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      Reliability of body composition assessment using A-mode ultrasound in a heterogeneous sample

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          Abstract

          Background/Objectives

          Several studies have addressed the validity of ultrasound (US) for body composition assessment, but few have evaluated its reliability. This study aimed to determine the reliability of percent body fat (%BF) estimates using A-mode US in a heterogeneous sample.

          Subjects/Methods

          A group of 144 healthy adults (81 men and 63 women), 30.4 (10.1) years (mean (SD)), BMI 24.6 (4.7) kg/m 2, completed 6 consecutive measurements of the subcutaneous fat layer thickness at 8 anatomical sites. The measurements were done, alternatively, by two testers, using a BodyMetrix™ instrument. To compute %BF, 4 formulas from the BodyView™ software were applied: 7-sites Jackson and Pollock, 3-sites Jackson and Pollock, 3-sites Pollock, and 1-point biceps.

          Results

          The formula with the most anatomic sites provided the best reliability quantified by the following measures: intraclass correlation coefficient (ICC) = 0.979 for Tester 1 (T1) and 0.985 for T2, technical error of measurement (TEM) = 1.07% BF for T1 and 0.89% BF for T2, and minimal detectable change (MDC) = 2.95% BF for T1, and 2.47% BF for T2. The intertester bias was −0.5% BF, whereas the intertester ICC was 0.972. The intertester MDC was 3.43% BF for the entire sample, 3.24% BF for men, and 3.65% BF for women.

          Conclusions

          A-mode US is highly reliable for %BF assessments, but it is more precise for men than for women. Examiner performance is a source of variability that needs to be mitigated to further improve the precision of this technique.

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          Most cited references37

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          A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research.

          Intraclass correlation coefficient (ICC) is a widely used reliability index in test-retest, intrarater, and interrater reliability analyses. This article introduces the basic concept of ICC in the content of reliability analysis.
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            STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT

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              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.
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                Author and article information

                Contributors
                neagu.monica@umft.ro
                Journal
                Eur J Clin Nutr
                Eur J Clin Nutr
                European Journal of Clinical Nutrition
                Nature Publishing Group UK (London )
                0954-3007
                1476-5640
                11 September 2020
                11 September 2020
                2021
                : 75
                : 3
                : 438-445
                Affiliations
                [1 ]GRID grid.22248.3e, ISNI 0000 0001 0504 4027, Center for Modeling Biological Systems and Data Analysis, Department of Functional Sciences, , Victor Babeş University of Medicine and Pharmacy, ; Timişoara, Romania
                [2 ]GRID grid.22248.3e, ISNI 0000 0001 0504 4027, Department of Orthopedics, , Victor Babeş University of Medicine and Pharmacy, ; Timişoara, Romania
                [3 ]GRID grid.134936.a, ISNI 0000 0001 2162 3504, Department of Physics & Astronomy, , University of Missouri, ; Columbia, MO USA
                Author information
                http://orcid.org/0000-0001-6801-3471
                http://orcid.org/0000-0003-3871-2188
                http://orcid.org/0000-0002-7845-7639
                Article
                743
                10.1038/s41430-020-00743-y
                7943421
                32917960
                133ff642-a16c-4f0c-a0eb-309ad3727b47
                © The Author(s) 2020

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 27 April 2020
                : 7 August 2020
                : 25 August 2020
                Categories
                Article
                Custom metadata
                © Springer Nature Limited 2021

                Nutrition & Dietetics
                risk factors,techniques and instrumentation
                Nutrition & Dietetics
                risk factors, techniques and instrumentation

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