Inter‐Rater Reliability of Quantitative Ultrasound Measures of Muscle in Critically ill Patients

PM&R ◽  
2022 ◽  
Author(s):  
Cameron M. Baston ◽  
Alfred C. Gellhorn ◽  
Catherine L. Hough ◽  
Aaron E. Bunnell
Keyword(s):  
Critically Ill ◽  
Quantitative Ultrasound ◽  
Critically Ill Patients ◽  
Rater Reliability

scholarly journals Inter-rater reliability of the Full Outline of UnResponsiveness score and the Glasgow Coma Scale in critically ill patients: a prospective observational study

Critical Care ◽  
2010 ◽  
Vol 14 (2) ◽  
pp. R64 ◽  
Author(s):  
Michael Fischer ◽  
Stephan Rüegg ◽  
Adam Czaplinski ◽  
Monika Strohmeier ◽  
Angelika Lehmann ◽  
...  
Keyword(s):  
Observational Study ◽  
Glasgow Coma Scale ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Prospective Observational Study ◽  
Rater Reliability ◽  
Coma Scale

scholarly journals P.061 Reliability of EEG reactivity in assessement of comatose patients under standardized protocol

2018 ◽  
Vol 45 (s2) ◽  
pp. S31-S31
Author(s):  
M AlKhateeb ◽  
L Norton ◽  
T Gofton ◽  
E AlThenayan ◽  
D Debicki
Keyword(s):  
Clinical Outcome ◽  
Standardized Testing ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Clinical Protocol ◽  
Clinical Tool ◽  
Rater Reliability ◽  
Important Indicator ◽  
Eeg Reactivity ◽  
London Health

Background: Electroencephalography (EEG) is a routine clinical tool that is used to evaluate thalamocortical function in comatose patients. The presence or absence of reactivity in background EEG patterns to afferent stimuli is believed to be an important indicator of clinical outcome. At present, there are no guidelines or standardized testing protocols for the assessment of EEG reactivity in critically ill patients. Moreover, the inter-rater reliability of subjectively identifying presence or absence of reactivity is known to be poor. Methods: Here we report the implementation of a clinical protocol formalizing the use of afferent stimuli – name-calling, clapping, nasal tickle, central painful stimuli and tracheal suction – administered during the routine EEG evaluation of behaviourally unresponsive patients in the critical care units at London Health Sciences Centre. EEGs were evaluated by qualified electroencephalographers. Results: This retrospective observational study of consecutive patients describes the inter-rater reliability of detecting presence or absence of EEG reactivity since implementation of the clinical protocol. Moreover it evaluates the relationship between EEG reactivity and clinical outcome to determine its reliability as a prognostic tool. Conclusions: The implementation of clinical protocols to standardize testing parameters may improve the ability to provide a reliable neurologic prognosis for critically ill patients in a comatose and behaviourally unresponsive state.

scholarly journals A Tunisian version of the Confusion Assessment Method for the intensive care unit (CAM-ICU): translation and validation

2020 ◽  
Author(s):  
Imen Ben Saida ◽  
Saiid Kortli ◽  
Badii Amamou ◽  
Nawres Kacem ◽  
Mariem Ghardallou ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Invasive Mechanical Ventilation ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Validity And Reliability ◽  
Rater Reliability ◽  
Predictive Values ◽  
Dsm V ◽  
Poor Outcomes

Abstract Background. Delirium is common in critically ill patients and it is associated with poor outcomes. In Tunisia, however, it is still underdiagnosed as there is no validated screening tool. The aim of this study was to translate and to validate a Tunisian version of the CAM-ICU. Methods. For the validation and inter-rater reliability assessment of the Tunisian CAM-ICU, two trained intensivists independently evaluated delirium in the patients admitted to the ICU between October 2017 and June 2018. All the patients consecutively admitted to the ICU for more than 24 hours and having a Richmond Agitation-Sedation Scale greater than or equal to “-3” were assessed for delirium excluding those with stroke, dementia, psychosis or persistent coma. The results were compared with the reference evaluation carried out by a psychiatrist using the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria. The inter-rater reliability was calculated using the kappa (κ) statistic. The CAM-ICU concurrent validity was assessed using Cronbach’s α coefficient, sensitivity, specificity as well as positive and negative predictive values (PPV and NPV, respectively) for the two Tunisian CAM-ICU raters. Results. The study involved 137 patients [median (IQR) age: 60 [49-68] years, male sex (n=102), invasive mechanical ventilation (n=49)]. Using the DSM-V criteria evaluations, 46 patients were diagnosed with delirium. When applying the Tunisian version of the CAM-ICU, 38(27.7%) patients were diagnosed with delirium for the first rater and 45(32.6%) patients for the second one. The Tunisian CAM-ICU showed a very-high inter-rater reliability for both intensivists (κ = 0.844, p<0.001). Using the DSM-V rater as the reference standard, the sensitivity of the two intensivists’ evaluations was 80.4 vs. 95.7%. Specificity was 98.9% for both. The Cronbach’s α of the first and second raters’ evaluations using the Tunisian version of the CAM-ICU were 0.886 and 0.887, respectively. Conclusions. The Tunisian version of the CAM-ICU showed almost perfect validity and reliability in detecting delirium in critically ill patients. It could therefore be used in Tunisian ICUs or where Tunisian translators are available following appropriate training.

scholarly journals A Tunisian version of the Confusion Assessment Method for the intensive care unit (CAM-ICU): translation and validation

2020 ◽  
Author(s):  
Imen Ben Saida ◽  
Saiid Kortli ◽  
Badii Amamou ◽  
Nawres Kacem ◽  
Mariem Ghardallou ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Invasive Mechanical Ventilation ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Validity And Reliability ◽  
Rater Reliability ◽  
Predictive Values ◽  
Dsm V ◽  
Poor Outcomes

Abstract Background. Delirium is common in critically ill patients and it is associated with poor outcomes. In Tunisia, however, it is still underdiagnosed as there is no validated screening tool. The aim of this study was to translate and to validate a Tunisian version of the CAM-ICU. Methods. For the validation and inter-rater reliability assessment of the Tunisian CAM-ICU, two trained intensivists independently evaluated delirium in the patients admitted to the ICU between October 2017 and June 2018. All the patients consecutively admitted to the ICU for more than 24 hours and having a Richmond Agitation-Sedation Scale greater than or equal to “-3” were assessed for delirium excluding those with stroke, dementia, psychosis or persistent coma. The results were compared with the reference evaluation carried out by a psychiatrist using the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria. The inter-rater reliability was calculated using the kappa (κ) statistic. The CAM-ICU concurrent validity was assessed using Cronbach’s α coefficient, sensitivity, specificity as well as positive and negative predictive values (PPV and NPV, respectively) for the two Tunisian CAM-ICU raters. Results. The study involved 137 patients [median (IQR) age: 60 [49-68] years, male sex (n=102), invasive mechanical ventilation (n=49)]. Using the DSM-V criteria evaluations, 46 patients were diagnosed with delirium. When applying the Tunisian version of the CAM-ICU, 38(27.7%) patients were diagnosed with delirium for the first rater and 45(32.6%) patients for the second one. The Tunisian CAM-ICU showed a very-high inter-rater reliability for both intensivists (κ = 0.844, p<0.001). Using the DSM-V rater as the reference standard, the sensitivity of the two intensivists’ evaluations was 80.4 vs. 95.7%. Specificity was 98.9% for both. The Cronbach’s α of the first and second raters’ evaluations using the Tunisian version of the CAM-ICU were 0.886 and 0.887, respectively. Conclusions. The Tunisian version of the CAM-ICU showed almost perfect validity and reliability in detecting delirium in critically ill patients. It could therefore be used in Tunisian ICUs or where Tunisian translators are available following appropriate training. Trial registration. Not applicable.

scholarly journals A Tunisian version of the Confusion Assessment Method for the intensive care unit (CAM-ICU): translation and validation

2019 ◽  
Author(s):  
Imen Ben Saida ◽  
Saiid Kortli ◽  
Badii Amamou ◽  
Nawres Kacem ◽  
Mariem Ghardallou ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Kappa Statistic ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Validity And Reliability ◽  
Rater Reliability ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Poor Outcomes

Abstract Background Delirium is common in critically ill patients and is associated with poor outcomes. In Tunisia, it remains however underdiagnosed, lacking a validated screening tool. The CAM-ICU is one of the most commonly used tools for detecting delirium in ICUs. The aim of the present study was to translate and validate a Tunisian version of the CAM-ICU. Methods A forward and backward translation was performed according to the guidelines suggested by the translation and cultural adaptation group. For the validation and inter-rater reliability assessment of the Tunisian CAM-ICU, two trained intensivists independently evaluated delirium in ICU patients admitted between October 2017 and June 2018. The results were compared with the reference evaluation carried out by a psychiatrist using the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The inter-rater reliability was calculated using the kappa statistic. Results The related material of the Tunisian translated version of the CAM-ICU is currently available at the website www.icudelirium.org (last access: October 19, 2019). The study enrolled 137 patients. The Tunisian CAM-ICU showed a very high inter-rater reliability for both intensivists in terms of assessing delirium (Kappa=0.844, p<0.001). Using the DSM-5 rater as the reference standard, the sensitivity of the two intensivists’ evaluations were 80.4% vs. 95.7%. Specificity was 98.9% for both respectively. Conclusions The Tunisian version of the CAM-ICU showed excellent validity and reliability in detecting delirium in critically ill patients. It could therefore be used in Tunisian ICUs or where Tunisian translators are available following appropriate training. Trial registration: Not applicable.

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