Interobserver Agreement in the Assessment of Clinical Findings in Children with Headaches

Autor: Nathan Kuppermann, Rakesh D. Mistry, Ariana E Gonzalez, Peter S. Dayan, Andrea T. Cruz, Daniel S. Tsze, Lawrence Richer, Julie B Ochs
Rok vydání: 2020
Předmět:
Male
Pediatrics
0302 clinical medicine
Prospective Studies
030212 general & internal medicine
Child
Medical History Taking
Statistic
Pediatric
Observer Variation
Emergency Service
medicine.diagnostic_test
Headache
Child
Preschool
Emergency Medicine
Female
Patient Safety
Headaches
medicine.symptom
Emergency Service
Hospital
Pediatric Research Initiative
medicine.medical_specialty
emergency department
Adolescent
red flag finding
Physical examination
Standardized test
Article
Paediatrics and Reproductive Medicine
Hospital
03 medical and health sciences
emergency medicine
Clinical Research
030225 pediatrics
interrater reliability
medicine
Humans
Medical history
Preschool
kappa
Physical Examination
business.industry
Prevention
Neurosciences
Reproducibility of Results
Human Movement and Sports Sciences
Emergency department
Inter-rater reliability
Cross-Sectional Studies
Pediatrics
Perinatology and Child Health
business
Kappa
Zdroj: J Pediatr
ISSN: 0022-3476
DOI: 10.1016/j.jpeds.2020.02.018
Popis: ObjectiveTo determine the interobserver agreement of history and physical examination findings in children undergoing evaluation in the emergency department (ED) for headaches.Study designWe conducted a prospective, cross-sectional study of children aged 2-17years evaluated at 3 tertiary-care pediatric EDs for non-traumatic headaches. Two clinicians independently completed a standardized assessment of each child and documented the presence or absence of history and physical examination variables. Unweighted κ statistics were determined for 68 history and 24 physical examination variables.ResultsWe analyzed 191 paired observations; median age was 12years, with 19 (9.9%) children younger than 7years. Interrater reliability was at least moderate (κ≥0.41) for 41 (60.3%) patient history variables. Eleven (61.1%) of 18 physical examination variables for which κ statistics could be calculated had a κ that was at least moderate.ConclusionsA substantial number of history and physical examination findings demonstrated at least moderate κ statistic values when assessed in children with headaches in the ED. These variables may be generalizable across different types of clinicians for evaluation of children with headaches. If also found to predict the presence or absence of emergent intracranial abnormalities, the more reliable clinical findings may be helpful in the development of clinical prediction rules or risk stratification models that could be used across settings for children with headaches.
Databáze: OpenAIRE
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