Interobserver variability of the 5-minute Apgar score
Interobserver variability of the 5-minute Apgar score
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DOI：
10.1016/j.jpeds.2006.05.040
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发表时间：
2006-10-01
影响因子：
5.1
通讯作者：
Morley, Colin J.
中科院分区：
文献类型：
--
作者：
O'Donnell, Colm P. F.;Kamlin, C. Omar F.;Morley, Colin J.
目的评估新生儿复苏视频(AS(VIDEO))评分的观察者间变异性，并将观察者对视频的评分与参加分娩的工作人员(AS(Del))给出的APGAR评分进行比较。研究设计向观察者展示30个新生儿在5分钟内拍摄的10秒片段。妊娠23-40周的婴儿接受了不同程度的复苏，并进行了脉搏血氧仪监测。42名观察者(新生儿/产科医护人员)对婴儿的呼吸努力、肌肉紧张度、反射应激性和颜色进行了评分。心率的值是从血氧计分配的，它在所有剪辑中都被屏蔽了。所有42个AS(视频)和AS(Del)都以图形方式表示每个婴儿。观察者间的信度通过使用方差分量模型来评估。结果(视频)在观察者之间差别很大。观察者分配的评分中的所有4个因素的可变性都很大，无论婴儿的疾病程度如何，都可以看到这一点。在大多数情况下，AS(Del)大于AS(Video)，平均高出2.4分。没有证据表明不同员工分组之间的差异水平有实质性差异。结论阿普加评分在观察者间的可信度较差。需要对新生儿的状况进行更客观和准确的衡量。
Objectives To assess interobserver variability of Apgar scores assigned with video recordings of neonatal resuscitation (AS(video)) and compare the scores assigned by observers of videos to the Apgar score given by staff attending the delivery (AS(del))Study design Ten-second clips of 30 newborns taken at 5 minutes were shown to observers. Infants were 23 to 40 weeks' gestation, received varying degrees of resuscitation, and were monitored with pulse oximetry. Forty-two observers (neonatal /obstetric medical/nursing staff) scored infants' respiratory effort, muscle tone, reflex irritability, and color. The value for heart rate was assigned from the oximeter, which was masked in all clips. All 42 AS(video) and the AS(del) were represented graphically for each infant. Interobserver reliability was assessed by use of a variance components model.Results AS(video) varied widely between observers. Variability was large for all 4 elements of the score observers assigned and was seen irrespective of the infant's level of illness. AS(del) was greater than AS(video) in most cases, on average by 2.4 points. There was no evidence that the level of discrepancy was substantially different between groupings of staff.Conclusion The Apgar score has poor interobserver reliability. More objective and precise measures of newborns' condition are required.