Accuracy and interobserver-agreement of respiratory rate measurements by healthcare professionals, and its effect on the outcomes of clinical prediction/diagnostic rules

Autor: Michelle Spek, Jean W M Muris, Jochen W L Cals, Patricia M. Stassen, Gideon H. P. Latten
Přispěvatelé: Family Medicine Education, RS: CAPHRI - R5 - Optimising Patient Care, Family Medicine, Interne Geneeskunde, MUMC+: MA Alg Interne Geneeskunde (9)
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Questionnaires
Intraclass correlation
Physiology
Health Care Providers
Video Recording
Nurses
Blood Pressure
Pathology and Laboratory Medicine
Vascular Medicine
EARLY WARNING SCORE
0302 clinical medicine
Heart Rate
Surveys and Questionnaires
Medicine and Health Sciences
030212 general & internal medicine
Medical Personnel
Observer Variation
Multidisciplinary
ARREST
Respiration
Early warning score
Systemic Inflammatory Response Syndrome
Professions
Research Design
Breathing
GUIDELINE
RELIABILITY
Medicine
Research Article
medicine.medical_specialty
Respiratory rate
Health Personnel
Science
Cardiology
Research and Analysis Methods
03 medical and health sciences
Signs and Symptoms
Respiratory Rate
Diagnostic Medicine
medicine
Humans
Categorical variable
Survey Research
SEPSIS
business.industry
INTERNATIONAL CONSENSUS DEFINITIONS
SEPTIC SHOCK
Biology and Life Sciences
030208 emergency & critical care medicine
medicine.disease
Systemic inflammatory response syndrome
Mews
Health Care
Emergency medicine
People and Places
Population Groupings
business
Physiological Processes
Kappa
Zdroj: PLoS ONE, Vol 14, Iss 10, p e0223155 (2019)
PLoS ONE
PLOS ONE, 14(10):0223155. Public Library of Science
ISSN: 1932-6203
Popis: OBJECTIVE: In clinical prediction/diagnostic rules aimed at early detection of critically ill patients, the respiratory rate plays an important role. We investigated the accuracy and interobserver-agreement of respiratory rate measurements by healthcare professionals, and the potential effect of incorrect measurements on the scores of 4 common clinical prediction/diagnostic rules: Systemic Inflammatory Response Syndrome (SIRS) criteria, quick Sepsis-related Organ Failure Assessment (qSOFA), National Early Warning Score (NEWS), and Modified Early Warning Score (MEWS).METHODS: Using an online questionnaire, we showed 5 videos with a healthy volunteer, breathing at a fixed (true) rate (13-28 breaths/minute). Respondents measured the respiratory rate, and categorized it as low, normal, or high. We analysed how accurate the measurements were using descriptive statistics, and calculated interobserver-agreement using the intraclass correlation coefficient (ICC), and agreement between measurements and categorical judgments using Cohen's Kappa. Finally, we analysed how often incorrect measurements led to under/overestimation in the selected clinical rules.RESULTS: In total, 448 healthcare professionals participated. Median measurements were slightly higher (1-3/min) than the true respiratory rate, and 78.2% of measurements were within 4/min of the true rate. ICC was moderate (0.64, 95% CI 0.39-0.94). When comparing the measured respiratory rates with the categorical judgments, 14.5% were inconsistent. Incorrect measurements influenced the 4 rules in 8.8% (SIRS) to 37.1% (NEWS). Both underestimation (4.5-7.1%) and overestimation (3.9-32.2%) occurred.CONCLUSIONS: The accuracy and interobserver-agreement of respiratory rate measurements by healthcare professionals are suboptimal. This leads to both over- and underestimation of scores of four clinical prediction/diagnostic rules. The clinically most important effect could be a delay in diagnosis and treatment of (critically) ill patients.
Databáze: OpenAIRE
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