Large observer variation of clinical assessment of dyspnoeic wheezing children

Bekhof, Jolita; Reimink, Roelien; Bartels, Ine-Marije; Eggink, Hendriekje; Brand, Paul

doi:10.1136/archdischild-2014-307143

Cited by 27 publications

(31 citation statements)

References 23 publications

(16 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although we did not validate symptom information captured in the daily diaries (other than doctor‐diagnosed AOM and pneumonia), we minimized inaccuracy of reporting by training parents how to recognize symptoms and complete the diary before they commenced the study. Furthermore, this study design has been used before successfully and this and other studies have shown that parents can be trained to recognize and document symptoms of interest, often as reliably as health professionals . While visits by trained healthcare workers to validate all symptoms would have been ideal, a study of this magnitude and scale would have been logistically challenging and resource intensive to conduct without parent participation.…”

Section: Discussionmentioning

confidence: 99%

The burden of community-managed acute respiratory infections in the first 2-years of life

et al. 2016

View full text Add to dashboard Cite

ARIs are a common cause of morbidity in the first 2-years of life, with children experiencing 13 discrete ARI episodes and almost 5-months of respiratory symptoms. Most ARIs are managed in the community by parents and family physicians. Antibiotic prescribing remains common for ARIs in young children. Secular societal changes, including greater use of childcare in early childhood, may have maintained the high ARI incidence in this age-group. Pediatr Pulmonol. 2016;51:1336-1346. © 2016 Wiley Periodicals, Inc.

show abstract

Section: Discussionmentioning

confidence: 99%

The burden of community-managed acute respiratory infections in the first 2-years of life

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Data on the health worker assessment of wheeze in children from observational studies in reference to a health worker of a higher level of training or computer assisted techniques is also conflicting[24,25]. Health worker training and formal standardization of assessments of dyspneic wheezing children [26] and verification by multiple healthcare workers may improve diagnostic accuracy and inter-observer reliability. Modern computer assisted techniques may also help assess wheeze and provide objectivity currently lacking in existing methods [27,28].…”

Section: Discussionmentioning

confidence: 99%

Wheeze as an adverse event in pediatric vaccine and drug randomized controlled trials: A systematic review

Marangu

Kovacs

Walson

et al. 2015

Vaccine

View full text Add to dashboard Cite

Introduction Wheeze is an important sign indicating a potentially severe adverse event in vaccine and drug trials, particularly in children. However, there are currently no consensus definitions of wheeze or associated respiratory compromise in randomized controlled trials (RCTs). Objective To identify definitions and severity grading scales of wheeze as an adverse event in vaccine and drug RCTs enrolling children <5 years and to determine their diagnostic performance based on sensitivity, specificity and inter-observer agreement. Methods We performed a systematic review of electronic databases and reference lists with restrictions for trial settings, English language and publication date ≥ 1970. Wheeze definitions and severity grading were abstracted and ranked by a diagnostic certainty score based on sensitivity, specificity and inter-observer agreement. Results Of 1,205 articles identified using our broad search terms, we identified 58 eligible trials conducted in 38 countries, mainly in high-income settings. Vaccines made up the majority (90%) of interventions, particularly influenza vaccines (65%). Only 15 trials provided explicit definitions of wheeze. Of 24 studies that described severity, 11 described wheeze severity in the context of an explicit wheeze definition. The remaining 13 studies described wheeze severity where wheeze was defined as part of a respiratory illness or a wheeze equivalent. Wheeze descriptions were elicited from caregiver reports (14%), physical examination by a health worker (45%) or a combination (41%). There were 21/58 studies in which wheeze definitions included combined caregiver report and healthcare worker assessment. The use of these two methods appeared to have the highest combined sensitivity and specificity. Conclusion Standardized wheeze definitions and severity grading scales for use in pediatric vaccine or drug trials are lacking. Standardized definitions of wheeze are needed for assessment of possible adverse events as new vaccines and drugs are evaluated.

show abstract

“…Work of breathing and respiratory rate have a proportion of agreement of 0.833, each with only 1 of the 12 participants scoring differently. However, previous work using a similar methodology to assess difficulty in breathing has demonstrated poor reliability between clinicians 9. The small sample size is a potential limitation in drawing conclusions from our result.…”

Section: Discussionmentioning

confidence: 59%

Inter-rater reliability in the Paediatric Observation Priority Score (POPS)

2018

View full text Add to dashboard Cite

Objective The primary objective of this study was to determine the level of inter-rater reliability between nursing staff for the Paediatric Observation Priority Score (POPS). Design Retrospective observational studySetting Single centre paediatric emergency department Participants 12 participants from a convenience sample of 21 nursing staff.Interventions Participants were shown video footage of three pre-recorded paediatric assessments and asked to record their own POPS for each child. The participants were blinded to the original, in person POPS. Further data were gathered in the form of a questionnaire to determine the level of training and experience the candidate had using the POPS score prior to undertaking this study. Main outcome measuresInter-rater reliability amongst participants scoring of the POPS. ResultsOverall Kappa value for case 1 was 0.74 (95% confidence interval 0.605 to 0.865), case 2 was 1 (perfect agreement) and case 3 was 0.66 (95% confidence interval 0.58 to 0.744). ConclusionThis study suggests there is good inter-rater reliability between different nurses use of POPS in assessing sick children in the Emergency Department.3

show abstract

Large observer variation of clinical assessment of dyspnoeic wheezing children

Cited by 27 publications

References 23 publications

The burden of community-managed acute respiratory infections in the first 2-years of life

The burden of community-managed acute respiratory infections in the first 2-years of life

Wheeze as an adverse event in pediatric vaccine and drug randomized controlled trials: A systematic review

Inter-rater reliability in the Paediatric Observation Priority Score (POPS)

Contact Info

Product

Resources

About