TY - JOUR
T1 - Variability in Apgar Score Assignment among Clinicians
T2 - Role of a Simple Clarification
AU - Gupta, Sabhya
AU - Natarajan, Girija
AU - Gupta, Dhruv
AU - Karnati, Sreenivas
AU - Dwaihy, Meghan
AU - Wang, Bo
AU - Chawla, Sanjay
N1 - Publisher Copyright:
Copyright © 2017 by Thieme Medical Publishers, Inc.
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Objective We aimed to evaluate variability in Apgar score (AS) assignment among health care providers (HCPs) and to evaluate whether a simple clarification improves accuracy and consistency of AS assignment. Study Design An electronic questionnaire survey was provided to pediatric residents, nurse practitioners, neonatal fellows, and faculty in level III neonatal intensive care unit and major academic centers in the United State to assign AS for three clinical scenarios. Next, we provided a simple clarification on various components of AS. After review of clarification, responders were asked to provide AS for the same scenarios. We also sought the opinion of responders on the subjectivity of five components of AS. Results A total of 107 responses were collected. Correct assignment before and after clarification improved significantly: heart rate (78 vs. 90%, p = 0.02), reflex (63 vs.75%, p = 0.06), and breathing (82 vs. 96%, p = 0.003). Correct scoring for color and tone were 86 and 67%, respectively. Interobserver agreement improved significantly after clarification. Conclusion There was variability among HCPs for AS assignment, with improvement in correct response as well as consistency after a simple clarification. Availability of this clarification, along with the AS table in delivery room, will improve the correct assignment and consistency of AS for high-risk infants.
AB - Objective We aimed to evaluate variability in Apgar score (AS) assignment among health care providers (HCPs) and to evaluate whether a simple clarification improves accuracy and consistency of AS assignment. Study Design An electronic questionnaire survey was provided to pediatric residents, nurse practitioners, neonatal fellows, and faculty in level III neonatal intensive care unit and major academic centers in the United State to assign AS for three clinical scenarios. Next, we provided a simple clarification on various components of AS. After review of clarification, responders were asked to provide AS for the same scenarios. We also sought the opinion of responders on the subjectivity of five components of AS. Results A total of 107 responses were collected. Correct assignment before and after clarification improved significantly: heart rate (78 vs. 90%, p = 0.02), reflex (63 vs.75%, p = 0.06), and breathing (82 vs. 96%, p = 0.003). Correct scoring for color and tone were 86 and 67%, respectively. Interobserver agreement improved significantly after clarification. Conclusion There was variability among HCPs for AS assignment, with improvement in correct response as well as consistency after a simple clarification. Availability of this clarification, along with the AS table in delivery room, will improve the correct assignment and consistency of AS for high-risk infants.
KW - Apgar score
KW - premature
KW - resuscitation
KW - variability
UR - http://www.scopus.com/inward/record.url?scp=84969248890&partnerID=8YFLogxK
U2 - 10.1055/s-0036-1584149
DO - 10.1055/s-0036-1584149
M3 - Article
C2 - 27182997
AN - SCOPUS:84969248890
VL - 34
SP - 8
EP - 13
JO - American Journal of Perinatology
JF - American Journal of Perinatology
SN - 0735-1631
IS - 1
ER -