Examining Interrater Reliability and Validity of a Paediatric Cardiopulmonary Physiotherapy Discharge Tool

Lati, Jamil; Pellow, Vanessa; Sproule, Jeannine; Brooks, Dina; Ellerton, Cindy

doi:10.3138/ptc.2013-23

Cited by 3 publications

(10 citation statements)

References 20 publications

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“…The inter-observer reliability for wheeze detection, expressed as the Fleiss Kappa coefficient, was moderate in our study, reflecting a higher inter-observer reliability than reported in most previous studies [ 17 , 28 – 30 ]. ROC analysis showed cut-off values of >2% for inspiratory and >3% for expiratory wheeze.…”

Section: Discussioncontrasting

confidence: 63%

Validation of computerized wheeze detection in young infants during the first months of life

et al. 2014

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BackgroundSeveral respiratory diseases are associated with specific respiratory sounds. In contrast to auscultation, computerized lung sound analysis is objective and can be performed continuously over an extended period. Moreover, audio recordings can be stored. Computerized lung sounds have rarely been assessed in neonates during the first year of life. This study was designed to determine and validate optimal cut-off values for computerized wheeze detection, based on the assessment by trained clinicians of stored records of lung sounds, in infants aged <1 year.MethodsLung sounds in 120 sleeping infants, of median (interquartile range) postmenstrual age of 51 (44.5–67.5) weeks, were recorded on 144 test occasions by an automatic wheeze detection device (PulmoTrack®). The records were retrospectively evaluated by three trained clinicians blinded to the results. Optimal cut-off values for the automatically determined relative durations of inspiratory and expiratory wheezing were determined by receiver operating curve analysis, and sensitivity and specificity were calculated.ResultsThe optimal cut-off values for the automatically detected durations of inspiratory and expiratory wheezing were 2% and 3%, respectively. These cutoffs had a sensitivity and specificity of 85.7% and 80.7%, respectively, for inspiratory wheezing and 84.6% and 82.5%, respectively, for expiratory wheezing. Inter-observer reliability among the experts was moderate, with a Fleiss’ Kappa (95% confidence interval) of 0.59 (0.57-0.62) for inspiratory and 0.54 (0.52 - 0.57) for expiratory wheezing.ConclusionComputerized wheeze detection is feasible during the first year of life. This method is more objective and can be more readily standardized than subjective auscultation, providing quantitative and noninvasive information about the extent of wheezing.

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Section: Discussioncontrasting

confidence: 63%

Validation of computerized wheeze detection in young infants during the first months of life

et al. 2014

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“…Some studies have evaluated patient wheezing in various clinical settings. 5,6 In our study, the setting in which auscultation was performed and interpreted was consistently the same.…”

Section: Discussionmentioning

confidence: 87%

“…The results of those studies may also have been influenced by the patients' environments and postural positions during auscultation. Some studies have evaluated patient wheezing in various clinical settings 5,6 . In our study, the setting in which auscultation was performed and interpreted was consistently the same.…”

Section: Discussionmentioning

confidence: 88%

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Interrater reliability of spectrogram for detecting wheezing in children

Bae

Kim

Yoon

2022

Pediatrics International

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Background: Auscultation is an easy way to evaluate and diagnose patients with lung conditions but has the shortcoming of being subjective. Using the spectrogram, it is possible to visualize wheezing. We therefore conducted a study to compare the efficacy of diagnosing wheezing by auscultation versus diagnosing wheezing by spectrogram. Methods: This was an investigation of interrater reliability and agreement in which the subject population consisted of children, and the rater population consisted of pediatric pulmonologists. We recorded 55 respiratory sound files from June to November 2019. Three pediatric pulmonologists listened to the respiratory sound files and assessed whether wheezing was present. All respiratory sound files were also converted into spectrograms; the same pulmonologists viewed these and assessed whether wheezing was present. We tested for interrater reliability and agreement between the auscultation results and spectrographic results and investigated the diagnostic reliability of auscultation versus spectrogram. Results: Agreement among the three raters of our auscultation respiratory recordings was 88% and reliability was good (j = 0.76, P < 0.001). Agreement among the three raters of our spectrograms was 83% and reliability was good (j =0.66, P < 0.001). The level of agreement between each rater's spectrographic findings and diagnosed wheezing was 91%, 75%, and 93%, respectively. Reliability was accordingly very good, moderate, and very good (j = 0.82, 0.49, 0.85, P < 0.001), respectively. Conclusions: A spectrogram may be a valuable tool for evaluating wheezing in children. It may also be used to improve a young clinician's ability to accurately diagnose wheezing in the future.

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“…This was reinforced by Jette, Grover and Keck (2003), who reported that when formulating discharge decisions, physiotherapists and occupational therapists consider the patient's preferences and needs, ability to participate in care, level of functioning and life context (Jette, Grover & Keck 2003). To assist physiotherapists with decision-making regarding discharge, there are multiple discharge tools available for different patient presentations (Lati et al 2014); however, it is acknowledged that each unique patient presentation must inform decisionmaking (Taylor et al 2010). Therefore, the complexity of decision-making relating to discharge planning (Frost 2001;Jette, Grover & Keck 2003;Taylor et al 2010) is considered an important area for pre-professional training and ongoing professional development (Frost 2001).…”

Section: Introductionmentioning

confidence: 99%

Hospital discharge planning: a qualitative study of new-graduate physiotherapists' experiences

Martin

Phan

Tan

et al. 2022

HEPJ

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Purpose: Discharge planning constitutes a large part of a physiotherapist's role when working in hospital settings. The challenges of decision-making relating to discharge planning have been identified by experienced physiotherapists. Despite known challenges associated with the transition from student to clinician, the experiences of new-graduates undertaking discharge planning are largely unknown. Therefore, this study aimed to explore:1) new-graduate physiotherapists' experiences of discharge planning in hospital settings, and2) the influence of pre-professional training on their perceived preparedness for discharge planning.Design: A qualitative general inductive approach using semi-structured interviews. New-graduate physiotherapists (n = 14) working in hospital settings were recruited.Finding: Four themes were generated: 1) responding to the pressures associated with discharging patients, 2) complex decision-making, 3) the role of the interprofessional team, and 4) desiring additional context and complexity from pre-professional training.Practice Implications: The study has identified that new-graduates underestimate the extent to which discharge planning features in their roles within hospital settings, and are unaware of the interprofessional practice required. Whilst they felt that their pre-professional training provides the technical skills required for their roles, they felt that they were not prepared for their role within the broader healthcare system, nor the complexity of clinical practice. This study encourages education providers to emphasise the role of physiotherapists within the broader health care system, through highlighting contexts where physiotherapy knowledge can be applied (i.e., discharge planning) and understanding the role of the physiotherapist within the interprofessional team.Limitations: Important perspectives of mentors and other members of the interprofessional team involved in discharge planning have not been included in this study which may have impacted the interpretation of the results.

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Examining Interrater Reliability and Validity of a Paediatric Cardiopulmonary Physiotherapy Discharge Tool

Abstract: Several of the items in the Paediatric CPT Discharge Tool demonstrate good IRR. The discharge tool is ready for further psychometric testing, specifically validity testing.

Cited by 3 publications

References 20 publications

Validation of computerized wheeze detection in young infants during the first months of life

Validation of computerized wheeze detection in young infants during the first months of life

Interrater reliability of spectrogram for detecting wheezing in children

Hospital discharge planning: a qualitative study of new-graduate physiotherapists' experiences

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