The new features of the ExaMe evaluation system and reliability of its fixed tests.

OBJECTIVES: The ExaMe system for the evaluation of targeted knowledge has been in development since 1998. The new features of the ExaMe system are introduced in this paper. Especially, the new three-layer architecture is described. Besides the system itself, the properties of fixed tests in the ExaMe system are studied. In special detail, the reliability of the fixed tests is discussed. The theory background is explained and some limitations of the reliability are pointed out. METHODS FOR ESTIMATION OF THE RELIABILITY: Three characteristics used for estimation of reliability of educational tests are discussed: Cronbach's alpha, standardized item alpha and split half coefficient. The relation between these characteristics and reliability and between characteristics themselves is investigated. In more detail, the properties of Cronbach's alpha, the characteristics mostly used for the estimation of reliability, are discussed. A confidence interval is introduced for the characteristics. RESULTS AND CONCLUSIONS: Since 2000, the serviceability of the ExaMe evaluation system as the supporting evaluation tool has been repeatedly shown at the courses of Ph.D. studies in biomedical informatics at Charles University in Prague. The ExaMe system also opens new possibilities for self-evaluation and distance learning, especially when connected with electronic books on the Internet. The estimation of reliability of tests contains some limitations. Keeping them in mind, we can still get some information about the quality of certain educational tests. Therefore, the estimation of reliability of the fixed tests is implemented in the ExaMe system.

Comparison of the influence of different rehabilitation programmes on clinical, spirometric and spiroergometric parameters in patients with multiple sclerosis.

PURPOSE: The aim of this study was to compare the effect of four different programmes on spiroergometric, spirometric and clinical parameters in multiple sclerosis (MS) patients. METHODS: One hundred and twelve MS patients were divided into four groups. The first group underwent neurophysiologically based physiotherapy, the second aerobic training, the third combined therapy (neurophysiologically based physiotherapy and aerobic training) and the fourth did not change any habits. Seventeen patients did not finish the study. Patients were examined on impairment (Expanded Disability Status Scale), disability (Barthel Index), handicap (Environment Status Scale), quality of life (Multiple Sclerosis Quality of Life), fatigue (Modified Fatigue Impact Scale), depression (Beck Depression Inventory Score), respiratory function (spirometric parameters on spirometry) and physical fitness (spiroergometric parameters on a bicycle ergometer). RESULTS: The patients who participated in one of our training programmes showed a significant improvement of the examined parameters in comparison to those who did not change their present habits. Each of the four training programmes had a different impact on the parameters, which means that each of them had a different effect. The neurophysiologically based physiotherapy had the greatest impact on impairment, and the aerobic training on spirometric and spiroergometric parameters. All methods (the neurophysiologically based physiotherapy, the aerobic training and the combined programme) had an impact on fatigue.