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Interobserver variability of the 5-minute Apgar score
Colm P F O'Donnell1, C Omar F Kamlin, Peter G Davis
1Division of Newborn Services, Royal Women's Hospital, Melbourne, Australia. colm.odonnell@rwh.org.au
The Journal of Pediatrics
|October 3, 2006
Summary
The Apgar score shows poor interobserver reliability when assessed via video recordings of neonatal resuscitation. More objective measures are needed to accurately assess newborns' condition.
Area of Science:
- Neonatal Medicine
- Clinical Assessment
- Medical Education
Background:
- The Apgar score is a standard assessment for newborns at birth.
- Evaluating neonatal resuscitation effectiveness is crucial for infant outcomes.
- Interobserver variability in clinical scoring can impact patient care.
Purpose of the Study:
- To evaluate the interobserver reliability of Apgar scores assigned from video recordings of neonatal resuscitation (AS(video)).
- To compare Apgar scores from video assessments with those assigned by delivery staff (AS(del)).
Main Methods:
- Forty-two observers scored 30 newborns from 10-second video clips at 5 minutes postpartum.
- Infants represented a range of gestational ages and resuscitation needs.
- Interobserver reliability was analyzed using a variance components model.
Main Results:
- Apgar scores assigned from videos showed wide interobserver variability across all scoring elements.
- Apgar scores assigned by delivery staff were generally higher than those from video assessments.
- Variability was consistent regardless of infant illness severity or observer group.
Conclusions:
- The Apgar score demonstrates poor interobserver reliability, particularly when assessed via video.
- Current methods for assessing newborns' condition require more objective and precise alternatives.
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