ABSTRACT OBJECTIVE This study aims to propose a comprehensive alternative to the Bland-Altman plot method, addressing its limitations and providing a statistical framework for evaluating the equivalences of measurement techniques. This involves introducing an innovative three-step approach for assessing accuracy, precision, and agreement between techniques, which enhances objectivity in equivalence assessment. Additionally, the development of an R package that is easy to use enables researchers to efficiently analyze and interpret technique equivalences. METHODS Inferential statistics support for equivalence between measurement techniques was proposed in three nested tests. These were based on structural regressions with the goal to assess the equivalence of structural means (accuracy), the equivalence of structural variances (precision), and concordance with the structural bisector line (agreement in measurements obtained from the same subject), using analytical methods and robust approach by bootstrapping. To promote better understanding, graphical outputs following Bland and Altman’s principles were also implemented. RESULTS The performance of this method was shown and confronted by five data sets from previously published articles that used Bland and Altman’s method. One case demonstrated strict equivalence, three cases showed partial equivalence, and one showed poor equivalence. The developed R package containing open codes and data are available for free and with installation instructions at Harvard Dataverse at https://doi.org/10.7910/DVN/AGJPZH. CONCLUSION Although easy to communicate, the widely cited and applied Bland and Altman plot method is often misinterpreted, since it lacks suitable inferential statistical support. Common alternatives, such as Pearson’s correlation or ordinal least-square linear regression, also fail to locate the weakness of each measurement technique. It may be possible to test whether two techniques have full equivalence by preserving graphical communication, in accordance with Bland and Altman’s principles, but also adding robust and suitable inferential statistics. Decomposing equivalence into three features (accuracy, precision, and agreement) helps to locate the sources of the problem when fixing a new technique.

ABSTRACT OBJECTIVE This study aims to propose a comprehensive alternative to the Bland-Altman plot method, addressing its limitations and providing a statistical framework for evaluating the equivalences of measurement techniques. This involves introducing an innovative three-step approach for assessing accuracy, precision, and agreement between techniques, which enhances objectivity in equivalence assessment. Additionally, the development of an R package that is easy to use enables researchers to efficiently analyze and interpret technique equivalences. METHODS Inferential statistics support for equivalence between measurement techniques was proposed in three nested tests. These were based on structural regressions with the goal to assess the equivalence of structural means (accuracy), the equivalence of structural variances (precision), and concordance with the structural bisector line (agreement in measurements obtained from the same subject), using analytical methods and robust approach by bootstrapping. To promote better understanding, graphical outputs following Bland and Altman’s principles were also implemented. RESULTS The performance of this method was shown and confronted by five data sets from previously published articles that used Bland and Altman’s method. One case demonstrated strict equivalence, three cases showed partial equivalence, and one showed poor equivalence. The developed R package containing open codes and data are available for free and with installation instructions at Harvard Dataverse at https://doi.org/10.7910/DVN/AGJPZH. CONCLUSION Although easy to communicate, the widely cited and applied Bland and Altman plot method is often misinterpreted, since it lacks suitable inferential statistical support. Common alternatives, such as Pearson’s correlation or ordinal least-square linear regression, also fail to locate the weakness of each measurement technique. It may be possible to test whether two techniques have full equivalence by preserving graphical communication, in accordance with Bland and Altman’s principles, but also adding robust and suitable inferential statistics. Decomposing equivalence into three features (accuracy, precision, and agreement) helps to locate the sources of the problem when fixing a new technique. BlandAltman threestep step accuracy precision assessment Additionally tests , (accuracy) (precision) subject, subject subject) bootstrapping understanding Altmans s implemented https//doi.org/10.7910/DVN/AGJPZH. httpsdoiorg107910DVNAGJPZH httpsdoiorgDVNAGJPZH https //doi.org/10.7910/DVN/AGJPZH. doi org 10 7910 DVN AGJPZH https://doi.org/10.7910/DVN/AGJPZH communicate misinterpreted alternatives Pearsons Pearson leastsquare least square regression communication (accuracy (precision https//doi.org/10.7910/DVN/AGJPZH httpsdoiorg DVNAGJPZH doiorg107910DVNAGJPZH doiorgDVNAGJPZH //doi.org/10.7910/DVN/AGJPZH 1 791 doiorg 79 7

Abstract Objective: Postoperative cognitive dysfunction may result from worsening in a condition of previous impairment. It causes greater difficulty in recovery, longer hospital stays, and consequent delay in returning to work activities. Digital games have a potential neuromodulatory and rehabilitation effect. In this study, a digital game was used as a neuropsychological test to assess postoperative cognitive dysfunction, with preoperative patient performance as control. Methods: It was a non-controlled study, with patients selected among candidates for elective non-cardiac surgery, evaluated in the preand postoperative periods. The digital game used has six phases developed to evaluate selective attention, alternating attention, visuoperception, inhibitory control, short-term memory, and long-term memory. The digital game takes about 25 minutes. Scores are the sum of correct answers in each cognitive domain. Statistical analysis compared these cognitive functions preand post-surgery using a generalized linear mixed model (ANCOVA). Results: Sixty patients were evaluated, 40% male and 60% female, with a mean age of 52.7 ± 13.5 years. Except for visuoperception, a reduction in post-surgery scores was found in all phases of the digital game. Conclusion: The digital game was able to detect decline in several cognitive functions postoperatively. As its completion is faster than in conventional tests on paper, this digital game may be a potentially recommended tool for assessing patients, especially the elderly and in the early postoperative period.

Abstract Objective: Cognitive dysfunction may occur postoperatively. Fast and efficient assessment of Postoperative Cognitive Dysfunction (POCD) can minimize loss of quality of life, and therefore, a study comparing a digital game with standard neuropsychological tests to assess executive, mnemonic, and attention functions to evaluate POCD seems to be relevant both for research and clinical practice. Methods: A battery of standardized tests and a digital game (MentalPlus®) were administered to 60 patients at the Central Institute of Hospital das Clínicas in São Paulo (36 women and 24 men), with ages between 29 and 82 years, preand post-surgery performed under anesthesia. Correlation and linear regression model were used to compare the scores obtained from the standardized tests to the scores of the six executive and cognitive functions evaluated by the game (shortand long-term memory, selective and alternating attention, inhibitory control, and visual perception). Results: After correlation analysis, a statistically significant result was found mainly for the correlation between the scores from the phase of the digital game assessing the visuoperception function and the scores from the A and B cards of the Stroop Test (p < 0.001, r = 0.99 and r = 0.64, respectively), and the scores from TMTA (p = 0.0046, r = 0.51). We also found a moderate correlation between the phase of the game assessing short-memory function and VVLT (p < 0.001, r = 0.41). No statistically significant correlations were found for the other functions assessed. Conclusion: The digital game provided scores in agreement with standardized tests for evaluating visual perception and possibly short-term memory cognitive functions. Further studies are necessary to verify the correlation of other phases of the digital game with standardized tests assessing cognitive functions.

A difusão do uso da Tecnologia de Informação (TI) é evidenciada por meio de um processo, que pode ser denominado informatização e que permeia nossa sociedade e negócios. Com relação aos negócios, os gestores necessitam de instrumentos para avaliar o uso organizacional da TI. O artigo apresenta um modelo de avaliação com base na mensuração do construto Grau de Informatização (GI). Cinco dimensões (fatores) de avaliação foram consideradas no modelo final: uso organizacional da TI, impactos da TI, atributos das aplicações da TI, infra-estrutura da TI e governança da TI. O modelo foi desenvolvido a partir do levantamento de dados de uma amostra de 830 empresas industriais do estado de São Paulo. Nele, a modelagem por equações estruturais foi utilizada para desenvolver e validar o GI. O construto satisfez os requisitos de consistência e validade interna e demonstrou possuir validade externa na medida em que as proposições em relação ao tamanho da empresa e não quanto aos níveis de investimentos em TI foram confirmadas.

The diffusion of Information Technology (IT) is evidenced through a process that can be named "Informatization", which permeates our society and businesses. Business managers need instruments to evaluate the organizational use of IT. This paper presents a model for evaluating the organizational use of IT based on the measurement of the Informatization Level (IL) construct. Five evaluation dimensions (factors) were considered: IT organizational use, IT impacts, IT application attributes, IT infra-structure and IT governance. The model developed was based on data collected from a sample of 830 industrial companies in the Brazilian state of São Paulo and structural equation modeling was employed to develop and validate the IL. The construct complied with reliability requirements and internal validity also showing external validity, as the hypothesis of being related to the company size and not related to IT investments was confirmed.

Este estudo teve como objetivo, avaliar e comparar a intensidade da dor referida por pacientes com fibromialgia, osteoartrite e lombalgia visando propor o tratamento fisioterapêutico mais adequado para estes grupos de pacientes. PACIENTES E MÉTODOS: Participaram do estudo 64 pacientes, sendo 24 com fibromialgia, 22 com osteoartrite e 18 com lombalgia. Foi utilizada a versão em português do Questionário de Dor da McGill onde os sujeitos deveriam escolher uma ou nenhuma palavra de uma lista de palavras organizadas em quatro categorias: sensorial, afetiva, avaliativa e micelânia, a que melhor descrevesse a dor que eles sentiam. RESULTADOS: Os pacientes com fibromialgia referiram, comparativamente, dor mais intensa o que pode ser observado através da escolha de um número mais alto de descritores das categorias afetiva e sensorial do que os outros dois grupos e somente eles escolheram específicos descritores afetivos tais como: "maldita", "miserável", "exaustiva", "enlouquecedora". CONCLUSÃO: A partir dos dados, pudemos verificar que cada patologia apresenta uma qualidade única de experiência da dor, já que houve escolha de palavras específicas pelos pacientes dos três grupos, sugerindo que juntamente com tratamento físico, nos pacientes com fibromialgia, que mostraram um forte componente psico-emocional, sejam incluídos também, cuidados emocionais/afetivos.

The purpose of this study was to evaluate and compare pain as reported by outpatients with fibromyalgia, osteoarthritis, and low back pain, in view of designing more adequate physical therapy treatment. PATIENTS AND METHODS: A Portuguese version of the McGill Pain Questionnaire - where subjects are asked to choose, from lists of pre-categorized words, one or none that best describes what they feel - was used to assess pain intensity and quality of 64 patients, of which 24 had fibromyalgia, 22 had osteoarthritis, and 18 had low back pain. The pre-categorized words were organized into 4 major classes -- sensory, affective, evaluative, and miscellaneous. RESULTS: Patients with fibromyalgia reported, comparatively, more intense pain through their choice of pain descriptors, both sensory and affective; they also chose a higher number of words from these classes than patients in the other groups and were the only ones to choose specific affective descriptors such as "vicious", "wretched", "exhausting", "blinding". CONCLUSION: Assuming that each disease presents unique qualities of pain experience, and that these can be pointed out by means of this questionnaire by patients' choice of specific groups of words, the findings suggest that fibromyalgia include not only a physical component, but also a psycho-emotional component, indicating that they require both emotional/affective and physical care.