Multicenter observational study on the reliability of the HEART score
| Autor: | Lucio Brugioni, Laura Bonfanti, Nicola Parenti, Giuseppe Lippi, Maria Letizia Bacchi Reggiani, Alberto Vegetti, Antonello Pietrangelo, Gianfranco Cervellin, Antonio Luciani, Mario Cavazza |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Acute coronary syndrome 030204 cardiovascular system & hematology Emergency Nursing Chest pain 03 medical and health sciences HEART score 0302 clinical medicine Cohen's kappa Emergency service hospital medicine hospital Reliability (statistics) business.industry Medical record 030208 emergency & critical care medicine Emergency department medicine.disease Confidence interval HEART pathway Emergency Medicine Physical therapy Observational study Original Article medicine.symptom business Emergency service |
| Zdroj: | Clinical and Experimental Emergency Medicine Università degli studi di Modena e Reggio Emilia-IRIS |
| ISSN: | 2383-4625 |
| Popis: | Objective To rapidly and safely identify the risk of developing acute coronary syndrome in patients with chest pain who present to the emergency department, the clinical use of the History, Electrocardiogram, Age, Risk Factors, and Troponin (HEART) scoring has recently been proposed. This study aimed to assess the inter-rater reliability of the HEART score calculated by a large number of Italian emergency physicians. Methods The study was conducted in three academic emergency departments using clinical scenarios obtained from medical records of patients with chest pain. Twenty physicians, who took the HEART score course, independently assigned a score to different clinical scenarios, which were randomly administered to the participants, and data were collected and recorded in a spreadsheet by an independent investigator who was blinded to the study's aim. Results After applying the exclusion criteria, 53 scenarios were finally included in the analysis. The general inter-rater reliability was good (kappa statistics [κ], 0.63; 95% confidence interval, 0.57 to 0.70), and a good inter-rater agreement for the high- and low-risk classes (HEART score, 7 to 10 and 0 to 3, respectively; κ, 0.60 to 0.73) was observed, whereas a moderate agreement was found for the intermediate-risk class (HEART score, 4 to 6; κ, 0.51). Among the different items of the HEART score, history and electrocardiogram had the worse agreement (κ, 0.37 and 0.42, respectively). Conclusion The HEART score had good inter-rater reliability, particularly among the high- and low-risk classes. The modest agreement for history suggests that major improvements are needed for objectively assessing this component. |
| Databáze: | OpenAIRE |
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