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Updated: Feb 16, 2026

Conducting Respiratory Oscillometry in an Outpatient Setting
Published on: April 8, 2022
Measurement of respiratory rate by multiple raters in a clinical setting is unreliable: A cross-sectional simulation
Mikkel Brabrand1, Peter Hallas2, Lars Folkestad3
1Department of Emergency Medicine, Odense University Hospital, Sdr. Boulevard 29, DK-5000 Odense C, Denmark; Department of Emergency Medicine, Hospital of South West Jutland, Finsensgade 35, DK-6700 Esbjerg, Denmark.
Objective:
To evaluate the inter-observer reliability of nurses assessing respiratory rate.
Methods:
We presented seven minimum 60-seconds long videos of thoraces of non-identifiable patients breathing to experienced nurses from several Danish emergency departments. Two videos were assessed by 50 raters while five were reviewed by eight. The videos were shown using an online system that also recorded the counted respiratory rate.
Results:
A total of 140 nurses participated with a median of 15years' experience. The range of counted respiratory rate was minimum 10 on each video. For videos evaluated by eight nurses, average Inter Class Coefficient (ICC) was 0.662 (0.000-0.960) and individual ICC 0.197 (0.000-0.750). For the two case-videos analyzed by 50 nurses, average ICC was 0.0 (0.000-0.991) and individual ICC 0.0 (0.000-0.677).
Conclusions:
We found a wide variation in measurements of RR with both few and many observers assessing exactly the same patients.
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