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首页> 外文期刊>BMC Pregnancy and Childbirth >An interrater reliability study on the Gothenburg obstetric triage system- a new obstetric triage system
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An interrater reliability study on the Gothenburg obstetric triage system- a new obstetric triage system

机译：哥德堡产科分流系统的中间人可靠性研究 - 新的产科分类系统

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Triage, identifying patients with critical and time-sensitive disorders, is an integrated process in general emergency medicine. Obstetric triage is more specialised, requiring assessment of both woman, fetus and labour status. Failure to identify severely ill obstetric patients has repeatedly led to maternal morbidity and mortality. Reliable triage systems, adapted to obstetric patients as well as local conditions, are thus essential. The study aims to assess the interrater reliability (IRR) of the Gothenburg Obstetric Triage System (GOTS). Midwives (n?=?6) and registered nurses with no experience in managing obstetric patients (n?=?7), assessed 30 paper cases based on actual real-life cases, using the GOTS. Furthermore, a reference group consisting of two midwives and two obstetricians, with extensive experience in obstetric care, determined the correct triage level in order to enable analysis of over- and undertriage. IRR was assessed, both with percentage of absolute agreement and with intra-class correlation coefficients (ICC) with 95% confidence intervals (CI). A total of 388 assessments were performed, comprising all five levels of acuity in the GOTS. Absolute agreement was found in 69.6% of the assessments. The overall IRR was good, with a Kappa value of 0.78 (0.69–0.87, 95% CI) for final triage level. Comparison with reference group assessments established that over- and undertriage had occurred in 9% and 21% of the cases, respectively. The main reasons for undertriage were “not acknowledging abnormal vital sign parameters” and “limitations in study design”. The GOTS is a reliable tool for triaging obstetric patients. It enables a standardized triage process unrelated to the assessors’ level of experience in assessing and managing obstetric patients and is applicable for triaging obstetric patients presenting for emergency care at obstetric or emergency units.
机译：鉴定患有关键和时间敏感疾病的患者进行分类是一般急诊医学中的综合过程。产科分类更专业，需要评估女性，胎儿和劳动力状态。未能识别严重的产科患者反复导致孕产妇发病率和死亡率。因此，适用于产科患者以及局部条件的可靠性分流系统是必不可少的。该研究旨在评估哥德堡产科分类系统（GOTS）的Interrader可靠性（IRR）。助产士（n？=？6）和注册护士，没有经常管理产科患者的经验（n？=？7），基于实际实际情况评估了30个纸箱，使用GOTS。此外，由两名助产士和两位产科医生组成的参考组，在产科护理方面拥有丰富的经验，确定了正确的分类水平，以便能够分析过度和底层。评估IRR，既有绝对协议的百分比，均具有95％置信区间（CI）的级别相关系数（ICC）。进行388个评估，包括GOTS中所有五个症症。在评估的69.6％中发现了绝对协议。总体的IRR良好，对于最终分类水平，Kappa值为0.78（0.69-0.87,95％CI）。与参考组评估的比较确立了9％和21％的案件中发生过度和下跌。下面的主要原因是“不承认异常生命体征参数”和“研究设计中的局限”。 Gots是三元产科患者的可靠工具。它使得标准化的分类过程与评估员的评估和管理产科患者的经验水平无关，适用于在产科或急诊单位提供紧急护理的产科患者。

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