Interrater variability in ASA physical status assignment: An analysis in the pediatric cancer setting Journal Article
| Authors: | Tollinche, L. E.; Yang, G.; Tan, K. S.; Borchardt, R. |
| Article Title: | Interrater variability in ASA physical status assignment: An analysis in the pediatric cancer setting |
| Abstract: | Background: The American Society of Anesthesiologists (ASA) physical status is a universal classification system that helps clinicians to categorize their patients preoperatively. However, there is a lack of both inter-rater and intra-rater reliability among clinicians for the ASA physical status classification. Our study focuses on testing these reliabilities within pediatric anesthesia providers in the cancer setting. Methods: In our retrospective observational study, a total of 1177 anesthesia records were reviewed. The cohort included all pediatric patients (≤ 18 years old) diagnosed with either retinoblastoma or neuroblastoma who had two or more anesthesia procedure within a 14-day time period. Results: Overall, the ASA physical status score among two different anesthesia providers for the same patient treated at different times had very little inter-rater reliability, κ = − 0.042 (95% CI − 0.17; 0.09). Of the 1177-patient anesthesia records, only 25% had two or more ASA physical status score assigned by the same anesthesiologist within a 14-day time period. There was moderate intra-rater reliability κ = 0.48 (95% CI 0.29; 0.68) for patients who were assigned an ASA physical status score by the identical anesthesia provider at different times points within a 14 day period. Conclusion: In contrast to observations in earlier studies, findings indicate poor agreement in inter-rater reliability. Although there was moderate agreement in intra-rater reliability, one would expect to find stronger, even perfect, intra-rater reliability. These findings suggest the need to develop a specific physical status classification system directed toward patients with a systemic illness such as cancer in both young and adult patients. © 2018, Japanese Society of Anesthesiologists. |
| Keywords: | pediatric; reliability; cancer; asa physical status |
| Journal Title: | Journal of Anesthesia |
| Volume: | 32 |
| Issue: | 2 |
| ISSN: | 0913-8668 |
| Publisher: | Springer Japan KK |
| Date Published: | 2018-04-01 |
| Start Page: | 211 |
| End Page: | 218 |
| Language: | English |
| DOI: | 10.1007/s00540-018-2463-2 |
| PROVIDER: | scopus |
| PMCID: | PMC5886792 |
| PUBMED: | 29441411 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 May 2018 -- Source: Scopus |
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