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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
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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

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