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Interobserver reliability of the click test: a rapid bedside test to determine surfactant function
D A Osborn1, C Lockley, H E Jeffery
1The Department of Neonatal Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia. davido@peri.rpa.cs.nsw.gov.au
Journal of Paediatrics and Child Health
|February 3, 1999
Summary
The click test demonstrates high interobserver reliability for assessing surfactant function. This rapid, bedside test is accurate and teachable, showing promise for predicting fetal lung maturity and surfactant dysfunction in neonates.
Area of Science:
- Neonatal Medicine
- Pulmonary Medicine
- Clinical Chemistry
Background:
- Surfactant dysfunction is a key factor in respiratory distress syndrome.
- Accurate and rapid bedside assessment of surfactant function is clinically important.
- The click test is a novel bedside method for evaluating surfactant activity.
Purpose of the Study:
- To evaluate the interobserver reliability of the click test.
- To assess the accuracy of the click test in a clinical setting.
Main Methods:
- One hundred samples (amniotic fluid, gastric, and tracheal aspirates) were analyzed.
- Two independent observers performed the click test, blinded to each other's results.
- Interobserver reliability was calculated using Kappa statistics for negative, equivocal, and positive results.
Main Results:
- High interobserver agreement was observed for the click test (0.83).
- Agreement beyond chance was significant (Kappa = 0.74).
- Dichotomized results (negative/equivocal combined) also showed high reliability (Kappa = 0.73).
Conclusions:
- The click test exhibits excellent interobserver reliability.
- It is a rapid, simple, and accurate bedside test for surfactant function.
- Potential applications include predicting fetal lung maturity and assessing surfactant dysfunction in neonates.