dc.contributor.author | Tønsager, Kristin | |
dc.contributor.author | Rehn, Marius | |
dc.contributor.author | Krüger, Andreas | |
dc.contributor.author | Røislien, Jo | |
dc.contributor.author | Ringdal, Kjetil G. | |
dc.date.accessioned | 2020-08-17T13:52:11Z | |
dc.date.available | 2020-08-17T13:52:11Z | |
dc.date.created | 2020-07-27T10:29:11Z | |
dc.date.issued | 2020 | |
dc.identifier.citation | Tønsager, K., Rehn, M., Krüger, A.J. et al. (2020) Assignment of pre-event ASA physical status classification by pre-hospital physicians: a prospective inter-rater reliability study. BMC Anesthesiology, 20(1) | en_US |
dc.identifier.issn | 1471-2253 | |
dc.identifier.uri | https://hdl.handle.net/11250/2672656 | |
dc.description.abstract | Background Individualized treatment is a common principle in hospitals. Treatment decisions are made based on the patient’s condition, including comorbidities. This principle is equally relevant out-of-hospital. Furthermore, comorbidity is an important risk-adjustment factor when evaluating pre-hospital interventions and may aid therapeutic decisions and triage. The American Society of Anesthesiologists Physical Status (ASA-PS) classification system is included in templates for reporting data in physician-staffed pre-hospital emergency medical services (p-EMS) but whether an adequate full pre-event ASA-PS can be assessed by pre-hospital physicians remains unknown. We aimed to explore whether pre-hospital physicians can score an adequate pre-event ASA-PS with the information available on-scene. Methods The study was an inter-rater reliability study consisting of two steps. Pre-event ASA-PS scores made by pre- and in-hospital physicians were compared. Pre-hospital physicians did not have access to patient records and scores were based on information obtainable on-scene. In-hospital physicians used the complete patient record (Step 1). To assess inter-rater reliability between pre- and in-hospital physicians when given equal amounts of information, pre-hospital physicians also assigned pre-event ASA-PS for 20 of the included patients by using the complete patient records (Step 2). Inter-rater reliability was analyzed using quadratic weighted Cohen’s kappa (κw). Results For most scores (82%) inter-rater reliability between pre-and in-hospital physicians were moderate to substantial (κw 0,47-0,89). Inter-rater reliability was higher among the in-hospital physicians (κw 0,77 to 0.85). When all physicians had access to the same information, κw increased (κw 0,65 to 0,93). Conclusions Pre-hospital physicians can score an adequate pre-event ASA-PS on-scene for most patients. To further increase inter-rater reliability, we recommend access to the full patient journal on-scene. We recommend application of the full ASA-PS classification system for reporting of comorbidity in p-EMS. | en_US |
dc.language.iso | eng | en_US |
dc.rights | Navngivelse 4.0 Internasjonal | * |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/deed.no | * |
dc.subject | anestesiologi | en_US |
dc.title | Assignment of pre-event ASA physical status classification by pre-hospital physicians: a prospective inter-rater reliability study | en_US |
dc.type | Peer reviewed | en_US |
dc.type | Journal article | en_US |
dc.description.version | publishedVersion | en_US |
dc.rights.holder | © The Author(s). 2020 | en_US |
dc.subject.nsi | VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Anestesiologi: 765 | en_US |
dc.source.volume | 20 | en_US |
dc.source.journal | BMC Anesthesiology | en_US |
dc.source.issue | 1 | en_US |
dc.identifier.doi | 10.1186/s12871-020-01083-x | |
dc.identifier.cristin | 1820560 | |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 1 | |