Reliability of a jugular venous pressure scale in cardiovascular clinical examination

Background: Noninvasively jugular venous pressure (JVP) is measured at bedside commonly by card and ruler. New tools have been developed for the measurement of JVP with the basis of this method. However, these tools have some limitations. Aim: The aim of this study was (1) to develop a JVP scale which would be devoid of common problems faced with currently available devices and (2) to test the provisional validity and reliability of the device in the estimation of JVP. Materials and Methods: We used two common plastic rulers – one as vertical and one as horizontal. The vertical ruler was cut at the level of 5 cm mark. A piece of aluminum sheet was used to make an adapter in which the vertical ruler can slide. This adapter was attached to the horizontal ruler. Both the rulers were equipped with spirit-level capsules. This device was used by 16 raters to measure JVP on five individuals twice. Inter-rater, intra-rater, and test–retest reliability were checked by the intraclass correlation coefficient (ICC) in IBM® SPSS® Statistics Version 20 software package. Results: For average measures, inter-rater ICC was 0.998 (P < 0.001), intra-rater ICC was 0.981 (P < 0.001), and test–retest ICC was 0.829 (P = 0.001). Inter- and intra-rater reliability was “excellent,” whereas test–retest reliability was “good.” Conclusions: Developed JVP scale is low cost and easy to build at any resource-limited settings. This would be an adjunct tool for bedside cardiovascular examination of patients with good to excellent reliability. This would also be used for teaching cardiovascular physiology for medical and allied science students.