Philip Keir E J, Pack Emma, Cambiano Valentina, Rollmann Hannah, Weil Simon, O'Beirne James
Royal Free London NHS Foundation Trust, London, UK,
J Clin Monit Comput. 2015 Aug;29(4):455-60. doi: 10.1007/s10877-014-9621-3. Epub 2014 Oct 2.
Respiratory rate (RR) is one of the most sensitive markers of a patient condition and a core aspect of multiple clinical assessment tools. Doctors use a number of methods to assess RR, including formal measurement, and 'spot' assessments, although this is not recommended. This study aimed to assess the accuracy of the methods of RR measurement being used by doctors. A cross-sectional study assessing the accuracy (range, bias, and imprecision) of doctors' 'spot' and 'formal' respiratory rate assessments, using videos of mock patients. 54 doctors in a London teaching hospital participated. Both methods showed high levels of inaccuracy, though formal methods were more accurate than 'spot' assessments. 52 and 19% of doctors did not identify the respiratory rates shown as abnormal, using 'spot' and formal assessment methods respectively. We observed a trend towards decreasing accuracy of 'spot' assessments with increasing clinical experience (p = 0.0490). Current methods of RR assessment by doctors are inaccurate. This may be significantly delaying appropriate clinical care, or even misguiding treatment.
呼吸频率（RR）是患者病情最敏感的指标之一，也是多种临床评估工具的核心方面。医生使用多种方法评估RR，包括正式测量和“即时”评估，不过不推荐使用“即时”评估。本研究旨在评估医生所使用的RR测量方法的准确性。一项横断面研究，利用模拟患者的视频评估医生“即时”和“正式”呼吸频率评估的准确性（范围、偏差和不精确性）。伦敦一家教学医院的54名医生参与了研究。两种方法都显示出高度的不准确性，不过正式方法比“即时”评估更准确。分别使用“即时”和正式评估方法时，52%和19%的医生未将显示的呼吸频率识别为异常。我们观察到随着临床经验增加，“即时”评估准确性呈下降趋势（p = 0.0490）。医生目前的RR评估方法不准确。这可能会显著延迟适当的临床护理，甚至误导治疗。
