John Lippmann1,2, Christopher Stevenson2, David McD Taylor3,4, Jo Williams2, Mohammadreza Mohebbi5. 1. Divers Alert Network (DAN) Asia-Pacific, PO Box 384, Ashburton, Victoria 3147, Australia, johnl@danap.org. 2. School of Health and Social Development, Deakin University, Geelong, Victoria, Australia. 3. Emergency Department, Austin Hospital, Victoria, Australia. 4. Department of Medicine, University of Melbourne, Australia. 5. Biostatistics Unit, Deakin University, Geelong, Victoria, Australia.
Abstract
INTRODUCTION: A scuba diving fatality usually involves a series of related events culminating in death. Several studies have utilised a chain of events-type analysis (CEA) to isolate and better understand the accident sequence in order to facilitate the creation of relevant countermeasures. The aim of this research was to further develop and better define a process for performing a CEA to reduce potential subjectivity and increase consistency between analysts. METHODOLOGY: To develop more comprehensive and better-defined criteria, existing criteria were modified and a template was created and tested using a CEA. Modifications comprised addition of a category for pre-disposing factors, expansion of criteria for the triggers and disabling agents present during the incident, and more specific inclusion criteria to better encompass a dataset of 56 fatalities. Four investigators (raters) used both the previous criteria and this template, in randomly assigned order, to examine a sample of 13 scuba diver deaths. Individual results were scored against the group consensus for the CEA. Raters' agreement consistency was compared using the Index of Concordance and intra-class correlation coefficients (ICC). RESULTS: The template is presented. The index of concordance between the raters increased from 62% (194⁄312) using the previous criteria to 82% (257⁄312) with use of this template indicating a substantially higher inter-rater agreement when allocating criteria. The agreement in scoring with and without template use was also quantified by ICC which were generally graded as low, illustrating a substantial change in consistency of scoring before and after template use. CONCLUSION: The template for a CEA for a scuba diving fatality improves consistency of interpretation between users and may improve comparability of diving fatality reports.
INTRODUCTION: A scuba diving fatality usually involves a series of related events culminating in death. Several studies have utilised a chain of events-type analysis (CEA) to isolate and better understand the accident sequence in order to facilitate the creation of relevant countermeasures. The aim of this research was to further develop and better define a process for performing a CEA to reduce potential subjectivity and increase consistency between analysts. METHODOLOGY: To develop more comprehensive and better-defined criteria, existing criteria were modified and a template was created and tested using a CEA. Modifications comprised addition of a category for pre-disposing factors, expansion of criteria for the triggers and disabling agents present during the incident, and more specific inclusion criteria to better encompass a dataset of 56 fatalities. Four investigators (raters) used both the previous criteria and this template, in randomly assigned order, to examine a sample of 13 scuba diver deaths. Individual results were scored against the group consensus for the CEA. Raters' agreement consistency was compared using the Index of Concordance and intra-class correlation coefficients (ICC). RESULTS: The template is presented. The index of concordance between the raters increased from 62% (194⁄312) using the previous criteria to 82% (257⁄312) with use of this template indicating a substantially higher inter-rater agreement when allocating criteria. The agreement in scoring with and without template use was also quantified by ICC which were generally graded as low, illustrating a substantial change in consistency of scoring before and after template use. CONCLUSION: The template for a CEA for a scuba diving fatality improves consistency of interpretation between users and may improve comparability of diving fatality reports.
Authors: John Lippmann; Douglas Walker; Chris Lawrence; Andrew Fock; Thomas Wodak; Scott Jamieson Journal: Diving Hyperb Med Date: 2011-06 Impact factor: 0.887
Authors: John Lippmann; Douglas Walker; Christopher L Lawrence; Andrew Fock; Thomas Wodak; Scott Jamieson Journal: Diving Hyperb Med Date: 2012-09 Impact factor: 0.887
Authors: John Lippmann; Christopher Lawrence; Andrew Fock; Scott Jamieson; Richard Harris Journal: Diving Hyperb Med Date: 2016-12 Impact factor: 0.887
Authors: Petar J Denoble; Neal W Pollock; Panchabi Vaithiyanathan; James L Caruso; Joel A Dovenbarger; Richard D Vann Journal: Diving Hyperb Med Date: 2008-12 Impact factor: 0.887
Authors: John Lippmann; Douglas Walker; Chris Lawrence; Andrew Fock; Thomas Wodak; Richard Harris; Scott Jamieson Journal: Diving Hyperb Med Date: 2013-03 Impact factor: 0.887