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dc.contributor.authorTønsager, Kristin
dc.contributor.authorRehn, Marius
dc.contributor.authorKrüger, Andreas
dc.contributor.authorRøislien, Jo
dc.contributor.authorRingdal, Kjetil G.
dc.date.accessioned2020-08-17T13:52:11Z
dc.date.available2020-08-17T13:52:11Z
dc.date.created2020-07-27T10:29:11Z
dc.date.issued2020
dc.identifier.citationTønsager, 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.issn1471-2253
dc.identifier.urihttps://hdl.handle.net/11250/2672656
dc.description.abstractBackground 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.isoengen_US
dc.rightsNavngivelse 4.0 Internasjonal*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/deed.no*
dc.subjectanestesiologien_US
dc.titleAssignment of pre-event ASA physical status classification by pre-hospital physicians: a prospective inter-rater reliability studyen_US
dc.typePeer revieweden_US
dc.typeJournal articleen_US
dc.description.versionpublishedVersionen_US
dc.rights.holder© The Author(s). 2020en_US
dc.subject.nsiVDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Anestesiologi: 765en_US
dc.source.volume20en_US
dc.source.journalBMC Anesthesiologyen_US
dc.source.issue1en_US
dc.identifier.doi10.1186/s12871-020-01083-x
dc.identifier.cristin1820560
cristin.ispublishedtrue
cristin.fulltextoriginal
cristin.qualitycode1


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