Indian Journal of Critical Care Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 22 , ISSUE 7 ( 2018 ) > List of Articles

BRIEF COMMUNICATION

Feasibility and accuracy of a nonmedical research person in assimilation and calculation of acute physiologic assessment and chronic health evaluation scores in an Indian intensive care unit

George Kurian, Pritish Korula, Mahasampath S. Gowri

Keywords : Acute Physiologic Assessment and Chronic Health Evaluation score, intensive care, interrater agreement

Citation Information : Kurian G, Korula P, Gowri MS. Feasibility and accuracy of a nonmedical research person in assimilation and calculation of acute physiologic assessment and chronic health evaluation scores in an Indian intensive care unit. Indian J Crit Care Med 2018; 22 (7):524-527.

DOI: 10.4103/ijccm.IJCCM_489_17

License: CC BY-ND 3.0

Published Online: 01-07-2018

Copyright Statement:  Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background: The Physiologic Assessment and Chronic Health Evaluation (APACHE) score assimilation and calculation, as well as other demographic data collection, is inherent to research and nonresearch related needs of intensive care. There may be a role for well-trained nonmedical personnel to collect this vital material to enhance research and the standard of care in the Intensive Care Units (ICUs) in countries that are poorly funded and resourced in terms of medical personnel. Aims: The aim of this study is to verify the interrater reliability of a trained nonmedical personnel and ICU trainee in the collection and calculation APACHE scores. Materials and Methods: In a prospective study, two raters who were blinded, one a trained nonmedical ward clerk and another an ICU trainee, assimilated data and calculated APACHE scores for 60 consecutive patients admitted to two tertiary mixed ICUs (with a total of 19 beds). Primary outcomes were to assess interrater and interclass correlation as well as the agreement of scores between the two raters. Results: There was an excellent correlation of APACHE scores (Kappa coefficient of 0.92) and Bland–Altman plot depicted overall good agreement with low bias between raters. Conclusions: A well-trained and supervised nonmedical research person can assimilate and calculate APACHE II scores with good agreement with an ICU trainee. This may help in deriving data from medically understaffed ICUs in India, thus promoting much-needed research from such ICUs.


PDF Share
  1. Brinkman S, Bakhshi-Raiez F, Abu-Hanna A, de Jonge E, Bosman RJ, Peelen L, et al. External validation of acute physiology and chronic health evaluation IV in Dutch Intensive Care Units and comparison with acute physiology and chronic health evaluation II and simplified acute physiology score II. J Crit Care 2011;26:105.e11-8.
  2. Swaroopa D, Bhaskar K, Mahathi T, Katkam S, Raju YS, Chandra N, et al. Association of serum interleukin-6, interleukin-8, and acute physiology and chronic health evaluation II score with clinical outcome in patients with acute respiratory distress syndrome. Indian J Crit Care Med 2016;20:518-25.
  3. Camporota L, Wyncoll D. Practical aspects of treatment with drotrecogin alfa (activated). Crit Care 2007;11 Suppl 5:S7.
  4. Kiekkas P, Brokalaki H, Manolis E, Samios A, Skartsani C, Baltopoulos G, et al. Patient severity as an indicator of nursing workload in the Intensive Care Unit. Nurs Crit Care 2007;12:34-41.
  5. Divatia JV, Jog S. Intensive care research and publication in India: Quo vadis? Intensive Care Med 2014;40:445-7.
  6. Amin AA, Vankar JR, Nimbalkar SM, Phatak AG. Perceived stress and professional quality of life in neonatal Intensive Care Unit nurses in Gujarat, India. Indian J Pediatr 2015;82:1001-5.
  7. Kho ME, McDonald E, Stratford PW, Cook DJ. Interrater reliability of APACHE II scores for medical-surgical intensive care patients: A prospective blinded study. Am J Crit Care 2007;16:378-83.
  8. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977;33:159-74.
  9. Divatia JV, Amin PR, Ramakrishnan N, Kapadia FN, Todi S, Sahu S, et al. Intensive care in India: The Indian intensive care case mix and practice patterns study. Indian J Crit Care Med 2016;20:216-25.
  10. Amte R, Munta K, Gopal PB. Stress levels of critical care doctors in India: A national survey. Indian J Crit Care Med 2015;19:257-64.
  11. Polderman KH, Jorna EM, Girbes AR. Inter-observer variability in APACHE II scoring: Effect of strict guidelines and training. Intensive Care Med 2001;27:1365-9.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.