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Inter-rater reliability in a bespoke scoring tool: the Paediatric Observation Priority Score
Adam Bonfield1, Damian Roland2,3
1College of Medicine Biological Sciences and Psychology, University of Leicester, Leicester, UK ab798@le.ac.uk.
Emergency Medicine Journal : EMJ
|November 27, 2019
Summary
Inter-rater reliability (IRR) for the Paediatric Observation Priority Score (POPS) was assessed. The study found moderate to excellent IRR among healthcare professionals using POPS for paediatric patients.
Area of Science:
- Pediatric Emergency Medicine
- Clinical Assessment Tools
- Healthcare Quality Improvement
Background:
- Inter-rater reliability (IRR) is crucial for the consistent application of clinical scoring systems.
- The Paediatric Observation Priority Score (POPS) is a bespoke tool for assessing paediatric deterioration in emergency departments (EDs).
- Limited data exists on the IRR of POPS, hindering its widespread adoption and validation.
Purpose of the Study:
- To determine the inter-rater reliability (IRR) of the overall Paediatric Observation Priority Score (POPS).
- To investigate the IRR of individual parameters within the POPS.
- To assess the consistency of POPS scoring among diverse healthcare professionals in a pediatric ED setting.
Main Methods:
- An experimental, single-centre study conducted in a UK children's ED.
- 45 healthcare professionals (nurses, healthcare assistants, doctors) evaluated 11 prerecorded paediatric video assessments.
- Intraclass correlation coefficient (ICC) was used for overall POPS reliability, and Fleiss kappa for individual parameters.
Main Results:
- The overall ICC for POPS was 0.84 (95% CI 0.71 to 0.95), indicating excellent reliability.
- Fleiss kappa values for individual parameters ranged from 0.44 to 1, demonstrating moderate to excellent reliability across most parameters.
- Parameters like oxygen saturation, response, medical history, heart rate, and temperature showed excellent IRR (kappa ≥ 0.76).
Conclusions:
- The POPS demonstrates statistically moderate to excellent inter-rater reliability.
- The scoring system is reliable when used by healthcare professionals with varying experience levels.
- POPS is a dependable tool for assessing clinical presentations and identifying deterioration in children within the ED setting.
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