Chendrasekhar Akella, Aleti Sireesha
State University of New York Downstate, Brooklyn, NY, USA.
Department of Surgery, Richmond University Medical Center, Staten Island, NY, USA.
Int J Gen Med. 2018 Jun 18;11:225-231. doi: 10.2147/IJGM.S162025. eCollection 2018.
Venous thromboembolic disease is a major cause of morbidity and mortality in hospitalized patients worldwide. The objective of this study is to compare interobserver reliability for qualitative and quantitative venous thromboembolism (VTE) risk assessments in hospitalized trauma patients.
We conducted a retrospective medical record review of 40 randomly selected trauma patients admitted to a 448-bed urban level-I trauma center from January 2013 to January 2014. Interclass correlation coefficient (ICC) was calculated based on a two-way mixed model. The sample was equally distributed between patients admitted to the floor and the intensive care unit (ICU). Eight fourth-year medical students performed the risk assessments by the medical record. Two forms for risk assessment were used: a qualitative screening and a quantitative screening. The composite of intraobserver and interobserver variabilities was determined.
The ICC for qualitative VTE risk assessments was 0.845 and for quantitative VTE risk assessment was 0.628.
To optimize accuracy of VTE risk stratification and appropriate prophylaxis, medical students and first-year residents should be formally trained to perform quantitative assessments.
静脉血栓栓塞性疾病是全球住院患者发病和死亡的主要原因。本研究的目的是比较住院创伤患者定性和定量静脉血栓栓塞（VTE）风险评估的观察者间可靠性。
我们对2013年1月至2014年1月期间随机选取的40例入住一家拥有448张床位的城市一级创伤中心的创伤患者进行了回顾性病历审查。基于双向混合模型计算组内相关系数（ICC）。样本在入住普通病房和重症监护病房（ICU）的患者之间平均分配。八名四年级医学生通过病历进行风险评估。使用了两种风险评估形式：定性筛查和定量筛查。确定了观察者内和观察者间变异的综合情况。
定性VTE风险评估的ICC为0.845，定量VTE风险评估的ICC为0.628。
为优化VTE风险分层的准确性和适当的预防措施，医学生和一年级住院医师应接受正式培训以进行定量评估。
