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Reliability of prehospital patient classification in helicopter emergency medical service missions.
Heino, A; Laukkanen-Nevala, P; Raatiniemi, L; Tommila, M; Nurmi, J; Olkinuora, A; Virkkunen, I; Iirola, T.
Afiliación
  • Heino A; Research and Development Unit, FinnHEMS Ltd, Vantaa, Finland. anssi.heino@tyks.fi.
  • Laukkanen-Nevala P; Department of Perioperative Services, Intensive Care Medicine and Pain Management, Turku University Hospital and University of Turku, Turku, Finland. anssi.heino@tyks.fi.
  • Raatiniemi L; Research and Development Unit, FinnHEMS Ltd, Vantaa, Finland.
  • Tommila M; Centre for Pre-Hospital Emergency Care, Oulu University Hospital, Oulu, Finland.
  • Nurmi J; Anaesthesia Research Group, MRC, Oulu University Hospital and University of Oulu, Oulu, Finland.
  • Olkinuora A; Department of Perioperative Services, Intensive Care Medicine and Pain Management, Turku University Hospital and University of Turku, Turku, Finland.
  • Virkkunen I; Emergency Medicine Services, Helsinki University Hospital, Helsinki, Finland.
  • Iirola T; Department of Emergency Medicine, University of Helsinki, Helsinki, Finland.
BMC Emerg Med ; 20(1): 42, 2020 05 25.
Article en En | MEDLINE | ID: mdl-32450816
BACKGROUND: Several scores and codes are used in prehospital clinical quality registries but little is known of their reliability. The aim of this study is to evaluate the inter-rater reliability of the American Society of Anesthesiologists physical status (ASA-PS) classification system, HEMS benefit score (HBS), International Classification of Primary Care, second edition (ICPC-2) and Eastern Cooperative Oncology Group (ECOG) performance status in a helicopter emergency medical service (HEMS) clinical quality registry (CQR). METHODS: All physicians and paramedics working in HEMS in Finland and responsible for patient registration were asked to participate in this study. The participants entered data of six written fictional missions in the national CQR. The inter-rater reliability of the ASA-PS, HBS, ICPC-2 and ECOG were evaluated using an overall agreement and free-marginal multi-rater kappa (Κfree). RESULTS: All 59 Finnish HEMS physicians and paramedics were invited to participate in this study, of which 43 responded and 16 did not answer. One participant was excluded due to unfinished data entering. ASA-PS had an overall agreement of 40.2% and Κfree of 0.28 in this study. HBS had an overall agreement of 44.7% and Κfree of 0.39. ICPC-2 coding had an overall agreement of 51.5% and Κfree of 0.47. ECOG had an overall agreement of 49.6% and Κfree of 0.40. CONCLUSION: This study suggests a marked inter-rater unreliability in prehospital patient scoring and coding even in a relatively uniform group of practitioners working in a highly focused environment. This indicates that the scores and codes should be specifically designed or adapted for prehospital use, and the users should be provided with clear and thorough instructions on how to use them.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ambulancias Aéreas / Gravedad del Paciente Aspecto: Patient_preference Límite: Female / Humans / Male País/Región como asunto: Europa Idioma: En Revista: BMC Emerg Med Asunto de la revista: MEDICINA DE EMERGENCIA Año: 2020 Tipo del documento: Article País de afiliación: Finlandia Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ambulancias Aéreas / Gravedad del Paciente Aspecto: Patient_preference Límite: Female / Humans / Male País/Región como asunto: Europa Idioma: En Revista: BMC Emerg Med Asunto de la revista: MEDICINA DE EMERGENCIA Año: 2020 Tipo del documento: Article País de afiliación: Finlandia Pais de publicación: Reino Unido