tailieunhanh - Báo cáo y học: "Inter-rater reliability of the Full Outline of UnResponsiveness score and the Glasgow Coma Scale in critically ill patients: a prospective observational study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Inter-rater reliability of the Full Outline of UnResponsiveness score and the Glasgow Coma Scale in critically ill patients: a prospective observational study. | Fischer et al. Critical Care 2010 14 R64 http content 14 2 R64 c CRITICAL CARE RESEARCH Open Access Inter-rater reliability of the Full Outline of UnResponsiveness score and the Glasgow Coma Scale in critically ill patients a prospective observational study Michael Fischer 1 Stephan Ruegg2 Adam Czaplinski2 Monika Strohmeier1 Angelika Lehmann1 Franziska Tschan3 Patrick R Hunziker1 and Stephan C Marsch 1 Abstract Introduction The Glasgow Coma Scale GCS is the most widely used scoring system for comatose patients in intensive care. Limitations of the GCS include the impossibility to assess the verbal score in intubated or aphasic patients and an inconsistent inter-rater reliability. The FOUR Full Outline of UnResponsiveness score a new coma scale not reliant on verbal response was recently proposed. The aim of the present study was to compare the interrater reliability of the GCS and the FOUR score among unselected patients in general critical care. A further aim was to compare the inter-rater reliability of neurologists with that of intensive care unit ICU staff. Methods In this prospective observational study scoring of GCS and FOUR score was performed by neurologists and ICU staff on 267 consecutive patients admitted to intensive care. Results In a total of 437 pair wise ratings the exact inter-rater agreement for the GCS was 71 and for the FOUR score 82 P the inter-rater agreement within a range of 1 score point for the GCS was 90 and for the FOUR score 92 P ns. . The exact inter-rater agreement among neurologists was superior to that among ICU staff for the FOUR score 87 vs. 79 P but not for the GCS 73 vs. 73 . Neurologists and ICU staff did not significantly differ in the inter-rater agreement within a range of 1 score point for both GCS 88 vs. 93 and the FOUR score 91 vs. 88 . Conclusions The FOUR score performed better than the GCS for exact inter-rater agreement but not for the clinically more relevant agreement within the range of 1 .