...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Interrater reliability of clinical findings in children with possible appendicitis
【24h】

Interrater reliability of clinical findings in children with possible appendicitis

机译：可能存在阑尾炎的儿童的临床发现在评估者之间具有可靠性

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

OBJECTIVE: Our objective was to determine the interrater reliability of clinical history and physical examination findings in children undergoing evaluation for possible appendicitis in a large, multicenter cohort. METHODS: We conducted a prospective, multicenter, cross-sectional study of children aged 3-18 years with possible appendicitis. Two clinicians independently evaluated patients and completed structured case report forms within 60 minutes of each other and without knowing the results of diagnostic imaging. We calculated raw agreement and assessed reliability by using the unweighted Cohen k statistic with 2-sided 95% confidence intervals. RESULTS: A total of 811 patients had 2 assessments completed, and 599 (74%) had 2 assessments completed within 60 minutes. Seventy-five percent of paired assessments were completed by pediatric emergency physicians. Raw agreement ranged from 64.9% to 92.3% for history variables and 4 of 6 variables had moderate interrater reliability (κ > .4). The highest k values were noted for duration of pain (κ = .56 [95% confidence intervals .51-.61]) and history of emesis (.84 [.80-.89]). For physical examination variables, raw agreement ranged from 60.9% to 98.7%, with 4 of 8 variables exhibiting moderate reliability. Among physical examination variables, the highest κ values were noted for abdominal pain with walking, jumping, or coughing (.54 [.45-.63]) and presence of any abdominal tenderness on examination (.49 [.19-.80]). CONCLUSIONS: Interrater reliability of patient history and physical examination variables was generally fair to moderate. Those variables with higher interrater reliability are more appropriate for inclusion in clinical prediction rules in children with possible appendicitis.
机译：目的：我们的目的是确定在多中心大型队列中接受阑尾炎评估的儿童的临床病史和体格检查结果的可靠性。方法：我们对3-18岁可能患有阑尾炎的儿童进行了一项前瞻性，多中心，横断面研究。两名临床医生在60分钟内彼此独立评估了患者并完成了结构化的病例报告表，并且不知道诊断成像的结果。我们使用两边95％置信区间的未加权Cohen k统计量来计算原始协议并评估可靠性。结果：总共811例患者完成了2项评估，其中599名患者（74％）在60分钟内完成了2项评估。配对评估中的百分之七十五是由儿科急诊医师完成的。历史变量的原始一致性从64.9％到92.3％，并且6个变量中的4个具有中等的信度（κ> .4）。在疼痛持续时间（κ= .56 [95％置信区间.51-.61]）和呕吐史（.84 [.80-.89]）中，k值最高。对于身体检查变量，原始一致性从60.9％到98.7％，在8个变量中有4个显示出中等的可靠性。在体格检查变量中，步行，跳跃或咳嗽引起的腹痛（.54 [.45-.63]）以及检查中是否有腹部压痛（.49 [.19-.80]）均显示出最高的κ值。 ）。结论：患者病史和体格检查变量的评估者信度一般为中等至中等。具有较高间位可靠性的变量更适合纳入可能患有阑尾炎的儿童的临床预测规则中。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号