Multicenter observational study on the reliability of the HEART score
Objective To rapidly and safely identify the risk of developing acute coronary syndrome in patients with chest pain who present to the emergency department, the clinical use of the History, Electrocardiogram, Age, Risk Factors, and Troponin (HEART) scoring has recently been proposed. This study aime...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
The Korean Society of Emergency Medicine
2019-09-01
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| Series: | Clinical and Experimental Emergency Medicine |
| Subjects: | |
| Online Access: | http://www.ceemjournal.org/upload/pdf/ceem-18-045.pdf |
| _version_ | 1828005289389981696 |
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| author | Nicola Parenti Giuseppe Lippi Maria Letizia Bacchi Reggiani Antonio Luciani Mario Cavazza Antonello Pietrangelo Alberto Vegetti Lucio Brugioni Laura Bonfanti Gianfranco Cervellin |
| author_facet | Nicola Parenti Giuseppe Lippi Maria Letizia Bacchi Reggiani Antonio Luciani Mario Cavazza Antonello Pietrangelo Alberto Vegetti Lucio Brugioni Laura Bonfanti Gianfranco Cervellin |
| author_sort | Nicola Parenti |
| collection | DOAJ |
| description | Objective To rapidly and safely identify the risk of developing acute coronary syndrome in patients with chest pain who present to the emergency department, the clinical use of the History, Electrocardiogram, Age, Risk Factors, and Troponin (HEART) scoring has recently been proposed. This study aimed to assess the inter-rater reliability of the HEART score calculated by a large number of Italian emergency physicians. Methods The study was conducted in three academic emergency departments using clinical scenarios obtained from medical records of patients with chest pain. Twenty physicians, who took the HEART score course, independently assigned a score to different clinical scenarios, which were randomly administered to the participants, and data were collected and recorded in a spreadsheet by an independent investigator who was blinded to the study’s aim. Results After applying the exclusion criteria, 53 scenarios were finally included in the analysis. The general inter-rater reliability was good (kappa statistics [κ], 0.63; 95% confidence interval, 0.57 to 0.70), and a good inter-rater agreement for the high- and low-risk classes (HEART score, 7 to 10 and 0 to 3, respectively; κ, 0.60 to 0.73) was observed, whereas a moderate agreement was found for the intermediate-risk class (HEART score, 4 to 6; κ, 0.51). Among the different items of the HEART score, history and electrocardiogram had the worse agreement (κ, 0.37 and 0.42, respectively). Conclusion The HEART score had good inter-rater reliability, particularly among the high- and low-risk classes. The modest agreement for history suggests that major improvements are needed for objectively assessing this component. |
| first_indexed | 2024-04-10T07:28:55Z |
| format | Article |
| id | doaj.art-88ef75d59d9d4e239652c932a15cf3ad |
| institution | Directory Open Access Journal |
| issn | 2383-4625 |
| language | English |
| last_indexed | 2024-04-10T07:28:55Z |
| publishDate | 2019-09-01 |
| publisher | The Korean Society of Emergency Medicine |
| record_format | Article |
| series | Clinical and Experimental Emergency Medicine |
| spelling | doaj.art-88ef75d59d9d4e239652c932a15cf3ad2023-02-24T04:12:48ZengThe Korean Society of Emergency MedicineClinical and Experimental Emergency Medicine2383-46252019-09-016321221710.15441/ceem.18.045242Multicenter observational study on the reliability of the HEART scoreNicola Parenti0Giuseppe Lippi1Maria Letizia Bacchi Reggiani2Antonio Luciani3Mario Cavazza4Antonello Pietrangelo5Alberto Vegetti6Lucio Brugioni7Laura Bonfanti8Gianfranco Cervellin9 Emergency Department, University Hospital of Modena, Modena, Italy Section of Clinical Biochemistry, University of Verona, Verona, Italy Emergency Department, University of Bologna, Bologna, Italy Emergency Department, University Hospital of Modena, Modena, Italy Emergency Department, University of Bologna, Bologna, Italy Internal Department, University Hospital of Modena, Modena, Italy Internal Department, University Hospital of Modena, Modena, Italy Emergency Department, University Hospital of Modena, Modena, Italy Emergency Department, University Hospital of Parma, Parma, Italy Emergency Department, University Hospital of Parma, Parma, ItalyObjective To rapidly and safely identify the risk of developing acute coronary syndrome in patients with chest pain who present to the emergency department, the clinical use of the History, Electrocardiogram, Age, Risk Factors, and Troponin (HEART) scoring has recently been proposed. This study aimed to assess the inter-rater reliability of the HEART score calculated by a large number of Italian emergency physicians. Methods The study was conducted in three academic emergency departments using clinical scenarios obtained from medical records of patients with chest pain. Twenty physicians, who took the HEART score course, independently assigned a score to different clinical scenarios, which were randomly administered to the participants, and data were collected and recorded in a spreadsheet by an independent investigator who was blinded to the study’s aim. Results After applying the exclusion criteria, 53 scenarios were finally included in the analysis. The general inter-rater reliability was good (kappa statistics [κ], 0.63; 95% confidence interval, 0.57 to 0.70), and a good inter-rater agreement for the high- and low-risk classes (HEART score, 7 to 10 and 0 to 3, respectively; κ, 0.60 to 0.73) was observed, whereas a moderate agreement was found for the intermediate-risk class (HEART score, 4 to 6; κ, 0.51). Among the different items of the HEART score, history and electrocardiogram had the worse agreement (κ, 0.37 and 0.42, respectively). Conclusion The HEART score had good inter-rater reliability, particularly among the high- and low-risk classes. The modest agreement for history suggests that major improvements are needed for objectively assessing this component.http://www.ceemjournal.org/upload/pdf/ceem-18-045.pdfheart scoreheart pathwaychest painacute coronary syndromeemergency service, hospital |
| spellingShingle | Nicola Parenti Giuseppe Lippi Maria Letizia Bacchi Reggiani Antonio Luciani Mario Cavazza Antonello Pietrangelo Alberto Vegetti Lucio Brugioni Laura Bonfanti Gianfranco Cervellin Multicenter observational study on the reliability of the HEART score Clinical and Experimental Emergency Medicine heart score heart pathway chest pain acute coronary syndrome emergency service, hospital |
| title | Multicenter observational study on the reliability of the HEART score |
| title_full | Multicenter observational study on the reliability of the HEART score |
| title_fullStr | Multicenter observational study on the reliability of the HEART score |
| title_full_unstemmed | Multicenter observational study on the reliability of the HEART score |
| title_short | Multicenter observational study on the reliability of the HEART score |
| title_sort | multicenter observational study on the reliability of the heart score |
| topic | heart score heart pathway chest pain acute coronary syndrome emergency service, hospital |
| url | http://www.ceemjournal.org/upload/pdf/ceem-18-045.pdf |
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