Interobserver variability in data collection of the APACHE II score in teaching and community hospitals.
To examine interobserver reliability of the Acute Physiologic and Chronic Health Evaluation (APACHE) II score and identify major causes of variability in data collection.
Descriptive, comparative analysis.
Nine intensive care units in two teaching and six community hospitals Subjects : A random sample of 342 patient records selected from a network database.
Measurements and Main Results
Data were reabstracted and compared with the original records.
Individual physiologic points derived from the APACHE II scoring system (instead of the actual physiologic values) were compared using the kappa statistic.
Paired measurements of the continuous variables were compared using the interclass correlation coefficient and Bland-Altman plots.
Excellent agreement was found in most demographic, admission, and discharge data.
The system failure requiring intensive care unit admission was consistently identified by both data collectors in 88% of cases, but only 66% agreed on the exact admitting diagnosis.
For APACHE II score components, the kappa statistic ranged from 0.315 for the Glasgow Coma Scale point to 0.976 for the age point.
Significant disagreement regarding the probability of death derived from the APACHE II model was evident in some patient records.
Overall agreement among groups of patients regarding the APACHE II score was good, however, with no significant difference in the mean score (20.2 vs. 20.1 ; p=758). (...)
Mots-clés Pascal : Soin intensif, Unité soin intensif, Enregistrement donnée, Qualité, Echelle évaluation, Mortalité, Comparaison interindividuelle, Observateur, Fiabilité, Reproductibilité, Evaluation, Méthodologie, Homme, Epidémiologie, Canada, Amérique du Nord, Amérique, Base donnée, Service hospitalier
Mots-clés Pascal anglais : Intensive care, Intensive care unit, Data logging, Quality, Evaluation scale, Mortality, Interindividual comparison, Observer, Reliability, Reproducibility, Evaluation, Methodology, Human, Epidemiology, Canada, North America, America, Database, Hospital ward
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0491232
Code Inist : 002B30A01A1. Création : 22/03/2000.