measured in 95 active adults using a standardized upper extremity balance-and-reach protocol. Intraclass correlation coefficients were used to assess reliability, and gender differences were analyzed using an independent samples t-test, whereas bilateral differences were analyzed using a dependent samples t-test for the normalized composite reach scores. Intraclass correlation coefficient (3.1) for test-retest reliability ranged from 0.80 to 0.99. Intraclass correlation coefficient (3.1) for interrater reliability was 1.00. Average composite scores (right/left) reported as a percentage of limb length were 81.7/82.3% for men and 80.7/80.7% for women. The results of the study suggest that the Upper Quarter Y Balance Test is a reliable test for measuring upper extremity reach distance while in a closed-chain position. It was further determined that there was no significant difference in performance between genders or between sides on the test when normalized to limb length. Coaches and sports medicine professionals may consider incorporating the Upper Quarter Y Balance Test as part of their preprogram testing to identify movement limitations and asymmetries in athletes and thereby may reduce injury.     

Reliability of the one-repetition-maximum power clean test in adolescent athletes

Although the power clean test is routinely used to assess strength and power performance in adult athletes, the reliability of this measure in younger populations has not been examined. Therefore, the purpose of this study was to determine the reliability of the 1-repetition maximum (1RM) power clean in adolescent athletes. Thirty-six male athletes (age 15.9 ± 1.1 years, body mass 79.1 ± 20.3 kg, height 175.1 ±7.4 cm) who had >1 year of training experience in weightlifting exercises performed a 1RM power clean on 2 nonconsecutive days in the afternoon following standardized procedures. All test procedures were supervised by a senior level weightlifting coach and consisted of a systematic progression in test load until the maximum resistance that could be lifted for 1 repetition using proper exercise technique was determined. Data were analyzed using an intraclass correlation coefficient (ICC[2,k]), Pearson correlation coefficient (r), repeated measures analysis of variance, Bland-Altman plot, and typical error analyses. Analysis of the data revealed that the test measures were highly reliable demonstrating a test-retest ICC of 0.98 (95% confidence interval = 0.96-0.99). Testing also demonstrated a strong relationship between 1RM measures in trials 1 and 2 (r = 0.98, p < 0.0001) with no significant difference in power clean performance between trials (70.6 ± 19.8 vs. 69.8 ± 19.8 kg). Bland-Altman plots confirmed no systematic shift in 1RM between trials 1 and 2. The typical error to be expected between 1RM power clean trials is 2.9 kg, and a change of at least 8.0 kg is indicated to determine a real change in lifting performance between tests in young lifters. No injuries occurred during the study period, and the testing protocol was well tolerated by all the subjects. These findings indicate that 1RM power clean testing has a high degree of reproducibility in trained male adolescent athletes when standardized testing procedures are followed and qualified instruction is present.     

A New 3-Dimensional Dynamic Quantitative Analysis System of Facial Motion: An Establishment and Reliability Test

This study aimed to establish a 3-dimensional dynamic quantitative facial motion analysis system, and then determine its accuracy and test-retest reliability. The system could automatically reconstruct the motion of the observational points. Standardized T-shaped rod and L-shaped rods were used to evaluate the static and dynamic accuracy of the system. Nineteen healthy volunteers were recruited to test the reliability of the system. The average static distance error measurement was 0.19 mm, and the average angular error was 0.29°. The measuring results decreased with the increase of distance between the cameras and objects, 80 cm of which was considered to be optimal. It took only 58 seconds to perform the full facial measurement process. The average intra-class correlation coefficient for distance measurement and angular measurement was 0.973 and 0.794 respectively. The results demonstrated that we successfully established a practical 3-dimensional dynamic quantitative analysis system that is accurate and reliable enough to meet both clinical and research needs.     

Comparison of the backward overhead medicine ball throw to power production in college football players

The purpose of this study was to determine the relationship of the backward overhead medicine ball (BOMB) throw to power production in college football players. Forty National Collegiate Athletic Association Division II college football players were studied at the end of an 8-week off-season conditioning program for power output determined from a countermovement vertical jump on a force plate and for maximal distance in the standing BOMB throw. Although the reliability of the BOMB test was high (interclass correlation coefficient = 0.86), there was a significant learning effect across 3 trials (p < 0.01). Peak and average powers generated during the vertical jump correlated moderately but significantly with the best BOMB throw distance (r = 0.59 and 0.63, respectively). Considering power relative to body mass or lean body mass failed to produce significant correlations with BOMB throw distance (r = 0.27 and 0.28, respectively). Therefore, the BOMB throw may have limited potential as a predictor of total body explosive power in college football players.     

Between-day reliability of MyotonPRO for the non-invasive measurement of muscle material properties in the lower extremities of patients with a chronic spinal cord injury

Measuring the muscle properties of patients with spinal cord injuries (SCIs) is important to better understand their biomechanical features. In this study, we sought to evaluate the between-day reliability of MyotonPRO, a handheld device that can measure muscle mechanical properties, and assess whether it is reliable to measure muscle properties over time in patients with SCI. Thirteen men with complete SCIs (age 53.9 ± 6.3 years, height 171.0 ± 5.2 cm, weight 66.1 ± 5.8 kg), and injury levels ranging from L1 to T12, were enrolled. Oscillation frequency; logarithmic decrement; dynamic stiffness; mechanical stress relaxation time; and creep of the biceps femoris, medial and lateral gastrocnemius, rectus femoris, tibialis anterior, and Achilles tendon were measured on consecutive days using MyotonPRO. The intraclass coefficient for most muscles and the Achilles tendon ranged from 0.53 to 0.99 for all parameters. The percentage standard error of the measurement for many parameters in most muscles and the Achilles tendon was less than 10%. Bland-Altman analysis showed a high agreement for all mechanical properties. No significant differences were observed in any muscle or Achilles tendon properties between days (all p > 0.05). These results indicate that the MyotonPRO is reliable for between-day measurements of the mechanical properties of lower limb muscles and Achilles tendon in patients with SCI.     

Reliability, minimal detectable change, and normative values for tests of upper extremity function and power

The purpose of this study was to examine the test-retest reliability, minimal detectable change (MDC), and determine normative values of 3 upper extremity (UE) tests of function and power. One hundred eighty participants, men (n = 69) and women (n = 111), were tested on 3 UE strength and power maneuvers in a multicenter study to determine baseline normative values. Forty-six subjects returned for a second day of testing within 5 days of the initial assessment for the reliability component of the investigation. Explosive power was assessed via a seated shot-put test for the dominant and nondominant arms. Relationships between the dominant and nondominant arms were also analyzed. A push-up and modified pull-up were performed to measure the amount of work performed in short (15-second) bursts of activity. The relationship between the push-up and modified pull-up was also determined. Analysis showed test-retest reliability for the modified pull-up, timed push-up, dominant single-arm seated shot-put tests, and nondominant single-arm seated shot-put tests to be intraclass correlation coefficient(3,1) 0.958, 0.989, 0.988, and 0.971, respectively. The MDC for both the push-up and modified pull-up was 2 repetitions. The MDCs for the shot put with the dominant arm and the nondominant arm were 17 and 18 in., respectively. The result of this study indicates that these field tests possess excellent reliability. Normative values have been identified, which require further validation. These tests demonstrate a practical and effective method to measure upper extremity functional power.     

Test battery designed to quickly and safely assess diverse indices of neuromuscular function after unweighting

Adequately describing the functional consequences of unweighting (e.g., bed rest, immobilization, spaceflight) requires assessing diverse indices of neuromuscular function (i.e., strength, power, endurance, central activation, force steadiness). Additionally, because unweighting increases the susceptibility of muscle to damage, testing should consider supplementary safety features. The purpose of this study was to develop a test battery for quickly assessing diverse indices of neuromuscular function. Commercially available exercise equipment was modified to include data acquisition hardware (e.g., force plates, position transducers) and auxiliary safety hardware (e.g., magnetic brakes). Ten healthy, ambulatory subjects (31 ± 5 years, 173 ± 11 cm, 73 ± 14 kg) completed a battery of lower- and upper-body neuromuscular function tests on 3 occasions separated by at least 48 hours. The battery consisted of the following tests, in order: (1) knee extension central activation, (2) knee extension force steadiness, (3) leg press maximal strength, (4) leg press maximal power, (5) leg press power endurance, (6) bench press maximal strength, (7) bench press force steadiness, (8) bench press maximal power, and (9) bench press power endurance. Central activation, strength, rate of force development, maximal power, and power endurance (total work) demonstrated good-to-excellent measurement reliability (SEM = 3-14%; intraclass correlation coefficient [ICC] = 0.87-0.99). The SEM of the force steadiness variables was 20-35% (ICC = 0.20-0.60). After familiarization, the test battery required 49 ± 6 minutes to complete. In conclusion, we successfully developed a test battery that could be used to quickly and reliably assess diverse indices of neuromuscular function. Because the test battery involves minimal eccentric muscle actions and impact forces, the potential for muscle injury has likely been reduced.     

Reliability of EMG spectral parameters in repeated measurements of back muscle fatigue.

The change in median frequency of the power spectrum of the electromyographic (EMG) signal may be used as a measure of muscle fatigue. The reliability of the median frequency parameters was investigated for EMG-recording sites at L1 and L5 right and left on the erector spinae. The reliability of subjective fatigue ratings of the back muscles (Borg CR-10 scale) and of maximal trunk extension torque (MVC) was also investigated. Eleven subjects with healthy backs performed a 45-s isometric trunk extension at 80% of MVC twice a day, on three different days. Two-factor analysis of variance was made to obtain the different variances from which the standard error of measurement (SEM) and the intra class correlation coefficient (ICC) were calculated. The SEM within-day was somewhat lower than that between-days. Both were about the same at all four electrode sites. The 95% confidence interval for the studied variables was for the initial median frequency +/- 10 Hz, for the slope +/- 0.4-0.5%/s, for the MVC +/- 36 Nm and for the Borg ratings +/- 1.6. We conclude that, with the presently used method, changes or differences within these limits should be regarded as normal variability. The slope may be of limited value because of its large variability. Whether the low intraclass correlation coefficient for the EMG parameters in the presently studied test group implies a low potential in discriminating subjects with back pain can not be decisively concluded.     

The reliability of the FitroDyne as a measure of muscle power

The FitroDyne is a device that attaches to conventional resistance-training equipment to measure speed of movement, from which muscle power is calculated. The aim of this study was to quantify the repeatability of the measurement of muscle power with the FitroDyne during squat jump and biceps curl exercises. Thirty male subjects completed 3 trials, each consisting of 6 squat jumps and 6 biceps curls of increasing loads. Upper body and lower body maximum power was predicted from the force-velocity curves derived from the range of weights used for each trial. Maximum power measurements of a squat jump (range, 911- 1,673 W) and biceps curl (range, 45-110 W) had intraclass correlation coefficients (ICC) of R = 0.97 (95% CI, 0.95-0.98) and R = 0.97 (95% CI, 0.95-0.98), respectively. The limits of agreement for the squat jump and biceps curl trials were -17 +/- 96 W and 0.11 +/- 13.90 W, respectively. It may be concluded that muscle power can be measured with a high degree of reliability with the FitroDyne. The limits of agreement need to be considered when data are interpreted.     

Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM

Reliability, the consistency of a test or measurement, is frequently quantified in the movement sciences literature. A common metric is the intraclass correlation coefficient (ICC). In addition, the SEM, which can be calculated from the ICC, is also frequently reported in reliability studies. However, there are several versions of the ICC, and confusion exists in the movement sciences regarding which ICC to use. Further, the utility of the SEM is not fully appreciated. In this review, the basics of classic reliability theory are addressed in the context of choosing and interpreting an ICC. The primary distinction between ICC equations is argued to be one concerning the inclusion (equations 2,1 and 2,k) or exclusion (equations 3,1 and 3,k) of systematic error in the denominator of the ICC equation. Inferential tests of mean differences, which are performed in the process of deriving the necessary variance components for the calculation of ICC values, are useful to determine if systematic error is present. If so, the measurement schedule should be modified (removing trials where learning and/or fatigue effects are present) to remove systematic error, and ICC equations that only consider random error may be safely used. The use of ICC values is discussed in the context of estimating the effects of measurement error on sample size, statistical power, and correlation attenuation. Finally, calculation and application of the SEM are discussed. It is shown how the SEM and its variants can be used to construct confidence intervals for individual scores and to determine the minimal difference needed to be exhibited for one to be confident that a true change in performance of an individual has occurred.     

Validation of Morphometric Analyses of Small-Intestinal Biopsy Readouts in Celiac Disease

Background

Assessment of the gluten-induced small-intestinal mucosal injury remains the cornerstone of celiac disease diagnosis. Usually the injury is evaluated using grouped classifications (e.g. Marsh groups), but this is often too imprecise and ignores minor but significant changes in the mucosa. Consequently, there is a need for validated continuous variables in everyday practice and in academic and pharmacological research.

Methods

We studied the performance of our standard operating procedure (SOP) on 93 selected biopsy specimens from adult celiac disease patients and non-celiac disease controls. The specimens, which comprised different grades of gluten-induced mucosal injury, were evaluated by morphometric measurements. Specimens with tangential cutting resulting from poorly oriented biopsies were included. Two accredited evaluators performed the measurements in blinded fashion. The intraobserver and interobserver variations for villus height and crypt depth ratio (VH:CrD) and densities of intraepithelial lymphocytes (IELs) were analyzed by the Bland-Altman method and intraclass correlation.

Results

Unevaluable biopsies according to our SOP were correctly identified. The intraobserver analysis of VH:CrD showed a mean difference of 0.087 with limits of agreement from −0.398 to 0.224; the standard deviation (SD) was 0.159. The mean difference in interobserver analysis was 0.070, limits of agreement −0.516 to 0.375, and SD 0.227. The intraclass correlation coefficient in intraobserver variation was 0.983 and that in interobserver variation 0.978. CD3⁺ IEL density countings in the paraffin-embedded and frozen biopsies showed SDs of 17.1% and 16.5%; the intraclass correlation coefficients were 0.961 and 0.956, respectively.

Conclusions

Using our SOP, quantitative, reliable and reproducible morphometric results can be obtained on duodenal biopsy specimens with different grades of gluten-induced injury. Clinically significant changes were defined according to the error margins (2SD) of the analyses in VH:CrD as 0.4 and in CD3⁺-stained IELs as 30%.