BACKGROUND: We previously constructed and tested a bronchiolitis severity assessment tool in 2 independent hospitals. The model uses age, work of breathing, dehydration and tachycardia to successfully predict disease severity. OBJECTIVE: To prospectively measure the interrater reliability of a bronchiolitis severity assessment tool and of its component variables. DESIGN: Prospective observational survey. SETTING: A county teaching hospital emergency department serving a mixed urban and rural population with an emergency medicine residency program in 2-3-4 format. SUBJECTS: Thirty-two physicians evaluated a convenience sample of children aged less than 18 months presenting to the emergency department with a clinical diagnosis of bronchiolitis during a single season. METHODS: Two physicians independently examined each patient. Each physician completed a physical examination template that included the variables used in the severity assessment tool. Interrater agreement was measured for the variables work of breathing and dehydration and for the tool as a whole using a weighted kappa statistic. RESULTS: One hundred and forty-six cases were enrolled. Twenty-five were dropped for incomplete data collection. The actual weighted agreement on overall classification was 92%; expected, 73%, kappa = 0.676; P < 0.0001. The actual weighted agreement for dehydration was at 95%; expected, 92%, kappa = 0.305; P = 0.0001. The agreement for work of breathing was 95%; expected, 86%; kappa = 0.611; P < 0.0001. The overall model showed better interrater reliability than its individual components. CONCLUSIONS: Overall interrater reliability for this bronchiolitis severity assessment tool is substantial.
BACKGROUND: We previously constructed and tested a bronchiolitis severity assessment tool in 2 independent hospitals. The model uses age, work of breathing, dehydration and tachycardia to successfully predict disease severity. OBJECTIVE: To prospectively measure the interrater reliability of a bronchiolitis severity assessment tool and of its component variables. DESIGN: Prospective observational survey. SETTING: A county teaching hospital emergency department serving a mixed urban and rural population with an emergency medicine residency program in 2-3-4 format. SUBJECTS: Thirty-two physicians evaluated a convenience sample of children aged less than 18 months presenting to the emergency department with a clinical diagnosis of bronchiolitis during a single season. METHODS: Two physicians independently examined each patient. Each physician completed a physical examination template that included the variables used in the severity assessment tool. Interrater agreement was measured for the variables work of breathing and dehydration and for the tool as a whole using a weighted kappa statistic. RESULTS: One hundred and forty-six cases were enrolled. Twenty-five were dropped for incomplete data collection. The actual weighted agreement on overall classification was 92%; expected, 73%, kappa = 0.676; P < 0.0001. The actual weighted agreement for dehydration was at 95%; expected, 92%, kappa = 0.305; P = 0.0001. The agreement for work of breathing was 95%; expected, 86%; kappa = 0.611; P < 0.0001. The overall model showed better interrater reliability than its individual components. CONCLUSIONS: Overall interrater reliability for this bronchiolitis severity assessment tool is substantial.
Authors: Chris Chee; Paul Walsh; Sam Kuan; Juanito Cabangangan; Kian Azimian; Christopher Dong; Joshua Tobias; Stephen J Rothenberg Journal: West J Emerg Med Date: 2010-02
Authors: Boniface Hakizimana; Edgar Kalimba; Augustin Ndatinya; Gemma Saint; Clare van Miert; Peter Thomas Cartledge Journal: PLoS One Date: 2021-11-04 Impact factor: 3.240
Authors: Paul Walsh; John Caldwell; Kemedy K McQuillan; Steven Friese; Dale Robbins; Stephen J Rothenberg Journal: Acad Emerg Med Date: 2008-04 Impact factor: 3.451