Among 40 candidate variables, only an abnormal lung examination, suspicion of pneumonia, and suspicion of acute pulmonary oedema had perfect inter-rater agreement.
What clinical variables have the highest inter-rater reliability among emergency physicians for ordering a chest X-ray in adult patients with non-traumatic chest pain?
Abnormal lung examination, suspicion of pneumonia, and suspicion of acute pulmonary edema are the most reliable clinical predictors agreed upon by emergency physicians for ordering a chest X-ray in non-traumatic chest pain.
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ABSTRACT Objective We sought to identify predictor variables for a future clinical decision rule for CXR ordering in non‐traumatic chest pain. Methods Emergency Medicine Physicians were asked to select variables that would result in a CXR being ordered. Inter‐rater reliability (using Fleiss' kappa) was calculated for the most commonly agreed upon. Results Of the 40 candidate variables, 10 were most agreed upon; however, only three had perfect inter‐rater agreement and reliability. Conclusions In this study, only an abnormal lung examination, a suspicion of pneumonia or of acute pulmonary oedema had perfect inter‐rater agreement and reliability. Further research is required on a larger scale to refine and identify the optimal candidate variables for inclusion in a clinical decision rule.
Joe Anthony Rotella (Wed,) reported a other. Among 40 candidate variables, only an abnormal lung examination, suspicion of pneumonia, and suspicion of acute pulmonary oedema had perfect inter-rater agreement.
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