Reliability of prehospital rating scales for case severity and status change

The purpose of this report is to determine the reliability and sensibility of the currently available prehospital rating scales by a prospective evaluation of ambulance call reports using generalizability methodology. Sequential samples of emergency call data from the Hamilton Base Hospital Paramedic program database were used to sample calls randomly for a two-phase study. Phase I and II used blinded ambulance call report forms presented to six rates during three sessions in each phase. Generalizability (reliability) coefficients were then generated to determine the degree of reliability for the scales in both phases of the study. The generalizability coefficients for all scales are substantial or excellent using the standards commonly applied to agreement statistics. The conclusion of the study is that all ambulance officers can use the prehospital scales reliably. The reliability of these general measures is one of the parameters that will allow us to evaluate where basic and advanced prehospital care have an impact on overall patient outcome.