Hostname: page-component-8448b6f56d-qsmjn Total loading time: 0 Render date: 2024-04-24T05:41:13.355Z Has data issue: false hasContentIssue false
  • English
  • Français

Improving Reliability of Abstracted Prehospital Care Data: Use of Decision Rules

Published online by Cambridge University Press:  28 June 2012

Ronald F. Maio  and
Richard E. Burney
Ronald F. Maio*
Affiliation:
Division of Emergency Services, Department of Surgery, University of Michigan, Ann Arbor, MI, USA
Richard E. Burney
Affiliation:
Section of Emergency Services, Department of Surgery, University of Michigan, Ann Arbor, MI, USA
*
Address for Reprints: Ronald Maio, DO, B1C255 University Hospital, 1500 E. Medical Center Dr., Ann Arbor, MI 48109-0014 USA
Get access Rights & Permissions [Opens in a new window]

Abstract

Our experience suggests that even with standard definitions, information on ambulance report forms may be abstracted inconsistently.

Hypothesis:

The use of written decision rules will improve agreement between paramedics abstracting data from records of prehospital cardiac arrest.

Methods:

Sixty-three ambulance reports were selected by a random sample of all out-of-hospital cardiac arrests. Four paramedic abstractors each were given a set of definitions for use in abstracting data and one pair, randomly assigned, also was given a set of decision rules. Abstractors recorded whether there was: (1) underlying cardiovascular disease; (2) a witnessed arrest; (3) bystander CPR; and (4) the presenting rhythm. Agreement between pairs of abstractors was determined by computing kappa values.

Results:

Kappa values for each variable, for abstractors without and with decision rules were: (1) 0.23, 0.33; (2) 0.39, 0.41; (3) 0.43, 0.66; and (4) 0.65, 0.80. Kappa values consistently were higher for the pair of abstractors using decision rules. The degree of improvement varied with the difficulty of the decision required.

Conclusion:

The addition of decision rules to variable definitions is worthwhile but does not ensure good or excellent levels of agreement in data abstracted from records by paramedics.

Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 6 , Issue 1 , March 1991 , pp. 15 - 20
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1991

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Kelsey, JL, Thompson, WD, Evans, AS: Methods in Observational Epidemiology. In: Monographs in Epidemiology and Biostatistics; V 10. New York: Oxford University Press, 1986, p. 293.Google Scholar
2. Estabrook, EA, Director of Research Projects, Mediqual Systems Inc.: Personal communication. 29 August 1989.Google Scholar
3. Fleiss, JL (ed): Statistical Methods for Rates and Proportions. 2nd ed, New York: John Wiley and Sons, 1981, pp 211–234.Google Scholar
4. Cicchetti, DV: Assessing inter-rater reliability for rating scales: Resolving some basic issues. Brit J Psychiat 1976; 129:452–456.CrossRefGoogle ScholarPubMed
5. Polnitsky, CA, Capone, RJ. Gagon, DE, McGinnis, KK: Prehospital coronary care: Proposal for a uniform reporting system. JAMA 1977;237:134–139.CrossRefGoogle ScholarPubMed
6. Eisenberg, MS, Bergner, L, Hearne, T: Out of hospital cardiac arrest: A review of major studies and a proposed uniform reporting system. Am J Public Health 1980;70:236–240.CrossRefGoogle Scholar
7. Eisenberg, MS, Horwood, BT, Cummins, RO, et al. Cardiac arrest and resuscitation: A tale of 29 cities. Ann Emerg Med 1990;19:179–186.CrossRefGoogle ScholarPubMed
8. Herrman, N, Cayten, CG, Senior, J, et al. Interobserver and intraobserver reliability in the collection of emergency medical services data. Health Services Research 1980; (Summer) 15:127–143.Google Scholar
9. Champion, H: Personal communication. 11 August 1988.Google Scholar