The relationship between neutrophil-to-lymphocyte ratio and albuminuria in type 2 diabetic patients: a pilot study.

Introduction: Diabetes mellitus (DM) has become a global economic burden due to treatment costs and attendant complications. Albuminuria is the precursor of end stage renal failure and is an inflammatory process. In the recent past, it has been reported that the neutrophil/lymphocyte ratio (NLR), which is a cost-effective and accessible marker, may be a favorable indicator of the inflammatory status.

Neutrophil-to-lymphocyte ratio in patients with peripheral vertigo: a prospective controlled clinical study.

We aimed to investigate the relationship between peripheral vertigo and inflammation by using the neutrophil-to-lymphocyte ratio (NLR) as an inflammatory marker. We recruited 103 patients with peripheral vertigo (71 women, 32 men; mean age, 39.8 ± 14.

Exploring psychometric models to enhance standardized patient quality assurance: evaluating standardized patient performance over time.

Purpose: To explore methods to assess standardized patient (SP) performance over time so as to sustain objective performance in a high-stakes clinical skills examination and to inform quality assurance.

Method: The authors selected data from the United States Medical Licensing Examination-Step 2 Clinical Skills to assess the relative usefulness of the classical measurement and common factor models in determining the difficulty and discrimination of SP-medical case pairs (SP-cases) on communication scores over time. The common factor model is an alternative to the classical measurement model and can be used to calibrate SP-case parameters.

Measurement precision for repeat examinees on a standardized patient examination.

Examinees who initially fail and later repeat an SP-based clinical skills exam typically exhibit large score gains on their second attempt, suggesting the possibility that examinees were not well measured on one of those attempts. This study evaluates score precision for examinees who repeated an SP-based clinical skills test administered as part of the US Medical Licensing Examination sequence. Generalizability theory was used as the basis for computing conditional standard errors of measurement (SEM) for individual examinees.

Evaluating construct equivalence and criterion-related validity for repeat examinees on a standardized patient examination.

Purpose: Prior studies report large score gains for examinees who fail and later repeat standardized patient (SP) assessments. Although research indicates that score gains on SP exams cannot be attributed to memorizing previous cases, no studies have investigated the empirical validity of scores for repeat examinees. This report compares single-take and repeat examinees in terms of both internal (construct) validity and external (criterion-related) validity.

A multivariate generalizability analysis of history-taking and physical examination scores from the USMLE step 2 clinical skills examination.

Background: In clinical skills, closely related skills are often combined to form a composite score. For example, history-taking and physical examination scores are typically combined. Interestingly, there is relatively little research to support this practice.

A comparison of alternative item weighting strategies on the data gathering component of a clinical skills performance assessment.

Background: Checklist scores used to produce the data gathering score on the Step 2 CS examination are currently weighted using an algorithm based on expert judgment about the importance of the item. The present research was designed to compare this approach with alternative weighting strategies.

Method: Scores from 21,140 examinees who took the United States Medical Licensing Examination Step 2 between May 2006 and February 2007 were subjected to five weighting models: (1) a regression weights model, (2) a factor loading weights model, (3) a standardized response model, (4) an equal weights model, and (5) the operational expert-judgment weights model.