Kemper K J, Fink H D, McCarthy P L
University of Washington, Seattle.
QRB Qual Rev Bull. 1989 Mar;15(3):77-80. doi: 10.1016/s0097-5990(16)30269-x.
Researchers at Yale-New Haven Hospital (New Haven, Connecticut) tested the reliability and validity of the Pediatric Appropriateness Evaluation Protocol (PAEP) through a comparison of inter-rater agreement between experienced pediatricians and less experienced clinicians. The PAEP is a diagnosis-independent instrument with 26 criteria in three categories used to assess appropriate hospital use in pediatrics. Pediatrician raters, using clinical judgment alone, and clinicians (fellows in pediatrics and nurse practitioners), using both clinical judgment and the PAEP, reviewed a sample of 47 days and judged which inpatient days were medically appropriate. A day was judged appropriate if any of the 26 criteria were fulfilled for that day and inappropriate if none of the criteria was fulfilled. The PAEP was found to be a reliable and valid instrument with a 93% sensitivity and a 78% specificity for detecting medically inappropriate days.
耶鲁-纽黑文医院（康涅狄格州纽黑文）的研究人员通过比较经验丰富的儿科医生和经验较少的临床医生之间的评分者间一致性，测试了儿科适宜性评估方案（PAEP）的可靠性和有效性。PAEP是一种独立于诊断的工具，有三类共26条标准，用于评估儿科医院的合理使用情况。仅使用临床判断的儿科医生评分者，以及同时使用临床判断和PAEP的临床医生（儿科住院医师和执业护士），对47天的样本进行了审查，并判断哪些住院日在医学上是合适的。如果某一天满足26条标准中的任何一条，则判断该日合适；如果没有一条标准得到满足，则判断为不合适。结果发现，PAEP是一种可靠且有效的工具，检测医学上不合适住院日的灵敏度为93%，特异度为78%。
