Interobserver reliability between a nurse and anaesthetist of tests used for predicting difficult tracheal intubation

Hilditch, W. G.; Kopka, A.; Crawford, J. M.; Asbury, A. J.

doi:10.1111/j.1365-2044.2004.03740.x

Cited by 14 publications

(10 citation statements)

References 19 publications

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“…However, they had only a short previous practice in anesthesia and airway management in the operating room. Although previous studies have shown generally variable agreement and inconsistency between assessors irrespective of their qualification (two specialists 8 , two residents 8,11 , specialist vs. resident 22 , anesthetist vs. nurse 10 ), the assessor's level of expertise may also influence the accuracy 8 . The only goal of the study was to compare the agreement of paired measurements of two assessors and not to determine the ability of the tests to predict DI.…”

Section: Discussionmentioning

confidence: 98%

“…Unfortunately, data describing its reproducibility are contradictory. Hilditch et al 10 found excellent agreement between a nurse and anesthesiologist in the measurement of TMD (ICC=0.85). We found poor to fair agreement depending on the coefficient used (ICC= -0.002, Pearson's correlation coefficient = 0.265).…”

Section: Discussionmentioning

confidence: 99%

“…The best agreement between assessors was found for determining neck circumference; the worst results were obtained for the goniometric measurements (anteroflexion and retroflexion of cervical spine). Inter-observer reproducibility of a test depends upon factors related to both rater and person examined 10 . Rater components of errors include incorrect/ inconsistent measurement technique that may be due to insufficient instructions and/or inaccurate methodology.…”

Section: Discussionmentioning

confidence: 99%

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Inter-Observer Reproducibility of 15 Tests Used for Predicting Difficult Intubation

Adamus¹,

Jor²,

Vavreckova³

et al. 2011

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Aim.To determine the inter-observer reproducibility of 15 tests used for predicting difficult tracheal intubation (DI). Material and methods. Following local ethics committee approval and informed consent, 101 volunteers were examined by two assessors using 15 tests for predicting DI. The two assessors who were blinded to the results of the other, examined each volunteer independently. Cohen's kappa (κ) or first-order agreement coefficient (AC1) were used to measure agreement between assessor ratings on a qualitative scale. Agreement between two quantitative outcomes was described using the intraclass correlation coefficient ( Conclusion. Best inter-rater agreement was found for the assessment of neck circumference while the highest discrepancies between raters were in goniometrically-measured mobility of the C-spine.Many of the pre-operative airway tests had only fair inter-observer reproducibility. This may be one reason why models for predicting difficult intubation are not universally reliable.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Inter-Observer Reproducibility of 15 Tests Used for Predicting Difficult Intubation

Adamus¹,

Jor²,

Vavreckova³

et al. 2011

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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“…[145] The reported incidence of a difficult laryngoscopy and tracheal intubation varies from 1.5% to 13% in patients undergoing elective surgery. [6] Because of potentially serious consequences of failed tracheal intubation, considerable attention has been focused on attempts to predict patients in whom laryngoscopy and intubation might be difficult,[57] and in this regard combination of different test and scores are developed, but none of them have proven to be totally reliable. [589]…”

Section: Introductionmentioning

confidence: 99%

Comparison of Mallampati test with lower jaw protrusion maneuver in predicting difficult laryngoscopy and intubation

Haq

Ullah

2013

J Anaesthesiol Clin Pharmacol

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Background:Failure to maintain a patent airway is one of the commonest causes of anesthesia-related morbidity and mortality. Many protocols, algorithms, and different combinations of tested methods for airway assessment have been developed to predict difficult laryngoscopy and intubation. The reported incidence of a difficult intubation varies from 1.5% to 13%. The objective of this study was to compare Mallampati test (MT) with lower jaw protrusion (LJP) maneuver in predicting difficult laryngoscopy and intubation.Materials and Methods:Seven hundred and sixty patients were included in the study. All the patients underwent MT and LJP maneuver for their airway assessment. After a standardized technique of induction of anesthesia, primary anesthetist performed laryngoscopy and graded it according to the grades described by Cormack and Lehane. Sensitivity, specificity, accuracy, and positive predictive value (PPV) and negative predictive value (NPV) were calculated for both these tests with 95% confidence interval (CI) using conventional laryngoscopy as gold standard. Area under curve was also calculated for both, MT and LJP maneuver. A P < 0.05 was taken as significant.Results:LJP maneuver had higher sensitivity (95.9% vs. 27.1%), NPV (98.7% vs. 82.0%), and accuracy (90.1% vs. 80.3%) when compared to MT in predicting difficult laryngoscopy and intubation. Both tests, however, had similar specificity and PPV. There was marked difference in the positive and negative likelihood ratio between LJP and MT. Similarly, the area under the curve favored LJP maneuver over MT.Conclusion:The results of this study show that LJP maneuver is a better test to predict difficult laryngoscopy and tracheal intubation. We recommend the addition of this maneuver to the routine preoperative evaluation of airway.

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“…Using airway assessment tests and clinical criteria, difficulty with airway management may be anticipated (3). However, patient factors, observer variability and experience contribute to poor reliability estimates in some bed-side tests (4). Consequently, unanticipated difficult tracheal intubation continues to occur with a low but consistent incidence.…”

Section: Introductionmentioning

confidence: 99%

The Management of Difficult Direct Laryngoscopy and Intubation in a Field Hospital: An Alternative to Fibreoptic Endoscopy

Tong

2007

J R Army Med Corps

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Fibreoptic endoscopy and intubation continues to be recommended in guidelines for the management of difficult airways. Since fibrescopes are unavailable within United Kingdom field hospitals, an alternative is needed. The Airtraq optical laryngoscope is a versatile, inexpensive, single-use option, which could readily fill this void. It is easy to use and provides a full view of the glottis when direct laryngoscopy has failed. Its introduction will reinforce existing difficult airway equipment and simplify the management of 'can ventilate - can't intubate' patients.

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Interobserver reliability between a nurse and anaesthetist of tests used for predicting difficult tracheal intubation

Cited by 14 publications

References 19 publications

Inter-Observer Reproducibility of 15 Tests Used for Predicting Difficult Intubation

Inter-Observer Reproducibility of 15 Tests Used for Predicting Difficult Intubation

Comparison of Mallampati test with lower jaw protrusion maneuver in predicting difficult laryngoscopy and intubation

The Management of Difficult Direct Laryngoscopy and Intubation in a Field Hospital: An Alternative to Fibreoptic Endoscopy

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