Interrater agreement of the HEART score history component: A chart review study
Abstract Study objectives This study investigated the interrater reliability of the history component of the HEART (history, electrocardiogram, age, risk, troponin) score between physicians in emergency medicine (EM) and internal medicine (IM) at 1 tertiary‐care center. Methods We conducted a retros...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-06-01
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| Series: | Journal of the American College of Emergency Physicians Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/emp2.12732 |
| _version_ | 1811333264503209984 |
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| author | Alec J. Pawlukiewicz Matthew R. Geringer W. Tyler Davis Daniel R. Nassery Michael D. April Matthew J. Streitz Jessica M. Hyams Alex W. Martin Sadie A. Martin Joshua J. Oliver |
| author_facet | Alec J. Pawlukiewicz Matthew R. Geringer W. Tyler Davis Daniel R. Nassery Michael D. April Matthew J. Streitz Jessica M. Hyams Alex W. Martin Sadie A. Martin Joshua J. Oliver |
| author_sort | Alec J. Pawlukiewicz |
| collection | DOAJ |
| description | Abstract Study objectives This study investigated the interrater reliability of the history component of the HEART (history, electrocardiogram, age, risk, troponin) score between physicians in emergency medicine (EM) and internal medicine (IM) at 1 tertiary‐care center. Methods We conducted a retrospective, secondary analysis of 60 encounters selected randomly from a database of 417 patients with chest pain presenting from January to June 2016 to an urban tertiary‐care center. A total of 4 raters (1 EM attending, 1 EM resident, 1 IM attending, and 1 IM resident) scored the previously abstracted history data from these encounters. The primary outcome was the interrater agreement of HEART score history components, as measured by kappa coefficient, between EM and IM attending physicians. Secondary outcomes included the agreement between attending and resident physicians, overall agreement, pairwise percent agreement, and differences in scores assigned. Results The kappa value for the EM attending physician and IM attending physician was 0.33 with 55% agreement. Interrater agreement of the other pairs was substantial between EM attending and resident but was otherwise fair to moderate. Percent agreement between the other pairs ranged from 48.3% to 80%. There was a significant difference in scores assigned and the subgroup in which there was disagreement between the raters demonstrated significantly higher scores by the EM attending and resident when compared to the IM attending. Conclusion This study demonstrates fair agreement between EM and IM attending physicians in the history component of the HEART score with significantly higher scores by the EM attending physician in cases of disagreement at 1 tertiary‐care center. |
| first_indexed | 2024-04-13T16:49:17Z |
| format | Article |
| id | doaj.art-49af82c474a14218bd7f54fed3dc5596 |
| institution | Directory Open Access Journal |
| issn | 2688-1152 |
| language | English |
| last_indexed | 2024-04-13T16:49:17Z |
| publishDate | 2022-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj.art-49af82c474a14218bd7f54fed3dc55962022-12-22T02:38:59ZengWileyJournal of the American College of Emergency Physicians Open2688-11522022-06-0133n/an/a10.1002/emp2.12732Interrater agreement of the HEART score history component: A chart review studyAlec J. Pawlukiewicz0Matthew R. Geringer1W. Tyler Davis2Daniel R. Nassery3Michael D. April4Matthew J. Streitz5Jessica M. Hyams6Alex W. Martin7Sadie A. Martin8Joshua J. Oliver9Department of Emergency Medicine San Antonio Uniformed Services Health Education Consortium San Antonio Texas USADepartment of Internal Medicine San Antonio Uniformed Services Health Education Consortium San Antonio Texas USADepartment of Emergency Medicine San Antonio Uniformed Services Health Education Consortium San Antonio Texas USADepartment of Internal Medicine San Antonio Uniformed Services Health Education Consortium San Antonio Texas USADepartment of Emergency Medicine San Antonio Uniformed Services Health Education Consortium San Antonio Texas USADepartment of Emergency Medicine San Antonio Uniformed Services Health Education Consortium San Antonio Texas USADepartment of Emergency Medicine San Antonio Uniformed Services Health Education Consortium San Antonio Texas USAUniversity of Arizona Tucson Arizona USAUniversity of Arizona Tucson Arizona USALeadership and Faculty Development Fellowship Madigan Army Medical Center, 9040 Fitzsimmons Dr, Joint Base Lewis‐McChord Washington USAAbstract Study objectives This study investigated the interrater reliability of the history component of the HEART (history, electrocardiogram, age, risk, troponin) score between physicians in emergency medicine (EM) and internal medicine (IM) at 1 tertiary‐care center. Methods We conducted a retrospective, secondary analysis of 60 encounters selected randomly from a database of 417 patients with chest pain presenting from January to June 2016 to an urban tertiary‐care center. A total of 4 raters (1 EM attending, 1 EM resident, 1 IM attending, and 1 IM resident) scored the previously abstracted history data from these encounters. The primary outcome was the interrater agreement of HEART score history components, as measured by kappa coefficient, between EM and IM attending physicians. Secondary outcomes included the agreement between attending and resident physicians, overall agreement, pairwise percent agreement, and differences in scores assigned. Results The kappa value for the EM attending physician and IM attending physician was 0.33 with 55% agreement. Interrater agreement of the other pairs was substantial between EM attending and resident but was otherwise fair to moderate. Percent agreement between the other pairs ranged from 48.3% to 80%. There was a significant difference in scores assigned and the subgroup in which there was disagreement between the raters demonstrated significantly higher scores by the EM attending and resident when compared to the IM attending. Conclusion This study demonstrates fair agreement between EM and IM attending physicians in the history component of the HEART score with significantly higher scores by the EM attending physician in cases of disagreement at 1 tertiary‐care center.https://doi.org/10.1002/emp2.12732agreementemergency medicineHEART scorehistoryinternal medicineinterrater |
| spellingShingle | Alec J. Pawlukiewicz Matthew R. Geringer W. Tyler Davis Daniel R. Nassery Michael D. April Matthew J. Streitz Jessica M. Hyams Alex W. Martin Sadie A. Martin Joshua J. Oliver Interrater agreement of the HEART score history component: A chart review study Journal of the American College of Emergency Physicians Open agreement emergency medicine HEART score history internal medicine interrater |
| title | Interrater agreement of the HEART score history component: A chart review study |
| title_full | Interrater agreement of the HEART score history component: A chart review study |
| title_fullStr | Interrater agreement of the HEART score history component: A chart review study |
| title_full_unstemmed | Interrater agreement of the HEART score history component: A chart review study |
| title_short | Interrater agreement of the HEART score history component: A chart review study |
| title_sort | interrater agreement of the heart score history component a chart review study |
| topic | agreement emergency medicine HEART score history internal medicine interrater |
| url | https://doi.org/10.1002/emp2.12732 |
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