Indirect calibration between clinical observers - Application to the New York Heart Association functional classification system

• Tipo: Artigo em Revista Científica Internacional
• Data: 2011

Autores

Severo M (Autor) FMUP; Gaio, R (Autor) FCUP; Lourenco, P (Autor) Outra; Alvelos, M (Autor) Outra; Bettencourt, P (Autor) FMUP; Azevedo, A (Autor) Outra

Revista

Título: BMC Research Notes

Vol. 4

Página Final: 276

ISSN: 1756-0500

Editora: Springer Nature

Indexação

ISI Web of Knowledge

Scopus - 11 Citações

Outras Informações

ID Authenticus: P-007-ZHA

DOI: 10.1186/1756-0500-4-276

Abstract (EN): Background: Previous studies showed an inter-observer agreement for the NYHA classification of approximately 55%. The aim of this study was to calibrate the New York Heart Association (NYHA) classification system between observers, increasing its reliability. Results: Among 1136 community-dwellers in Porto, Portugal, aged 45 years, 265 reporting breathlessness answered a 4-item questionnaire to characterize symptom severity. The questionnaire was administered by 7 physicians who also classified the subject's functional capacity according to NYHA. Each subject was assessed by one physician. We calibrated NYHA classifications by the concurrent method, using 1-parameter logistic graded response model. Discrepancies between observers were assessed by differences in ability thresholds between NYHA classes I-II and II-III. The ability estimated by the model was used to predict the NYHA classification for each observer. Estimates of the first and second thresholds for each observer ranged from -1.92 to 0.46 and from 1.42 to 2.30, respectively. The agreement between estimated ability and the observers' NYHA classification was 88% (kappa = 0.61). Conclusions: The study objectively indicates the main reason why several studies have reported low inter-observer is the existence of discrepant thresholds between observers in the definition of NYHA classes. The concurrent method can be used to minimize the reliability problem of NYHA classification. © 2010 Severo et al; licensee BioMed Central Ltd.

Idioma: Inglês

Tipo (Avaliação Docente): Científica