Assessment of quadriceps muscle thickness using bedside ultrasonography by nurses and physicians in the intensive care unit:Intra- and inter-operator agreement  

作　　者：Rohit Kumar Tajamul Hussain Shah Vijay Hadda Pawan Tiwari Saurabh Mittal Karan Madan Maroof Ahmad Khan Anant Mohan 

机构地区：[1]Department of Pulmonary,Critical Care and Sleep Medicine,All India Institute of Medical Sciences,New Delhi 110029,India [2]Department of Biostatistics,All India Institute of Medical Sciences,New Delhi 110029,India

出　　处：《World Journal of Critical Care Medicine》2019年第7期127-134,共8页世界重症医学杂志

摘　　要：BACKGROUND Data regarding the agreement among multiple operators for measurement of quadriceps muscle thickness by bedside ultrasonography(USG)are sparse.AIM To statistically assess the agreement among 5 operators for measurement of quadriceps muscle thickness on bedside USG.METHODS This was a cross-sectional observational study.The 5 operators of varied experience(comprised of 1 critical care consultant,2 fellows,and 2 nurses)independently measured quadriceps muscle thickness in triplicate for 45 critically ill patients each,using USG.Intra-and interrater agreement rates among the 5 operators were assessed using intraclass correlation coefficient(ICC)and expressed with 95%confidence interval(CI).RESULTS The 5 operators produced a total of 135 readings and 675 observations for ICC calculations to determine the intraoperator and interoperator variations respectively.For intraoperator agreement,the overall ICC(95%CI)was 0.998(0.997,0.999)for operator 1,0.998(0.997,0.999)for operator 2,0.997(0.995,0.999)for operator 3,0.999(0.998,0.999)for operator 4,and 0.998(0.997,0.999)for operator 5.For interoperator agreement,the overall ICC(95%CI)was 0.977(0.965,0.986;P<0.001)for reading 1,0.974(0.960,0.984;P<0.001)for reading 2,and 0.975(0.961,0.985;P<0.001)for reading 3.CONCLUSION USG measurement of quadriceps muscle thickness was not dependent on clinical experience,supporting training for nurses in it.BACKGROUND Data regarding the agreement among multiple operators for measurement of quadriceps muscle thickness by bedside ultrasonography(USG) are sparse.AIM To statistically assess the agreement among 5 operators for measurement of quadriceps muscle thickness on bedside USG.METHODS This was a cross-sectional observational study. The 5 operators of varied experience(comprised of 1 critical care consultant, 2 fellows, and 2 nurses)independently measured quadriceps muscle thickness in triplicate for 45 critically ill patients each, using USG. Intra-and interrater agreement rates among the 5 operators were assessed using intraclass correlation coefficient(ICC) and expressed with 95% confidence interval(CI).RESULTS The 5 operators produced a total of 135 readings and 675 observations for ICC calculations to determine the intraoperator and interoperator variations respectively. For intraoperator agreement, the overall ICC(95%CI) was 0.998(0.997, 0.999) for operator 1, 0.998(0.997, 0.999) for operator 2, 0.997(0.995, 0.999)for operator 3, 0.999(0.998, 0.999) for operator 4, and 0.998(0.997, 0.999) for operator 5. For interoperator agreement, the overall ICC(95%CI) was 0.977(0.965, 0.986; P < 0.001) for reading 1, 0.974(0.960, 0.984; P < 0.001) for reading 2,and 0.975(0.961, 0.985; P < 0.001) for reading 3.CONCLUSION USG measurement of quadriceps muscle thickness was not dependent on clinical experience, supporting training for nurses in it.

关 键 词：AGREEMENT INTENSIVE care unit Critical illness Muscle thickness Quadricepsmuscle ULTRASONOGRAPHY 

分 类 号：O17[理学—数学]