The Power of Flash Mob Research: Conducting a Nationwide Observational Clinical Study on Capillary Refill Time in a Single Day.

Autor:	Alsma J; Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands. Electronic address: j.alsma@erasmusmc.nl., van Saase JLCM; Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands., Nanayakkara PWB; Section Acute Medicine, Department of Internal Medicine, VU University Medical Centre, Amsterdam, the Netherlands., Schouten WEMI; Department of Internal Medicine, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands., Baten A; Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, the Netherlands., Bauer MP; Department of Infectious Diseases, Leiden University Medical Center, Leiden, the Netherlands., Holleman F; Section Acute Medicine, Department of Internal Medicine, Academic Medical Center, Amsterdam, the Netherlands., Ligtenberg JJM; Emergency Department, Department of Internal Medicine, University Medical Center Groningen, Groningen, the Netherlands., Stassen PM; Department of Internal Medicine, Division General Medicine, Section Acute Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; Maastricht University, Department of Health Services Research, and CAPHRI School for Public Health and Primary Care, Maastricht, the Netherlands., Kaasjager KHAH; Department of Internal Medicine, University Medical Center Utrecht, Utrecht, the Netherlands., Haak HR; Maastricht University, Department of Health Services Research, and CAPHRI School for Public Health and Primary Care, Maastricht, the Netherlands; Department of Internal Medicine, Máxima Medical Centre, Eindhoven, the Netherlands; Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands., Bosch FH; Department of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands., Schuit SCE; Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Emergency Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands.
Jazyk:	angličtina
Zdroj:	Chest [Chest] 2017 May; Vol. 151 (5), pp. 1106-1113. Date of Electronic Publication: 2016 Dec 07.
DOI:	10.1016/j.chest.2016.11.035
Abstrakt:	Background: Capillary refill time (CRT) is a clinical test used to evaluate the circulatory status of patients; various methods are available to assess CRT. Conventional clinical research often demands large numbers of patients, making it costly, labor-intensive, and time-consuming. We studied the interobserver agreement on CRT in a nationwide study by using a novel method of research called flash mob research (FMR). Methods: Physicians in the Netherlands were recruited by using word-of-mouth referrals, conventional media, and social media to participate in a nationwide, single-day, "nine-to-five," multicenter, cross-sectional, observational study to evaluate CRT. Patients aged ≥ 18 years presenting to the ED or who were hospitalized were eligible for inclusion. CRT was measured independently (by two investigators) at the patient's sternum and distal phalanx after application of pressure for 5 s (5s) and 15 s (15s). Results: On October 29, 2014, a total of 458 investigators in 38 Dutch hospitals enrolled 1,734 patients. The mean CRT measured at the distal phalanx were 2.3 s (5s, SD 1.1) and 2.4 s (15s, SD 1.3). The mean CRT measured at the sternum was 2.6 s (5s, SD 1.1) and 2.7 s (15s, SD 1.1). Interobserver agreement was higher for the distal phalanx (κ value, 0.40) than for the sternum (κ value, 0.30). Conclusions: Interobserver agreement on CRT is, at best, moderate. CRT measured at the distal phalanx yielded higher interobserver agreement compared with sternal CRT measurements. FMR proved a valuable instrument to investigate a relatively simple clinical question in an inexpensive, quick, and reliable manner. (Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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